Nelson Essentials of Pediatrics, 9th Edition

Cover
Any screen.Any time.Anywhere
Nelson ESSENTIALS OF PEDIATRICS
Copyright
Dedication
Contributors
Preface
Acknowledgments
Contents
Section 1
The Profession Of Pediatrics Ahmeneh Ghavam | Karen J. Marcdante
1 Population and Culture: The Care of Children in Society
Care of Children in Society
Current Challenges
Landscape of Health Care for Children in the United States
Other Health Issues that Affect Children in the United States
Health Disparities in Health Care for Children
Changing Morbidity: Social/Emotional Aspects of Pediatric Practice
Culture
Pearls for Practitioners
2 Professionalism
Concept of Professionalism
Professionalism for Pediatricians
Pearls for Practitioners
3 Ethics and Legal Issues
Ethics in Health Care
Ethical Principles Related to Infants, Children, and Adolescents
Legal Issues
Ethical Issues in Practice
Confidentiality
Ethical Issues in Genetic Testing and Screening in Children
Religious Issues and Ethics
Children as Human Subjects in Research
Ethical Issues Surrounding Scarce Resource Allocation
Pearls for Practitioners
4 Palliative Care and End-of-Life Issues
Palliative and End-of-Life Care
Bereavement
Cognitive Issues in Children and Adolescents: Understanding Death and Dying
Cultural, Religious, and Spiritual Concerns About Palliative Care and End-of-Life Decisions
Ethical Issues in End-of-Life Decision-Making
Organ Donation in Pediatrics
Pearls for Practitioners
Suggested Readings
Pearls For Practitioners
1
Population and Culture: The Care of Children in Society
2
Professionalism
3
Ethics and Legal Issues
4
Palliative Care and End-of-Life Issues
Section 2
Growth and Development
5 Normal Growth
Health Maintenance Visit
Pearls for Practitioners
6 Disorders of Growth
Pearls for Practitioners
7 Normal Development
Physical Development
Newborn Period
Later Infancy
School Age/Preadolescent
Adolescence
Developmental Milestones
Psychosocial Assessment
Bonding and Attachment in Infancy
Developing Autonomy in Early Childhood
Early Childhood Education
School Readiness
Adolescence
Modifying Psychosocial Behaviors
Temperament
Pearls for Practitioners
8 Disorders of Development
Developmental Surveillance and Screening
Other Issues in Assessing Development and Behavior
Evaluating Developmental and Behavioral Issues
Pearls for Practitioners
9 Evaluation of the Well Child
Screening Tests
Newborn Screening
Metabolic Screening
Hemoglobin Electrophoresis
Critical Congenital Heart Disease Screening
Hearing Evaluation
Hearing and Vision Screening of Older Children
Infants and Toddlers
Children 3 Years of Age and Older
Anemia Screening
Lead Screening
Tuberculosis Testing
Cholesterol
Sexually Transmitted Infection Testing
Depression Screening
Immunizations
Dental Care
Nutritional Assessment
Anticipatory Guidance
Safety Issues
Fostering Optimal Development
Pearls for Practitioners
10 Evaluation of the Child with Special Needs
Multifaceted Team Assessment of Complex Problems
Medical Assessment
Motor Assessment
Psychologic Assessment
Educational Assessment
Social Environment Assessment
Management of Developmental Problems
Intervention in the Primary Care Setting
Counseling Principles
Interdisciplinary Team Intervention
Selected Clinical Problems: The Special Needs Child
Intellectual Disability
Vision Impairment
Hearing Impairment
Speech-Language Impairment
Cerebral Palsy
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
Normal Growth
Disorders of Growth
Normal Development
Disorders of Development
Evaluation of the Well Child
Evaluation of the Child with Special Needs
Section 3
Behavioral Disorders
11 Crying and Colic
Normal Development
Colic
Epidemiology
Etiology
Clinical Manifestations
Differential Diagnosis
Anticipatory Guidance and Management
Prognosis
Pearls for Practitioners
12 Temper Tantrums
Etiology
Epidemiology
Clinical Manifestations
Differential Diagnosis
Anticipatory Guidance And Management
Pearls For Practitioners
13 Attention-Deficit/Hyperactivity Disorder
Etiology
Epidemiology
Clinical Symptoms
Diagnosis and Evaluation
Differential Diagnosis
Co-morbidities
Treatment
Medications
Complementary Alternative Medicine
Pearls For Practitioners
14 Control of Elimination
Normal Development Of Elimination
Enuresis
Etiology
Epidemiology
Clinical Manifestations
Differential Diagnosis
Treatment
Complications
Functional Constipation And Encopresis
Epidemiology
Etiology
Diet
Withholding Behaviors
History
Clinical Manifestations
Differential Diagnosis
Treatment
Prevention
Pearls For Practitioners
15 Normal Sleep and Pediatric Sleep Disorders
Adolescent Sleep
Sleep Disorders
Epidemiology
Clinical Manifestations and Evaluation
Differential Diagnosis
Complications
Prevention and Treatment
Pearls For Practitioners
Suggested Readings
Pearls For Practitioners
11
Crying and Colic
12
Temper Tantrums
13
Attention-Deficit/Hyperactivity Disorder
14
Control of Elimination
15
Normal Sleep and Pediatric Sleep Disorders
Section 4
Psychiatric Disorders
16 Somatoform Disorders, Factitious Disorders, and Malingering
Pearls for Practitioners
17 Anxiety and Phobias
Pearls for Practitioners
18 Depression and Bipolar Disorders
Bipolar and Related Disorders
Pearls for Practitioners
19 Obsessive-Compulsive Disorder
Pearls for Practitioners
20 Pervasive Developmental Disorders and Psychoses
Schizophrenia Spectrum Disorders
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
16
Somatoform Disorders, Factitious Disorders, and Malingering
17
Anxiety and Phobias
18
Depression and Bipolar Disorders
Depressive Disorders
Bipolar Disorders (BD)
19
Obsessive-Compulsive Disorder
20
Pervasive Developmental Disorders and Psychoses
Autism Spectrum Disorder (ASD)
Schizophrenia Spectrum Disorders
Section 5
Psychosocial Issues
21 Failure to Thrive
Etiology
Diagnosis and Clinical Manifestations
Treatment
Complications
Psychosocial Short Stature
Pearls for Practitioners
22 Child Abuse and Neglect
Neglect
Physical Abuse
Medical Child Abuse
Sexual Abuse
Commercial Sexual Exploitation of Children (CSEC)
Management
Pearls for Practitioners
23 Sexuality and Gender Identity
Development of Sexuality
Sexual Orientation
Development of Gender Identity
Gender Dysphoria
Pearls for Practitioners
24 Family Structure and Function
Family Functions
Family Structure
Single-Parent Families
Children Living with LGBTQ Parents
Adoption
Foster Care
Family Dysfunction: Physical Needs
Family Dysfunction: Emotional Support, Education, and Socialization
Pearls For Practitioners
25 Violence
Intimate Partner Violence and Children
Dating Violence and Date Rape
Bullying
Assault
Community Violence
Violence and Technology
Youth Violence, the Juvenile Justice System, and Health
Trauma-Informed Care
Pearls for Practitioners
26 Divorce, Separation, and Bereavement
Divorce
Reaction to Divorce at Different Ages
Outcome of Divorce
Role of the Pediatrician
Separations from Parents
Death of a Parent or Family Member and Bereavement
Explaining Death to a Child
Should the Child Attend the Funeral?
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
21
Failure to Thrive
22
Child Abuse and Neglect
23
Sexuality and Gender Identity
24
Family Structure and Function
25
Violence
26
Divorce, Separation, and Bereavement
Section 6
Pediatric Nutrition and Nutritional Disorders
27 Diet of the Normal Infant
Breast-Feeding
Common Breast-Feeding Problems
Contraindications (see Table 27.1)
Maternal Drug Use
Formula Feeding
Complementary Foods
Iron Supplements
Pearls For Practitioners
28 Diet of the Normal Child and Adolescent
Nutrition Issues For Toddlers And Older Children
Milk
Juices
General Recommendations
Salt Intake
Iron Intake
Nutrition Issues For Adolescents
Pearls for Practitioners
29 Obesity
Definitions
Epidemiology
Etiology
Clinical Manifestations
Assessment
Prevention
Treatment
Treatment for Children Who Are Overweight
Treatment for Children Who Are Obese
Medications
Weight-Loss Surgery
Pearls For Practitioners
30 Pediatric Undernutrition
Failure To Thrive
Marasmus
Kwashiorkor
Mixed Marasmus-Kwashiorkor
Treatment Of Malnutrition
Complications Of Malnutrition
Pearls For Practitioners
31 Vitamin and Mineral Deficiencies
Water-Soluble Vitamins
Ascorbic Acid
B Vitamins
Thiamine
Riboflavin
Niacin
Vitamin B6
Folate
Vitamin B12
Fat-Soluble Vitamins
Vitamin A
Vitamin E
Vitamin D
Vitamin K
Minerals
Calcium
Iron
Zinc
Fluoride
Pearls For Practitioners
Suggested Readings
Pearls For Practitioners
27
Diet of the Normal Infant
28
Diet of the Normal Child and Adolescent
29
Obesity
30
Pediatric Undernutrition
31
Vitamin and Mineral Deficiencies
Section 7
Fluids and Electrolytes
32 Maintenance Fluid Therapy
Body Composition
Regulation Of Intravascular Volume And Osmolality
Maintenance Fluids
Pearls For Practitioners
33 Dehydration and Replacement Therapy
Replacement Therapy
Dehydration
Laboratory Evaluation
Calculation of Fluid Deficit
Approach to Dehydration
Monitoring And Adjusting Therapy
Oral Rehydration
Pearls For Practitioners
34 Parenteral Nutrition
Indications
Access For Parenteral Nutrition
Composition Of Parenteral Nutrition
Complications
Pearls For Practitioners
35 Sodium Disorders
Hyponatremia
Etiology
Clinical Manifestations
Treatment
Hypernatremia
Etiology
Clinical Manifestations
Treatment
Pearls For Practitioners
36 Potassium Disorders
Hypokalemia
Etiology
Clinical Manifestations
Diagnosis
Treatment
Hyperkalemia
Etiology
Clinical Manifestations
Diagnosis
Treatment
Pearls For Practitioners
37 Acid-Base Disorders
Clinical Assessment of Acid-Base Disorders
Metabolic Acidosis
Etiology
Clinical Manifestations
Diagnosis
Treatment
Metabolic Alkalosis
Etiology
Clinical Manifestations
Diagnosis
Treatment
Respiratory Acid-Base Disturbances
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
Maintenance Fluid Therapy
Dehydration and Replacement Therapy
Parenteral Nutrition
Sodium Disorders
Potassium Disorders
Acid-Base Disorders
Section 8
The Acutely Ill or Injured Child
38 Assessment and Resuscitation
Initial Assessment
History
Physical Examination
Common Manifestations
Initial Diagnostic Evaluation
Screening Tests
Diagnostic Tests and Imaging
Resuscitation
Cardiopulmonary Arrest
Pediatric Advanced Life Support and Cardiopulmonary Resuscitation
Circulation
Airway
Breathing
Medications
Pearls for Practitioners
39 Respiratory Failure
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Prevention
Pearls For Practitioners
40 Shock
Etiology and Epidemiology
Hypovolemic Shock
Distributive Shock
Cardiogenic Shock
Obstructive Shock
Dissociative Shock
Clinical Manifestations
Hypovolemic Shock
Distributive Shock
Cardiogenic Shock
Obstructive Shock
Dissociative Shock
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
General Principles
Organ-Directed Therapeutics
Fluid Resuscitation
Cardiovascular Support
Respiratory Support
Renal Salvage
Complications
Prognosis
Prevention
Pearls for Practitioners
41 Injury Prevention
Epidemiology and Etiology
Education for Preventing Injuries
Pearls For Practitioners
42 Major Trauma
Assessment and Resuscitation
Etiology and Epidemiology
Laboratory and Imaging Studies
Clinical Manifestations and Treatment
Head Trauma
Spinal Cord Trauma
Thoracic Trauma
Abdominal Trauma
Liver Trauma
Renal Injury
Pancreatic Injury
Intestinal Injury
Complications
Prognosis
Prevention
Pearls for Practitioners
43 Drowning
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Prognosis
Prevention
Pearls for Practitioners
44 Burns
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Complications
Prognosis
Prevention
Pearls for Practitioners
45 Poisoning
Etiology and Epidemiology
Clinical Manifestations
Complications
Coma
Direct Toxicity
Metabolic Acidosis
Dysrhythmias
Gastrointestinal Symptoms
Seizures
Laboratory and Imaging Studies
Treatment
Supportive Care
Gastrointestinal Decontamination
Enhanced Elimination
Specific Antidotes
Prognosis
Prevention
Pearls for Practitioners
46 Sedation and Analgesia
Assessment
Procedural Sedation
Nonprocedural Sedation
Pain and Analgesia
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
Assessment and Resuscitation
Respiratory Failure
Shock
Injury Prevention
Major Trauma
Drowning
Burns
Poisoning
Sedation and Analgesia
Section 9
Human Genetics and Dysmorphology
47 Patterns of Inheritance
Types of Genetic Disorders
Introduction To Genetics And Genomics
Pedigree Drawing
Autosomal Dominant Disorders
Achondroplasia
Neurofibromatosis Type 1
Marfan Syndrome
Autosomal Recessive Disorders
Sickle Cell Disease
Tay-Sachs Disease
X-Linked Disorders
X-Linked Recessive Inheritance
Duchenne Muscular Dystrophy
Hemophilia A
X-Linked Dominant Inheritance
Other Types Of Genetic Disorders
Multifactorial Disorders
Hypertrophic Pyloric Stenosis
Neural Tube Defects, Including Myelomeningocele
Disorders with Unusual Patterns of Inheritance
Mitochondrial Inheritance
Uniparental Disomy
Prader-Willi and Angelman Syndromes
Expansion of a Trinucleotide Repeat
Teratogenic Agents
Maternal Infections
Maternal Disease
Medications and Chemicals
Radiation
Pearls For Practitioners
48 Genetic Assessment and Diagnosis
Preconception and Prenatal Counseling
Familial Factors
Screening
Maternal Factors
Postnatal—Newborn and Infant
Adolescent and Adult
General Approach To Patients
Family History
Pregnancy
Delivery and Birth
Medical History
Development
Physical Examination
Laboratory Evaluation
Chromosome Analysis
Fluorescent In Situ Hybridization
Microarray Comparative Genomic Hybridization
DNA Sequencing
Exome Sequencing
Whole Genome Sequencing
Pearls for Practitioners
49 Chromosomal Disorders
Abnormalities In Number (Aneuploidy)
Trisomies
Down Syndrome
Trisomy 18
Trisomy 13
Klinefelter Syndrome
Monosomies
Turner Syndrome
Syndromes Involving Chromosomal Deletions
Cri du Chat Syndrome
Williams Syndrome
Aniridia Wilms Tumor Association
Prader-Willi Syndrome
Angelman Syndrome
Chromosome 22q11.2 Deletion Syndromes (22q11DS)
Syndromes Involving Chromosome Duplication
Inverted Duplication Chromosome 15
Cat-Eye Syndrome
Pearls For Practitioners
50 Approach to the Dysmorphic Child
Definitions
History and Physical Examination
Pregnancy History
Family History
Physical Examination
Growth
Craniofacial
Neck
Trunk
Extremities
Genitalia
Laboratory Evaluation
Diagnosis
Pearls For Practitioners
Suggested Readings
Pearls for Practitioners
Patterns of Inheritance
Genetic Assessment and Diagnosis
Chromosomal Disorders
Approach to the Dysmorphic Child
Section 10
Metabolic Disorders
51 Metabolic Assessment
Signs and Symptoms
Types of Clinical Presentation of Inborn Errors
Toxic Presentation
Severe Neonatal Hyperammonemia
Moderate Neonatal Hyperammonemia
Clinical Hyperammonemia in Later Infancy and Childhood
Specific Organ Presentation
Energy Deficiency
Ketosis and Ketotic Hypoglycemia
Disorders Associated with Dysmorphic Findings
Storage Disorders
Clinical Assessment and Laboratory Testing
Genetic Aspects of Inborn Errors
Mechanisms of Inheritance
Identification of Molecular Pathology
Identification of Inborn Errors by Neonatal Screening
Disorders Identified by Neonatal Screening
Strategy of Neonatal Screening
Confirmatory Testing Principles
Specialized Laboratory and Clinical Testing
Overview of Treatment
Pearls for Practitioners
52 Carbohydrate Disorders
Glycogen Storage Diseases
Galactosemia
Pearls for Practitioners
53 Amino Acid Disorders
Disorders of Amino Acid Metabolism
Phenylketonuria
Tyrosinemias
Homocystinuria
Maple Syrup Urine Disease
Disorders of Ammonia Disposal
Treatment of Hyperammonemia
Disorders of Amino Acid Transport that Affect Specific Transport Mechanisms in the Kidney and Intestine
Pearls for Practitioners
54 Organic Acid Disorders
Disorders of Organic Acid Metabolism
Propionic Acidemia and Methylmalonic Acidemia
Isovaleric Acidemia
Glutaric Acidemia I
Biotinidase Deficiency and Holocarboxylase Synthetase Deficiency
Pearls for Practitioners
55 Fatty Acid Oxidation Disorders
Disorders of Fatty Acid Oxidation
Glutaric Aciduria Type II
Carnitine Deficiency
Pearls for Practitioners
56 Lysosomal and Peroxisomal Disorders
Peroxisomal Disorders
Lysosomal Storage Disorders
Diagnostic Testing
Treatment Strategies
Pearls for Practitioners
57 Mitochondrial Disorders
Mitochondrial Function
Signs and Symptoms of Genetic Disorders of Mitochondrial Function
Biochemical Abnormalities in Mitochondrial Function
Genetics of Mitochondrial Disorders
Treatment of Mitochondrial Disorders
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
Metabolic Assessment
Carbohydrate Disorders
Amino Acid Disorders
Organic Acid Disorders
Fatty Acid Oxidation Disorders
Lysosomal and Peroxisomal Disorders
Mitochondrial Disorders
Section 11
Fetal and Neonatal Medicine
58 Assessment of the Mother, Fetus, and Newborn
Assessment Of The Mother
Fetus and Newborn
Assessment Of The Fetus
Assessment of the Newborn
Routine Delivery Room Care and Resuscitation
Physical Examination and Gestational Age Assessment
Appearance
Vital Signs
Gestational Age
Skin
Skull
Face, Eyes, and Mouth
Neck and Chest
Lungs
Heart
Abdomen
Genitalia
Extremities
Spine
Hips
Neurologic Assessment
Special Conditions Requiring Resuscitation in the Delivery Room
Cyanosis
Life-Threatening Congenital Malformations
Perinatal Hypoxia and Asphyxia
Shock
Birth Injury
Temperature Regulation
Elevated Temperature
Miscellaneous Disorders
Hypocalcemia
Neonatal Drug Withdrawal
Opiates
Cocaine
Pearls for Practitioners
59 Maternal Diseases Affectingthe Newborn
Antiphospholipid Syndrome
Idiopathic (Immune) Thrombocytopenia
Systemic Lupus Erythematosus
Neonatal Hyperthyroidism
Diabetes Mellitus
Other Conditions
Pearls for Practitioners
60 Diseases of the Fetus
Intrauterine Growth Restriction And Small For Gestational Age
Hydrops Fetalis
Pearls For Practitioners
61 Respiratory Diseases of the Newborn
Respiratory Distress Syndrome (Hyaline Membrane Disease)
Lung Development
Clinical Manifestations
Complications of Respiratory Distress Syndrome
Patent Ductus Arteriosus
Pulmonary Air Leaks
Bronchopulmonary Dysplasia (Chronic Lung Disease)
Retinopathy of Prematurity (Retrolental Fibroplasia)
Transient Tachypnea of the Newborn
Meconium Aspiration Syndrome
PERSISTENT Pulmonary Hypertension of the Newborn
Apnea Of Prematurity
Pearls For Practitioners
62 Anemia and Hyperbilirubinemia
Anemia
Etiology
Decreased Red Blood Cell Production
Increased Red Blood Cell Destruction
Blood Loss
Diagnosis and Management
Hyperbilirubinemia
Etiology of Indirect Unconjugated Hyperbilirubinemia
Etiology of Direct Conjugated Hyperbilirubinemia
Kernicterus Spectrum Disorder (Bilirubin Encephalopathy)
Therapy of Indirect Hyperbilirubinemia
Polycythemia (Hyperviscosity Syndrome)
Coagulation Disorders
Clinical Manifestations and Differential Diagnoses of Bleeding Disorders
Pearls for Practitioners
63 Necrotizing Enterocolitis
Pearls for Practitioners
64 Hypoxic-Ischemic Encephalopathy, Intracranial Hemorrhage, and Seizures
Neonatal Seizures
Intracranial Hemorrhage
Hypoxic-Ischemic Encephalopathy
Pearls for Practitioners
65 Sepsis and Meningitis
Pearls for Practitioners
66 Congenital Infections
Toxoplasmosis
Rubella
Cytomegalovirus
Herpes Simplex Virus
Congenital Syphilis
Human Immunodeficiency Virus
Hepatitis B
Neisseria Gonorrhoeae
Chlamydia
Mycobacterium Tuberculosis
Zika Virus
COVID-19
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
Assessment of the Mother, Fetus, and Newborn
Maternal Diseases Affecting the Newborn
Diseases of the Fetus
Respiratory Diseases of the Newborn
Anemia and Hyperbilirubinemia
Necrotizing Enterocolitis
Hypoxic-Ischemic Encephalopathy, Intracranial Hemorrhage, and Seizures
Sepsis and Meningitis
Congenital Infections
Section 12
Adolescent Medicine
67 Overview and Assessment of Adolescents
Interviewing Adolescents
Physical Growth and Development of Adolescents
Girls
Boys
Changes Associated with Physical Maturation
Psychologic Growth and Development of Adolescents
Pearls for Practitioners
68 Well-Adolescent Care
Early Adolescence (Ages 10–14 Years)
Middle Adolescence (Ages 15–17 Years)
Late Adolescence (Ages 18–21 Years)
Gynecologic Examination
Breast Changes in Girls and Boys
Breast Asymmetry and Masses in Girls
Gynecomastia in Boys
Pearls for Practitioners
69 Adolescent Gynecology
Vaginal Discharge
Menstrual Disorders
Amenorrhea
Abnormal Uterine Bleeding
Dysmenorrhea
Pregnancy
Diagnosis
Continuation of the Pregnancy
Termination
Contraception
Steroidal Contraception
Long-Acting Reversible Contraceptives
Implants
Intrauterine Devices
Hormonal Injections
Combined Hormonal Contraceptives
Progestogen-Only Pill
Barrier Methods
Condoms
Sponge, Caps, and Diaphragm
Emergency Postcoital Contraception
Coitus Interruptus and Rhythm Method (Periodic Coital Abstinence)
Oral and Anal Sex
Sexual Violence
Pearls for Practitioners
70 Eating Disorders
Anorexia Nervosa
Clinical Manifestations and Diagnosis
Treatment and Prognosis
Bulimia Nervosa
Avoidant Restrictive Food Intake Disorder (ARFID)
Pearls for Practitioners
71 Substance Abuse
Acute Overdose
Acute and Chronic Effects
Treatment
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
Overview and Assessment of Adolescents
Well-Adolescent Care
Adolescent Gynecology
Eating Disorders
Substance Abuse
Section 13
Immunology
72 Immunologic Assessment
History
Physical Examination
Differential Diagnosis
Diagnostic Evaluation
Laboratory Tests
Diagnostic Imaging
Pearls for Practitioners
73 Lymphocyte Disorders
Etiology and Clinical Manifestations
Antibody Deficiency Diseases
Combined Immunodeficiency Diseases
Treatment
Prevention and Newborn Screening
Pearls for Practitioners
74 Neutrophil Disorders
Etiology and Clinical Manifestations
Disorders of Neutrophil Numbers
Disorders of Neutrophil Migration
Disorders of Neutrophil Function
Laboratory Diagnosis
Treatment
Prognosis and Prevention
Pearls for Practitioners
75 Complement System
Etiology
Laboratory Studies
Treatment
Pearls for Practitioners
76 Hematopoietic Stem Cell Transplantation
Complications
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
Immunologic Assessment
Lymphocyte Disorders
Neutrophil Disorders
Complement System
Hematopoietic Stem Cell Transplantation
Section 14
Allergy
77 Allergy Assessment
History
Physical Examination
Initial Diagnostic Evaluation
Screening Tests
Diagnostic Imaging
Pearls for Practitioners
78 Asthma
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Long-Term Control Medications
Inhaled Corticosteroids
Leukotriene Modifiers
Long-Acting β2 Agonists
Theophylline
Biologics
Quick-Relief Medications
Short-Acting β2 Agonists
Anticholinergic Agents
Oral Corticosteroids
Approach to Therapy
Complications
Prognosis
Prevention
Pearls for Practitioners
79 Allergic Rhinitis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Pharmacotherapy
Allergen Immunotherapy
Complications
Prognosis and Prevention
Pearls for Practitioners
80 Atopic Dermatitis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Prevention
Pearls for Practitioners
81 Urticaria, Angioedema, and Anaphylaxis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Prevention
Pearls for Practitioners
82 Serum Sickness
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment and Prevention
Pearls for Practitioners
83 Insect Allergies
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Prevention
Pearls for Practitioners
84 Adverse Reactions to Foods
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Diagnosis
Treatment
Complications
Prognosis and Prevention
Pearls for Practitioners
85 Adverse Reactions to Drugs
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Prevention
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
Allergy Assessment
Asthma
Allergic Rhinitis
Atopic Dermatitis
Urticaria, Angioedema, and Anaphylaxis
Serum Sickness
Insect Allergies
Adverse Reactions to Foods
Adverse Reaction to Drugs
Section 15 RHEUMATIC DISEASES OF CHILDHOOD
CHAPTER 86 Rheumatic Assessment
HISTORY
PHYSICAL EXAMINATION
COMMON MANIFESTATIONS
INITIAL DIAGNOSTIC EVALUATION
LABORATORY TESTING
DIAGNOSTIC IMAGING
PEARLS FOR PRACTITIONERS
CHAPTER 87 IgA Vasculitis (Henoch-Schönlein Purpura)
ETIOLOGY
EPIDEMIOLOGY
CLINICAL MANIFESTATIONS
LABORATORY AND IMAGING STUDIES
DIFFERENTIAL DIAGNOSIS
TREATMENT
COMPLICATIONS
PROGNOSIS
PEARLS FOR PRACTITIONERS
88 Kawasaki Disease
Etiology
Epidemiology
Clinical Manifestations
Acute PhaseThe
Subacute Phase
Convalescent Phase
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Pearls for Practitioners
CHAPTER 89 Juvenile Idiopathic Arthritis
ETIOLOGY
EPIDEMIOLOGY
CLINICAL PRESENTATION
LABORATORY AND IMAGING STUDIES
DIFFERENTIAL DIAGNOSIS
TREATMENT
COMPLICATIONS
PROGNOSIS
PEARLS FOR PRACTITIONERS
CHAPTER 90 Systemic Lupus Erythematosus
ETIOLOGY
EPIDEMIOLOGY
LABORATORY AND IMAGING STUDIES
DIFFERENTIAL DIAGNOSIS
TREATMENT
COMPLICATIONS
PROGNOSIS
PEARLS FOR PRACTITIONERS
91 Juvenile Dermatomyositis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Pearls for Practitioners
CHAPTER 92 Musculoskeletal Pain Syndromes
GROWING PAINS
BENIGN HYPERMOBILITY
MYOFASCIAL PAIN SYNDROMES AND FIBROMYALGIA
PEARLS FOR PRACTITIONERS
PEARLS FOR PRACTITIONERS
Rheumatic Assessment
IgA Vasculitis (Henoch-Schönlein Purpura)
Kawasaki Disease
Juvenile Idiopathic Arthritis
Systemic Lupus Erythematosus
Juvenile Dermatomyositis
Musculoskeletal Pain Syndromes
Section 16
Infectious Diseases
93 Infectious Disease Assessment
Initial Diagnostic Evaluation
Differential Diagnosis
Screening Tests
Diagnostic Imaging
Pearls for Practitioners
94 Immunization and Prophylaxis
Immunization
Prophylaxis
Meningococcus
Tetanus
Rabies
Pearls for Practitioners
95 Antiinfective Therapy
Pearls for Practitioners
96 Fever Without a Focus
Fever in Infants Younger than 2 Months of Age
Fever in Children 2 Months to 3 Years of Age
Fever of Unknown Origin
Pearls for Practitioners
97 Infections Characterized byFever and Rash
Measles (Rubeola)
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Rubella (German or 3-Day Measles)
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Roseola Infantum (Exanthem Subitum)
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Erythema Infectiosum (Fifth Disease)
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Varicella-Zoster Virus Infection (Chickenpox and Zoster)
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
98 Cutaneous Infections
Superficial Bacterial Infections
Impetigo
Cellulitis
Folliculitis
Perianal Dermatitis
Superficial Fungal Infections
Superficial Viral Infections
Herpes Simplex Virus
Human Papillomaviruses (Warts)
Molluscum Contagiosum
Pearls for Practitioners
99 Lymphadenopathy
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
100 Meningitis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
101 Encephalitis
Etiology
Epidemiology
Clinical Manifestations
Differential Diagnosis
Laboratory and Imaging Studies
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
102 The Common Cold
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
103 Pharyngitis
Etiology
Epidemiology
Clinical Manifestations
Laboratory Evaluation
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
104 Sinusitis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
105 Otitis Media
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
106 Otitis Externa
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
107 Croup (Laryngotracheobronchitis)
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
108 Pertussis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
109 Bronchiolitis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
110 Pneumonia
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
111 Infective Endocarditis
Etiology
Epidemiology
Clinical Manifestations
Laboratory Studies and Imaging
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
112 Acute Gastroenteritis
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
113 Viral Hepatitis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
114 Urinary Tract Infection
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls For Practitioners
115 Vulvovaginitis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
116 Sexually Transmitted Infections
Pelvic Inflammatory Disease
Gonorrhea (Neisseria gonorrhoeae)
Chlamydia (Chlamydia trachomatis)
Syphilis (Treponema pallidum)
Herpes Simplex Virus Infection
Trichomoniasis (Trichomonas vaginalis)
Genital Warts (Human Papillomaviruses)
Pubic Lice (Phthirus pubis)
Pearls for Practitioners
117 Osteomyelitis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
118 Infectious Arthritis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
119 Ocular Infections
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
120 Infection in the Immunocompromised Person
Etiology
Epidemiology
Clinical Manifestations
Laboratory Tests and Imaging
Differential Diagnosis
Treatment
Prevention
Pearls for Practitioners
121 Infections Associated with Medical Devices
Vascular Device Infections
Ventilator-Associated Pneumonia
Urinary Catheters
Peritoneal Dialysis–Associated Infections
Central Nervous System Shunts
Pearls for Practitioners
122 Zoonoses and Vector-Borne Infections
Lyme Disease (Borrelia burgdorferi)
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Rocky Mountain Spotted Fever (Rickettsia rickettsii)
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Ehrlichiosis (Ehrlichia chaffeensis) and Anaplasmosis (Anaplasma phagocytophilum)
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
West Nile Virus (see Chapter 101)
Dengue Fever
Ebola Virus
Chikungunya Virus
Zika Virus
Pearls for Practitioners
123 Parasitic Diseases
Protozoal Diseases
Malaria
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Toxoplasmosis
Helminthiases
Hookworm Infections
Ascariasis
Visceral Larva Migrans
Enterobiasis (Pinworm)
Schistosomiasis
Echinococcosis
Neurocysticercosis
Pearls for Practitioners
124 Tuberculosis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Diagnostic Imaging
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Pearls for Practitioners
125 Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Prevention
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
93
Infectious Disease Assessment
94
Immunization and Prophylaxis
95
Antiinfective Therapy
96
Fever Without a Focus
97
Infections Characterized by Fever and Rash
98
Cutaneous Infections
Lymphadenopathy
Meningitis
Encephalitis
102
The Common Cold
103
Pharyngitis
Sinusitis
105
Otitis Media
106
Otitis Externa
107
Croup (Laryngotracheobronchitis)
108
Pertussis
109
Bronchiolitis
110
Pneumonia
111
Infective Endocarditis
112
Acute Gastroenteritis
Viral Hepatitis
114
Urinary Tract Infection
Vulvovaginitis
Sexually Transmitted Infections
117
Osteomyelitis
Infectious Arthritis
Ocular Infections
Infection in the Immunocompromised Person
121
Infections Associated with Medical Devices
122
Zoonoses and Vector-Borne Infections
123
Parasitic Diseases
124
Tuberculosis
125
Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome
Section 17
The Digestive System
Dawn R. Ebach | Warren P. Bishop
126 Digestive System Assessment
History
Physical Examination
Screening Tests
Diagnostic Imaging
Radiology
Endoscopy
Common Manifestations of Gastrointestinal Disorders
Abdominal Pain
General Considerations
Acute Abdominal Pain
Distinguishing Features
Initial Diagnostic Evaluation
Differential Diagnosis
Functional Abdominal Pain and Irritable Bowel Syndrome
Differential Diagnosis
Distinguishing Features
Treatment of Recurrent Abdominal Pain
Vomiting
Differential Diagnosis
Distinguishing Features
Acute and Chronic Diarrhea
Differential Diagnosis
Distinguishing Features
Constipation and Encopresis
Differential Diagnosis
Distinguishing Features
Evaluation and Treatment of Functional Constipation
Gastrointestinal Bleeding
Differential Diagnosis
Distinguishing Features
Treatment
Pearls for Practitioners
127 Oral Cavity
Effects of Systemic Disease on the Oral Cavity
Deciduous and Primary Teeth
Dental Caries
Etiology
Epidemiology and Treatment
Prevention
Cleft Lip and Palate
Epidemiology
Etiology
Clinical Manifestations and Treatment
Complications
Thrush
Epidemiology
Clinical Manifestations
Treatment
Pearls for Practitioners
128 Esophagus and Stomach
Gastroesophageal Reflux
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Eosinophilic Esophagitis
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment and Prognosis
Complications
Esophageal Atresia and Tracheoesophageal Fistula
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment and Prognosis
Complications
Esophageal Foreign Bodies
Etiology and Epidemiology
Clinical Manifestations
Diagnosis
Treatment
Complications
Caustic Injuries and Pill Ulcers
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Complications
Pyloric Stenosis
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Peptic Disease
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Cyclic Vomiting Syndrome
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Pearls for Practitioners
129 Intestinal Tract
Malrotation
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Intestinal Atresia
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Other Congenital Disorders
Inflammatory Bowel Disease
Epidemiology and Etiology
Laboratory and Imaging Studies
Treatment
Ulcerative Colitis
Crohn Disease
Celiac Disease
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Milk and Soy Protein Intolerance (Allergic Colitis)
Intussusception
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Appendicitis
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Pearls for Practitioners
130 Liver Disease
Cholestasis
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Viral Hepatitis
Fulminant Liver Failure
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Chronic Liver Disease
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Selected Chronic Hepatic Disorders
Wilson Disease
Autoimmune Hepatitis
Nonalcoholic Fatty Liver Disease
Pearls for Practitioners
131 Pancreatic Disease
Pancreatic Insufficiency
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Acute Pancreatitis
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Chronic Pancreatitis
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Pearls for Practitioners
132 Peritonitis
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
Digestive System Assessment
Oral Cavity
Esophagus and Stomach
Intestinal Tract
Liver Disease
Pancreatic Disease
Peritonitis
Section 18
The Respiratory System
133 Respiratory System Assessment
Anatomy of the Respiratory System
Pulmonary Physiology
Pulmonary Mechanics
Respiratory Gas Exchange
Lung Defense Mechanisms
History
Physical Examination
Diagnostic Measures
Imaging Techniques
Measures of Respiratory Gas Exchange
Pulmonary Function Testing
Endoscopic Evaluation of the Airways
Examination of Sputum
Lung Biopsy
Therapeutic Measures
Oxygen Administration
Aerosol Therapy
Chest Physiotherapy and Airway Clearance Techniques
Intubation
Tracheostomy
Mechanical Ventilation
Pearls for Practitioners
134 Control of Breathing
Apnea
Etiology
Brief Resolved Unexplained Events
Sudden Infant Death Syndrome
Etiology and Epidemiology
Differential Diagnosis
Prevention
Pearls for Practitioners
135 Upper Airway Obstruction
Etiology
Clinical Manifestations
Diagnostic Studies
Differential Diagnosis
Choanal Stenosis (Atresia)
Croup (Laryngotracheobronchitis)
Epiglottitis
Bacterial Tracheitis
Laryngomalacia
Etiology
Clinical Manifestations
Diagnostic Studies
Treatment
Subglottic Stenosis
Etiology
Clinical Manifestations
Diagnostic Studies
Treatment
Mass Lesions
Vocal Cord Paralysis
Etiology
Clinical Manifestations
Treatment and Prognosis
Adenoidal and Tonsillar Hypertrophy
Etiology
Clinical Manifestations
Diagnostic Studies
Treatment
Pearls for Practitioners
136 Lower Airway, Parenchymal, and Pulmonary Vascular Diseases
Etiology
Clinical Manifestations
Diagnostic Studies
Differential Diagnosis
Asthma
Tracheomalacia
Etiology
Clinical Manifestations
Treatment
Tracheoesophageal Fistula
Extrinsic Tracheal Compression
Foreign Body Aspiration
Epidemiology
Clinical Manifestations
Diagnostic Studies
Prevention
Bronchiolitis
Bronchopulmonary Dysplasia
Congenital Lung Anomalies
Primary Ciliary Dyskinesia
Etiology
Clinical Manifestations
Diagnostic Studies
Treatment
Pneumonia
Pulmonary Edema
Etiology
Clinical Manifestations
Diagnostic Studies
Treatment and Prognosis
Acute Respiratory Distress Syndrome
Pulmonary Arterial Hypertension and Cor Pulmonale
Etiology
Clinical Manifestations and Diagnostic Studies
Treatment and Prognosis
Pulmonary Hemorrhage
Etiology
Clinical Manifestations
Diagnostic Studies
Treatment
Pulmonary Embolism
Etiology
Clinical Manifestations
Diagnostic Studies
Treatment
Pearls for Practitioners
137 Cystic Fibrosis
Etiology and Epidemiology
Clinical Manifestations
Diagnostic Studies
Treatment
Pearls for Practitioners
138 Chest Wall and Pleura
Pectus Excavatum and Carinatum
Pectus Excavatum
Pectus Carinatum
Pneumothorax
Etiology
Clinical Manifestations
Diagnostic Studies
Treatment
Pneumomediastinum
Pleural Effusion
Etiology
Clinical Manifestations
Diagnostic Studies
Treatment
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
133
Respiratory System Assessment
134
Control of Breathing
135
Upper Airway Obstruction
136
Lower Airway, Parenchymal, and Pulmonary Vascular Diseases
137
Cystic Fibrosis
138
Chest Wall and Pleura
Section 19
The Cardiovascular System
139 Cardiovascular System Assessment
History
Physical Examination
Heart Sounds
Clicks
Murmurs
Laboratory and Imaging Tests
Pulse Oximetry
Electrocardiography
Chest Radiography
Echocardiography
Cardiac Catheterization
Cardiac Computed Tomography/Magnetic Resonance Imaging
Pearls for Practitioners
140 Syncope
Etiology
Clinical Manifestations
Diagnostic Studies
Pearls for Practitioners
141 Chest Pain
Etiology
Clinical Manifestations
Diagnostic Studies
Pearls for Practitioners
142 Dysrhythmias
Etiology and Differential Diagnosis
Atrial Dysrhythmias
Ventricular Dysrhythmias
Heart Block
Treatment
Pearls for Practitioners
143 Acyanotic Congenital Heart Disease
Etiology and Epidemiology
Ventricular Septal Defect
Etiology and Epidemiology
Clinical Manifestations
Imaging Studies
Treatment
Atrial Septal Defect
Etiology and Epidemiology
Clinical Manifestations
Imaging Studies
Treatment
Patent Ductus Arteriosus
Etiology and Epidemiology
Clinical Manifestations
Imaging Studies
Treatment
Endocardial Cushion Defect
Etiology and Epidemiology
Clinical Manifestations
Imaging Tests
Treatment
Pulmonary Stenosis
Etiology
Clinical Manifestations
Imaging Tests
Treatment
Aortic Stenosis
Etiology and Epidemiology
Clinical Manifestations
Imaging Studies
Treatment
Coarctation of the Aorta
Etiology and Epidemiology
Clinical Manifestations
Imaging Studies
Treatment
Pearls for Practitioners
144 Cyanotic Congenital Heart Disease
Tetralogy of Fallot
Etiology and Epidemiology
Clinical Manifestations
Imaging Studies
Treatment
Transposition of the Great Arteries
Etiology and Epidemiology
Clinical Manifestations
Imaging Studies
Treatment
Tricuspid Atresia
Etiology and Epidemiology
Clinical Manifestations
Imaging Studies
Treatment
Truncus Arteriosus
Etiology and Epidemiology
Clinical Manifestations
Imaging Studies
Treatment
Total Anomalous Pulmonary Venous Return
Etiology and Epidemiology
Clinical Manifestations
Imaging Studies
Treatment
Hypoplastic Left Heart Syndrome
Etiology and Epidemiology
Clinical Manifestations
Imaging Studies
Treatment
Complications of Congenital Heart Disease
Pearls for Practitioners
145 Heart Failure
Etiology and Epidemiology
Clinical Manifestations
Imaging Studies
Treatment
Pearls for Practitioners
146 Rheumatic Fever
Etiology and Epidemiology
Clinical Manifestations
Treatment and Prevention
Pearls for Practitioners
147 Cardiomyopathies
Etiology
Clinical Manifestations
Imaging Studies
Treatment
Pearls for Practitioners
148 Pericarditis
Etiology and Epidemiology
Clinical Manifestations
Imaging and Laboratory Studies
Treatment
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
Cardiovascular System Assessment
Syncope
Chest Pain
Dysrhythmias
Acyanotic Congenital Heart Disease
Cyanotic Congenital Heart Disease
Heart Failure
Rheumatic Fever
Cardiomyopathies
Pericarditis
Section 20
Hematology
149 Hematology Assessment
History
Physical Examination and Common Manifestations
Initial Diagnostic Evaluation
Developmental Hematology
Pearls for Practitioners
150 Anemia
Etiology
Clinical Manifestations
Laboratory Studies
Differential Diagnosis
Microcytic Anemia
Iron-Deficiency Anemia
Etiology
Epidemiology
Clinical Manifestations
Treatment
Prevention
Thalassemia Minor
Etiology and Epidemiology
Laboratory Testing
Treatment
Lead Poisoning
Normocytic Anemia
Etiology and Treatment
Macrocytic Anemia
Marrow Failure/Pancytopenia
Etiology
Differential Diagnosis
Aplastic Anemia
Etiology and Epidemiology
Laboratory Studies
Treatment
Fanconi Anemia
Etiology and Epidemiology
Clinical Manifestations
Treatment
Marrow Replacement
Pancytopenia Resulting from Destruction of Cells
Hemolytic Anemias
Major Hemoglobinopathies
Alpha Chain Hemoglobinopathies
Etiology.
Beta Chain Hemoglobinopathies
β-Thalassemia Major (Cooley Anemia)
Etiology and Epidemiology
Clinical Manifestations
Treatment
Sickle Cell Disease
Etiology and Epidemiology
Clinical Manifestations and Treatment
Laboratory Diagnosis
Treatment
Enzymopathies
Etiology
Epidemiology
Clinical Manifestations
Laboratory Studies
Treatment and Prevention
Membrane Disorders
Etiology
Clinical Manifestations
Laboratory Diagnosis
Treatment
Hemolytic Anemia Caused by Disorders Extrinsic to the Red Blood Cell
Etiology and Clinical Manifestations
Laboratory Diagnosis
Treatment and Prognosis
Pearls for Practitioners
151 Hemostatic Disorders
Normal Hemostasis
Developmental Hemostasis
Hemostatic Disorders
Etiology and Epidemiology
Clinical Manifestations
Laboratory Testing
Differential Diagnosis
Disorders of Platelets
Thrombocytopenia Resulting from Decreased Platelet Production
Thrombocytopenia Resulting from Peripheral Destruction
Etiology
Clinical Manifestations
Treatment
Idiopathic Thrombocytopenic Purpura
Etiology
Clinical Manifestations
Diagnosis
Treatment and Prognosis
Other Disorders
Disorders of Platelet Function
Etiology
Clinical Manifestations
Disorders of Clotting Factors
Etiology
Hemophilia
Etiology
Clinical Manifestations
Laboratory Studies
Treatment
von Willebrand Disease
Etiology
Clinical Manifestations
Laboratory Testing
Treatment
Vitamin K Deficiency
Disseminated Intravascular Coagulation
Etiology
Clinical Manifestations
Treatment
Thrombosis
Etiology
Clinical Manifestations
Diagnostic and Imaging Studies
Treatment
Pearls for Practitioners
152 Blood Component Therapy
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
Hematology Assessment
Anemia
Hemostatic Disorders
Blood Component Therapy
Section 21
Oncology
153 Oncology Assessment
History
Physical Examination
Common Manifestations
Differential Diagnosis
Initial Diagnostic Evaluation
Screening Tests
Diagnostic Imaging
Pearls for Practitioners
154 Principles of Cancer Treatment
Oncologic Emergencies
Surgery
Chemotherapy
Radiation Therapy
Other Therapies
Adverse Effects
Pearls for Practitioners
155 Leukemia
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Pearls for Practitioners
156 Lymphoma
Etiology
Epidemiology
Clinical Manifestations
Laboratory/Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Pearls for Practitioners
157 Central Nervous System Tumors
Etiology
Epidemiology
Clinical Manifestations
Laboratory/Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Pearls for Practitioners
158 Neuroblastoma
Etiology
Epidemiology
Clinical Manifestations
Laboratory/Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Pearls for Practitioners
159 Wilms Tumor
Etiology and Epidemiology
Clinical Manifestations
Laboratory/Imaging Studies
Differential Diagnosis
Treatment
Prognosis and Complications
Pearls for Practitioners
160 Sarcomas
Etiology
Epidemiology
Clinical Manifestations
Laboratory/Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
Oncology Assessment
Principles of Cancer Treatment
Leukemia
Lymphoma
Central Nervous System Tumors
Neuroblastoma
Wilms Tumor
Sarcomas
Section 22
Nephrology and Urology
161 Nephrology and Urology Assessment
Renal Physiology
Clinical Manifestations
History and Physical Examination
Diagnostic Studies
Laboratory Studies
Imaging Studies
Pearls for Practitioners
162 Nephrotic Syndrome and Proteinuria
Etiology and Epidemiology
Clinical Manifestations
Diagnostic Studies
Treatment
Complications
Prognosis
Pearls for Practitioners
163 Glomerulonephritis and Hematuria
Etiology and Epidemiology
Clinical Manifestations
Diagnostic Studies
Treatment
Prognosis and Prevention
Pearls for Practitioners
164 Hemolytic Uremic Syndrome
Etiology and Epidemiology
Clinical Manifestations
Diagnostic Studies
Treatment and Prognosis
Pearls for Practitioners
165 Acute Kidney Injury and Chronic Kidney Disease
Acute Kidney Injury
Etiology
Clinical Manifestations
Diagnostic Studies
Treatment
Prognosis
Chronic Kidney Disease
Etiology and Epidemiology
Clinical Manifestations
Treatment
Prognosis
Pearls for Practitioners
166 Hypertension
Definition
Etiology
Clinical Manifestations
Diagnostic Studies
Treatment
Prognosis
Pearls for Practitioners
167 Vesicoureteral Reflux
Etiology and Epidemiology
Clinical Manifestations
Diagnostic Studies
Management
Pearls for Practitioners
168 Congenital and Developmental Abnormalities of the Urinary Tract
Etiology and Epidemiology
Abnormal Kidney Structure
Abnormal Kidney Position
Abnormal Urinary Tract
Pearls for Practitioners
169 Other Urinary Tract and Genital Disorders*
Urinary Stone Disease
Etiology
Clinical Manifestations
Diagnostic Studies
Treatment
Voiding Dysfunction
Etiology and Epidemiology
Clinical Manifestations
Diagnostic Studies
Treatment
Disorders of the Penis
Etiology
Clinical Manifestations and Treatment
Disorders of the Scrotum and its Contents
Epidemiology
Clinical Manifestations
Complications
Treatment
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
Nephrology and Urology Assessment
Nephrotic Syndrome and Proteinuria
Glomerulonephritis and Hematuria
Hemolytic Uremic Syndrome
Acute Kidney Injury and Chronic Kidney Disease
Hypertension
Vesicoureteral Reflux
Congenital and Developmental Abnormalities of the Urinary Tract
Other Urinary Tract and Genital Disorders
Section 23
Endocrinology
170 Endocrinology Assessment
Hypothalamic-Pituitary Axis
Disorders of the Hypothalamic-Pituitary Axis
Pearls for Practitioners
171 Diabetes Mellitus
Definition
Type 1 Diabetes Mellitus
Etiology
Epidemiology
Clinical Manifestations
Diabetic Ketoacidosis
Pathophysiology
Clinical Presentation
Treatment
Hyperglycemia
Acidosis
Electrolyte Imbalances
Monitoring
Complications
Transition to Outpatient Management
Honeymoon Period
Outpatient Type 1 Diabetes Mellitus Management
Goals
Insulin Regimens
Blood Glucose Testing
Insulin Pumps, Continuous Glucose Monitors, and Closed-Loop Systems
Nutrition
Long-Term Glycemic Control
Complications
Other Disorders
Special Problems: Hypoglycemia
Prognosis
Type 2 Diabetes Mellitus
Pathophysiology
Epidemiology
Clinical Manifestations and Differential Diagnosis
Therapy
Maturity-Onset Diabetes of Youth (MODY)
Pearls for Practitioners
172 Hypoglycemia
Definition
Clinical Manifestations
Sequelae
Pathophysiology
Hormonal Signal
Hyperinsulinemia
Factitious Hyperinsulinemia
Defects in Counter-Regulatory Hormones
Energy Stores
Idiopathic Ketotic Hypoglycemia
Disrupted Metabolic Response Pathways
Glycogenolysis
Gluconeogenesis
Fatty Acid Oxidation
Other Metabolic Disorders
Medications and Intoxication
Diagnosis
Emergency Management
Pearls for Practitioners
173 Short Stature
Growth
Growth Hormone Physiology
Measurement of Growth
Endocrine Evaluation of Growth Hormone Secretion
Abnormalities of Growth
Short Stature Caused by Growth Hormone Deficiency
Etiology and Epidemiology
Clinical Manifestations
Treatment
Other Causes of Short Stature
Diagnosis
Pearls for Practitioners
174 Disorders of Puberty
Physiology
Delayed Puberty
Constitutional Delay in Growth and Adolescence
Hypogonadotropic Hypogonadism
Isolated Gonadotropin Deficiency
Abnormalities of the Central Nervous System
Acquired Causes of Hypogonadotropic Hypogonadism
Hypergonadotropic Hypogonadism
Primary Amenorrhea
Evaluation
Treatment
Sexual Precocity
Classification
Central Precocious Puberty (GnRH-Dependent Precocious Puberty)
GnRH-Independent Precocious Puberty
Evaluation of Sexual Precocity
Treatment
Variations in Pubertal Development
Isolated Premature Thelarche (Premature Breast Development)
Gynecomastia
Isolated Premature Adrenarche (Pubarche)
Pearls for Practitioners
175 Thyroid Disease
Thyroid Physiology and Development
Thyroid Disorders
Hypothyroidism
Congenital Hypothyroidism
Acquired Hypothyroidism
Hashimoto Thyroiditis
Hyperthyroidism
Graves Disease
Clinical Manifestations
Treatment
Drugs
Radioiodine
Surgery
Thyroid Storm
Congenital Hyperthyroidism
Nodules/Tumors of the Thyroid
Pearls for Practitioners
176 Disorders of Parathyroid Bone and Mineral Endocrinology
Parathyroid Hormone and Vitamin D
Hypocalcemia
Rickets
Pearls for Practitioners
177 Disorders of Sexual Development
Normal Sexual Development
Classification
Abnormal Sexual Development
46,XX Disorders of Sexual Development
46,XY Disorders of Sexual Development
Sex Chromosome and Ovotesticular Disorders of Sexual Development
Approach to the Infant with Genital Ambiguity
Diagnosis
Treatment
Pearls for Practitioners
178 Adrenal Gland Dysfunction
Physiology
Adrenal Insufficiency
21-Hydroxylase Deficiency
Other Enzyme Defects
Addison Disease
Cushing Syndrome
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
Endocrinology Assessment
Diabetes Mellitus
Hypoglycemia
Short Stature
Disorders of Puberty
Thyroid Disease
Disorders of Parathyroid Bone and Mineral Endocrinology
Disorders of Sexual Development
Adrenal Gland Dysfunction
Section 24 Neurology
179 Neurology Assessment
History
Physical Examination
Neurologic Examination of a Neonate
Mental Status
Reflexes
Motor Examination and Tone
Neurologic Examination of a Child
Mental Status and Developmental Evaluation
Cranial Nerve Evaluation
Cranial Nerve I
Cranial Nerve II
Cranial Nerves III, IV, and VI
Cranial Nerve V
Cranial Nerve VII
Cranial Nerve VIII
Cranial Nerves IX and X
Cranial Nerve XI
Cranial Nerve XII
Motor Examination
Tone
Bulk
Strength
Coordination
Gait
Reflexes
Sensory Examination
Special Diagnostic Procedures
Cerebrospinal Fluid Analysis
Electroencephalography
Electromyography and Nerve Conduction Studies
Neuroimaging
Pearls for Practitioners
180 Headache and Migraine
Etiology and Epidemiology
Clinical Manifestations
Diagnostic Studies
Treatment
Pearls for Practitioners
181 Seizures
Etiology and Epidemiology
Focal Seizures
Generalized Seizures
Absence Seizures
Atypical Absence, Myoclonic, and Atonic Seizures
Febrile Seizures
Psychogenic Nonepileptic Events
Epilepsy Syndromes
Status Epilepticus
Laboratory and Diagnostic Evaluation
Long-Term Therapy
Pearls for Practitioners
182 Weakness and Hypotonia
Etiology
Clinical Manifestations
Disease of the Upper Motor Neuron
Etiology and Epidemiology
Diseases of the Lower Motor Neuron
Spinal Muscular Atrophy
Etiology
Clinical Manifestations
Laboratory and Diagnostic Studies
Treatment
Acute Flaccid Myelitis
Peripheral Neuropathy
Guillain-Barré Syndrome
Chronic Inflammatory Demyelinating Polyneuropathy
Hereditary Motor Sensory Neuropathy
Tick Paralysis
Myasthenia Gravis
Juvenile Myasthenia
Transient Neonatal Myasthenia Gravis
Congenital Myasthenic Syndromes
Diagnostic Studies
Infant Botulism
Muscular Dystrophy
Etiology
Clinical Manifestations
Laboratory and Diagnostic Studies
Treatment
Myotonic Dystrophy
Etiology and Epidemiology
Clinical Manifestations
Other Forms of Childhood Muscle Disease
Metabolic Myopathies
Laboratory and Diagnostic Studies
Malignant Hyperthermia
Neonatal and Infantile Hypotonia
Hypotonia Without Significant Weakness (Central Hypotonia)
Stroke in Childhood
Etiology
Clinical Manifestations
Differential Diagnosis
Diagnostic Tests and Imaging
Treatment
Pearls for Practitioners
183 Ataxia and Movement Disorders
Ataxia
Clinical Manifestations
Etiologies
Movement Disorders
Pearls for Practitioners
184 Altered Mental Status
Disorders of Consciousness
Acute Disorders of Consciousness
Assessment
Etiology
Clinical Manifestations
Laboratory and Diagnostic Imaging
Treatment
Prognosis
Transient, Recurrent Depression of Consciousness
Increased Intracranial Pressure
Etiology
Clinical Manifestations
Laboratory and Diagnostic Studies
Treatment of Elevated Intracranial Pressure
Traumatic Brain Injury
Concussion
Traumatic Intracranial Hemorrhage
Skull Fractures
Other Complications of Head Trauma
Evaluation and Treatment
Prognosis
Pearls for Practitioners
185 Neurodegenerative Disorders
Hereditary and Metabolic Degenerative Diseases
Sphingolipidoses
Neuronal Ceroid Lipofuscinoses
Adrenoleukodystrophy
Mucopolysaccharidoses
Mitochondrial Disorders
Rett Syndrome
Degenerative Diseases with Focal Manifestations
Acquired Illnesses Mimicking Degenerative Diseases
Pearls for Practitioners
186 Neurocutaneous Disorders
Neurofibromatosis Type 1
Etiology
Clinical Manifestations
Neurofibromatosis Type 2
Tuberous Sclerosis Complex
Etiology
Clinical Manifestations
Sturge-Weber Syndrome
Pearls for Practitioners
187 Congenital Malformations of the Central Nervous System
Congenital Anomalies of the Spinal Cord
Etiology and Clinical Manifestations
Diagnostic Studies
Treatment and Prevention
Congenital Malformations of the Brain
Macrocephaly and Microcephaly
Disorders of Neuronal Migration
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
179
Neurology Assessment
180
Headache and Migraine
181
Seizures
182
Weakness and Hypotonia
183
Ataxia and Movement Disorders
184
Altered Mental Status
185
Neurodegenerative Disorders
186
Neurocutaneous Disorders
187
Congenital Malformations of the Central Nervous System
Section 25
Dermatology
188 Dermatology Assessment
History
Physical Examination
Common Manifestations
Initial Diagnostic Evaluation and Tests
Pearls for Practitioners
189 Acne Vulgaris
Etiology
Epidemiology
Clinical Manifestations
Treatment
Complications
Prognosis
Prevention
Pearls for Practitioners
190 Atopic Dermatitis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Prevention
Pearls for Practitioners
191 Contact Dermatitis
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prevention
Pearls for Practitioners
192 Seborrheic Dermatitis
Etiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Prognosis
Prevention
Other Papulosquamous Dermatoses
Pityriasis Rosea
Psoriasis
Pearls for Practitioners
193 Pigmented Lesions
Dermal Melanocytosis
Café-Au-Lait Macules
Congenital Melanocytic Nevi
Giant Congenital Melanocytic Nevi
Acquired Melanocytic Nevi
Pearls for Practitioners
194 Vascular Anomalies
Vascular Tumors
Infantile Hemangiomas
Pyogenic Granuloma
Vascular Malformations
Port-Wine Stain
Pearls for Practitioners
195 Erythema Multiforme, Reactive Infectious Mucocutaneous Eruption, Stevens-Johnson Syndrome, and Toxic Epidermal Necrolys ...
Erythema Multiforme
Reactive Infectious Mucocutaneous Eruption
Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
Pearls for Practitioners
196 Cutaneous Infestations
Scabies
Pediculoses
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
Dermatology Assessment
Acne Vulgaris
Atopic Dermatitis
Contact Dermatitis
Seborrheic Dermatitis
Pigmented Lesions
Vascular Anomalies
Erythema Multiforme, Reactive Infectious Mucocutaneous Eruption, Stevens-Johnson Syndrome, and Toxic Epidermal Necrolysis
Cutaneous Infestations
Section 26
Orthopedics
197 Orthopedics Assessment
Growth and Development
Developmental Milestones
Infants
Gait
Limping Child
Pearls for Practitioners
198 Fractures
Pediatric Fracture Patterns
Physeal Fractures
Management of Pediatric Fractures
Special Concerns
Remodeling
Overgrowth
Progressive Deformity
Neurovascular Injury
Compartment Syndrome
Toddler’s Fracture
Child Abuse
Pearls for Practitioners
199 Hip
Developmental Dysplasia of the Hip
Etiology
Clinical Manifestations
Radiographic Evaluation
Treatment
Complications
Transient Monoarticular Synovitis
Etiology and Epidemiology
Clinical Manifestations and Evaluation
Treatment
Legg-Calve-Perthes Disease
Etiology and Epidemiology
Clinical Manifestations
Radiologic Evaluation
Treatment and Prognosis
Slipped Capital Femoral Epiphysis
Etiology and Epidemiology
Classification
Clinical Manifestation
Radiologic Evaluation
Treatment
Complications
Pearls for Practitioners
200 Lower Extremity and Knee
Torsional Variations
In-Toeing
Femoral Anteversion
Internal Tibial Torsion
Treatment of In-Toeing
Out-Toeing
External Tibial Torsion
Angular Variations
Genu Valgum
Genu Varum
Tibia Vara (Blount Disease)
Clinical Manifestations
Radiologic Evaluation
Treatment
Leg-Length Discrepancy
Measuring Leg-Length Discrepancy
Treatment
Knee
Discoid Lateral Meniscus
Popliteal Cyst
Osteochondritis Dissecans
Osgood-Schlatter Disease
Patellofemoral Disorders
Anterior Cruciate Ligament Tears
Pearls for Practitioners
201 Foot
Clubfoot (Talipes Equinovarus)
Etiology
Clinical Manifestations
Radiologic Evaluation
Treatment
Metatarsus Adductus
Clinical Manifestations
Treatment
Calcaneovalgus Foot
Hypermobile Pes Planus (Flexible Flatfoot)
Clinical Manifestations
Treatment
Tarsal Coalition
Clinical Manifestations
Radiologic Evaluation
Treatment
Cavovarus Foot
Idiopathic Avascular Necrosis
Sever Disease (Calcaneal Apophysitis)
Clinical Manifestations
Treatment
Toe Deformities
Pearls for Practitioners
202 Spine
Spinal Deformities
Clinical Manifestations
Radiologic Evaluation
Scoliosis
Idiopathic Scoliosis
Etiology and Epidemiology
Clinical Manifestations
Treatment
Congenital Scoliosis
Neuromuscular Scoliosis
Compensatory Scoliosis
Kyphosis
Postural Kyphosis
Scheuermann Kyphosis
Congenital Kyphosis
Torticollis
Etiology and Epidemiology
Clinical Manifestations and Evaluation
Treatment
Back Pain in Children
Etiology and Epidemiology
Clinical Manifestations and Management
Spondylolysis and Spondylolisthesis
Etiology and Epidemiology
Clinical Manifestations
Radiologic Evaluation
Treatment
Spondylolysis
Spondylolisthesis
SpondylodisKitis
Clinical Manifestations
Radiologic Evaluation
Treatment
Pearls for Practitioners
203 Upper Extremity
Shoulder
Sprengel Deformity
Clavicular Fractures
Brachial Plexus Injuries
Glenohumeral Dislocation
Overuse Injuries
Proximal Humeral Epiphysiolysis
Elbow
Radial Head Subluxation
Panner Disease
Throwing Injuries in the Elbow
Wrist and Hand
Finger Abnormalities
Pearls for Practitioners
204 Benign Bone Tumors and Cystic Lesions
Pearls for Practitioners
Suggested Readings
Pearls for Practitioners
Orthopedics Assessment
Fractures
Hip
Lower Extremity and Knee
Foot
Spine
Upper Extremity
Benign Bone Tumors and Cystic Lesions
Index