Cover
Brief Content
Title Page
Burns’ Pediatric Primary Care
Copyright
Dedication
Contributors
Reviewers
Preface
Acknowledgments
Contents
Unit I Influences on Child Health and Child Health Assessment
1 - Health Status of Children: Global and National Perspectives
Global Health Status of Children
Progress on the Millennium Development Goals
Sustainable Development Goals
Health Status of Children in the United States
Food and Housing Insecurity and Effect on Children’s Health
Addressing Children’s Health in the United States
Healthy People 2020
Social Determinants of Health and Health Equity
Adverse Childhood Events and Impact on Child Health Outcomes
Child Health and Access to Care
Role of Primary Care Providers for Improving Child Health
Health Promotion and Evidence-Based Clinical Preventive Services
2 - Unique Issues in Pediatrics
Two-Generation or Dual Patient
Looking Through a Developmental Lens
Parents, Families, and Behavioral Economics
Early Investment in Lifelong Health
Health Literacy
Transitioning to Adult Care
3 - Genetics and Genomics: The Basics for Child Health
Basic Principles of Genetics
Deoxyribonucleic Acid
Chromosomes
Genes
Mutations
Point Mutations
Nucleotide Repeat Expansions
Copy Number Variations
Chromosome Mutations
Genetics and Diseases
Single Gene Disorders
Chromosome Disorders
Multifactorial Disorders
Teratogens
Mitochondrial Disorders
Patterns of Inheritance
Terminology
Mendelian Inheritance Patterns
Autosomal Dominant
Autosomal Recessive
X-Linked Inheritance
X-Linked Dominant. When a disorder is classified as X-linked dominant, it means that a single abnormal gene on the X chromosome ...
X-Linked Recessive. When a disorder is classified as X-linked recessive, it usually occurs in males (Fig 3.7). This pattern is s...
Nontraditional Inheritance Patterns
Mitochondrial Inheritance
Codominant Inheritance
Genomic Imprinting
Uniparental Disomy
Epigenetics
Integration of Basic Genetics and Genomics into Pediatric Primary Care
Assessment
Family Health History and Pedigree
Three-Generation Pedigree. The pedigree is a valuable visual record of genetic links and health-related information. It should i...
Genetic Red Flags From the History. Genetic red flags indicate the potential for genetic risk. For some providers, it is easiest...
Physical Findings Indicating Inherited or Congenital Disorders
Minor and Major Anomalies
Diagnostic Studies
Screening
Newborn Screening. Newborn screening is used to identify inherited and congenital disorders that can benefit from early diagnosi...
Prenatal Screening. Screening and diagnostic tests to detect inherited and congenital disorders have become standard prenatal ca...
Diagnostic Genetic Testing
Carrier Testing
Other Testing
Ethical Issues
4 - Environment and Child Health
Introduction
Principles for Understanding Children’s Environmental Health
Epidemiologic Model of Environmental Health Hazards: Assessment of Risk
Principles of Toxicology
Exposure
Absorption
Distribution
Metabolism
Tissue Sensitivity
Toxic Effects
Children’s Increased Risk for Environment-Related Illness
Clinical Findings
History
Physical Examination and Clinical Findings
Diagnostic Studies
Approach to Management of Environmental Health Risks
Ambient Air Pollution
Outdoor Air
Indoor Air
Management of Outdoor and Indoor Air Pollution
Endocrine Disruptors
Climate Change
Additional Resources
5 - Child and Family Assessment
Child Assessment
Assessment Basics
Measurement
Health Supervision, Surveillance, and Screening
History and Physical Exam
History
Physical Exam
Family Assessment
Rethinking Family—Changing Composition
Family Assessment—The Basics
Assessing Family Composition/Structure
Assessing the Family Lifecycle
Assessing Family “Functioning”
Assessing for Protective Factors
Shared Decision-Making
Additional Resources
Bright Futures
Strengthening Families
6 - Cultural Considerations for Pediatric Primary Care
Culture
Cultural Congruence Model
The Provider Level of the Model
The Client Level of the Model
The System Level of the Model
Best Practices for Providing Culturally Congruent Care
Assessment Framework
Relationship-Based Communication
Immigrant Children, Refugees, and International Adoptees
Overseas Health Assessment
Domestic Health Assessment
Mental Health Assessment
Internationally Adopted Children
Cultural Beliefs and Healing Practices
Barriers to Health Care Access
Language Barriers
Primary Care Management
Additional Resources
7 - Children With Special Health Care Needs
Identifying the Population
Levels of Complex Care
Primary Care
Subspecialty Care
Tertiary Care
Home-Care/Community Services
Components of Care
Technology Dependence and Medication
Costs and Family Burden of Caring for Children With Special Health Care Needs
Government Resources for Children With Special Health Care Needs
Medicaid and Supplemental Security Income
Durable Medical Equipment and Medicaid Reimbursement
Community and School-Based Services
Early Intervention and the Public School System
Individual Education Plan and 504 Plan
Care Coordination
Health Issues for Primary Care Providers
Strategies and Models to Improve Care for Children With Special Health Care Needs
The Patient-Centered Healthcare Home
Shared Plan of Care
Supportive Care Needs for Children With Special Health Care Need
Respite Care
Support Groups and Services
Transition of Care
Legal Issues
Additional Resources
Patient-Centered Medical Home
Letters of Medical Necessity
Resources for Families
Support Groups
UNIT II Child Development
8 - Principles of Developmental Management of Children
Developmental Principles
Theories of Child Development
Cognitive-Structural Theories: Language and Thought
Sensorimotor Stage (Birth to 2 Years)
Preoperational Stage (2 to 7 Years)
Concrete Operational Stage (7 to 12 Years)
Formal Operational Stage (13 Years Through Adulthood)
Psychoanalytic Theories: Personality and Emotions
The Role of Social Interaction in Cognitive Development
Behavioral Theories: Human Actions and Interactions
Humanistic Theories
Ecologic Theories
Behavioral Economics
Theories of Family and Parent Development
Family Theories
Parent Development Theory
Cultural Influences on Development
Management Strategies in Child Development
Promoting Parent Development and Parent-Child Interaction: Anticipatory Guidance
Family-Centered Care
Concerns about Delayed Development and Developmental Red Flags
Talking With Parents About Developmental Delays
Additional Resources
9 - Developmental Management of Newborns
Standards of Care
Anatomy and Physiology
Pathophysiology
Assessment of the Neonate
History
Physical Examination
After Stabilization
Screening
Management Strategies
Initial Care
Establishing Feeding
Anticipatory Guidance Before Discharge
Early Discharge and Follow-up
Common Neonatal Conditions
Skin Conditions
Milia
Sebaceous Hyperplasia
Erythema Toxicum
Transient Neonatal Pustular Melanosis
Sucking Blisters
Cutis Marmorata
Harlequin Color Change
Nevus Sebaceous
Skin Dimpling
Preauricular Sinus Tracts and Pits
Supernumerary Nipples
Head, Face, and Eye Conditions
Caput Succedaneum
Clinical Findings
Differential Diagnosis
Management
Cephalohematoma
Craniotabes
Sudden Unexpected Infant Death
Clinical Findings
History
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management and Prevention
10 - Developmental Management of Infants
Infant Mortality
Growth
Weight
Height
Head Circumference
Chest Circumference
Vital Signs Maturation
Body Systems Maturation
Infant Development
One Through Three Months Old
Physical Development
Gross and Fine Motor Skill Development
Communication and Language Development
Social and Emotional Development
Cognitive Development
Four Through Five Months Old
Physical Development
Gross and Fine Motor Skills Development
Communication and Language Development
Social and Emotional Development
Cognitive Development
Six Through Eight Months Old
Physical Development
Gross and Fine Motor Skills Development
Communication and Language Development
Social and Emotional Development
Cognitive Development
Nine Through Twelve Months Old
Physical Development
Gross and Fine Motor Skills Development
Communication and Language Development
Social and Emotional Development
Cognitive Development
Developmental Assessment of Infants
Developmental Screening in Infants
Periodic Wellness Visits
The Prenatal Visit
One Through Three Months Old
Regulation and Sleep-Awake Patterns
Strength and Motor Coordination
Nutrition
Communication and Language
Social and Emotional Growth
Cognitive and Environmental Stimulation
Four Through Five Months Old
Regulation and Sleep-Awake Patterns
Strength and Motor Coordination
Nutrition
Communication and Language
Social and Emotional Growth
Cognitive and Emotional Stimulation
Six Through Eight Months Old
Regulation and Sleep-Wake Patterns
Strength and Motor Coordination
Nutrition
Communication and Language
Social and Emotional Growth
Cognitive and Environmental Stimulation
Nine Through Twelve Months Old
Regulation and Sleep-Wake Patterns
Strength and Motor Coordination
Nutrition
Communication and Language
Social and Emotional Growth
Cognitive and Environmental Stimulation
Common Developmental Issues for Infants and Families
Sleep
Nutrition
Crying
Postpartum Psychiatric Disorders
Red Flags for Infant Development
11 - Developmental Management of Early Childhood
Development of Early Childhood
Physical Development
Motor Skills Development
Communication and Language Development
Articulation
Lexicon
Syntax
Semantics
Bilingualism
Social and Emotional Development
Peer Relationships
Morality
Body Image
Cognitive Development
Developmental Assessment of Early Childhood
Screening Strategies During Early Childhood
Physical Development
Motor Skills Development
Communication and Language Development
Social and Emotional Development
Cognitive and Intellectual Development
Anticipatory Guidance for Early Childhood
Regulation and Sleep-Wake Patterns
Strength and Motor Coordination
Nutrition, Self-Care, and Safety
Communication and Language
Social and Emotional Growth
Cognitive and Environmental Stimulation
Common Developmental Issues in Early Childhood
Sibling Rivalry
Assessment
Management
Temper Tantrums
Toilet Training
Child Care and Preschools
Child Care
Preschool
Safety
Developmental Red Flags in Early Childhood
Physical Disorders
Cognitive Disorders
Language Disorders
12 - Developmental Management of Middle Childhood
Developmental Approach to Health Assessment and Health Promotion for Middle Childhood
Physical Development
History
Physical Examination
Anticipatory Guidance
Gross and Fine Motor Development
History
Physical Examination
Anticipatory Guidance
Communication and Language Development
History
Physical Examination
Anticipatory Guidance
Cognitive Development
History
Physical Examination
Anticipatory Guidance
Social Development
History
Physical Examination
Anticipatory Guidance
Emotional Development
History
Physical Examination
Anticipatory Guidance
Developmental Assessment of Middle Childhood
Nutrition
Oral Health
Sleep
Safety
Common Developmental Issues for Middle Childhood
School Adjustment
Learning Challenges
School Refusal
Management
Overview of the Preventive Health Visit in Middle Childhood
History
Physical Examination
Diagnostic Screening
Anticipatory Guidance
Developmental Red Flags for Middle Childhood
13 - Developmental Management of Adolescents and Young Adults
Adolescent and Young Adult Development
Physical Development
Sexual Maturity Rating
Psychosocial, Emotional, and Cognitive Development
Influences on Psychosocial, Emotional, and Cognitive Development
Principles of Behavior Changes
Emotional Changes of Adolescence
Developmental Screening and Assessment
Principles and Approaches to Assessment
Assessment
Physical Development
Cognitive Development
Social and Emotional Development
Parent Assessment
Anticipatory Guidance During Adolescence
Phases of Adolescence
Early Adolescence (11 to 14 Years Old)
Physical Development
Cognitive Development
Social and Emotional Development
Health Supervision
Anticipatory Guidance
Middle Adolescence (15 to 17 Years Old)
Physical Development
Cognitive Development
Social and Emotional Development
Health Supervision
Anticipatory Guidance
Late Adolescence (18 to 21 Years Old)
Physical Development
Cognitive Development
Social and Emotional Development
Health Supervision
Anticipatory Guidance
Common Developmental Issues for Adolescents
Risk Behavior: General
Description
Assessment
Management
Risk Behavior: Tobacco Use
Description
Assessment
Management
Risk Behavior: Self-Injurious Behaviors
Description
Assessment
Management
Risk Behavior: Technology and Social Media Use
Description
Assessment
Management
UNIT III Child Health Supervision: Health Promotion and Health Protection
14 - Introduction to Health Promotion and Health Protection
Pediatric Nurse Practitioners—Then and Now
Pediatric Primary Care
The Pediatric Medical Home/Neighborhood
Bright Futures—Health Promotion and Preventive Care Initiative
Primary Care Versus Primary Prevention
SECTION A Behavioral-Mental Health Wellness
15 - Behavioral and Mental Health Promotion
Mental Health Foundations
Emotional Well-Being: The Foundation for Health, Behavior, and Learning
Theories of Well-Being
The Science of Early Childhood Development
Concept 1: Responsive Relationships and Positive Experiences Build Strong Brain Architecture
Concept 2: Adversity Disrupts the Foundations of Learning, Behavior, and Health
Concept 3: Protective Factors in Early Years Strengthen Resilience
Protective, Promotive, and Risk Factors
Relationships and Attachment
Safe, Stable, Nurturing Relationships
Patterns of Attachment
Temperament
Family Assets
Connectedness and Developmental Relationships
Social-Emotional and Spiritual Development
Resilience and Self-Regulation
Spiritual and Moral Development
Family and Community Influences on Mental Health of Children
Parent Well-Being and Parenting Style
Family Functioning and Dynamics
Assessment of Mental Health
Principles of Conducting a Psychosocial Assessment
Approaches to Behavioral Assessment of Children of Different Ages
Infants and Early Childhood
School-Age Children and Adolescents
History
Relationship as a Vital Sign, and PRN
The Symptom Analysis: Behavioral Manifestations
Family Stress History
Social-Emotional Development and Behavioral Screening
Physical Examination and Diagnostic Studies
Mental Health Management Strategies
Mental Health Promotion
Strategies to Build Relationships
Strategies to Promote Family Functioning and Parenting
Social and Emotional Strategies
Prevent and Mitigate Effects of Stress
Violence Prevention
Counseling and Brief Evidence-Based Interventions
Mindfulness
Parent-Focused Interventions
Collaborative Problem-Solving: The Nurtured Heart
Motivational Interviewing
Common Factors Intervention (HELP)
Cognitive Behavioral Therapy Strategies
Parent Training Models/Behavioral Therapies
Referral and Follow-Up
Behavioral Issues
Difficulties in Relationship: Attachment and Parenting Style
Management
Social Difficulties: The Shy Child, the Fearful Child, the Child with Lack of Moral Integrity
Management
Emotional Difficulties: The Upset, Angry Child With Underdeveloped Coping Skills
Management
Bereavement—Loss and Grief
Management
Difficulties with Sensory Processing
Management
Recurrent Physical Symptoms
Management
Bullying
Management
Parenting Challenges and Special Circumstances
Separation, Divorce, and Remarriage
Management
Deployment
Management
Adolescent Parent(s)
Management
Premature or Multiple Birth
Management
Adoption
Management
Foster Care
Management
SECTION B Biophysical Health Management
16 - Breastfeeding
Breastfeeding Recommendations
Hospital-Based Support
Baby-Friendly Hospital Initiative
Benefits of Breastfeeding
Contraindications to Breastfeeding
Special Situations
Induced Lactation and Relactation
Lactation Consultants
Stages of Milk Production
Colostrum
Transitional Milk
Mature Milk
Characteristics of Human Milk
Water
Lipid (Fat) Content
Protein
Carbohydrates
Vitamins and Minerals
Anatomy and Physiology
Assessment of the Breastfeeding Dyad
Maternal History
Infant History
Maternal Examination
Infant Examination
Positions for Breastfeeding
Principles of Correct Positioning
Cradle Position and Cross Cradle Position
Football Hold
Side-Lying Position
Physiologic Laid-back Position
Ending a Feeding Session
Dynamics of Breastfeeding
Early Feedings
Frequency and Duration of Feedings
Hand Expression and Pumping
Collection and Storage of Breast Milk
Growth Spurts
Breastfeeding Toddlers
Weaning
Clinical Indications of Successful Breastfeeding
Infant Weight Gain
Urine Output Guidelines
Stool Output Guidelines
Maternal Nutritional Needs During Breastfeeding
Medications for Breastfeeding Mothers
Returning to Work
Common Breastfeeding Problems
Flat or Inverted Nipples
Differential Diagnosis
Management
Complications
Sore Nipples
Clinical Findings
Differential Diagnosis
Management
Severe Engorgement
Clinical Findings
Differential Diagnosis
Management
Mastitis
Clinical Findings
Differential Diagnosis
Management
Complications
Nipple Preference
Clinical Findings
Differential Diagnosis
Management
Complications
Breast Milk Jaundice
Clinical Findings
Differential Diagnosis
Management
Oral Candidiasis (Thrush)
Poor Weight Gain
Clinical Findings
Infant Factors
Technique Factors
Maternal Factors
Differential Diagnosis
Management
Complications
17 - Nutrition
Pediatric Dietary Guidelines
Nutritional Requirements and Dietary Reference Intakes
Energy
Water
Electrolytes
Sodium
Potassium
Chloride
Macronutrients
Protein
Carbohydrates
Fats
Micronutrients
Fat-Soluble Vitamins. Several characteristics of fat-soluble vitamins (A, D, E, and K) have implications for dietary assessment ...
Water-Soluble Vitamins. In contrast to fat-soluble vitamins, water-soluble vitamins (C and B vitamins) are stored in very small ...
Minerals and Elements
Use of Vitamin and Mineral Supplements
Assessment of Nutritional Status
History
Physical Examination
Diagnostic Studies
Management Strategies for Optimal Nutrition
Developing Healthy Eating Habits
Nutrition Education
MyPlate, MyPlate for Kids, and SuperTracker
Age-Specific Nutritional Considerations
Newborns and Infants
Energy. Rapid infant growth requires high caloric intake. Adequate intake of breast milk or infant formula meets all energy need...
Fat. For proper myelination to occur, infants must have adequate fat intake. Children younger than 2 years old require more than...
Vitamins. Vitamin D (400 IU daily) is recommended for all breastfed infants and infants who receive an unfortified formula from ...
Iron. Iron deficiency is the leading cause of anemia in children, and iron supplements are necessary in some cases. Term infants...
Fluoride. The American Dental Association (ADA) recommends fluoride treatment starting at 6 months old in nonfluoridated communi...
Infant Formulas. Breast milk is the ideal food for newborns and infants and should be promoted unless it is medically harmful to...
Gastroesophageal Reflux. All babies “spit up,” especially directly after a feeding or when burped. A small regurgitation of undi...
Introduction of Solid Foods. Introduction of solid foods is recommended when the child is 6 months old. Development in a term in...
Eating Habits. Feeding on demand in early infancy is important, and neonates should not be allowed to sleep for long periods of ...
Early Childhood
Energy and Protein. The growth rate in early childhood is slower than that of infants, resulting in decreased energy needs per u...
Vitamin and Mineral Supplements. Vitamin D supplementation is recommended in early childhood for all children. Children who tole...
Eating Habits. In early childhood, children learn how and what to eat by observing adults around them and by responding to the f...
Middle Childhood
Energy and Protein. Energy and protein needs of school-age children vary depending on body size, growth patterns, and activity l...
Vitamin and Mineral Supplements. Poor eating habits and irregular meal schedules place school-age children at risk for deficienc...
Eating Habits. Food likes and dislikes carry over from early childhood. There is great variation in appetite and intake as a res...
Adolescents
Energy and Protein. The rapid growth rate of adolescents is remarkable. High levels of energy are needed to support this growth,...
Vitamin and Mineral Supplements. Thiamin, riboflavin, niacin, folate, iron, zinc, and calcium needs increase during adolescence....
Eating Habits. Eating habits of adolescents are influenced by their increasing independence and social activity, perceptions of ...
Pregnancy in Adolescence. Nutrition for the pregnant teenager can be easily compromised and must be carefully monitored. Provide...
Physical Activity
Vegetarian and Vegan Diets
Clinical Findings
Management
Altered Patterns of Nutrition in Children
Disorders Requiring Increased Caloric Intake
Disorders Requiring Decreased Caloric Intake
Disorders Requiring Restricted or Supplemental Diets
Disorders Requiring Physical Alterations in Diet Management
Eating Disorders
Childhood Obesity and Overweight
Risk Factors and Predictors for Obesity
Biologic Mechanisms. Insulin and leptin are two major hormones that normally serve to control satiety and influence weight. Resi...
Physical Activity and Screen Time. Decreased physical activity is a factor in the increased prevalence of childhood overweight a...
Psychosocial and Environmental Factors. Numerous psychosocial and environmental factors put children at risk for being overweigh...
Food Addiction. Addictive-like eating behaviors may play a role in obesity and overweight, although more research needs to be do...
Clinical Findings
History. The history should review patterns of eating and exercise for both the child and the family system. Also consider under...
Physical Examination. Perform a complete physical examination to determine child’s level of fitness and anthropometric status
Diagnostic Studies
Differential Diagnosis
Management
Lifestyle Changes. Initially, lifestyle changes with active involvement of the entire family and regular monitoring by the PCP (...
Medications. Medications should be used only after an intensive, formal trial of lifestyle change has proven ineffective and the...
Bariatric Surgery. The Pediatric Endocrine Society recommends bariatric surgery only for adolescents who meet the following crit...
Community Changes. Individual and family interventions may not be sufficient to deal with the causes of obesity. For example, if...
Complications
Adverse Food Reactions
Clinical Findings
History. The history should assess the following
Physical Examination. Signs and symptoms of adverse food reactions vary by type and severity, from a mild local reaction to life...
Diagnostic Studies. A double-blind, placebo-controlled food challenge is recognized as the “gold standard” for determining the p...
Differential Diagnosis
Management
Elimination Diet. The standard of practice is to avoid the offending food or foods. Efforts to eliminate the food from the diet ...
Oral Immunotherapy. Oral immunotherapy (OIT) has shown promise as an effective treatment for food allergy and may raise the thre...
Revisiting the Food Challenge. The child’s allergic status should be reevaluated at regular intervals. Food allergies and food i...
Medication. Self-administered epinephrine is prescribed for children with moderate or severe allergies. Children, their parents,...
Education. Education of families, children, and adults who are responsible for the child’s well-being is critical. The provider ...
Complications
Toxic Exposures in Foods
Effect of Medications on Nutritional Status
Controversies in Pediatric Nutrition
Sugar Consumption
Gluten-Free Diets
18 - Elimination
Normal Patterns of Elimination: Bowel and Urinary
Assessment of Patterns
Health History
Description of Current Status
Birth and Early Infancy History
Review of Systems
Family History
Environmental and Psychosocial Issues
Physical Examination
Diagnostic Studies
Management Strategies for Normal Patterns
Toileting Skills
Elimination Communication
Altered Patterns of Elimination: Bladder and Bowel Dysfunction
19 - Physical Activity and Sports for Children and Adolescents
Physical Activity: Overview
Promoting Physical Activity: Guidelines and Standards
Health Benefits of Physical Activity
Physical Activity and Children With Special Health Care Needs
Special Consideration: Atlantoaxial or Atlanto-Occipital Instability
Strategies to Support Physical Activity for Children and Adolescents
Health Care Providers’ Influence on Lifestyle Behaviors
Counseling Families About Organized Sports for Their Children
Early Specialization in Sports
Strength Training
Preseason Conditioning and Injury Prevention
Intentional Weight Loss
Considerations of Climate and Environment
Heat and Humidity
Dehydration
Sports Training Acclimatization for Prevention of Heat-Related Illnesses
Recreational Activities: Safety Issues
Use of Helmets for Cycling and Winter Sports
Performance Enhancing Nutrition and Supplements
Macronutrients: Important for Sports Participation
Protein
Fats
Nutritional Supplements
Sports Drinks Versus Energy Drinks
Energy Drinks
Use of Ergogenic Drugs and Supplements
Anabolic-Androgenic Steroids
Androstenedione and Dehydroepiandrosterone
Growth Hormone
Creatine and Other Supplements
Ephedra
The Preparticipation Sports Physical Examination for Sports
Medical Clearance and Liability Issues
Components of the Preparticipation Physical Examination
Health History
Physical Examination
Diagnostic Studies
Evaluation and Management of Sports Participation for Athletes With Chronic Health Conditions
Asthma
Cardiac Conditions
Cardiac Murmurs
Diabetes Mellitus
Hypertension
Seizures
Sickle Cell Trait
Acute Infectious Conditions
Infectious Mononucleosis
Skin Infections
Human Immunodeficiency Virus and Other Blood-Borne Viral Pathogens
Exercise-Induced Dyspnea
High-Risk Conditions for Sports Participation
Sudden Cardiac Death in Young Athletes
Hernia
Absence of Paired Organs
Musculoskeletal and Overuse or Traumatic Injuries
Overuse Injuries in Baseball/Softball. Young baseball/softball throwers and pitchers are at particular risk of overuse injury or...
Neck Injury
Burners and Stingers
Head Injury/Concussions
Special Considerations for the Female Athlete
Injuries and the Female Athlete
The Female Athlete Triad
20 - Sleep
Sleep-Wake Cycle and Health
Electronic Devices and Sleep Problems
American Academy of Pediatrics Recommendations to Promote Adequate Sleep in Children
Electronic Device Recommendations
Infant Recommendations
Adolescent Recommendations
Normal Sleep Stages and Cycles
Circadian Rhythm and Establishment of Normal Sleep Patterns
Sleep Cycle
Nonrapid Eye Movement Sleep
Stage 1 (NREM1 or N1)
Stage 2 (NREM1 or N2)
Stage 3 (NREM3 or N3)
Rapid Eye Movement Sleep
Sleep Patterns by Age Group
Newborns
Sudden Unexpected Infant Death
Protective Factors for Infant Sleep
Health Professional Strategies to Reduce Sudden Infant Death Syndrome
Early Childhood
3 to 5 Years of Age
Middle Childhood 5 to 12 Years of Age
Adolescents
Assessment of Sleep
History
Chief Complaint
Past Medical History and Review of Symptoms
Family Assessment
Physical Examination
Diagnostic Studies
Sleep in Children With Developmental and Neurologic Conditions
Anxiety
ADHD
Autism
Strategies for Prevention and Management of Sleep Problems
Sleep Hygiene Promotion and Medications
Primary Care Interventions for Dyssomnias
Common Sleep Problems
Parasomnias
Nonrapid Eye Movement Parasomnias
Confusional Arousals
Sleep Walking
Night Terrors
Rapid Eye Movement Parasomnias
Assessment of Parasomnias
History
Treatment of Parasomnias
Circadian Rhythm Disorders
Delayed Sleep Phase
Advanced Sleep Phase
Inappropriate or Unpredictable Schedules
Chronic Health Conditions and Dyssomnias
Nocturnal Enuresis
Restless Legs Syndrome and Periodic Limb Movements
Clinical Findings and Treatment
Head Banging and Bruxism
Epilepsy and Sleep
Sleep Disordered Breathing
Clinical Findings
Surgical and Medical Treatment of Sleep Disordered Breathing
Central Sleep Apnea
Narcolepsy
21 - Sexuality, Sex, and Gender Identity
Standards
Patterns of Sexuality
Historical and Cultural Context of Sexuality
Contemporary Definitions
Developmental Stages/Patterns of Sexuality
Infancy to 2 Years Old
2 to 5 Years Old
5 to 9 Years Old
Preadolescence
Adolescence
Sexuality in Individuals With Intellectual and Physical Developmental Disabilities
Factors That Can Alter Sexual Behaviors
Assessment of Patterns of Sexual Development
Confidentiality
History
Types of Sexual Histories
Approach to Taking a Sexual History
Physical Examination
Management Strategies
Setting the Stage
Sexuality Education
Counseling of the Adolescent
Contraceptive and Safer Sex Counseling
Special Counseling Needs
Lesbian, Gay, Bisexual, and Transgender Youth
Management and Complications
SECTION C Health Protection–Focused Care
22 - Immunizations
Vaccine Preventable Diseases
Barriers to Vaccination
Family and Community Barriers
Healthcare Providers
System Barriers
Strategies to Improve Immunization Rates
Community Strategies
Individual Provider Strategies
System Strategies
Eliminating Vaccine Shortages
Understanding Vaccines
Live and Inactivated Vaccines
Safety of Childhood Vaccines
Adverse Reactions to Vaccines
Vaccine Safety and Resources for Providers
Immunization Schedules in the United States
Inactivated Vaccines
Inactivated Vaccines in Current Use
Diphtheria-Tetanus-Acellular Pertussis Vaccine
Polio Vaccine
Haemophilus Influenzae Type B Vaccine
Hepatitis A Virus Vaccine
Hepatitis B Virus Vaccine
Human Papillomavirus Vaccine
Influenza Vaccine
Meningococcal Vaccine
Pneumococcal Vaccines
Live Virus Vaccines
Precautions Regarding Administration of Live Vaccines
Measles-Mumps-Rubella and Measles-Mumps-Rubella-Varicella Vaccines
Measles Vaccine
Measles Exposure or Epidemics
Mumps Vaccine
Rubella Vaccine
Varicella Vaccine
When to Consider Postexposure Prophylaxis for Varicella Disease
Measles, Mumps, Rubella, and Varicella Vaccine
Rotavirus Vaccine
Bacille Calmette-Guérin Vaccine
Smallpox Vaccine
Passive Immunity
The Immunoglobulins
Respiratory Syncytial Virus Prophylaxis
23 - Dental Health and Oral Disorders
Dental Care Standards and Guidelines
Normal Growth and Development
Teeth
Pattern of Tooth Eruption
Teething
Performing the Oral Examination
Clinical Findings
Oral Mucosa
Saliva
Teeth
Aberrations in Primary Tooth Eruption and Gums
Natal and Neonatal Teeth
Atypical Tooth Eruption
Preeruption Cysts
Bohn Nodules
Professional Dental Care
Fear of the Dentist
Choosing a Dentist
First Dental Visit
Dental Health Education
Bacterial Diseases of the Mouth
Tooth Decay
Clinical Findings
Management and Prevention Strategies
Periodontal Diseases
Gingivitis
Aggressive Periodontitis
Necrotizing Periodontal Disease
Pyogenic Granuloma
Viral Diseases of the Mouth
Herpes Stomatitis
Idiopathic Oral Conditions
Ankyloglossia (Tongue-Tie)
Aphthous Ulcers (Canker sores)
Benign Migratory Glossitis (Geographic Tongue; Erythema Migrans)
Bruxism/Grinding
Dental Erosion
Diastema
Gingival Hyperplasia
Halitosis (“Bad Breath”)
Malocclusion
Mucocele
Pericoronitis
Ranula
Temporomandibular Joint Disorder (TMJ)
Traumatic Injuries to Oral Structures
Clinical Findings
History
Complications
Patient/Family Education
Lifestyle Choices That Affect Dental Health
Oral/Intraoral Piercings and Tattoos
Smokeless Tobacco and Betel Nut Use
Tooth Whitening (Bleaching)
Eating Disorders
Dental Care for Children With Special Health Care Needs
24 - Injury Prevention and Child Maltreatment
Unintentional Injuries
Principles of Injury Control
Common Injury Mechanisms and Injury Control Methods
Motor Vehicle–Related Injuries
Falls
Drowning
Fires/Burns
Poisoning
Intentional Injuries
General Assessment Guidelines
General Management Strategies
Neglect
Clinical Findings
Differential Diagnosis
Management
Psychological Maltreatment
Clinical Findings
Differential Diagnosis
Management
Patient and Family Education and Prevention
Physical Abuse
Clinical Findings
Diagnostic Studies
Differential Diagnosis
Management
Patient and Family Education and Prevention
Sexual Abuse, Assault, and Human Trafficking
Clinical Findings
Diagnostic Studies
Differential Diagnosis
Management
Patient and Family Education and Prevention
Violence
Clinical Findings
Management
Youth Violence Prevention
Intimate Partner Violence (Domestic Violence)
Clinical Findings
Management
Patient Education and Prevention
UNIT IV Common Childhood Conditions and Disorders
SECTION A Introduction to Child Disease Management
25 - Key Concepts, Assessment, and Management of Children With Acute or Chronic Disease
Key Concepts in Disease Management of Children
Shared Decision-Making as Part of Child- and Family-Centered Care
Health Literacy
Health Care Education
Considerations for Care of Children With Illnesses
Parents as Observers of Illness
Parent Management of Illness
Working with Non–English-Speaking Families
Medication, Complementary Therapies, Pain, and Fever
Urgent Care and Emergency Department Utilization
Primary Care for Chronically Ill Children
Assessment and Management of Children with Acute or Chronic Illnesses
History and Physical Examination
Considerations about Diagnostic Studies
Determining an Accurate Diagnosis
Referral and Consultations
National and Local Organizations and Resources
Documentation of Patient Visit
Telehealth Management of Illnesses
Telephone Triage Systems
Texting and Email
Social Media
Office Telephone and Electronic Messaging Policy
26 - Prescribing Medications in Pediatrics
National Safety Goals Regarding Prescribing Medications
Regulation and Safety of Pharmaceuticals
Safety Issues With Pharmaceutical Manufacturers
Issues With Pharmaceutical Testing
Guidelines for Writing a Prescription
General Prescribing Guidelines
Prescribing Medications for Children
Pharmaceuticals Used In Pediatrics: Off-Label Prescribing
Perils of Prescribing Off-Label
Other Factors to Consider in Medication Management
Medication Adherence
Overprescribing Antibiotics: A Continuing Problem
Advances in Pharmacologic Research: Maximizing Therapeutic Efficacy
Disposal of Pharmaceuticals
27 - Complementary Medicine in Pediatric Primary Care With an Introduction to Functional Medicine
Standards and Guidelines
Use of Complementary Therapies by Children and Adolescents
Scientific Studies of Complementary Medicine Therapies
Integrating Complementary/Integrative and Functional Medicine into Pediatric Primary Care
Common Principles of an Integrative Care Practice Model
Common Principles of a Functional Medicine Care Practice Model
Patient-Provider Communication Regarding the Use of Complementary Medicine
Pharmacovigilance of Dietary Supplements and Botanicals
Use of Aromatherapy
Professional Oversight
Common Complementary Therapies for Some Health Conditions
Irritable Bowel Syndrome With Constipation and Diarrhea
Attention-Deficit/Hyperactivity Disorder
Headaches/Migraines
Insomnia
Depression/Anxiety/Obsessive Compulsive Disorder
Common Cold/Upper Respiratory Infection and Influenza
Otitis Media
The Allergic Triad (Allergies/Atopic Dermatitis/Asthma)
28 - Pediatric Pain and Fever Management
Pediatric Pain Management
Pediatric Pain Management
Overview of Pain
Factors Influencing Pediatric Pain Management
Physiological
Psychosocial
Barriers to Effective Pain Management
Patient and Family
Healthcare Providers
Healthcare Systems
Pain Assessment
Pain History
Physical Exam Focus Points
Behavioral Indicators
Physiologic Indicators
Laboratory and Imaging Studies
Management of Pediatric Pain
Pharmacologic Considerations
Procedural Pain Management
Prior to Procedure
During the Procedure
After the Procedure
Acute Pain Management
Persistent Pain Management
Partnership in Care
Overview of Pediatric Fever
Factors Influencing Pediatric Fever Management
Fever Assessment
History and Physical Exam
Management of Pediatric Fever
Fever as a Friend
Non-Pharmacologic Measures
Pharmacologic Measures
Fever Without Focus in Infants and Young Children
Clinical Findings
Management
Fever of Unknown Origin
Clinical Findings
History
Physical Examination
Diagnostic Studies
Management
SECTION B Disease Management
29 - Perinatal Conditions
Pathophysiology
High-Risk Pregnancy
Acquired Health Problems
Perinatal Complications and Injuries
Immediately After Birth
Premature/Special Needs Newborns
Common Neonatal Conditions
Skin & HEENT
Amniotic Band/Constriction Syndrome
Branchial Cleft and Thyroglossal Cysts and Sinuses
Cleft Lip and Palate
Clinical Findings
Management and Complications
HEENT
Congenital Cataracts, Glaucoma, and Retinopathy of Prematurity (Chapter 35)
Cardiac Conditions (Chapter 38)
Transient Tachypnea of the Newborn
Respiratory Conditions
Neonatal Respiratory Distress Syndrome
History and Clinical Findings
Physical Examination
Diagnostic Studies
Management, Prognosis, and Prevention
History and Clinical Findings
Diagnostic Studies
Management and Prognosis
Meconium Aspiration Syndrome
Clinical Findings
Diagnostic Studies
Management, Prognosis, and Prevention
Gastrointestinal and Abdominal Conditions
Esophageal Atresia and Tracheoesophageal Fistula
Duodenal Atresia
Malrotation With Volvulus
Pyloric Stenosis
Hirschsprung Disease (Congenital Aganglionic Megacolon)
Imperforate Anus
Omphalocele and Gastroschisis
Necrotizing Enterocolitis
Meconium Ileus
Diaphragmatic Hernia
Management and Prognosis
Umbilical Hernia
Genitourinary and Renal Conditions
Hydrocele and Inguinal Hernia
Acute Renal Failure
Hydronephrosis
Cystic Kidney Disease
Renal Artery or Vein Thrombosis
Neuroblastoma
Renal Agenesis
Endocrine Conditions
Congenital Hypothyroidism and Congenital Adrenal Hyperplasia
Metabolic Conditions
Hypoglycemia
Infant of a Diabetic Mother
Hematologic Conditions
Polycythemia
Hemorrhagic Disease in the Newborn
Anemia
Blood in Vomitus or Stool
Orthopedic Conditions
Fractured Clavicle and Brachial Palsy
Polydactyly and Syndactyly
Central Nervous System Conditions
Congenital Hydrocephalus
Intraventricular Hemorrhage
Hypoxic-Ischemic Insults
Myelomeningocele
Infections of the Newborn
Toxoplasmosis
Congenital Rubella
Cytomegalovirus
Group B Streptococcus
Listeriosis
Congenital Varicella
Sexually Transmitted Infections
Gonorrhea
Chlamydia
Syphilis
Herpes Simplex Virus
Human Immunodeficiency Virus
Drug Exposure
Neonatal Abstinence Syndrome
Cocaine (Crack) Exposure
Heroin and Methadone Exposure
Fetal Alcohol Syndrome
30 - Neurodevelopmental, Behavioral, and Mental Health Disorders
Assessment and Management of Behavioral Health Disorders
Making Mental Health and Behavioral Diagnoses
Management Strategies
Common Behavioral Health Disorders
Anxieties
Anxiety
Separation Anxiety Disorder
Generalized Anxiety Disorder
Obsessive-Compulsive Disorder
Clinical Findings
Differential Diagnosis
Management
Tic Disorders
Clinical Findings and Diagnostic Studies
Management
Posttraumatic Stress Disorder
Clinical Findings
Differential Diagnosis
Management
Mood Disorders
Depression
Bipolar Disorder
Attention-Deficit/Hyperactivity Disorder
Definition and Diagnostic Criteria
Clinical Findings and Assessment
Management
Follow-up and Referral
Specific Learning Disorders
Definition and Diagnostic Criteria
Clinical Findings and Assessment
Screening and Specialty Referral for Diagnosis
Management
Follow-up and Referral
Intellectual disability and Global Developmental Delay
Definition and Diagnostic Criteria
Clinical Findings and Assessment
Screening and Specialty Referral for Diagnosis
Management
Follow-up and Referral
Aggression and Disruptive Behavior Disorders
Social Aggression
Conduct Disorder
Oppositional Defiant Disorder
Autism Spectrum Disorder
Definition and Diagnostic Criteria
Clinical Findings and Assessment
Screening and Specialty Referral for Diagnosis
Management
Follow-up and Referral
Eating Disorders
Clinical Findings
Differential Diagnosis
Diagnostic Studies
Management
Complications
Substance Abuse Disorder
Clinical Findings
Differential Diagnosis
Diagnostic Studies
Management
31 - Infectious Diseases
Pathogenesis of Infectious Diseases
Clinical Findings
History
Physical Examination
Diagnostic Aids
Laboratory and Imaging Studies
Complete Blood Count
Platelet Count
C-Reactive Protein
Procalcitonin
Erythrocyte Sedimentation Rate
Cultures, Stains, and Antimicrobial Susceptibility Testing
Other Technologies
Immunoserology
Imaging Techniques
General Management Strategies
Preventing the Spread of Infection
Use of Antibiotics
Prevention of Infection Through the Use of Vaccines
Infections in Children in Child Care Settings
Specific Viral Diseases
Enteroviruses
Nonpolio Enteroviruses
Clinical Findings
Poliomyelitis Virus
Hepatoviruses
Hepatitis A Virus
Clinical Findings
Hepatitis B Virus
Hepatitis C Virus
Hepatitis D Virus
Hepatitis E Virus
Herpes Family of Viruses
Herpes Simplex Virus
Patient and Family Education
Infectious Mononucleosis Syndrome
Roseola Infantum (Exanthem Subitum)
Varicella
Clinical Findings
Patient and Family Education
Influenza Viral Infections
Typical Influenza
Highly Pathogenic Avian Influenza
Other Viral Diseases
Human Immunodeficiency Virus
Measles (Rubeola)
Clinical Findings. The clinical manifestations include
Complications
Mumps
Erythema Infectiosum
Parainfluenza Virus
Rubella (German or 3-Day Measles)
Mosquito-Borne Viruses
Zika Virus
West Nile Virus
Dengue Virus
Hantavirus Pulmonary Syndrome
Additional Noteworthy Viruses in Circulation
Human Pneumovirus (Metapneumovirus)
Human Calicivirus Infections (Norovirus and Sapovirus)
Coronaviruses
Potential Emerging and Reemerging Viruses on the Horizon
Middle Eastern Respiratory Syndrome
Monitoring the Global Spread of Viruses
Parasitic-Caused Disease: Malaria
Tick-Borne Diseases
Lyme Disease
Ehrlichiosis and Anaplasmosis
Rocky Mountain Spotted Fever
Bacterial Infections
Community-Acquired Methicillin-Resistant Staphylococcus aureus
Other Emerging Drug-Resistant Bacterial Infections
Cat-Scratch Disease
Kingella kingae Infection
Meningococcal Disease
Streptococcal Disease
Group A Streptococcus
Non–Group A or B Streptococci
Tuberculosis
Clinical Findings Primary Pulmonary Tuberculosis
Helminthic Zoonoses
Toxocariasis
The Child Presenting With Fever
Fever Without Focus in Infants and Young Children
Clinical Findings
Management
Fever of Unknown Origin
Clinical Findings
Infectious Agents Used in Bioterrorism
32 - Congenital and Inherited Disorders
Genetics Referral
Creating an Emergency Plan
Primary Care for Children with Congenital and Inherited Disorders
General Guidelines for Primary Care Providers Caring for Children With Congenital and/or Inherited Disorders
33 - Atopic, Rheumatic, and Immunodeficiency Disorders
Pathophysiology and Defense Mechanisms
Allergic and Atopic Disorders
Rheumatic Disorders
Immune Deficiency
General Management Strategies
Atopic Disorders
Asthma
Overview of Asthma Guidelines and Tools
Clinical Findings
Differential Diagnosis
Management
Chronic Asthma
Acute Exacerbations of Asthma
Complications
Patient and Parent Education and Prevention
Prognosis
Allergic Rhinitis
Clinical Findings
Diagnostic Studies and Allergy Testing. History, including an evaluation of risk factors, and characteristic clinical findings a...
Differential Diagnosis
Management
Allergy Immunotherapy and Other Treatments
Complications and Prognosis
Patient and Parent Education and Prevention
Atopic Dermatitis
Clinical Findings
Diagnostic Studies. The diagnosis of AD is based on characteristic clinical findings. A chronic or recurring rash that is prurit...
Differential Diagnosis
Management
Pharmacotherapy
Non-Pharmacological Therapy
Other Therapies
Environmental Management
Dietary Management
Complications and Prognosis
Patient and Parent Education and Prevention
Rheumatologic Disorders
Juvenile Idiopathic Arthritis
Clinical Findings
Differential Diagnosis
Management
Complications and Prognosis
Patient and Parent Education and Prevention
Systemic Lupus Erythematosus
Clinical Findings
Differential Diagnosis
Management
Complications and Prognosis
Juvenile Fibromyalgia Syndrome
Clinical Findings
Differential Diagnosis
Management
Prognosis
Patient and Parent Education
Clinical Finding
History
Physical Examination. Exam findings may be normal or painful lymph nodes may be present
Diagnostic Studies
Differential Diagnosis
Management
Reactive Arthritis Related to Streptococcal Infection: Acute Rheumatic Fever and Post-Streptococcal Reactive Arthritis
Post-Streptococcal Reactive Arthritis
Acute Rheumatic Fever
Clinical Findings and History
Management
Primary and Secondary Prevention of Acute Rheumatic Fever
Complications
Pediatric Vasculitis
Henoch-Schönlein Purpura
Clinical Findings
Differential Diagnosis
Management
Complications and Prognosis
Kawasaki Disease
Clinical Findings
Differential Diagnosis
Management
Complications and Prognosis
Pediatric Primary Immunodeficiency Disorders
Physiology of the Immune System
Primary and Secondary Immunodeficiency Disorders
Clinical Presentation
Management
34 - Dermatologic Disorders
Anatomy and Physiology
Pathophysiology and Defense Mechanisms
Normal Variations and/or Common Skin Problems
Assessment of the Skin and Subcutaneous Tissue
History
Physical Examination
Diagnostic Studies
Management Strategies
Hydration and Lubrication
Bathing and Moisturizers
Other Considerations
Dressings
Wet Dressings
Occlusive Dressings
Sunscreens and Sunblocks
Medications
General Considerations
Antibacterial Agents
Antifungal Agents
Antiviral Agents
Anti-Inflammatory Agents
Antipruritic Agents
Calcineurin Inhibitors
Scabicides and Pediculicides
Hair and Scalp Preparations
Bacterial Infections of the Skin and Subcutaneous Tissue
Impetigo
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Cellulitis
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Folliculitis and Furuncle
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Paronychia
Clinical Findings
Differential Diagnosis
Management
Fungal Infections of the Skin
Candidiasis (Moniliasis)
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Tinea
Tinea Capitis
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Tinea Corporis
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Tinea Cruris
Clinical Findings
Differential Diagnosis
Management
Tinea Pedis
Clinical Findings
Differential Diagnosis
Management
Patient and Family Education
Complications
Onychomycosis
Clinical Findings
Differential Diagnosis
Management
Patient and Family Education
Tinea Versicolor
Clinical Findings
Differential Diagnosis
Management
Patient and Family Education
Viral Infections of the Skin
Herpes Simplex
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Herpes Zoster
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Molluscum Contagiosum
Clinical Findings
Differential Diagnosis
Management
Patient and Family Education
Complications
Patient and Family Education
Warts
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Infestations of the Skin
Pediculosis
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Scabies
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Allergic and Inflammatory Skin Conditions
Acne Vulgaris
Clinical Findings
Differential Diagnosis
Management
Patient and Family Education
Complications
Atopic Dermatitis
Contact Dermatitis
Clinical Findings
Differential Diagnosis
Management
Diaper Dermatitis
Clinical Findings
Differential Diagnosis
Management
Complications
Seborrheic Dermatitis
Clinical Findings
Differential Diagnosis
Management
Complications
Drug Eruptions
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Vascular Skin Conditions
Urticaria and Angioedema
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Erythema Multiforme, Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Papulosquamous Eruptions of the Skin
Pityriasis Rosea
Clinical Findings
Differential Diagnosis
Management
Patient and Family Education
Psoriasis
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Lichen Striatus
Clinical Findings
Differential Diagnosis
Management
Patient and Family Education
Keratosis Pilaris
Clinical Findings
Differential Diagnosis
Management
Patient and Family Education
Congenital Skin Conditions
Vascular and Pigmented Nevi
Clinical Findings
History
Physical Examination. Findings include the following (Box 34.8)
Differential Diagnosis
Management
Complications
Patient and Family Education
Cutaneous Manifestations of Underlying Disease
Acanthosis Nigricans
Clinical Findings
Differential Diagnosis
Management
Patient and Family Education
Lentigines
Vitiligo and Hypopigmentation Disorders
Clinical Findings
Differential Diagnosis
Management
Complications
Hair Loss
Traumatic Alopecia
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Alopecia Areata
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Body Modifications
Tattoos, Body Piercing, and Scarification
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
35 - Eye Disorders
Standards for Visual Screening and Care
Development, Physiology, and Pathophysiology of the Eye
Development of the Ocular Structures
Anatomy and Physiology of the Eye
Pathophysiology of the Eyes
Assessment
History
Physical Examination
Screening Tests
Conducting Screening Tests
Red Reflex
Visual Acuity Testing
Color Vision Testing
Peripheral Vision Testing
Testing for Ocular Mobility and Alignment
Assessment of Visual Loss
Diagnostic Studies
Photoscreening and Autorefractors
Laboratory and Imaging Studies
Fluorescein Staining
Management Strategies
Referral for Ophthalmologic and Specialty Management
Occlusion
Corrective Lenses
Ophthalmic Medications
Topical Antibiotics
Ophthalmic Corticosteroids
Other Topical Preparations
Systemic Medications
Prevention of Eye Injury
Sunglasses
Sports Protection
Laser Pointers
Computer Use
Vision Therapy, Lenses, and Prisms
Visual Disorders
Refractive Errors and Amblyopia
Clinical Findings
Management
Strabismus
Clinical Findings
Management
Complications
Blepharoptosis
Management
Nystagmus
Clinical Findings
Management and Prognosis
Cataracts
Clinical Findings
Management
Complications
Prognosis and Prevention
Glaucoma
Clinical Findings
Management
Complications and Prognosis
Retinopathy of Prematurity
Clinical Findings
Management
Complications
Prevention
Retinoblastoma
Screening Guidelines
Clinical Findings
Management
Complications and Prognosis
Infections
Conjunctivitis
Conjunctivitis in the Newborn (Ophthalmia Neonatorum)
Inclusion Conjunctivitis (Chlamydia)
Bacterial Conjunctivitis
Viral Conjunctivitis
Allergic Conjunctivitis
Blepharitis
Clinical Findings
Differential Diagnosis
Management
Hordeolum (Stye)
Clinical Findings
Differential Diagnosis
Management
Chalazion
Clinical Findings
Management
Complications
Nasolacrimal Duct Conditions: Dacryostenosis and Dacryocystitis
Management
Preseptal (Periorbital) Cellulitis
Clinical Findings
Differential Diagnosis
Management
Complications
Keratitis and Corneal Ulcers
Clinical Findings
Management
Inflammation of the Uveal Tract
Clinical Findings
Management
Complications
Trachoma
Clinical Findings
Management
The Injured Eye
Subconjunctival Hemorrhage
Eyelid Contusion (“Black Eye”)
Corneal Abrasion
Clinical Findings
Management
Foreign Body
Clinical Findings
Management
Complications
Burns
Clinical Findings
Management
Lacerations of the Orbit
Clinical Findings
Management
Traumatic Hyphema
Clinical Findings
Management
Complications
Retinal Detachment
Clinical Findings
Management
Orbital Hematoma and Contusion of the Globe
Clinical Findings
Management
Complications
Orbital Fractures
Clinical Findings
Management
Deformities of the Eyelids
Entropion
Ectropion
Euryblepharon
Pterygium
Visual Impairment
Clinical Findings and Developmental and Behavioral Effects
Assessment
Management
36 - Ear and Hearing Disorders
Embryonic Development
Anatomy and Physiology
Pathophysiology
Defense Mechanisms
Assessment of the Ear
Clinical Findings
History
Physical Examination
Cerumen Removal
Standards for Hearing Screening
Diagnostic Studies
Hearing Impairment: Sensorineural, Conductive, and Mixed Hearing Loss
Clinical Findings
History
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Complications
Developmental and Behavioral Effects
Prevention of Noise-Induced Hearing Loss
Clinical Findings
History
Physical Examination
Management
Foreign Body in the Ear Canal
Clinical Findings
History
Physical Examination
Management
Complications
Ear Conditions in Children
Otitis Externa
Clinical Findings
History
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Complications
Prevention
Acute Otitis Media
Clinical Findings
History
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Management of Persistent and Recurrent Acute Otitis Media
Other Treatment Issues
Complications
Prevention and Education
Otitis Media With Effusion
Clinical Findings
History
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Complications
Perforated Tympanic Membrane
Clinical Findings
History, Physical Examination, and Diagnostic Studies
Differential Diagnosis
Management
Medications
Other Treatment Considerations
Auricular Hematoma
Clinical Findings
History and Physical Examination
Differential Diagnosis
Management and Complications
Cholesteatoma
Clinical Findings
History and Physical Examination
Differential Diagnosis
Management and Complications
Mastoiditis
Clinical Findings
History, Physical Examination, and Diagnostic Studies
Differential Diagnosis
Management
Tympanostomy or Pressure-Equalizing Tubes
Management
37 - Respiratory Disorders
Anatomy and Physiology
Upper Respiratory Tract
Lower Respiratory Tract
Pathophysiology
Obstructive Processes
Upper Airway Obstruction
Lower Airway Obstructions
Restrictive Processes
Defense Systems
Assessment of the Respiratory System
History
Physical Examination
Diagnostic Studies
Basic Respiratory Management Strategies
General Measures
Medications
Patient and Family Education
Disorders of Respiratory Function
Upper Respiratory Tract Infection
Clinical Findings
Differential Diagnosis
Management
Complications
Pharyngitis, Tonsillitis, and Tonsillopharyngitis
Clinical Findings
Physical Examination
Diagnostic Studies
Management
Complications
Indications for Tonsillectomy and Adenoidectomy
Rhinosinusitis
Clinical Findings
Differential Diagnosis
Management
Complications
Prevention
Diphtheria
Clinical Findings
Management
Complications and Prevention
Recurrent Epistaxis
Clinical Findings
Differential Diagnosis
Management
Prevention
Nasal Foreign Body
Clinical Findings
Physical Examination
Differential Diagnosis
Management
Airway Disorders
Croup (Laryngotracheobronchitis) and Spasmodic Croup
Clinical Finding
Differential Diagnosis
Management
Indications for Hospitalization
Complications
Acute Spasmodic Croup
Epiglottitis
Clinical Findings
Management
Complications
Prevention
Bronchiolitis
Clinical Findings
Differential Diagnosis
Management
Complications
Prevention
Foreign Body Aspiration
Clinical Findings
Management
Complications
Bronchitis
Clinical Findings
Differential Diagnosis
Management
Complications
Common Types of Childhood Pneumonia
Clinical Findings in Infants and Young Children
Differential Diagnosis
Management
Prognosis
Complications
Prevention
Valley Fever (Coccidioidomycosis)
Clinical Findings in Infants and Children
Differential Diagnosis
Management
Indications for Hospitalization
Prevention
Pertussis
Clinical Findings
Diagnostic Studies
Differential Diagnosis
Management
Care of Exposed Children
Complications
Prevention
Cystic Fibrosis
Clinical Findings
Management
Pectus Deformity
Clinical Findings
Diagnostic Studies
Brief Resolved Unexplained Events
Clinical Findings
Diagnostic Studies
Differential Diagnosis
Management
38 - Cardiovascular Disorders
Anatomy and Physiology
Fetal Circulation
Neonatal Circulation
Normal Cardiac Structure and Function
Conduction System
Assessment of the Cardiovascular System
History
Physical Examination
Vital Signs
General Appearance and Growth Parameters
Palpation
Auscultation of Heart Sounds
Murmurs
Common Diagnostic Studies
Primary Health Care Management Strategies
Referral
Genetic Testing
Family Support
Congenital Heart Disease: General Information
Specific Congenital Heart Diseases
Congestive Heart Failure
Left-to-Right Shunting Congenital Heart Disease (Acyanotic)
Atrial Septal Defect
Clinical Findings
Management
Ventricular Septal Defect
Clinical Findings
Management
Atrioventricular Septal Defect (Atrioventricular Canal Defect or Endocardial Cushion Defect)
Clinical Findings
Management
Patent Ductus Arteriosus
Clinical Findings
Management
Right-to-Left Shunting Congenital Heart Disease (Cyanotic)
Tetralogy of Fallot
Clinical Findings
Management
Transposition of the Great Arteries
Clinical Findings
Management
Prognosis
Tricuspid Atresia, Hypoplastic Left Heart Syndrome, and Other Single Ventricle Defects
Clinical Findings
Management
Complications. Complications include development of collateral arterial and venous vessels, protein-losing enteropathy, arrhythm...
Obstructive Cardiac Lesions
Aortic Stenosis and Insufficiency
Clinical Findings
Management
Pulmonic Stenosis
Clinical Findings
History
Physical Examination
Diagnostic Studies
Management
Coarctation of the Aorta
Clinical Findings
Management
Sudden Cardiac Death
Clinical Findings
Diagnostic Studies
Management
Long-Term Complications for Children and Young Adults With Congenital Heart Disease: Transitioning to Adult Care
Acquired Heart Disease
Chest Pain
Clinical Findings
Differential Diagnosis
Management
Hypertension
Clinical Findings
History. Inquire about
Physical Examination. Note the following
Diagnostic Studies
Management
Complications
Patient and Family Education
Infective Endocarditis
Clinical Findings
Differential Diagnosis
Management and Complications
Patient and Family Education
Myocarditis
Clinical Findings
Differential Diagnosis
Management
Complications and Prognosis
Pericarditis
Heart Conduction Disturbances
Cardiac Arrhythmias
Clinical Findings
Management and Complications
Syncope
Clinical Findings
Management and Differential Diagnosis
39 - Hematologic Disorders
Anatomy and Physiology
Erythrocytes
Hemoglobin
Structural Variations
Normal Values
Antigenic Properties of Red Blood Cells (Blood Type)
Leukocyte
Granulocytes
Agranulocytes: Lymphocytes and Monocytes
Platelet Cells and Coagulation Factors
Pathophysiology
Assessment of Erythrocyte Disorders
History
Physical Examination
Erythrocyte Disorders
Anemia
Assessment
Microcytic Anemia: Iron Deficiency Anemia
Effects of Iron Deficiency
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Thalassemias
α Thalassemias
Management
β Thalassemia Minor/Minima
Clinical Findings
Management
β Thalassemia Intermedia
β Thalassemia Major
Clinical Findings
Management
Complications
Macrocytic Anemia
Clinical Findings
Management
Normocytic Anemias
Transient Erythroblastopenia of Childhood
Clinical Findings
Differential Diagnosis
Management
Hemolytic Anemia
Sickle Cell Anemia and Trait
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Hereditary Spherocytosis
Clinical Findings
Management
Complications
Glucose-6-Phosphate Dehydrogenase Deficiency
Clinical Findings
Management
Patient and Family Education
Platelet and Coagulation Disorders
Overview of Diagnostic Studies
Immune or Idiopathic Thrombocytopenic Purpura
Clinical Findings
Differential Diagnosis
Management
Complications
Hemophilia A and B and von Willebrand Disease
Clinical Findings
Management
Complications
Thrombophilia
Pancytopenia
White Blood Cell Disorders
White Blood Cell Count
White Blood Cell Dysfunction
Alterations of Granulocytes
Lymphocytosis
Cancer
Leukemias
Clinical Findings
Management
Lymphomas
Non-Hodgkin Lymphoma
Hodgkin Lymphoma
Late Effects of Childhood Cancers
40 - Gastrointestinal Disorders
Anatomy and Physiology
Pathophysiology
Assessment
History
Physical Examination
Common Diagnostic Studies
Laboratory tests
Radiography
Abdominal Ultrasonography
Magnetic Resonance Imaging
Computed Tomography
Management Strategies
Medications
Probiotics and Prebiotics
Upper Gastrointestinal Tract Disorders
Dysphagia
Clinical Findings
History
Physical Examination
Diagnostic Studies
Diagnostic tests may include
Differential Diagnosis
Management
Vomiting
Clinical Findings
Differential Diagnosis
Management
Vomiting
Dehydration
Complications
Patient and Family Education
Cyclic Vomiting Syndrome
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Abdominal Migraine
Clinical Findings
Differential Diagnosis
Management
Prognosis
Gastroesophageal Reflux Disease
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Pyloric Stenosis
Clinical Findings
Physical Examination
Eosinophilic Esophagitis
Clinical Findings
Management
Peptic Ulcer Disease
Clinical Findings
Diagnostic Studies
Laboratory Studies
Imaging Studies
Procedures
Studies to Detect Helicobacter Pylori
Differential Diagnosis
Management
Complications
Patient and Family Education
Lower Gastrointestinal Tract Disorders
Foreign Body Ingestion
Esophageal Foreign Bodies
Clinical Findings
Management
Complications
Appendicitis
Clinical Findings
History
Differential Diagnosis
Management
Complications
Intussusception
Clinical Findings
History
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Complications
Hirschsprung Disease (Congenital Aganglionic Megacolon)
Clinical Findings
Childhood Functional Abdominal Pain and Functional Abdominal Pain Syndrome
Clinical Findings
Differential Diagnosis
Management
Prognosis and Complications
Irritable Bowel Syndrome
Clinical Findings
Differential Diagnosis
Management
Malabsorption Syndromes: Celiac Disease, Lactose Intolerance, Cow’s-Milk Protein Intolerance or Allergy, Food Protein Immunologi...
Clinical Findings
Diagnostic Studies
Specific Tests for Celiac Disease
Specific Tests for Lactose Intolerance
Differential Diagnosis
Management
Complications and Prognosis
Rectal and Intestinal Polyps
Clinical Findings
History
Physical Examination
Diagnostic Studies
Management
Complications
Anal Fissure
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Inflammatory Bowel Disease
Crohn Disease
Clinical Findings
Differential Diagnosis
Management
Complications
Prevention and Prognosis
Ulcerative Colitis
Clinical Findings
History
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Complications
Prevention and Prognosis
Failure to Thrive
Clinical Findings and Risk Factors
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Prognosis
Encopresis/Constipation
Physiologic
Psychosocial
Clinical Findings
Differential Diagnosis
Management
Complications
Patient and Family Education
Toilet Refusal Syndrome
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Complications
Patient and Family Education
Diarrhea
Acute Diarrhea
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Complications
Prevention
Chronic Diarrhea
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Complications
Intestinal Parasites
Clinical Findings, Management, and Differential Diagnosis
Patient and Family Education
Congenital Gastrointestinal Conditions
41 - Genitourinary Disorders
Standards of Care
Anatomy and Physiology
Pathophysiology and Defense Mechanisms
Assessment of the Genitourinary System
History and Clinical Findings
Physical Examination
Diagnostic Studies
Management Strategies
Education and Counseling
Referral
Dysfunctional Voiding
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Patient and Family Education
Enuresis
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Patient and Family Education
Genitourinary Tract Disorders
Urinary Tract Infection and Pyelonephritis
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Infants 2 to 24 Months Old
Asymptomatic Bacteriuria
Uncomplicated Cystitis
Patient and Family Education, Prevention, and Prognosis
Vesicoureteral Reflux
History and Clinical Findings
Diagnostic Studies
Management
Patient and Family Education, Prevention, and Prognosis
Hematuria
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Proteinuria
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Nephrotic Syndrome
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Complications
Patient and Family Education, Prevention, and Prognosis
Nephritis and Glomerulonephritis
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Complications
Patient and Family Education, Prevention, and Prognosis
Myoglobinuria
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Patient and Family Education, Prevention and Prognosis
Renal Tubular Acidosis
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Complications
Patient and Family Education, Prevention, and Prognosis
Nephrolithiasis and Urolithiasis
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Wilms Tumor
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Complications
Patient and Family Education, Prevention, and Prognosis
Chronic Genitourinary Conditions in Males
Hypospadias
History and Clinical Findings
Physical Examination
Differential Diagnosis
Management
Complications
Patient and Family Education, Prevention, and Prognosis
Cryptorchidism (Undescended Testes)
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Complications
Patient and Family Education, Prevention, and Prognosis
Hydrocele
History and Clinical Findings
Physical Examination
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Spermatocele
History and Clinical Findings
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Varicocele
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Complications
Patient and Family Education, Prevention, and Prognosis
Inguinal Hernia
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Complications
Patient and Family Education, Prevention, and Prognosis
Testicular Masses
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Acute Male Genitourinary Conditions
Scrotal Trauma
Clinical Findings
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Testicular Torsion
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Torsion of the Appendix Testis
History and Clinical Findings
Differential Diagnosis
Management
Epididymitis
History and Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Phimosis and Paraphimosis
History and Clinical Findings
Physical Examination
Management
Patient and Family Education, Prevention, and Prognosis
Balanitis and Balanoposthitis
History and Clinical Findings
Management
Patient and Family Education, Prevention, and Prognosis
42
- Pediatric and Adolescent Gynecology
Anatomy, Physiology, and Assessment of the Female Reproductive System
The External Genitalia and Vagina Before Puberty
External Genitalia and Vagina After the Onset of Puberty
Internal Reproductive Organs
Female Pubertal Development and the Menstrual Cycle
Physiology of Menstrual Bleeding
Ovulatory and Anovulatory Menstrual Cycles
Coagulation Pathway and the Menstrual Cycle
Early Pregnancy: Key Concepts for Adolescent Providers
Physiology of Early Pregnancy
Addressing Common Misperceptions About Pregnancy
Vulvar and Vaginal Concerns
Evaluation
Prepubertal Vulvar and Vaginal Concerns
Lichen Sclerosis
Prepubertal Vaginal Bleeding
Labial Adhesions
Imperforate Hymen
Adolescent Vulvar and Vaginal Concerns
Vulvovaginitis in Adolescents
Nonsexual Genital Ulcers
Concerns About Labial Appearance
Menstrual Concerns
Amenorrhea
History and Physical
Additional Testing
Causes of Amenorrhea
Abnormal Uterine Bleeding
Heavy Menstrual Bleeding
Causes of Abnormal Uterine Bleeding
Treatment of Abnormal Uterine Bleeding
Treating the Underlying Cause of Abnormal Uterine Bleeding
Pelvic Pain
Acute Pelvic Pain
Chronic and Recurrent Pelvic Pain
Dysmenorrhea
Mittelschmerz
Ovarian Cysts
Endometriosis
Premenstrual Syndrome
Breast Concerns
Asymmetric Breasts
Mastalgia
Breast Cyst or Mass
Nipple Discharge
Gynecologic Concerns in Adolescents With Physical and Developmental Disabilities
Sexual Health
Best Practices in Contraceptive Counseling
Address Confidentiality Concerns
Use Tools and Techniques That Reflect Best Practices
Follow Updated Clinical Recommendations
Contraceptive Methods
The Implant
Intrauterine Devices
Depot Medroxyprogesterone Acetate
Combined Hormonal Contraception
Managing Common Expected Side Effects
Progestin-Only Pills
Emergency Contraception
Condoms
Coitus Interruptus and Other Less Effective Methods
Teen pregnancy
Understanding Teen Pregnancy
Diagnosis of Teen Pregnancy
After Diagnosing Pregnancy
Preconceptual Counseling
Ectopic Pregnancy
Sexually Transmitted Infections
STI: Adolescent Health Disparity
STI: Prevention and Screening
Common Sexually Transmitted Infections
Treatment and Counseling
Pelvic Inflammatory Disease
43 - Musculoskeletal Disorders
Anatomy and Physiology
Pathophysiology and Defense Mechanisms
Pathophysiology
Systemic Problems
Genetic Disorders
Intrauterine Compression Deformations
Injuries
Defense Mechanisms
Fracture Healing
Growth Plate Fractures
Shaft Fractures
Assessment of the Orthopedic System
History
Physical Examination
Inspection and Palpation
Range-of-Motion Examination
Gait Examination
Posture
Hip Examinations
Galeazzi Maneuver
Barlow Maneuver
Ortolani Maneuver
Klisic Test
Trendelenburg Sign
Medial (Internal) and Lateral (External) Rotation
Back Examination
Adams Test or the Adams Forward Bend Test
Diagnostic Studies
Management Strategies
Counseling
Anticipatory Guidance: Musculoskeletal Development
Shoes
Care of Children in Casts and Splints
Physical and Occupational Therapy
Orthopedic Conditions Specific to Children
Annular Ligament Displacement
Clinical Findings
Brachial Plexus Injuries
Clinical Findings
Clavicular Fracture
Clinical Findings
Costochondritis and Sternochondritis
Back Pain
Scoliosis
Idiopathic Scoliosis
Kyphosis
Lumbar Lordosis
Developmental Dysplasia of the Hip
Clinical Findings
Legg-Calvé-Perthes Disease
Clinical Findings
Management
Slipped Capital Femoral Epiphysis
Femoral Anteversion
Genu Varum
Genu Valgum
Clinical Findings
History
Physical Examination
Tibial Torsion
Clinical Findings
Diagnostic Studies. Radiographs are usually not necessary
Popliteal Cysts
Sports-Related Injuries
Knee Injuries
Pes Planus
Talipes Equinovarus
Overriding Toes
In-Toeing and Out-Toeing Rotational Problems
Clinical Findings
History
Physical Examination
Management. See the individual diagnoses for management strategies
Toe Walking
Clinical Findings
Management
Leg Aches of Childhood
Clinical Findings
Differential Diagnosis
Management
Limps
Clinical Findings
History. A careful history is needed, including
Physical Examination
Diagnostic Studies. A CBC with differential and measurement of ESR and CRP levels should be obtained to rule out infection, infl...
Differential Diagnosis
Management
Overuse Syndromes of Childhood and Adolescence
Clinical Findings
Differential Diagnosis
Management
Muscle Diseases
Clinical Findings
History
Physical Examination
Management
Ganglions of the Hands
Clinical Findings
Management
44 - Common Pediatric Injuries and Toxic Exposures
Trauma to the Skin and Soft Tissue
Abrasions
Clinical Findings
Management
Puncture Wounds
Clinical Findings
Management
Patient and Parent Education
Ingrown Toenail (Onychocryptosis) and Nail Hematoma
Management
Lacerations
Clinical Findings
Management
Patient and Parent Education
Burns
Clinical Findings
Differential Diagnosis
Patient and Parent Education
Contusions and Hematomas
Clinical Findings
Differential Diagnosis
Management and Complications
Patient and Parent Education
Bites and Stings
Animal and Child Bites
Clinical Findings
Hymenoptera (Bees, Wasps, and Ants)
Clinical Findings
Differential Diagnosis and Management
Patient and Parent Education
Mosquitoes, Fleas, and Chiggers (Red Bug or Harvest Mites)
Clinical Findings
Differential Diagnosis and Management
Patient and Parent Education
Spiders and Scorpions
Clinical Findings
Differential Diagnosis and Management
Patient and Parent Education
Snakebites
Clinical Findings
Management
Patient and Parent Education
Heat and Cold Injuries
Frostbite
Clinical Findings
History. The provider should assess the following
Physical Examination. Typical initial findings include the following
Differential Diagnosis and Management
Patient and Parent Education
Hypothermia
Clinical Findings
Patient and Parent Education
Hyperthermia: Common Heat-Related Illness
Acute Pediatric Poisoning
Clinical Findings
History
Physical examination
Management and Patient/Family Education
Common Environmental Toxins: Heavy Metals and Pesticides
Lead
Clinical Findings
Differential Diagnosis
Management
Patient and Family Education
Mercury
Clinical Findings
Differential Diagnosis
Management
Patient and Family Education
Arsenic
Clinical Findings
Management
Patient and Family Education
Pesticides
Clinical Findings
Management
Patient and Family Education
45 - Endocrine and Metabolic Disorders
Anatomy and Physiology
Pathophysiology
Assessment
History
Physical Examination
Diagnostic Studies
Management Strategies
General Measures
Genetic Counseling
Medications
Dietary Considerations
Patient and Family Education
Disorders of Endocrine Function
Growth Disorders
Growth Hormone Deficiency
Clinical Findings
Constitutional Growth Delay
Clinical Findings
Growth Excess
Pubertal Disorders
Early Puberty/Precocious Puberty
Delayed Puberty
Clinical Findings
Complications
Adrenal Disorders
Anatomy and Physiology
Adrenal Insufficiency
Clinical Findings
Hyperadrenal States
Clinical Findings
Disorders of Sex Development
Management
Thyroid Disorders
Anatomy and Physiology
Hypothyroidism
Clinical Findings
Hyperthyroidism
Clinical Findings
Diabetes Mellitus
Type 1 Diabetes
Type 2 Diabetes
Clinical Findings
Obesity
Diagnostic Studies
Management
Posterior Pituitary Gland Disorders
Introduction to Inborn Errors of Metabolism
Classification of Inborn Errors of Metabolism
Pathophysiology
Assessment of Inborn Errors of Metabolism
Clinical Findings
Management
Metabolic Emergencies
Stable Metabolic Disorders
Complications
Specific Metabolic Disorders of Children
Disorders of Carbohydrate Metabolism
Glycogen Storage Diseases
Clinical Findings
Management
Galactosemia
Clinical Findings
Complications
Management
Classic Homocystinuria
Disorders of Fatty Acid Oxidation
Complications
Lysosomal Storage Disorders
Dyslipidemia: Hypercholesterolemia and Hyperlipidemia
Management
46 - Neurologic Disorders
Anatomy and Physiology
Anatomy
Autonomic Nervous System
Physiology
Pathophysiology and Defense Mechanisms
Assessment of the Nervous System
History
History of Present Illness
Medical History
Family Disease History
Developmental, Functional Health, and Social Context
Physical Examination
Specifics of the Neurologic Examination
Behavior and Mental Status
Cranial Nerve Function
Motor Examination
Sensory Examination
Reflexes
Coordination
Cranium Examination
Autonomic Nervous System
Meningeal Signs
Diagnostic Studies
Management Strategies
Neurologic Development
Educational Needs
Referrals for Other Key Assessments
Medications
Specific Neurologic Problems of Children: Headaches and Head Injury
Headaches
Clinical Findings
Head Injury or Concussion
Clinical Findings
Prevention
Disturbances of Head Growth
Macrocephaly
Hydrocephalus
Microcephaly
Craniosynostosis
Clinical Findings
Epilepsy, Febrile Seizures and Benign Paroxysmal Vertigo
Epilepsy
Clinical Findings
Differential Diagnosis
Management
Febrile Seizures
Clinical Findings
Differential Diagnosis
Management
Patient and Parent Education
Complications
Benign Paroxysmal Vertigo
Cerebral Palsy and Hypotonia
Cerebral Palsy
Clinical Findings
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
The Hypotonic Infant
Injuries and Congenital Conditions
Brachial Palsy
Clinical Findings
Differential Diagnosis
Management
Prognosis
Bell Palsy
Clinical Findings
Differential Diagnosis
Management
Complications
Tethered Cord
Arnold-Chiari Malformation
Myelomeningocele
Clinical Findings
Management and Complications
Prognosis
Prevention
Infection and Immune Disorders
Central Nervous System Infections
Clinical Findings
Management and Complications
Zika Virus
Reye Syndrome
Myasthenia Gravis
Clinical Findings
Physical Examination. The key findings of this disorder include
Diagnostic Studies
Differential Diagnosis
Management
Complications
Neurofibromatosis
Guillain-Barré Syndrome
Clinical Findings
History. The following are reported
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Complications
Neurodegenerative Disorders
Rett Syndrome
Multiple Sclerosis
Appendix
A -
Growth Charts
B -
Body Measurements
C -
Nutrition
D -
Gesell Figures
Index
