Ever wonder what if the cafe au lait macule on your patient might be something more than just a benign birth mark? Learn more about neurofibromatosis 1 and other genetic disorders associated with cafe au lait macules in today’s episode. This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Suma Shankar (pediatric genomic medicine). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comKey Points:* Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder with complete penetrance but variable expression.* NF1 can be diagnosed clinically if a patient has the following features and meets the specific clinical criteria: cafe au lait macules, neurofibromas, freckling, optic gliomas, iris hamartomas, an osseous lesion, and/or a first degree relative with NF1Sources:Pediatrics, Miller et al (2019) 143 (5): e20190660. https://doi.org/10.1542/peds.2019-0660 (https://doi.org/10.1542/peds.2019-0660)

Have you ever wondered if your patient pausing to breathe in their sleep is concerning or not? Learn about the signs of central sleep apnea and which medical conditions it is often associated with in pediatric patients in this episode.This episode was written by pediatricians Tammy Yau, Lidia Park, and Jessica Ahn, with content support from Ambika Chidambaram (UCD pediatric pulmonology). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com Key Points* Central sleep apnea (CSA) occurs when the brain’s central respiratory drive can’t send proper signals to the muscles that are part of breathing.* CSA is diagnosed by a polysomnogram if there are apneic episodes that last 20 seconds or longer or if they are associated with oxygen desaturations, arousals, or heart rate changes (specific criteria in footnote).* Central apneas are considered normal during certain stages of sleep (onset, during REM, after arousal), in premature infants less than 37 weeks corrected gestational age, and when ascending to altitudes greater than 3500 m above sea level.* Common pediatric conditions associated with CSA include congenital central hypoventilation syndrome, achondroplasia, and Arnold-Chiari malformations. Diagnostic Criteria for CSA* Apneic episodes last 20 seconds or longer OR* The apnea lasts at least the duration of two breaths during baseline breathing and is associated with an arousal or at least a 3% oxygen desaturation OR* If the event occurs in an infant younger than 1 years old, it has to last at least the duration of two breaths during baseline breathing AND be associated with a decrease in heart rate to less than 50 beats per minute for at least 5 seconds OR less than 60 beats per minute for 15 secondsDiagnostic Criteria for Periodic Breathing* At least three episodes of central pauses lasting for at least 3 seconds interspersed by less than 20 seconds of normal breathing. References* Gipson K, Lu M, Kinane TB. Sleep-Disordered breathing in children. Pediatrics in Review. 2019;40(1):3-13. doi:10.1542/pir.2018-0142* McLaren AT, Bin-Hasan S, Narang I. Diagnosis, management and pathophysiology of central sleep apnea in children. Paediatric Respiratory Reviews. 2018;30:49-57. doi:10.1016/j.prrv.2018.07.005* Berry RB, Budhiraja R, Gottlieb DJ, et al. Rules for scoring respiratory events in sleep: Update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Journal of Clinical Sleep Medicine. 2012;08(05):597-619. doi:10.5664/jcsm.2172* Javaheri S, Dempsey JA. Central sleep apnea. Comprehensive Physiology. Published online December 10, 2012:141-163. doi:10.1002/cphy.c110057* Selim BJ, Somers V, Caples SM. Central sleep apnea,

Wondering how you describe the rash of measles, molluscum contagiosum, hand foot mouth, or chickenpox? Learn how in today’s episode!This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Aruna Venkatesan and Gabriel Molina (dermatologists at Santa Clara Valley Medical Center). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comKey Points:* When describing a rash, include the basic morphology, size, color, location, distribution and configuration, and any secondary morphology* When taking photos, try to have natural light and make sure the rash is in focus. If taking a close up photo, make sure to have a photo further away so that the location of the rash is clear.Sources:* Stanford Medicine: https://stanfordmedicine25.stanford.edu/the25/dermatology.html (https://stanfordmedicine25.stanford.edu/the25/dermatology.html)* Allmon A, Deane K, Martin KL. Common skin rashes in children. American family physician. 2015 Aug 1;92(3):211-6. * CDC Measles: https://www.cdc.gov/measles/data-research/index.html (https://www.cdc.gov/measles/data-research/index.html) 

How do you know when a head injury can be observed or if more work-up needs to be done? Find out in this episode!This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Julia Magana (pediatric emergency medicine). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comKey Points:* Low risk head injuries do not need head imaging. The criteria for low risk head injuries are those where the patient’s GCS is 15 without altered mental status and do not have signs of skull fracture. If any of these signs are present, head imaging with a head CT is recommended* If the head injury includes history of loss of consciousness or vomiting, a non-frontal scalp hematoma (ie parietal, temporal, or occipital), a severe mechanism of injury, or a severe headache, then generally observation is still recommended but a head CT can be obtained based on clinical decision making. Sources:* Stat Pearls. Pediatric Head Trauma. Micelle J, et al. February 2024: https://www.ncbi.nlm.nih.gov/books/NBK537029/ (https://www.ncbi.nlm.nih.gov/books/NBK537029/)* Pediatrics. Abusive Head Trauma in Infants and Children: Technical Report. Sandeep Narang, et all. February 2025: https://publications.aap.org/pediatrics/article/155/3/e2024070457/201049/Abusive-Head-Trauma-in-Infants-and-Children (https://publications.aap.org/pediatrics/article/155/3/e2024070457/201049/Abusive-Head-Trauma-in-Infants-and-Children) 

Opioid use disorders affect babies and children in all ways. In newborns, it can present as neonatal opioid withdrawal syndrome (also known as NOWS). Learn how hospital systems are managing infants with NOWS with the Eat, Sleep, Console protocol in ...

Learn about language and speech development, potential etiologies of speech delay, and early interventions for speech delay.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comThis episode was written by pediatricians Lidia Park and Tammy Yau as well as UCD pediatrics resident Elaine Ho, with content support from Anisha Srinivasan (UCD child development and behavioral pediatrician). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation. Key Points* CDC and AAP have created updated 2022 developmental guidelines that includes changes in speech and language milestones for childrens and have added guidelines forage ages 15 months and 30 months * Differential for speech delay is broad and includes hearing loss, global developmental delay, autism, and isolated language disorders * Interventions include speech therapy services and exercises at home* Pediatricians play critical role in surveillance, evaluation, and management of speech delays to allow for earlier intervention and improved outcomes Sources  * Jennifer M. Zubler, Lisa D. Wiggins, Michelle M. Macias, Toni M. Whitaker, Judith S. Shaw, Jane K. Squires, Julie A. Pajek, Rebecca B. Wolf, Karnesha S. Slaughter, Amber S. Broughton, Krysta L. Gerndt, Bethany J. Mlodoch, Paul H. Lipkin; Evidence-Informed Milestones for Developmental Surveillance Tools. Pediatrics March 2022; 149 (3): e2021052138. 10.1542/peds.2021-052138* Maris Rosenberg, MD, Nancy Tarshis, MA, MS, 2016. "Speech and Language Concerns (Chapter 195)", American Academy of Pediatrics Textbook of Pediatric Care, Thomas K. McInerny, MD, FAAP, Henry M. Adam, MD, FAAP, Deborah E. Campbell, MD, FAAP, Thomas G. DeWitt, MD, FAAP, Jane Meschan Foy, MD, FAAP, Deepak M. Kamat, MD, PhD, FAAP, Rebecca Baum, MD, FAAP, Kelly J. Kelleher, MD, MPH, FAAP* Heidi M. Feldman; Evaluation and Management of Language and Speech Disorders in Preschool Children. Pediatr Rev April 2005; 26 (4): 131–142. https://doi.org/10.1542/pir.26-4-131 (https://doi.org/10.1542/pir.26-4-131)* Henry Adam; Speech and Language Concerns. Quick References 2022; 10.1542/aap.ppcqr.396455* ASHA Communication Milestones and Age Ranges https://www.asha.org/public/developmental-milestones/communication-milestones/ (https://www.asha.org/public/developmental-milestones/communication-milestones/) Audio Clips: From Youtube Channel “Pathways”The 4 to 6 Month Baby Communication Milestones to Look For: https://www.youtube.com/watch?v=d0FGHFrMRXI (https://www.youtube.com/watch?v=d0FGHFrMRXI)10-12 month Old Communication Milestones https://www.

Vaccines are life saving medical treatments. Like all medicine, there are benefits and risks to vaccines. Learn how to address common concerns about vaccines and combat misinformation in this episode!Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com (mailto:pediagogypod@gmail.com)This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Dean Blumberg (UC Davis pediatric infectious disease). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation. Key Points:* Vaccine benefits largely outweigh risks.* Vaccines do not cause autism. The frequently cited study that reportedly links vaccines to autism was funded by an anti-vaccine group and only looked at 12 children.* Thimerisol is a preservative that is not used in routine vaccinations other than certain influenza vaccines. Anti vaccine groups raise the concern for ethylmercury toxicity from thimerisol but studies looking at mercury levels after vaccination with thimerisol containing vaccines showed the peak mercury levels to still be within the normal EPA range.* Oral rotavirus is associated with an increased risk of intussusception. A history of intussusception is a contraindication to the rotavirus vaccineSources:* Pediatrics (2016) 138 (3): e20162146. https://doi.org/10.1542/peds.2016-2146 (https://nam13.safelinks.protection.outlook.com/?url=https%3A%2F%2Fdoi.org%2F10.1542%2Fpeds.2016-2146&data=05%7C02%7Clidpark%40health.ucdavis.edu%7C5ab5779bbb524d7754a808ddb3a80fb1%7Cd791615b4e1b48b08c51101688e1999b%7C0%7C0%7C638864256591309151%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=KgjaO3J9UL3vIY0NiJrkuNy82dqzRajZ0Diu%2FnL2Ao0%3D&reserved=0)* Pediatrics (2024) 153 (3): e2023065483. https://doi.org/10.1542/peds.2023-065483 (https://nam13.safelinks.protection.outlook.com/?url=https%3A%2F%2Fdoi.org%2F10.1542%2Fpeds.2023-065483&data=05%7C02%7Clidpark%40health.ucdavis.edu%7C5ab5779bbb524d7754a808ddb3a80fb1%7Cd791615b4e1b48b08c51101688e1999b%7C0%7C0%7C638864256591318817%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=UXN%2B8q6WDNCZtckOQZ3qO4oQBhFtfeDpNZLWANaGAWA%3D&reserved=0)* Desai R, Cortese MM, Meltzer MI, et al. Potential intussusception risk versus benefits of rotavirus vaccination in the United States. Pediatr Infect Dis J. 2013;32(1):1-7. doi:10.1097/INF.0b013e318270362c* Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children [retracted in: Lancet. 2004 Mar 6;363(9411):750. doi: 10.1016/S0140-6736(04)15715-2. Lancet. 2010 Feb 6;375(9713):445. doi: 10.1016/S0140-6736(10)60175-4.]. Lancet. 1998;351(9103):637-641. doi:10.1016/s0140-6736(97)11096-0* Deer B. Secrets of the MMR scare. The Lancet's two days to bury bad news. BMJ. 2011;342:c7001. Published 2011 Jan 18. doi:10.1136/bmj.c7001* Pichichero ME, Gentile A, Giglio N, et al. Mercury levels in newborns and infants after receipt of thimerosal-containing vaccines. Pediatrics. 2008;121(2):e208-e214. doi:10.1542/peds.2006-3363* Uhlmann V, Martin CM, Sheils O, et al. Potential viral pathogenic mechanism for new variant inflammatory bowel disease. Mol Pathol. 2002;55(2):84-90. doi:10.1136/mp.55.2.84* Uptodate “Autism spectrum disorder and chronic disease: no evidence for vaccines or thimerisol as a contributing factor”*

With increasing awareness and diagnosis of autism, there has also been an increase in misinformation regarding autism. The goal of today's episode is to provide a brief overview on autism and provide evidenced based information to better inform listeners!Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com (mailto:pediagogypod@gmail.com)This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Kathleen Angkustsiri (UC Davis developmental and behavioral pediatric specialist). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation. Key Points:* Autism diagnostic criteria have changed to increase detection of milder cases. Asperger's is included in autism. * Per the DSM-5, autism is a condition with impairments in social communication (social and emotional reciprocity, non-verbal communication, and relationships) and restrictive and repetitive behaviors.  * Autism diagnosis also requires 2 out of 4 restrictive or repetitive behaviors: 1. Restrictive or repetitive patterns of behavior, interests, or activities 2. Insistence of sameness, inflexible adherence to routines, ritualized patterns 3. Highly restricted, fixated interest abnormal in intensity or focus. 4. Hyper or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment* Autism can present as regression of social and/or language skills.* The Modified Checklist for Autism in Toddlers – Revised with Follow-up (MCHAT-R/F) is the most widely known and validated screening tool for autism for ages 16-30 months. A score of 8 or more is high risk for autismSources:* Pediatrics (2020) 145 (1): e20193447. https://doi.org/10.1542/peds.2019-3447 (https://nam13.safelinks.protection.outlook.com/?url=https%3A%2F%2Fdoi.org%2F10.1542%2Fpeds.2019-3447&data=05%7C02%7Clidpark%40health.ucdavis.edu%7C5ab5779bbb524d7754a808ddb3a80fb1%7Cd791615b4e1b48b08c51101688e1999b%7C0%7C0%7C638864256591290123%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=rB6ONu7ywvz6Wt2NPPZsLtFDvpC1KbXdVpRNjBXX0FA%3D&reserved=0)

Ever get caught in a sticky ethical situation regarding genetic testing? You're not alone. Join us as we try to navigate these real life issues.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com (mailto:pediagogypod@gmail.com)This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Video Jhaveri (UC Davis neonatology fellow). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation. Key points:* Genetic testing may seem relatively benign and non-invasive but is actually fraught with unforeseen issues such as surprise consanguinity and non-paternity.* Racial and economic disparities are prevalent with genetic testing and their interpretation. For example most test value interpretations are based on people of European and Asian descent.* We cannot easily predict outcomes and prognosticate even with genetic testing. Prognosis is often fraught with the issue of promoting "ableism".Sources:Katharine P. Callahan, Ellen W. Clayton, Amy A. Lemke, Bimal P. Chaudhari, Tara L. Wenger, Allison N. J. Lyle, Kyle B. Brothers; Ethical and Legal Issues Surrounding Genetic Testing in the NICU. Neoreviews March 2024; 25 (3): e127–e138. https://doi.org/10.1542/neo.25-3-e127 (https://doi.org/10.1542/neo.25-3-e127) 

Osteomyelitis is an infection of the bone and is often a delayed diagnosis given the ambiguity of the signs and symptoms. Listen in on how you might be able to better detect and treat osteomyelitis without delay.  Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com  This episode was written by pediatric resident Victoria Tran Toft and pediatricians Tammy Yau and Lidia Park with content support from Natasha Nakra (UC Davis pediatric infectious disease). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.   Key points: * Osteomyelitis can present as limp or hesitancy with movement; this can occur with or without fevers and localizing signs.  * Main diagnostics include CRP, which also aids in assessing treatment response. * Treatment is a long course of antibiotics. Typically, starting empiric IV antibiotics in the hospital and then transitioning to oral agents.  Sources: * PIDS/IDSA Guideline on Diagnosis and Management of Acute Hematogenous Osteomyelitis in Pediatrics. Published 8/5/2021. Journal of the Pediatric Infectious Diseases Society. https://doi.org/10.1093/jpids/piab027 

Want to know how to differentiate a normal white patch on the tongue vs a not normal white patch? Learn about thrush in this week’s episode!Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comThis episode was written by pediatricians Tammy Yau and Lidia Park with content support from Julia Froud (UC Davis pediatrician). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation. Key Points:* Thrush is due to candida yeast infection* It cannot be wiped off the tongue as compared to milk residue* Treat with topical nystatin solutionSources:* Pediatric in Review, 2007: https://publications.aap.org/pediatricsinreview/article/28/1/15/34605/Oral-Conditions (https://publications.aap.org/pediatricsinreview/article/28/1/15/34605/Oral-Conditions) * Thrush Pediatric Patient Education (2024) https://doi.org/10.1542/ppe_schmitt_240 (https://doi.org/10.1542/ppe_schmitt_240) AAP Redbook, 2021, Candidiasis: https://doi.org/10.1542/9781610025782-S3_025 (https://doi.org/10.1542/9781610025782-S3_025)

Wondering why your patient’s diaper rash won’t go away? Pay attention to this video to learn if there’s something else going on!Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comThis episode was written by pediatricians Tammy Yau and Lidia Park with content support from Lisa Rasmussen (UC Davis pediatrician). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation. Key Points:* Typical diaper rash is an irritant contact dermatitis due to excess moisture, pH imbalance, and excessive friction. It can be a red patch or red macules and papules in the diaper region that spares the skin folds* Candidal diaper rashes involve the skin folds and have satellite lesions* Don’t forget in your differential: perianal strep, hand foot mouth syndrome, psoriasis, eczema, scabies, and Langerhans cell histiocytosisSources: * Pediatrics in Review, January 2021, Helms and Burrows: https://publications.aap.org/pediatricsinreview/article/42/1/48/35437/Diaper-Dermatitis (https://publications.aap.org/pediatricsinreview/article/42/1/48/35437/Diaper-Dermatitis)

Uvula deviation, sore throat, fever? Learn all about peritonsillar abscesses in this episode!Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comThis episode was written by pediatricians Tammy Yau and Lidia Park with content support from Dean Blumberg (UC Davis pediatric infectious disease). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation. Key Points:* Peritonsillar abscess (PTA) is a suppurative infection of the tissue between the palatine tonsil capsule and the pharyngeal muscles* Symptoms include fever, sore throat, uvular deviation, trismus, voice changes, drooling, unilateral tonsillar swelling with deviation of the uvula to the contralateral side* Diagnosis can be clinical but imaging is often obtained * Treat with antibiotics (empiric amoxicillin, cephalosporin, or clindamycin but adjust based on cultures) and incision and drainage Sources:* A Clinical Approach to Tonsillitis, Tonsillar Hypertrophy, and Peritonsillar and Retropharyngeal Abscesses. R Bochner, et al. Pediatrics in Review (2017) 38 (2): 81–92. https://doi.org/10.1542/pir.2016-0072

Marijuana, cannabis, THC, and CBD are among the many common words and forms of cannabis that pediatric patients are being exposed to in our current day and age. Keep up to date about the official AAP policy and recommendations with today's episode. Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com (mailto:pediagogypod@gmail.com) This episode was written by pediatricians Tammy Yau and Lidia Park. Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.  Key Points: * At the time of this episode release, marijuana is considered a schedule I drug at the federal level meaning here is high potential for abuse, no medical use, and/or lack of safety with using this drug. The official AAP stance is to avoid cannabinoid use in most children. More studies need to be done to determine the long term effects. * Cannabis plants generally have both THC and CBD which are types of cannabinoids. THC can cause intoxication, analgesia, and antiemesis. CBD is less intoxicating and anxiolytic.  * Cannabis intoxication can cause tachycardia, hypertension, red eyes, dry mouth, orthostatic hypotension, increased appetite and thirst, drowsiness, insomnia, anxiety, short term memory loss, ataxia, stroke, nystagmus, hypothermia, hypotonia, and rarely respiratory depression. Treatment is supportive. * THC can be detected in breastmilk. There is not enough information about long term safety and implications of THC exposure in utero or while breastfeeding.  * In children, epidiolex is the only plant derived cannabinoid FDA approved for use of severe seizures in children. Sources: * Ammerman S, et al. The impact of marijuana policies on youth: clinical, research, and legal update. Pediatrics. 2015 Mar 1;135(3):e769-85. doi: 10.1542/peds.2014-4146 * Hale’s Medications & Mothers’ Milk 2023: A Manual of Lactational Pharmacology * Fischedick J, Van Der Kooy F, Verpoorte R. Cannabinoid receptor 1 binding activity and quantitative analysis of Cannabis sativa L. smoke and vapor. Chem Pharm Bull (Tokyo). 2010;58(2):201-207. doi:10.1248/cpb.58.201 

Don't miss this cause of anemia in your differential in today’s episode about autoimmune hemolytic anemia! Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bsky.social, and connect with us at pediagogypod@gmail.com (mailto:pediagogypod@gmail.com) This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Anjali Pawar (UC Davis pediatric hematology). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.  Key Points: * Autoimmune hemolytic anemia is an extravascular hemolysis * Symptoms can include pallor, fatigue, lightheadedness, jaundice, tachycardia, acrocyanosis, dark urine, splenomegaly, and gallstones with labs showing anemia with schistocytes, reticulocytosis, hyperbilirubinemia, elevated LDH, elevated AST, and positive Coombs testing. * AIHA can be triggered by infections, underlying autoimmune diseases, malignancy, immunosuppression, and medications. *  Treatment is steroids or rituximab for warm AIHA and avoiding the cold for cold AIHA. In refractory cases, splenectomy or stem cell transplant may be needed. Transfusions are generally not recommended due to ongoing hemolysis unless anemia is severe. Sources:  * Voulgaridou A, Kalfa TA. Autoimmune Hemolytic Anemia in the Pediatric Setting. J Clin Med. 2021;10(2):216. Published 2021 Jan 9. doi:10.3390/jcm10020216 * Noronha, Suzie A. "Acquired and congenital hemolytic anemia." Pediatrics in Review 37.6 (2016): 235-246. doi: 10.1542/pir.2015-0053   

Plan ahead for the flu season with our episode today where we talk about how to treat the common flu, also known as influenza.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bsky.social, and connect with us at pediagogypod@gmail.com (mailto:pediagogypod@gmail.com) This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Dean Blumberg (UC Davis pediatric infectious disease). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.  Key Points: * The influenza vaccine is important every flu season! * Anti-viral neuraminidase inhibitors like oseltamivir/Tamiflu (oral), zanamavir (inhaled), and peramavir (IV) prevent the flu virus from fusing with infected cell membranes preventing the release of the virus  * Baloxivir is a endonuclease inhibitor that inhibits mRNA synthesis that can be given as a one time dose to treat influenza infections. * Otitis media, PNA, retropharyngeal abscesses, Pott puffy tumors, empyema, meningitis, encephalitis, GBS, acute cerebella ataxia, transverse myelitis, myositis, pericarditis, and myocarditis are all serious complications that can occur with influenza infections Sources: * O’Leary ST, et al. Recommendations for Prevention and Control of Influenza in Children, 2024–2025: Technical Report. Pediatrics. 2024 Oct 1;154(4). doi: 10.1542/peds.2024-068508 * AAP Red Book, 2023. doi:10.1542/9781610025782-S3_068 * Moscona, A. Neuraminidase Inhibitors for Influenza. N Engl J Med 2005;353:1363-1373. 2025 Sept 9. doi: 10.1056/NEJMra05074 

Have you ever wondered if your patient's snoring is concerning or not? Learn about how we screen for obstructive sleep apnea in pediatric patients in this episode.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bsky.social, and connect with us at pediagogypod@gmail.comThis episode was written by pediatricians Lidia Park, Tammy Yau, and Jessica Ahn with content support from Ambika Chidambaram (UCD pediatric pulmonology). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.   Key Points* Obstructive sleep apnea (OSA) occurs when there is either complete or partial narrowing of the upper airway during sleep that causes an awakening from sleep and/or results in at least 3% drop in oxygen saturation and lasts 2 breath lengths.* Symptoms of OSA can include episodes of apnea, gasping, choking, frequent awakenings, sleep enuresis, attention difficulties, behavioral problems, daytime sleepiness.* On physical exam, watch out for enlarged tonsils and/or adenoids, micrognathia, retrognathia, or hypotonia.* Untreated OSA is an independent comorbid factor for many conditions such as failure to thrive, obesity, and cardiovascular diseases like insulin resistance, fatty liver disease, and hypertension.* Disorders associated with OSA include Down syndrome, Duchenne Muscular Dystrophy, Prader Willi, achondroplasia, hypothyroidism, and acromegaly.* The gold standard for diagnosis of OSA is polysomnography and is based off of AHI scores: 1-5 is mild, 6-10 is moderate, and 11 or greater is severe.* First line treatment for most children is adenotonsillectomy. If this fails, second line treatment is CPAP or BiPAP. References* Krishna J, Kalra M, McQuillan ME. Sleep disorders in childhood. Pediatrics in Review. 2023;44(4):189-202. doi:10.1542/pir.2022-005521* American Academy of Sleep Medicine. Obstructive Sleep Apnea.; 2008. (https://aasm.org/resources/factsheets/sleepapnea.pdf)https://aasm.org/resources/factsheets/sleepapnea.pdf (https://aasm.org/resources/factsheets/sleepapnea.pdf). Accessed October 29, 2024.* Benedek P, Balakrishnan K, Cunningham MJ, et al. International Pediatric Otolaryngology group (IPOG) consensus on the diagnosis and management of pediatric obstructive sleep apnea (OSA). International Journal of Pediatric Otorhinolaryngology. 2020;138:110276. doi:10.1016/j.ijporl.2020.110276* Basha S, Bialowas C, Ende K, Szeremeta W. Effectiveness of adenotonsillectomy in the resolution of nocturnal enuresis secondary to obstructive sleep apnea. The Laryngoscope. 2005;115(6):1101-1103. doi:10.1097/01.mlg.0000163762.13870.83

Join us for part 2 of our 2 part series on sickle cell disease. In this episode, we’ll go over the acute complications related to sickle cell disease and their management.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bsky.social, and connect with us at pediagogypod@gmail.comThis episode was written by pediatricians Tammy Yau and Lidia Park with content support from Anjali Pawar (UC Davis pediatric hematology). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation. Key Points:* Consider acute chest syndrome in a patient with cough, fever, hypoxemia, and new infiltrate on CXR * Acute pain episodes should be treated with IV hydration, oxygen as needed, and adequate pain management. * Chronic complications often result from chronic vascular blockage and inadequate oxygenation such as splenomegaly, avascular necrosis, retinopathy, nephropathy, and ulcers. Sources:* Pediatrics 2024, A. Yates. https://doi.org/10.1542/peds.2024-066842 (https://doi.org/10.1542/peds.2024-066842) 

In part 1 of this 2 part series on sickle cell disease, we’re going to discuss the general pediatric management of a patient with sickle cell disease including what special precautions and additional routine health maintenance they need. Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bsky.social, and connect with us at pediagogypod@gmail.comThis episode was written by pediatricians Tammy Yau and Lidia Park with content support from Anjali Pawar (UC Davis pediatric hematologist). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation. Key Points:* Patients with sickle cell disease should receive penicillin prophylaxis from 2 months old til 5 years old or until pneumococcal vaccine series is completed * For patients with HbSS or sickle beta zero thalassemia, offer hydroxyurea at 9 months of age, even if they don’t have clinical symptoms. They should also receive stroke risk screening with an annual transcranial doppler* Patients with sickle cell disease should receive annual screening for retinopathy and nephropathy around age 10* Patients with sickle cell disease should receive an additional pneumococcal (20 or 23) vaccine and the meningococcal ACWY vaccine at age 10 and men B after age 10 if they have functional asplenia or a splenectomySources:Pediatrics 2024, A. Yates. https://doi.org/10.1542/peds.2024-066842 (https://doi.org/10.1542/peds.2024-066842)

Wondering how to get pesky eczema under control? Listen up in today’s episode.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bsky.social, and connect with us at pediagogypod@gmail.comThis episode was written by pediatricians Tammy Yau and Lidia Park with content support from Smita Awasthi (UC Davis pediatric dermatology). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.Key Points:●  Daily moisturization, cotton clothing, avoiding allergens and irritants like dust mites help prevent eczema flares●  For eczema flares, treat with a topical steroid, lower potency on the face and higher potency elsewhere on the body●  Look out for superimposed bacterial infections from Staphloccocus aureus or group A streptococcus and treat with topical or oral antibiotics depending on the spread (local vs extensive)●  Eczema herpeticum is due to HSV and should be treated with acyclovir, sometimes requiring hospitalization if severe or close to the eyesSources:-   AAP Patient Care Atopic Dermatitis: (https://www.aap.org/en/patient-care/atopic-dermatitis/treatment-of-atopic-dermatitis/)https://www.aap.org/en/patient-care/atopic-dermatitis/treatment-of-atopic-dermatitis/ (https://www.aap.org/en/patient-care/atopic-dermatitis/treatment-of-atopic-dermatitis/)-   Pediatrics in Review, April 2018, Waldman et al, (https://doi.org/10.1542/pir.2016-0169)https://doi.org/10.1542/pir.2016-0169 (https://doi.org/10.1542/pir.2016-0169)