BIOSOFT HELP FILES

Faber is an acronym for flexion, abduction, external rotation, and extension of hip joint.  If this maneuver causes anterior hip pain the test is positive.  If the Fabere is positive and there is a significant loss of passive range of hip movements consider hip arthritis or avascular necrosis.  If Fabere is positive with normal hip passive movements then iliopsoas tendonitis is a likely diagnosis.  If Fabere is positive with a posterior hip pain consider sacroiliac joint dysfunction.

(Bryan 2005)

1)      Acute sinusitis

2)      Chronic sinusitis

3)      Acute parotitis

4)      Myofascial pain syndromes – maxillary area and preauricular area pain in lateral pterygoid MFPS, maxillary, mandibular, forehead, preauricular area pain in masseter MFPS, preauricular, inside the ear, mastoid area pain in medial pterygoid MFPS, supraorbital, paranasal, upper lip, orbicular, mandibular and maxillary pain in platysma MFPS, maxillary pain and forehead pain in sternocleidomastoid sternal division MFPS, maxillary and upper premolar/molar teeth pain spreading over supraorbital, frontal, temporal head regions in temporalis muscle MFPS.  See notes under myofascial pain syndrome for diagnostics criteria and therapy.

5)      Dental abscess

6)      Pericoronitis

7)      Temporomandibular joint dysfunctions

8)      Neuralgias – SUNCT

1)      Lip swelling – Oral Allergy Syndrome

2)      Facial Urticaria

3)      Dental abscess

1)      Periorbital swellings of angioedema

2)      Periorbital swelling of generalized edema states – acute nephritic syndrome, heart failure, liver failure etc

3)      Acute infectious parotitis

4)      Recurrent parotitis

5)      Cervical lymphadenopathy

1)      Swelling of the face neck and arms with a fixed elevation of JVP,  cyanosis, plethora, distended veins, cough, hoarseness, dyspnea, stridor, Dysphagia, headaches confusion, come (superior vena cava obstruction)

2)      asdasd

(Referral Guidelines for suspected cancer in adults and in children at National Guideline Clearinghouse 2007 update)

1)      Bell’s palsy – paralysis of all ipsilateral facial muscles (“close your eyes”, “show me your teeth”), hyperacusis (abnormally loud sound on the ipsilateral side), loss of tears, loss of taste, Tx – valacyclovir 1 g bid for 1 week OR famciclovir 750 mg tid OR acyclovir 800 mg five times a day for 5 days and oral prednisolone 1 mg/kg/day for 1 week, if complete paralysis after 1 week, do electroneurography, if this shows 90% degeneration, refer for surgical decompression, among patients without 90% degeneration 80-100% regain good outcome.

2)      Stroke

1)      Elderly, hypertension, impairment of taste, pain other than in the ear, complete facial weakness (poor prognosis for recovery from facial paresis)

2)      Bilateral facial palsy (neurologist referral for evaluation for underlying causes)

3)      Recurrent facial palsy (neurologist referral for evaluation for underlying causes)

4)      Development of other cranial palsies

5)      Facial twitch or spasm preceded the development of the palsy (? CNS tumor)

6)      Nystagmus, ataxia, facial numbness, tinnitus (structural lesions in the pons, cerebellopontine angle etc)

7)      Tinnitus, nystagmus, hearing loss (structural lesions associated with temporal bone)

8)      Parotid mass (parotid tumor)

9)      Head injury (intracranial lesions)

(Gilden 2004)

1)      Normal Centile Shifting – growth of a baby and a child is highly variable, with 5% of children shifting up or down two inter centile spaces between 0-6 weeks, 5% shifting 2 inter centile spaces, and 1% 3 spaces between 6 weeks to 1 yr.  5% of children in the 98^th centile (large babies) may shift down 2 centile spaces during regression to mean, and 1% of children in the 2^nd centile (small babies) may cross 2 spaces during regression to mean.  Clinical evaluation of these children includes growth over time, development status, dietary status, and psychosocial factors to determine the overall severity of FT if present.

2)      Familial short stature – infant and parents small, growth runs parallel to and just below the normal curves,

3)      Constitutional Growth Delay – weight and height percentiles drop at the end of 1 yr, but run parallel to the normal curves in middle childhood, but then accelerate towards adolescence, adult size is normal or if at all taller than average, parents had similar growth patterns of childhood short stature, delayed puberty (delayed age of menarche of mother, age of first shaving of the father), eventual normal adult height,

4)      Kwashiorkor – in the 2^nd yr of life, limb edema, skin lesions (typically hyperpigmentation, depigmentation, desquamation, ulceration, mucous membrane changes), brittle sparse hair, apathy, lethargy, anemia, hepatomegaly, hypoalbuminemia – Mx pediatric referral

5)      Marasmus – in the 1^st yr of life, smaller and lighter than kwashiorkor babies of same age, markedly reduced subcutaneous fat and muscle mass, - Mx pediatric referral

6)      Underweight – as a mild malnutrition present with acute gastroenteritis, acute respiratory infections, pulmonary TB, apathy, debilitation, poor school performance, Mx – exclude underlying infections, treat anemia, worms, medical nutritional therapy, 15-20 ml/kg milk added to the child’s present diet, 

7)      Chronic Energy Deficiency – Poor weight gain due to dietary energy deficiency, the commonest cause of FT, may affect growth and cognitive development, treatment is by medical nutrition therapy to give the energy requirements

8)      Slow weight gain in the 6-12/12 age – maternal anxiety, a medical consultation, and forced feeding, more food refusal, more maternal anxiety

9)      Low weight but apparently well child – small parents, light for dates at birth, past chronic diseases now in remission like asthma, acute nephritis syndrome

10)  Underfeeding of babies – low milk intake, nipple retraction, sore nipples, preterm babies (full-term baby needs 150 ml milk/kg/day while a preterm requires 188 ml/kg/day), errors in the reconstitution of powdered  milk, parental food fads, despite mothers report baby is hungry – Tx – proper feeding according to schedules

11)  Emotional deprivation – frequently crying, loss of weight,

12)  Child abuse OR non-accidental injury – repeated injuries, constant crying, mother complaining about child’s bad behavior, delayed consultations, history incompatible with clinical syndromes, burns, poisoning, any fracture below 2 yrs old child,

13)  GERD

14)  Rumination syndrome