NEET MDS Synopsis
Child Neglect
PedodonticsChild Neglect and Munchausen Syndrome by Proxy
Overview
Child neglect is a serious form of maltreatment that can have profound
effects on a child's physical, emotional, and psychological well-being.
Understanding the different types of neglect is essential for identifying
at-risk children and providing appropriate interventions. Additionally,
Munchausen syndrome by proxy is a specific form of abuse that involves the
fabrication or induction of illness in a child by a caregiver.
Types of Child Neglect
Safety Neglect:
Definition: A gross lack of direct or indirect
supervision by parents or caretakers regarding the safety of the child.
Examples:
Leaving a young child unsupervised in potentially dangerous
situations (e.g., near water, traffic, or hazardous materials).
Failing to provide adequate supervision during activities that
pose risks, such as playing outside or using equipment.
Emotional Neglect:
Definition: Inadequate affection and emotional
support, which can manifest as a lack of nurturing or emotional
responsiveness from caregivers.
Examples:
Lack of "mothering" or emotional warmth, leading to feelings of
abandonment or unworthiness in the child.
Permitting maladaptive behaviors, such as refusing necessary
remedial care for diagnosed medical and emotional problems, which
can hinder the child's development and well-being.
Physical Neglect:
Definition: Failure to care for a child according
to accepted standards, particularly in meeting basic needs.
Examples:
Not providing adequate food, clothing, shelter, or hygiene.
Failing to ensure that the child receives necessary medical care
or attention for health issues.
Munchausen Syndrome by Proxy
Definition: A form of child abuse in which a caregiver
(usually a parent) fabricates or induces illness in a child to gain
attention, sympathy, or other benefits.
Mechanism:
The caregiver may intentionally cause symptoms or exaggerate
existing medical conditions, leading to unnecessary medical
interventions.
For example, a caregiver might induce chronic diarrhea in a child by
administering laxatives or other harmful substances.
Impact on the Child:
Children subjected to this form of abuse may undergo numerous
medical tests, treatments, and hospitalizations, which can lead to
physical harm and psychological trauma.
The child may develop a mistrust of medical professionals and
experience long-term emotional and developmental issues.
Mandibular Second Deciduous Molar.
Dental Anatomy
Mandibular Second Deciduous Molar.
-This tooth resembles the lower first permanent molar that is d
istal to it in the dental arch.
-There are two roots and five cusps. The three buccal cusps are all about the same size. This is in contrast to the lower first molar where the 'distal' cusp is smaller that the mesiobuccal and distobuccal cusps.
-The distal of the three buccal cusps may be shifted of onto the distal marginal ridge.
NOTE
-Upper molars have three roots, lowers have two roots.
-Upper and lower second deciduous molars resemble first permanent molars in the same quadrant.
-Upper first deciduous molars vaguely resemble upper premolars. -Lower first deciduous molars are odd and unique unto themselves.
-First deciduous molars (upper and lower) have a prominent bulge of enamel on the buccal at the mesial. These help in determining right and left.
Autism in Pedodontics
PedodonticsAutism in Pedodontics
Autism Spectrum Disorder (ASD) is a complex developmental disorder that
affects communication, behavior, and social interaction. In the context of
pediatric dentistry (pedodontics), understanding the characteristics and
challenges associated with autism is crucial for providing effective dental
care. Here’s an overview of autism in pedodontics:
Characteristics of Autism
Developmental Disability:
Autism is classified as a lifelong developmental disability that
typically manifests during the first three years of life. It is
characterized by disturbances in mental and emotional development,
leading to challenges in learning and communication.
Diagnosis:
Diagnosing autism can be difficult due to the variability in
symptoms and behaviors. Early intervention is essential, but many
children may not receive a diagnosis until later in childhood.
Symptoms:
Poor Muscle Tone: Children with autism may exhibit
low muscle tone, which can affect their physical coordination and
ability to perform tasks.
Poor Coordination: Motor skills may be
underdeveloped, leading to difficulties in activities that require fine
or gross motor skills.
Drooling: Some children may have difficulty with
oral motor control, leading to drooling.
Hyperactive Knee Jerk: This may indicate
neurological differences that can affect overall motor function.
Strabismus: This condition, characterized by
misalignment of the eyes, can affect visual perception and coordination.
Feeding Behaviors:
Children with autism may exhibit atypical feeding behaviors, such as
pouching food (holding food in the cheeks without swallowing) and a
strong preference for sweetened foods. These behaviors can lead to
dietary imbalances and increase the risk of dental caries (cavities).
Dental Considerations for Children with Autism
Communication Challenges:
Many children with autism have difficulty with verbal communication,
which can make it challenging for dental professionals to obtain a
medical history, understand the child’s needs, or explain procedures.
Using visual aids, simple language, and non-verbal communication
techniques can be helpful.
Behavioral Management:
Children with autism may exhibit anxiety or fear in unfamiliar
environments, such as a dental office. Strategies such as
desensitization, social stories, and positive reinforcement can help
reduce anxiety and improve cooperation during dental visits.
Oral Health Risks:
Due to dietary preferences for sweetened foods and potential
difficulties with oral hygiene, children with autism are at a higher
risk for dental caries. Dental professionals should emphasize the
importance of oral hygiene and may need to provide additional support
and education to caregivers.
Special Accommodations:
Dental offices may need to make accommodations for children with
autism, such as providing a quiet environment, allowing extra time for
appointments, and using calming techniques to help the child feel more
comfortable.
Prostaglandines
Pharmacology
Prostaglandines:
Every cell in the body is capable of synthesizing one or more types of PGS. The four major group of PGs are E, F, A, and B.
Pharmacological actions:
stimulation of cyclicAMP production and calcium use by various cells
CVS
PGE2 acts as vasodilator; it is more potent hypotensive than Ach and histamine
Uterous
PGE2 and PGF2α Contract human uterus
Bronchial muscle
PGF2α and thromboxan A2 cause bronchial muscle contraction.
PGE2 & PGI2 cause bronchial muscle dilatation
GIT: PGE2 and PGF2α cause colic and watery diarrhoea
Platelets
Thromboxan A2 is potent induce of platelets aggregation
Kidney
PGE2 and PGI2 increase water, Na ion and K ion excretion (act as diuresis) that cause renal vasodilatation and inhibit
tubular reabsorption
USE
PGI2: Epoprostenol (inhibits platelets aggregation)
PGE1: Alprostadil (used to maintain the potency of arterioles in neonates with congenital heart defects).
PGE2: Dinoproste (used as pessaries to induce labor)
Synthetic analogue of PGE1: Misoprostol (inhibit the secretion of HCl).
Muscles Around the Nose
AnatomyMuscles Around the Nose
The Nasalis Muscle
This muscle consists of a transverse (compressor naris) and alar (dilator naris) parts.
It is supplied by the buccal branch of the facial nerve.
VITAMINS
Biochemistry
VITAMINS
Based on solubility Vitamins are classified as either fat-soluble (lipid soluble) or water-soluble. Vitamins A, D, E and K are fat-soluble
Vitamin C and B is water soluble.
B-COMPLEX VITAMINS
Eight of the water-soluble vitamins are known as the vitamin B-complex group: thiamin (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), vitamin B6 (pyridoxine), folate (folic acid), vitamin B12, biotin and pantothenic acid.
Pharyngeal Arch
Anatomy
Pharyngeal Arch
Arch Artery
Cranial Nerve
Skeletal elements
Muscles
1
Terminal Branch of maxillary artery
Maxillary and mandibular division of trigemenial (V)
Derived from arch cartilages (originating from neural crest):
From maxillary cartilages:
Alispenoid, incus
From mandibular:
Mackel’s cartilage, malleus
Upper portion of external ear (auricle) is derived from dorsal aspect of 1st pharyngeal arch.
Derived by direct ossification from arch dermal mesenchyme:
Maxilla, zygomatic, squamous portion of temporal bone, mandible
Muscles of mastication (temporalis, masseter, and pterygoids), mylohyoid, anterior belly of digastric, tensor tympani, tensor veli palatini (originate from cranial somitomere 4)
2
Stapedius artery (embryologic) and cortiotympanic artery (adult)
Facial nerve (VII)
Stapes, styloid process, stylohyoid ligament, lesser horns and upper rim of hyoid (derived from the second arch cartilage; originate from neural crest).
Lower portion of external ear (auricle) is derived from 2nd pharyngeal arch.
Muscles of facial expression (orbicularis oculi, orbicularis oris, auricularis, platysma, fronto-ooccipitalis, buccinator), posterior belly of digastric, stylohyoid, stapedius (originate from cranial somitomere 6)
3
Common carotid artery, most of internal carotid
Glossopharyngeal (IX)
Lower rim and greater horn of hyoid (derived from the third arch cartilage; originate from neural crest cells)
Sytlopharyngeus (originate from cranial somitomere 7)
4
Left: Arch of aorta;
Right: Right subclavian artery;
Original sprouts of pulmonary arteries
Superior laryngeal branch of vagus (X)
Laryngeal cartilages (Derived from the 4th arch cartilage, originate from lateral plate mesoderm)
Constrictors of pharynx, cricothyroid, levator veli palatine (originate from occipital somites 2-4)
6
Ductus arteriosus; roots of definitive pulmonary arteries
Recurrent laryngeal branch of vagus (X)
Laryngeal cartilages (derived from the 6th-arch cartilage; originate from lateral plate mesoderm)
Intrinsic muscles of larynx (originate from occipital somites 1 and 2)
Seborrheic keratosis
General Pathology
Seborrheic keratosis
1. A round, brown-colored, flat wart.
2. Most often seen in middle-aged to older adults.
3. A benign lesion.