kanak2 dan sakit jiwa

assalamulaikum..

marilah kita sama2 belajar sambil mendalami pesakit2 yg kurg bernasib baik..bersyukurlah kita yg dikurniakan aqal sempurna dan kesihatan tubuh badan untuk melakukan amal ibadah..

allahumma afini fi badani
allahumma afini fi sam'i
allahumma afini fi basari

Tetralogy of Fallot

4 cardinal features (SHOP)

· VSD
· Hypertrophy of right ventricle
· Overriding aorta
· Pulmonary stenosis

Symptoms

· Diagnosed antenatally or murmur in the 1st or 2nd month of life
· Hypercyanotic spells – tissue acidosis with severe hypoxia, SOB, pallor with inconsolable crying and blue face which can cause MI/CVA
· Severe cyanosis
· Squatting on exercise

Signs

· Clubbing of fingers and toes
· Loud harsh ejection systolic murmur at LSE
· Single second heart sound
· When pulmonary obstruction is increased with murmur shorten and cyanotic increase

Ix

· CXR – in older child, boot shaped (R ventricular hypertrophy), pulmonary artery ‘bay’, decreased pulmonary vascular markings, reduced pulmonary blood flow
· ECG – normal at birth, RVHt when older
· Echo – small/stenosed pulmonary artery

Mx

· Medical
· Corrective surgery at 6 months
· Closing VSD and relief R ventricular flow obstrxn with artificial patch
· If very cyanosed – shunt to increase pulmonary blood flow; artificial tube betw subclavian artery and pulmonary artery or balloon dilatation of RV outflow tract
· >15 mins hypercyanotic spells; sedation with morphine, propanolol as peripheral vasoconstrictor, bicarbonate to correct acidosis

Personality Disorder

Personality- traits/characteristics of an individual as shown in ways of behaving in a wide variety of circumstances. It is not diagnosed in adolescent/ young adults as potential major change is still present.

Personality types
(a) Affective (cyclothymic) - persistent anomalies of mood ; depressive, euphoric or alternating
(b) Explosive – instability of mood, liable to sudden irritability, anger, impulsive
(c) OCD – extremely cautious, conscientious, rigid, perfectionist, vacillating and doubting
(d) Paranoid - Sensitive and blaming others / aggravating preoccupation with personal rights
May have ‘overvalued ideas’ but no psychotic features
Touchy and suspicious, don’t make friends easily
Jealous, stubborn, argumentative
(e) Schizoid – extreme reserve, shyness, aloofness, may be eccentric behavior
(f) Asthenic – passive dependent, lack of resilience and mental vigor
(g) Hysterical – shallow, labile affective features, over dependence on others, erratic relationships
(h)Borderline personality disorder – persons who show instability in a variety of areas, including interpersonal behavior, mood and self image
(i) Anti social (psychopathic) - persistent antisocial behavior with lack of sympathetic feeling/remorse

selamat belajar~!