C. Los marxistas -
2. es el precursor del pensamiento del Antiguo y del Nuevo Testamento, así como de la filosofía (pensamiento bíblico) que lo acompaña
Age Common Tests
1. Newborn *DOLL’S EYES TEST--- Test for blindness
= Done on the 10th day
General Appearance: = Pupil go to opposite direction when head is moved Can only see 10-12 inches
Visual Acuity 20 /200 to 20/ 800 *GLOBELLAR’S TEST ---Test for Blink Reflex. = Points near nose & the baby should blink Infant & Children * Test the ability to follow object past midline 2. 3 years old to School Age *ALLEN CARDS ---Test for Visual Acuity
= Show common pictures 20 ft away
*ISHIHARAS PLATES = Test for Color Blindness 3. Preschool *E CHART --- Test for Stereopsi of depth perception
* COVER TESTING TEST --- Test for Strabismus = Cover 1 eye for 10- 15 minutes. Then remove. Note For:
ESOTROPIA = inward movement of eye ball EXOTROPIA = outward movement of eye 4. School Age To Adult * SNELLENS TEST --- Test for normal vision
* E CHART
DISEASES:
1. RETINOBLASTOMA = Malignant tumor of the retina Outstanding Sign: Cat’s Eye Reflex – the whitish glow of pupil
- With red painful eye - Can lead to blindness Mgt.
a. Surgery: Enucliation – the removal of the eyeball & replacement of artificial aye
B. Assessment of the NOSE (Sense Of Smell) Normal color of nasal membrane: Pinkish
1. Check for presence of creases & pale color of nasal membrane Indicative of Chronic Rhinitis
2. Check if inflamed & reddened Indicative of infection 3. Check for Flaring of Alenase
A case of RDS 4. Check for Cyanosis at rest
Indicative of CHOANAL ATRESIA = The posterior nares obstructed with bone or membrane
Sx:
a. Resistance during catheter insertion in suctioning b. Emergency---- Surgery within 24 hrs
5. Check for sense of smell = Blindfold the child & let him common foods 5. Check for presence of hair in nose: Cilia
Adolescent with no hair with ulceration of nasal mucosa: Cocaine user NOTE FOR:
a. EPISTAXIS or Nosebleed N.I:
Position: Sit upright, head slightly forward to facilitate drainage & prevent aspiration Put Cold compress & apply gentle pressure
Give Epinephrine
*Most developed sense of newborn – SENSE OF TOUCH The way the baby can identify the mother
C. Assessment of the Ears: (Sense of hearing)
*1st sense to develop & last to disappear – HEARING
* Normal Color of the Tympanic Membrane : Pearly Gray 1. Check for symmetry
If ears not properly aligned with the outer cantus of eyes or low set ears: Suspect A. KIDNEY MALFORMATION:
1. RENAL AGINESIS = the absence of kidney 2 Types: a. Unilateral = only 1 is present
b. Bilateral = absence of 2 kidneys Sign in uterus : Oligohydramnios
Sign in newborn: 2 vessel cord Sx: Failure to void within 24 hrs Mgt: Kidney Transplant 2. PRUNE BELLY SYNDROME
The newborn has a wrinkled abdomen that looks like a prune d/t abdomen swelled with fluid in the womb, then lost that fluid after birth, leading to puckering of excess skin.
B. CHROMOSOMAL ABERRATIONS: Cause: Advance maternal age >35 y/o
1.NONDISJUNCTION = Uneven division of chromosome a. TRISOMY 21 or “DOWN SYNDROME”
= Extra #21 chromosome
= Related to advance paternal age: 47xx + 21 Sx:
Low set ears Mongolian slant Broad, flat nose
Epicanthal Fold = extra fold of eyelids
Brushfield’s Spot = black & white specks in the iris Pectum Excavatum = sunken sternum
Puppy’s neck
Hypotonic = muscle tone prone to URTI Simian crease = a single transverse line on palm. Alert:
Always check PR for tachycardia d/t hypotonia Check for respiration
Check for mental retardation----educable b. TRISOMY 18 or “ENDVARD SYNDROME”
-
Affecting more girls than three times as boys.-
Caused by the presence of an extra number 18 chromosome Sx:Pecan Carinatum (protruding sternum) Small Jaw (micrognathia)
Hypoplastic (underdeveloped) fingernails c. TRISOMY 13 “ PATAU SYNDROME”
- Associated w/ multiple abnormalities, including defects of the brain that lead to seizures, apnea, deafness, and eye
abnormalities. Sx:
Coloboma
Cleft lip & cleft palate Low set ears
d. TURNER’S “Monosomy X Syndrome/Bonnevie-Ullrich Syndrome” - Occurs only in females
- The girl's cells are missing an X chromosome, or part of an X chromosome. Sx evident during puberty
Sx:
Short height
Lack of developing ovaries Sterile
e. KLINEFELTER’S SYNDROME
- 47XXY or XXY syndrome is a condition caused by a
chromosome nondisjunction in males; affected individuals have a pair of X sex chromosomes instead of just one
- Has male genitalia - No deepening of voice - Small testes, penis -sterile
*Klinefelter – Calvin Kline – male *Turner – Tina Turner – female
2. DELETION ABNORMALITIES = deletion of the genes on chromosomes
a. CRI-DU-CHAT SYNDROME or “Chromosome 5p deletion syndrome” - Results from a missing piece of chromosome # 5.
Sx:
Severe mental retardation – outstanding sx Wide-set eyes (hypertelorism)
Downward slant of the eyes (palpebral fissures) All other sx of down syndrome
- Changes in the long arm of the X chromosome
- Most common cause of inherited mental retardation in males - A fragile area on the X chromosome (called FMR1) has repeats in the genetic code. The more repeats, the more likely there is to be a problem. Boys and girls can both be affected, but because boys have only one X chromosome, a single fragile X is likely to affect them more severely.
Sx: Same with other chromosomal abnormalities
3. TRANSLOCATION ABNORMALITIES
- Abnormalities in chromosome structure follow a chromosome break & during the repair process, the reunion of the wrong segments of the chromosome.
- Involves two nonhomologous chromosomes (e.g., chromosome 2 and chromosome 6). Following a break in each of the chromosomes & subsequent reunion, a segment of chromosome 2 becomes attached to chromosome 6 and vice versa.
a. BALANCED TRANSLOCATION CARRIER
- When there is no loss or gain of chromosomal material & the individual is mentally & physically normal. However, there is an increased risk of having chromosomally abnormal offspring because individuals who carry balanced chromosome rearrangements may produce chromosomally unbalanced gametes. b. UNBALANCED TRANSLOCATION SYNDROME
- Happens if following repair, there is a loss or gain of chromosomal material . There are significant clinical consequences for this type. 4. Others
a. MOSAICISM
– a situation where the nondisjunction of chromosomes occurs during the mitotic cell division after fertilization results to diff. cells contains different # of chromosomes.
- Where an individual has two or more cell populations that differ in genetic makeup. This situation can affect any type of cell, including blood cells, gametes (egg and sperm cells) & skin.
b. ISOCHROMOSOMES
– a situation w/in the chromosomes instead of dividing vertically it divides horizontally