Iraqi Board Pediatrics key terms

A newborn whose birth weight lies below the 10th percentile for gestational age on a validated growth chart. It describes size at birth only and does not by itself prove pathological growth restriction.

A pathological slowing of fetal growth so that the fetus fails to reach its genetic growth potential. Diagnosis requires serial growth assessment plus placental, maternal, or fetal findings, not a single weight measurement.

A standardized physical and neuromuscular assessment used after birth to estimate gestational age in weeks. It is most useful when antenatal dating is unavailable or uncertain, especially in preterm or growth-restricted infants.

Neonatal respiratory failure caused by surfactant deficiency, producing grunting, tachypnea, retractions, and ground-glass chest radiographs. Risk rises with prematurity and falls after antenatal corticosteroid exposure; exogenous surfactant and positive pressure support are mainstays.

Betamethasone or dexamethasone given to a mother at risk of preterm delivery between roughly 24 and 34 weeks. They accelerate fetal lung maturation, reduce respiratory distress syndrome and intraventricular hemorrhage, and lower neonatal mortality.

Non-invasive respiratory support that delivers a steady distending pressure through nasal prongs or mask, keeping alveoli open and reducing work of breathing. It is first-line support for many preterm infants with respiratory distress.

Instillation of exogenous animal-derived or synthetic surfactant into the trachea of a ventilated infant with respiratory distress syndrome. It lowers surface tension, improves lung compliance, and reduces pneumothorax and mortality.

Yellow discoloration from unconjugated bilirubin accumulation, common in the first week of life. Timing, rate of rise, feeding, and haemolysis markers determine whether it is physiological or requires phototherapy or exchange transfusion.

Permanent bilirubin-induced injury to the basal ganglia, hippocampus, and brainstem, producing choreoathetosis, gaze palsy, hearing loss, and enamel dysplasia. It follows severe untreated hyperbilirubinaemia and is largely preventable with timely phototherapy or exchange transfusion.

Blue-green light treatment that converts bilirubin in skin to water-soluble isomers excreted without conjugation. It is the main treatment for significant neonatal hyperbilirubinaemia; irradiance, exposed surface area, and distance from the light all affect efficacy.

An acquired inflammatory necrosis of the immature intestine, usually in preterm infants, causing feeding intolerance, abdominal distension, bloody stools, and pneumatosis intestinalis. Management includes stopping feeds, antibiotics, and surgery for perforation.

Persistence of the fetal ductus arteriosus beyond the first days of life, causing a left-to-right shunt with a continuous murmur, bounding pulses, and pulmonary overcirculation. It is common in preterm infants and may be treated medically or by closure.

Pulmonary vascular disease with reversed or bidirectional shunting that develops after long-standing uncorrected left-to-right shunts. It causes cyanosis and polycythaemia, and closure of the defect is then contraindicated.

Continuous intravenous alprostadil used to keep the ductus arteriosus open in duct-dependent congenital heart lesions such as transposition or critical pulmonary stenosis. Apnoea, hypotension, and fever are common adverse effects requiring monitoring.

A sudden paroxysm of deep cyanosis and hyperpnoea in a child with tetralogy of Fallot, usually triggered by crying, feeding, or defecation. Knee-chest position, oxygen, morphine, and fluids reduce right-to-left shunting; beta-blockers prevent recurrence.

Deep, rapid, regular breathing without distress, typical of metabolic acidosis such as diabetic ketoacidosis. It reflects respiratory compensation for a low pH and resolves as the acidosis is corrected.

A metabolic emergency of insulin deficiency with hyperglycaemia, ketonaemia, and acidosis, presenting with vomiting, dehydration, abdominal pain, and Kussmaul breathing. Treatment requires fluids, insulin, and careful potassium replacement.

Brain swelling from fluid accumulation, in children most feared as a complication of diabetic ketoacidosis therapy. Headache, bradycardia, hypertension, and falling consciousness demand immediate mannitol or hypertonic saline.

A scored assessment of eye opening, verbal response, and motor response used to grade consciousness after head injury or during critical illness. Paediatric versions adapt the verbal scale for pre-verbal children.

A seizure occurring with fever in a child aged 6 months to 5 years who has no intracranial infection or prior unprovoked seizures. Simple episodes are generalized and brief; complex ones are focal, prolonged, or recurrent within 24 hours.

Needle sampling of cerebrospinal fluid from the lumbar subarachnoid space for cell count, protein, glucose, and culture. In suspected meningitis it is deferred only for signs of raised intracranial pressure or cardiorespiratory instability.

Resistance or pain when the hip is flexed and the knee then extended with the patient supine, suggesting meningeal irritation. It supports but never confirms a diagnosis of meningitis.

A laboratory test detecting antibody or complement bound to the surface of red cells. A positive result in a jaundiced newborn supports immune haemolysis such as rhesus or ABO incompatibility.

Anaemia resulting from premature red cell destruction, shown by raised reticulocytes, unconjugated bilirubin, and lactate dehydrogenase with low haptoglobin. Causes include membrane defects, enzyme deficiencies, haemoglobinopathies, and immune-mediated destruction.

An X-linked enzyme defect that leaves red cells vulnerable to oxidative stress, causing episodic haemolysis after infection, fava beans, or oxidant drugs. Screening before certain antimalarials and sulphonamides prevents severe crises.

The difference between measured serum sodium and the sum of chloride and bicarbonate, normally about 8 to 12 mmol/L. A raised gap narrows the differential to acids such as ketones, lactate, urea, or toxins.

Toxicity from aspirin overdose causing vomiting, tachypnoea, mixed respiratory and metabolic acidosis, tinnitus, and altered consciousness. Urinary alkalinization with sodium bicarbonate enhances elimination; haemodialysis is reserved for severe cases.

A fine carbon powder given orally to bind many drugs and toxins within the gut and reduce absorption. It is most effective within one hour of ingestion and is avoided in unprotected airways and caustic or iron ingestions.

Viral laryngotracheitis producing a barking cough, hoarse voice, and inspiratory stridor, most often from parainfluenza virus. A single dose of dexamethasone, with nebulized adrenaline in severe cases, is standard treatment.

Acute bacterial inflammation of the epiglottis, now rare where Haemophilus influenzae type b vaccine is used. The child is toxic, drools, and prefers sitting upright; the airway is secured by skilled staff before any examination of the throat.

Lower respiratory infection of infants, usually by respiratory syncytial virus, causing coryza, wheeze, crackles, and feeding difficulty. Treatment is supportive with oxygen and hydration; bronchodilators and corticosteroids are not routinely effective.

Non-invasive estimation of arterial oxygen saturation from light absorption through a pulsatile vascular bed. Readings are unreliable with poor perfusion, motion, nail polish, or abnormal haemoglobins such as carboxyhaemoglobin.

The maximum speed of forced expiration, measured with a portable meter and compared with the child's personal best or predicted value. It supports asthma diagnosis and monitoring but is effort-dependent and insensitive to small changes.

The typical progression of allergic disease from infantile eczema and food sensitization to childhood asthma and allergic rhinitis. Recognizing the sequence helps anticipate later disease and target early skin and environmental management.

An immune reaction to milk proteins, either IgE-mediated with rapid urticaria and wheeze or non-IgE-mediated with vomiting, diarrhoea, and poor growth. Diagnosis relies on history and elimination trials; extensively hydrolysed formula is the usual substitute.

An autoimmune enteropathy triggered by gluten in genetically susceptible children, causing chronic diarrhoea, failure to thrive, and iron deficiency. Tissue transglutaminase IgA with total IgA, followed by duodenal biopsy, confirms the diagnosis.

Inadequate physical growth in infancy or childhood, shown by weight crossing centile lines downward or persistently below expected norms. It signals undernutrition from inadequate intake, malabsorption, increased needs, or psychosocial factors.

A calculated target adult height from the parents' heights, adjusted by sex, used to judge whether a child's growth is appropriate for genetic background. Values outside the target range warrant investigation of growth or puberty.

Radiographic assessment of skeletal maturation, usually from a left hand and wrist film, compared with chronological age. It helps distinguish constitutional delay from endocrine causes of short stature or precocious puberty.

A low-bicarbonate acidosis with an elevated unmeasured-anion gap, caused by accumulated lactate, ketones, urea, or toxins. Calculating the gap early narrows the differential and guides targeted treatment.

Retrograde flow of urine from the bladder into the ureter and sometimes kidney, graded I to V on voiding cystourethrography. It predisposes to pyelonephritis and renal scarring, and management ranges from surveillance to surgery.

Bacterial infection of the urinary tract, diagnosed by culture of an appropriately collected specimen. In infants it may present only with fever, so urine testing is routine in febrile young infants.

Irreversible loss of renal parenchyma, usually from recurrent pyelonephritis or obstruction, seen as cortical thinning on imaging. It may lead to hypertension and chronic kidney disease, so prevention targets reflux and infection.

A glomerular disorder with heavy proteinuria, hypoalbuminaemia, oedema, and hyperlipidaemia. Most childhood cases are minimal change disease responsive to corticosteroids; atypical features prompt biopsy.

An acute medium-vessel vasculitis of young children with fever, conjunctivitis, rash, mucosal changes, and extremity swelling. Coronary artery aneurysms are the key complication, and early intravenous immunoglobulin plus aspirin reduces their risk.

Pooled human antibody given for replacement in immunodeficiency and as immunomodulation in Kawasaki disease and immune thrombocytopenia. Infusion reactions and rare thrombotic or renal events require monitoring.

The rate at which red cells settle in a tube, reflecting acute-phase proteins such as fibrinogen. It rises in infection and inflammation but is nonspecific and influenced by anaemia and immunoglobulins.

An acute-phase protein produced by the liver that rises quickly with infection or inflammation and falls quickly on recovery. It helps monitor response to treatment but cannot identify the cause of inflammation.

Reduced amniotic fluid volume, most often from fetal urine production failure or membrane rupture. Persistent early oligohydramnios can cause pulmonary hypoplasia and limb compression deformities.

A pattern of flattened facies, low-set ears, limb deformities, and pulmonary hypoplasia caused by severe oligohydramnios, typically from bilateral renal agenesis. It is usually lethal because of lung underdevelopment.

Chromosomal disorder from trisomy 21, causing hypotonia, characteristic facies, intellectual disability, and congenital heart defects. Surveillance covers thyroid disease, coeliac disease, hearing loss, and atlantoaxial instability.

A laboratory picture of an individual's chromosomes arranged by size and banding pattern, used to detect aneuploidy, translocations, and large structural abnormalities. It cannot resolve small deletions or single-gene mutations.

A technique using labelled DNA probes to detect specific chromosome sequences on a microscope slide. It is faster than karyotyping and useful for microdeletions such as 22q11.2, but only targeted regions are examined.

Structural malformations of the heart or great vessels present at birth, ranging from asymptomatic murmurs to duct-dependent cyanotic lesions. Presentation depends on the lesion and includes cyanosis, heart failure, and shock.