Pediatric Mood & Anxiety Disorders - Differential Diagnosis Algorithm Bipolar Mood • Major Depressive Disorder • Persistent Depressive Disorder • Disruptive Mood Dysregulation Disorder* Anxiety • Panic Disorder and Agoraphobia • Specific Phobia • Social Phobia • Generalized Anxiety Disorder • Selective Mutism* • Separation Anxiety Disorder* #Mood #Anxiety #Disorders #Differential #Diagnosis #Algorithm #Causes #Peds #Pediatrics #Psychiatry

Causes of Pediatric Spells - Differential Diagnosis Algorithm Neonates and Infant Spells: • Benign Sleep Myoclonus • Shuddering attacks • Infantile Colic • Sandifer Syndrome Older Infants and Toddler Spells: • Breath-holding spells • Benign Paroxysmal Vertigo • Benign Paroxysmal Torticollis • Night Terrors Childhood and Adolescents Spells: • Daydreaming • Syncope • Migraine-variants • Panic Attack • Transient Ischemic Attack • Narcolepsy • Cataplexy #Spells #Differential #Diagnosis #Algorithm #Causes #Peds #Pediatrics

Causes of Unprovoked Pediatric Seizures - Epilepsy Syndromes - Differential Diagnosis Algorithm Infantile: • Benign Focal Epilepsy of Infancy • West Syndrome • Dravet Syndrome Generalized Epilepsies: • Childhood Absence Epilepsy • Myoclonic Absence Epilepsy • Juvenile Absence Epilepsy • Juvenile Myoclonic Epilepsy • Lennox Gastaut Syndrome Focal Epilepsies: • Rolandic Epilepsy • Panayiotopoulas Syndrome • Landau-Kleffner Syndrome #Epilepsies #Epilepsy #Unprovoked #Seizures #Differential #Diagnosis #Algorithm #Causes #Peds #Pediatrics

Causes of Provoked Pediatric Seizures - Differential Diagnosis Algorithm - "DIMS" Mnemonic Drugs: • Drug overdose • Alcohol Withdrawal • Poisoning Infection: • Febrile Seizures • Sepsis • Meningitis • Encephalitis Metabolic: • Hypoglycemia • Hyperglycemia • Hypocalcemia • Hyponatremia Structural: • Head Injury • Stroke • Tumours • Congenital Abnormality • Tuberous Sclerosis • Sturge-Weber Syndrome #DIMS #Mnemonic #Seizures #Provoked #Differential #Diagnosis #Algorithm #Causes #Peds #Pediatrics

Causes of Pediatric Seizures - Differential Diagnosis Algorithm Infantile: • Benign Focal Epilepsy of Infancy • West Syndrome • Dravet Syndrome Generalized Epilepsies: • Childhood Absence Epilepsy • Myoclonic Absence Epilepsy • Juvenile Absence Epilepsy • Juvenile Myoclonic Epilepsy • Lennox Gastaut Syndrome Focal Epilepsies: • Rolandic Epilepsy • Panayiotopoulas Syndrome • Landau-Kleffner Syndrome Provoked - Drugs: • Drug overdose • Alcohol Withdrawal • Poisoning Provoked - Infection: • Febrile Seizures • Sepsis • Meningitis • Encephalitis Provoked - Metabolic: • Hypoglycemia • Hyperglycemia • Hypocalcemia • Hyponatremia Provoked - Structural: • Head Injury • Stroke • Tumours • Congenital Abnormality • Tuberous Sclerosis • Sturge-Weber Syndrome Neonates and Infant Spells: • Benign Sleep Myoclonus • Shuddering attacks • Infantile Colic • Sandifer Syndrome Older Infants and Toddler Spells: • Breath-holding spells • Benign Paroxysmal Vertigo • Benign Paroxysmal Torticollis • Night Terrors Childhood and Adolescents Spells: • Daydreaming • Syncope • Migraine-variants • Panic Attack • Transient Ischemic Attack • Narcolepsy • Cataplexy #Seizures #Epilepsy #Differential #Diagnosis #Algorithm #Causes #Peds #Pediatrics

Salter Harris Physeal Injury Classification S - Straight through - Type I - Separation through the physis A - Above - Type II - Fracture through a portion of the physis that extends through the metaphyses L - Lower - Type III - Fracture line goes below the physis through the epiphysis, and into the joint T - Through - Type IV - Fracture Line through the metaphysis, physis and epiphysis R - cRush - Type V - Compression fracture of the growth plate #SalterHarris #Physeal #Classification #Fracture #SALTR #Diagnosis #Peds #Pediatrics #Orthopedics #Types

Causes of Common Accidental and Non-Accidental Pediatric Fractures - Differential Diagnosis Algorithm Accidental Trauma - Distal Radius • Torus (junction of metaphysis) • Green stick (bone bent at convex side • Complete (spiral, oblique, transverse) - Clavicle Fracture - Tibia Fibular Fracture - Elbow • Supra condylar • Lateral supracondylar - Toddlers Fracture • < 2 y.o. - Distal Radius • Torus (junction of metaphysis) • Green stick (bone bent at convex side • Complete (spiral, oblique, transverse) Non-Accidental Trauma (indication of child abuse) - Femur # < 1 y.o. - Scapular # Without Traumatize Hx - Transverse Fractures <3 y.o. • Femur, Humerus, Tibia, Ribs, Radius, Skull, Spine, Ulna, Fibula #NonAccidental #Fractures #Locations #Differential #Diagnosis #Algorithm #Causes #Peds #Pediatrics

Causes of Apparent Life Threatening Event (ALTE) - Differential Diagnosis Algorithm Cardiac: • Congenital Heart Disease • Arrhythmia • Cardiomyopathy • Myocarditis Metabolic: • Inborn Errors of Metabolism • Reye's Syndrome • Electrolyte Disturbances Neurologic: • Seizure • Malignancy • Neuromuscular • Disorders • Central Apnea Respiratory: • Anatomical Foreign Body Aspiration • Breath-holding spell (age-dependent) Infectious: • Pneumonia • Sepsis • Upper Respiratory Tract Infection • Empyema • Urinary Tract Infection Gastrointestinal: • Gastroesophageal Reflux • Volvulus • Gastroenteritis • Incarcerated Hernia Witnessed Choking Spell Injury: • Non-Accidental • Unnoticed • Factitious by Proxy Apnea: • Periodic Breathing • Apnea of Infancy #LifeThreatening #Event #ALTE #BRUE #Differential #Diagnosis #Algorithm #Causes #Peds #Pediatrics

Causes of Enuresis - Differential Diagnosis Algorithm Primary Nocturnal Enuresis (Urinary Control Never Achieved) • Delayed Maturation (Familial) • Idiopathic • Sleep Disorders (Obstructive Sleep Apnea) • Anatomic Abnormality Secondary Nocturnal Enuresis (Red Flag) (>6 Month Continence Prior): • Urinary Tract Infection • Idiopathic • Behavioural/Psychogenic (Child Abuse) • Cystitis • Diabetes Mellitus • Other (Diabetes Insipidus, Urethral Obstruction, Cerebral Palsy, Neurogenic Bladder, Seizure Disorder) Diurnal Enuresis: • Pediatric Unstable Bladder • Infrequent Voiding (Urinary Tract Infection) • Cystitis • Behavioural/Psychogenic • Idiopathic • Non-neurogenic (Hinman Syndrome) • Vaginal Voiding (Labial Adhesion) #Nocturnal #Enuresis #Differential #Diagnosis #Algorithm #Causes #Peds #Pediatrics

Causes of Sudden Unexpected Death in Infancy (SUDI) - Differential Diagnosis Algorithm Congenital Anomaly / Disorder: • Cardiac Anomaly • Cardiac Arrhythmia • Neurologic Anomaly • Pulmonary Anomaly • Metabolic Disorders Infection: • Severe Pneumonia • Sepsis • Gastrointestinal infection Injury: • Deliberate (abuse) • Accidental* Other: • Acute Illness Sudden Infant Death Syndrome (SIDS): • Autopsy negative • 80% of SUDI • Risk Factors: - Prone Sleeping position - Tobacco exposure - Sharing a Sleeping Surface - Prematurity #SIDS #SUDI #SuddenDeath #Unexpected #Infancy #Infant #Differential #Diagnosis #Algorithm #Causes #Peds #Pediatrics