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Netter's Pediatrics E-Book

BOOK

Netter's Pediatrics E-Book

Todd Florin | Stephen Ludwig, MD | Paul L. Aronson | Heidi C. Werner

(2011)

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Additional Information

Book Details

ISBN
978-1-4557-1064-5
Edition
Language
English
Pages
864
Subjects
Paediatric medicine
Neonatal medicine
Medical study & revision guides & reference material

Abstract

Netter’s Pediatrics, edited by Drs. Todd Florin and Stephen Ludwig, is a rich visual aid with more than 500 images by Dr. Frank Netter and other artists working in his style that will help you diagnose and care for children with common clinical conditions. This is the first time that Netter’s drawings of pediatric illness are brought together in a single volume. The superb, accurate artwork accompanies up-to-date text contributed by physicians at the prestigious Children’s Hospital of Philadelphia. The book provides you with all the at-a-glance information you need for a quick overview of common issues from nutrition, allergy, infectious disease, and adolescent medicine, to cancer and heart disease. This user-friendly, clinical reference is also a great tool for patient and staff education.

  • Efficiently review key details for each condition with 500 detailed, crystal-clear images provided by Frank H. Netter and others working in the Netter tradition.

  • Apply dependable, concise, clinical advice from a team of physicians at Children’s Hospital of Philadelphia, one of the top children’s hospitals in the U.S.

  • Get answers at a glance during pediatric rotations when studying for exams or preparing for consultations.

Table of Contents

Section Title Page Action Price
Front cover cover
Marketing page i
Netter's Pediatrics iii
Copyright page iv
About the Editors v
About the Artists vi
Preface vii
Dedication viii
Acknowledgments ix
Editors x
Contributors xii
Table of Contents xx
I Care of the Acutely Ill Child 1
1 Resuscitation 2
Etiology and Pathogenesis 2
Clinical Presentation 2
Initial Assessment 2
Primary Assessement 2
Airway 3
Breathing 6
Circulation 6
Disability 9
Exposure 9
Secondary Assessment 10
Future Directions 10
Suggested Readings 10
2 Shock 11
Etiology and Pathogenesis 11
Compensated (Early) Shock 11
Uncompensated (Late) Shock 11
Classification of Shock 11
Hypovolemic Shock 11
Distributive Shock 11
Cardiogenic Shock 12
Neurogenic Shock 12
Septic Shock 12
Clinical Manifestations and Evaluation 12
Management 13
General Principles 13
Circulatory Support 14
Special Circumstances: Shock in Neonates 15
Future Directions 15
Suggested Readings 16
3 Respiratory Distress 17
Etiology and Pathogenesis 17
Clinical Presentation 17
Initial Assessment 17
History 17
Physical Examination 17
Vital Signs 17
Respiratory Examination 17
Differential Diagnosis 19
Evaluation and Management 19
Algorithm 19
Initial Management 19
Diagnostic Studies 21
Radiographs 21
Blood Tests 22
Suggested Readings 23
4 Diabetic Ketoacidosis 24
Etiology and Pathogenesis 24
Clinical Presentation 24
Differential Diagnosis 24
Evaluation and Management 26
Dehydration 26
Electrolyte Loss 26
Acidosis 27
Hyperglycemia 27
Monitoring 27
Complications 27
Resolution 27
Future Directions 28
Suggested Readings 28
5 The Acute Abdomen 29
Etiology and Pathogenesis 29
Clinical Presentation 29
Differential Diagnosis 29
History 29
Pain Character 29
Associated Symptoms 30
Pertinent Medical History 31
Physical Examination 31
Evaluation and Management 32
Laboratory Testing 32
Imaging Studies 33
Management 34
Future Directions 34
Suggested Readings 34
6 Drowning 35
Etiology and Pathogenesis 35
Clinical Presentation 35
Evaluation and Management 36
Prevention 37
Future Directions 38
Suggested Readings 38
7 Burns 39
Etiology and Pathogenesis 39
Clinical Presentation 39
Evaluation and Management 41
Suggested Readings 44
8 Injury and Trauma 45
Etiology and Pathogenesis 45
Evaluation and Management 45
Primary Survey (see Chapter 1) 45
Airway 45
Breathing 45
Circulation 46
Disability 47
Exposure and Environment 47
Secondary Survey 47
Head 48
Neck and Spine 50
Chest 51
Abdomen 52
Pelvis 54
Extremities and Neurologic Status 54
Radiation 54
Prevention 54
Suggested Readings 54
9 Poisoning 56
Etiology and Pathogenesis 56
Tricyclic Antidepressants 56
Antimalarials 56
Calcium Channel Blockers and Beta-Adrenergic Blockers 56
Camphor 56
Salicylates 56
Sulfonylureas 56
Opioids 56
Antidiarrheals 57
Clinical Presentation 57
Evaluation and Management 57
Activated Charcoal 59
Gastric Lavage 59
Whole-Bowel Irrigation 60
Dilution 60
Ipecac 60
Cathartics 60
Future Directions 61
Suggested Readings 61
10 Neurologic Emergencies 62
Status Epilepticus 62
Etiology and Pathogenesis 62
Clinical Presentation 62
History 62
Physical Examination 62
Differential Diagnosis 62
Evaluation and Management 63
Altered Level of Consciousness 63
Etiology and Pathogenesis 64
Evaluation and Management 64
Increased Intracranial Pressure 65
Etiology and Pathogenesis 65
Clinical Manifestations 65
Evaluation and Management 65
Suggested Readings 66
11 Apparent Life-Threatening Event and Sudden Infant Death Syndrome 67
Apparent Life-Threatening Event 67
Etiology and Pathogenesis 67
Clinical Presentation 67
Evaluation and Management 67
Home Apnea Monitoring 68
Future Directions 69
Sudden Infant Death Syndrome 69
Etiology and Pathogenesis 69
Clinical Presentation 70
Evaluation and Management 70
Prevention and Future Directions 71
Suggested Readings 71
Apparent Life-Threatening Event 71
Sudden Infant Death Syndrome 71
12 Child Abuse and Neglect 72
Physical Abuse 72
Clinical Presentation 72
Evaluation and Management 72
Sexual Abuse 73
Clinical Presentation 73
Evaluation and Management 73
Physical Abandonment and Neglect 77
Clinical Presentation 78
Evaluation and Management 78
Suggested Readings 79
II Nutrition 81
13 Nutritional Requirements and Growth 82
Nutritional Requirements 82
Fluids and Electrolytes 82
Calories 82
Macronutrients 82
Protein 82
Fat 82
Carbohydrates 82
Micronutrients 83
Calcium 83
Vitamin D 83
Iron 83
Other Micronutrients 83
Counseling 84
Infants 84
Children 84
Beverages 84
Growth 84
Types of Measurements 85
Measurement Methods 85
Use of Growth Curves 85
Assessing a Child’s Growth 85
Weight 86
Height and Length 86
Weight for Height and Body Mass Index 87
Head Circumference 87
Future Directions 87
Suggested Readings 87
14 Malnutrition 88
Clinical Presentation 88
Differential Diagnosis 88
Physiologic Changes Accompanying Malnutrition 88
Diagnostic Evaluations 88
Management 89
Management of Dehydration in Severely Malnourished Children 91
Future Directions 92
Suggested Readings 92
15 Obesity 93
Etiology and Pathogenesis 93
Clinical Presentation 93
Management 93
Prevention 93
Treatment Options 93
Behavioral 93
Pharmacologic 94
Surgery 95
Future Directions 95
Suggested Readings 96
16 Nutritional Deficiencies 97
Deficiencies 97
Iron 97
Iodine 97
Zinc 97
Vitamin A 97
Vitamin B 98
Vitamin C 100
Vitamin D 100
Future Directions 101
Suggested Readings 101
17 Failure to Thrive 102
Definition 102
Etiology and Pathogenesis 102
Nonorganic Factors 102
Organic Factors 102
Clinical Presentation 102
Differential Diagnosis 103
Evaluation and Management 103
Evaluation 103
Diet and Feeding 103
Psychosocial Factors Contributing to Failure to Thrive 103
Organic Causes of Failure to Thrive 104
Associated Conditions 105
Management 105
Treatment of Underlying Cause 105
Treatment of Feeding Difficulties 105
Supplemental Feeds 105
Hospitalization 105
Social Services 105
Future Directions 106
Suggested Readings 106
III Allergy and Immunology 107
18 Anaphylaxis 108
Etiology and Pathogenesis 108
Clinical Presentation 108
Differential Diagnosis 108
Evaluation and Management 109
Management 109
Emergency Management 110
Hospital Management 111
Disposition 112
Outpatient Management 112
Future Directions 112
Suggested Readings 113
19 Atopic Dermatitis 114
Etiology and Pathogenesis 114
Clinical Presentation 114
History 114
Physical Examination 114
Complications 114
Staphylococcus aureus Superinfection 114
Eczema Herpeticum 115
Evaluation and Management 115
Laboratory Testing 115
Diagnosis 116
Approach to Therapy 116
Topical Calcineurin Inhibitors 117
Additional Pharmacologic Therapies 117
Nonpharmacologic Interventions 117
Prevention of Atopic Dermatitis in Infants 117
Treatment of Complications 117
Treatment of Staphylococcus aureus Skin Colonization 117
Future Directions 118
Suggested Readings 118
20 Urticaria and Angioedema 119
Etiology and Pathogenesis 119
Acute Urticaria 119
Chronic Idiopathic Urticaria 119
Physical Urticaria 119
Angioedema 120
Clinical Presentation 120
History 121
Physical Examination 121
Evaluation and Management 122
Laboratory Testing 122
Management 122
Future Directions 123
Suggested Readings 123
21 Approach to the Child with Primary Immunodeficiency 124
Etiology and Pathogenesis 124
Disorders of the Innate Immune System 124
Phagocytes 124
Natural Killer Cells 124
Complement 124
Toll-like Receptors 124
Disorders of the Adaptive Immune System 125
Humoral Immune System 125
Cell-Mediated Immune System 125
Other Defects of the Adaptive Immune System 126
Clinical Presentation 126
History 126
Physical Exam 126
Differential Diagnosis 126
Evaluation and Management 126
Laboratory Studies 126
Radiographic Studies 127
Management 127
Future Directions 128
Suggested Readings 129
IV Bone and Joint Disorders 131
22 Common Fractures 132
Fracture Description 132
Common Fracture Types in Children 132
Physeal Fractures 132
Salter-Harris Type I Fracture 132
Salter-Harris Type II Fracture 132
Salter-Harris Type III Fracture 133
Salter-Harris Type IV Fracture 133
Salter-Harris Type V Fracture 133
Greenstick Fractures 133
Torus Fractures 133
Bowing Fractures 134
Apophyseal Avulsion Fractures 134
Fractures of the Upper Extremity 134
Clavicle Fractures 134
Fractures of the Humerus 135
Elbow Fractures 135
Anatomy of the Elbow 135
Supracondylar Fractures 135
Forearm Fractures 136
Fractures of the Hand and Wrist 136
Fractures of the Wrist 136
Metacarpal Fractures 136
Fractures of the Phalanges 137
Fractures of the Pelvis and Lower Extremities 137
Fractures of the Pelvis 137
Fractures of the Femur 138
Fractures of the Tibia and Fibula 138
Toddler’s Fracture 138
Fractures of the Ankle and Foot 139
Distal Tibial and Fibular Fractures 139
Fractures of the Foot 140
Future Directions 140
Suggested Readings 140
23 Disorders of the Hip and Lower Extremity 141
Congenital 141
Clubfoot 141
Developmental 141
In-toeing 141
Metatarsus Adductus 141
Internal Tibial Torsion 141
Femoral Anteversion 141
Bowlegs 142
Blount’s Disease and Adolescent Tibia Vara 142
Rickets 142
Developmental Dysplasia of the Hip 142
Acquired 144
Slipped Capital Femoral Epiphysis 144
Legg-Calvé-Perthes Disease 144
Transient Synovitis 145
Osteoid Osteoma 145
Future Directions 146
Suggested Readings 146
24 Disorders of the Neck and Spine 147
Congenital Muscular Torticollis 147
Scoliosis 147
Kyphosis 148
Spondylolysis and Spondylolisthesis 148
Vertebral Compression Fractures 149
Intervertebral Disk Herniation 149
Future Directions 150
Suggested Readings 150
25 Sports Medicine 151
Etiology and Pathogenesis 151
Injuries by Body System 151
Shoulder Injuries 151
Acromioclavicular Separation 151
Anterior Shoulder Dislocation 151
Elbow Injuries 151
Elbow Dislocation 152
Elbow Overuse Injuries 152
Hip Injuries 153
Avulsion Fractures 153
Femoral Neck Stress Fractures 153
Knee Injuries 153
Patellar Dislocation 153
Osgood-Schlatter Disease 154
Patellofemoral Pain Syndrome 154
Osteochondritis Dissecans 155
Soft Tissue Injuries 155
Leg, Ankle, and Foot Injuries 155
Shin Splints 155
Ankle Sprains 155
Sever Disease 156
Future Directions 156
Suggested Readings 156
V Rheumatologic Disorders 157
26 Chronic Arthritis 158
Etiology and Pathogenesis 158
Clinical Presentation 158
Oligoarticular Juvenile Idiopathic Arthritis 158
Polyarticular Juvenile Idiopathic Arthritis 158
Systemic Juvenile Idiopathic Arthritis 158
Psoriatic Arthritis 160
Enthesitis-Related Arthritis 160
Undifferentiated Arthritis 160
Differential Diagnosis 161
Evaluation and Management 161
Laboratory Analysis 161
Synovial Fluid Analysis 162
Imaging 162
Clinical Management 162
Pharmacologic Interventions 162
Surgical Management 162
Physical and Occupational Therapy 162
Future Directions 162
Suggested Readings 162
27 Juvenile Dermatomyositis 163
Etiology and Pathogenesis 163
Clinical Presentation 163
Cutaneous Features 163
Musculoskeletal Features 163
Other Disease Manifestations 164
Differential Diagnosis 164
Evaluation and Management 164
Future Directions 165
Suggested Readings 166
28 Vasculitis 167
Etiology and Pathogenesis 167
Classification 167
Clinical Presentation 167
Physical Examination 167
Evaluation and Management 168
Laboratory Evaluation 168
Management 168
Henoch Schönlein Purpura 168
Kawasaki Disease 170
Future Directions 171
Suggested Readings 172
29 Systemic Lupus Erythematosus 173
Etiology and Pathogenesis 173
Clinical Presentation 173
Skin and Mucus Membrane Manifestations 173
Musculoskeletal Manifestations 173
Renal Manifestations 173
Neuropsychiatric Manifestations 174
Hematologic Manifestations 174
Cardiopulmonary Manifestations 174
Differential Diagnosis 174
Morbidity and Mortality 175
Evaluation and Management 175
Management 176
Mild Disease 177
Moderate to Severe Disease 177
Future Directions 177
Suggested Readings 177
30 Granulomatous Disease 178
Sarcoidosis 178
Etiology and Pathogenesis 178
Clinical Presentation 178
Lymphoreticular System Manifestations 178
Pulmonary Manifestations 178
Ocular Manifestations 178
Skin Manifestations 178
Musculoskeletal Manifestations 178
Central Nervous System Manifestations 178
Other Manifestations 179
Differential Diagnosis 179
Evaluation and Management 179
Blood and Urine Studies 179
Imaging 180
Histology 181
Pulmonary Function Testing 181
Ophthalmologic Evaluation 181
Management 181
Wegener Granulomatosis 181
Etiology and Pathogenesis 181
Clinical Presentation 181
Pulmonary Manifestations 181
Renal Manifestations 181
Ear, Nose, and Throat Manifestations 181
Ocular Manifestations 181
Musculoskeletal Manifestations 181
Skin Manifestations 181
CNS Manifestations 181
Other Manifestations 181
Differential Diagnosis 182
VI Disorders of the Head, Neck, and Upper Airway 185
31 Otitis 186
Otitis Externa 186
Etiology and Pathogenesis 186
Clinical Presentation 186
Evaluation and Management 186
Future Directions 187
Otitis Media 188
Etiology and Pathogenesis 188
Clinical Presentation 188
Acute Otitis Media 188
Otitis Media with Effusion 189
Evaluation and Management 189
Acute Otitis Media Treatment 190
Otitis Media with Effusion Treatment 190
Future Directions 191
Suggested Readings 191
Otitis Externa 191
Otitis Media 191
32 Disorders of the Eye 192
Abnormal Red Light Reflex 192
Cataracts 192
Retinoblastoma 192
Disorders of Eye Movement 192
Strabismus 192
Amblyopia 192
Red Eye 193
Viral Conjunctivitis 193
Bacterial Conjunctivitis 193
Allergic Conjunctivitis 194
Chemical Conjunctivitis 194
Uveitis 194
Disorders of Adnexal Structures 194
Nasolacrimal Duct Obstruction 194
Hordeolum and Chalazion 194
Preseptal (Periorbital) Cellulitis 194
Orbital Cellulitis 194
Ocular Trauma 195
Corneal Abrasion 195
Hyphema 195
Retinal Hemorrhage 196
Subconjunctival Hemorrhage 196
Future Directions 196
Suggested Readings 196
33 Sinusitis 198
Etiology and Pathogenesis 198
Clinical Presentation 198
Evaluation and Management 198
Evaluation 198
Management 199
Antimicrobial Therapy 199
Adjuvant and Surgical Therapy 200
Rhinitis without Sinusitis 200
Complications 201
Future Directions 201
Suggested Readings 201
34 Dentition and Common Oral Lesions 202
Dentition 202
Normal Tooth Anatomy 202
Dental Trauma 202
Dental Infections 202
Caries 202
Periodontal Infections 204
Lesions of the Oral Soft Tissues 204
Anatomic Lesions of the Oral Cavity 204
Ankyloglossia 204
Geographic Tongue 204
Common Soft Tissue Lesions of the Oral Cavity 204
Mucocele 204
Ranula 204
Traumatic Ulcers 204
Aphthous Ulcers 205
Soft Tissue Infections of the Oral Cavity 205
Candidiasis 205
Primary Herpetic Gingivostomatitis 205
Enterovirus Infections 206
Future Directions 206
Suggested Readings 206
35 Pharyngitis 207
Etiology and Pathogenesis 207
Clinical Presentation 207
Evaluation and Management 207
Future Directions 211
Suggested Readings 211
36 Stridor 212
Etiology and Pathogenesis 212
VII Disorders of the Respiratory System and Lower Airway 217
37 Bronchiolitis and Wheezing 218
Etiology and Pathogenesis 218
Bronchiolitis 218
Asthma 218
Other Causes of Wheezing 220
Clinical Presentation 220
Evaluation and Management 222
Future Directions 222
Suggested Readings 223
38 Asthma 224
Etiology and Pathogenesis 224
Clinical Presentation 224
Differential Diagnosis 225
Evaluation 226
Chronic Disease 226
Acute Exacerbation 226
Management 229
Chronic Disease 229
Acute Exacerbation 229
Future Directions 230
Conclusion 231
Suggested Readings 231
39 Congenital Anomalies of the Lung 232
Congenital Anomalies of the Airway 232
Etiology and Pathogenesis 232
Clinical Presentation 232
Evaluation and Management 233
Congenital Anomalies of Lung Parenchyma 233
Etiology and Pathogenesis 233
Clinical Presentation 234
Evaluation and Management 235
Antenatal 235
Postnatal 235
Pulmonary Vascular Malformations 236
Etiology and Pathogenesis 236
Clinical Presentation 237
Evaluation and Management 237
Future Directions 237
Suggested Readings 237
40 Pleural Effusions and Pneumothorax 239
Pleural Effusions 239
Etiology and Pathogenesis 239
Clinical Presentation 239
Evaluation and Management 240
Pneumothorax 242
Etiology and Pathogenesis 242
Primary Spontaneous Pneumothorax 242
Secondary Spontaneous Pneumothorax 243
Clinical Presentation 243
Evaluation and Management 244
Future Directions 244
Suggested Readings 244
41 Cystic Fibrosis 246
Etiology and Pathogenesis 246
Clinical Presentation 246
Diagnosis 248
Management 248
Future Directions 249
Suggested Readings 249
VIII Disorders of the Cardiovascular System 251
42 Development of the Cardiovascular System 252
Embryologic Development 252
Heart Tube Formation 252
Cardiac Looping 252
Endocardial Cushion Development and Atrial Septation 252
Ventricular Septation 253
Development of Major Aortic and Pulmonary Outflow Tracts 254
Development of the Great Arteries 254
Development of Major Systemic and Pulmonary Veins 254
Development of Cardiac Conduction System and Coronary Vessels 256
Fetal Circulation 256
Postnatal Transitions And Neonatal Circulation 257
Future Directions 258
Suggested Readings 258
43 Acyanotic Congenital Heart Disease 259
Shunt Lesions 259
Atrial Septal Defect 259
Ventricular Septal Defect 259
Common Atrioventricular Canal 260
Patent Ductus Arteriosus 261
Nonshunt Lesions 261
Aortic Valve Disease 261
Coarctation of the Aorta 263
Pulmonary Valve Disease 266
Mitral Valve Disease 267
Vascular Ring 267
Future Directions 268
Suggested Readings 268
44 Cyanotic Congenital Heart Disease 269
Pathophysiology Of Cyanosis 269
Clinical Presentation And Evaluation 269
Transposition of the Great Arteries 270
Tetralogy of Fallot 271
Double Outlet Right Ventricle with Pulmonic Stenosis 272
Tricuspid Atresia 272
Critical Pulmonic Stenosis 273
Pulmonary Atresia 273
Ebstein’s Anomaly of the Tricuspid Valve 273
Total Anomalous Pulmonary Venous Connection 275
Truncus Arteriosus Communis 275
Future Directions 275
Suggested Readings 277
45 Arrhythmias 278
Sinus Arrhythmias and Premature Impulses 278
Sinus Bradycardia 278
Sinus Arrhythmia 278
Sinus Pauses 278
Premature Atrial Contractions 278
Premature Ventricular Contractions 278
Bradyarrhythmias 278
Sinus Node Dysfunction 278
Atrioventricular Conduction Abnormalities 278
First-Degree Atrioventricular Block 278
Second-Degree Atrioventricular Block 279
Third-Degree Atrioventricular Block or Complete Atrioventricular Block 279
Congenital Complete Heart Block 279
Acquired Complete Heart Block 280
Tachyarrhythmias 281
Supraventricular Tachycardias 281
Reentry Tachycardia with an Accessory Pathway 281
Reentry Tachycardia without an Accessory Pathway 281
Automatic Tachycardias 282
Ventricular Tachycardia 283
Long Qt Syndromes And Sudden Death 283
future directions 283
Suggested Readings 284
46 Heart Failure 285
Etiology And Presentation 285
Evaluation and Management 285
Case Example 287
Future Directions 288
Suggested Readings 288
47 Hypertension 289
Etiology And Pathogenesis 289
Definitions 289
Physiology 289
Clinical Presentation 289
Evaluation 289
Measurement of Blood Pressure 289
Cuff Size and Location 290
Diagnostic Approach 290
Management 292
Future Directions 293
Suggested Readings 293
48 Syncope 294
Etiology And Pathogenesis 294
Neurally Mediated Syncope 294
Vasovagal Syncope 294
Situational Syncope 294
Orthostatic Syncope 294
Postural Orthostatic Tachycardia Syndrome 294
Dysautonomia 294
Breath-Holding Spells 294
Cardiac Syncope 295
Arrhythmias 295
Long QT Syndrome 295
Preexcitation Syndromes 295
Short QT Syndrome 295
Brugada Syndrome 295
Catecholaminergic Polymorphic Ventricular Tachycardia 296
Bradycardia 296
Structural Heart Disease 296
Hypertrophic Cardiomyopathy 296
Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia 297
Dilated Cardiomyopathy 297
Aortic Stenosis 297
Abnormal Origin of the Coronary Arteries 297
Pulmonary Hypertension 297
Acute Myocarditis 297
Congestive Heart Failure 297
Metabolic Syncope 297
Syncope-like Events 297
Evaluation And Diagnostic Approach 298
Management: Indications For Referral And Admission 298
Future Directions 298
Suggested Readings 299
49 Acute Rheumatic Fever and Rheumatic Heart Disease 300
Etiology And Pathogenesis 300
Clinical Presentation 300
Diagnostic Evaluation 300
Laboratory Studies 300
Cardiac Evaluation 302
Chest Radiography 302
Electrocardiography 302
Two-Dimensional Echocardiography and Color Doppler 302
Cardiac Magnetic Resonance Imaging 302
Cardiac Catheterization 302
Management And Therapy 302
Acute Rheumatic Fever and Rheumatic Carditis 302
Chronic Rheumatic Heart Disease 304
Future Directions 305
Suggested Readings 306
IX Hematologic Disorders 307
50 Disorders of Red Blood Cells 308
Etiology and Pathogenesis 308
Congenital Red Blood Cell Disorders 308
Membrane Defects 308
Thalassemias 308
Hemoglobinopathies 308
Enzyme Deficiencies 308
Diamond-Blackfan Anemia 309
Congenital Bone Marrow Failure Syndromes 309
Acquired Red Blood Cell Disorders 309
Mechanical Red Blood Cell Destruction 309
Autoimmune Hemolytic Anemia 309
Anemia of Chronic Disease 309
Nutritional Deficiencies 310
Transient Erythroblastopenia of Childhood 310
Transient Red Blood Cell Aplasia from Parvovirus B19 310
Clinical Presentation and Differential Diagnosis 310
Diagnostic Approach 310
Management and Therapy 312
Congenital Disorders 312
Acquired Disorders 312
Future Directions 313
Suggested Readings 313
51 Disorders of White Blood Cells 314
Etiology and Pathogenesis 314
Clinical Presentation and Differential Diagnosis 314
Congenital Disorders of Neutrophils 314
Neutrophil Function Defects 314
Acquired Disorders of Neutrophils 314
Infection-Associated Neutropenia 314
Autoimmune Neutropenia 314
Isoimmune or Alloimmune Neonatal Neutropenia 315
Drug-Induced Neutropenia 315
Other Causes of Acquired Neutropenia 315
Leukocytosis 315
Neutrophilia 316
Monocytosis 316
Basophilia 316
Eosinophilia 316
Evaluation and Management 318
Future Directions 320
Suggested Readings 320
52 Platelet Disorders 321
Etiology and Pathogenesis 321
Congenital Platelet Disorders 321
Glanzmann’s Thrombasthenia 321
Bernard-Soulier Syndrome 321
Storage Pool Defects 321
Thrombocytopenia Absent Radii 321
Congenital Amegakaryocytic Thrombocytopenia 321
Wiskott-Aldrich 321
Macrothrombocytopenia Disorders 322
Essential Thrombocytosis 322
Acquired Platelet Disorders 322
Immune Thrombocytopenia 323
Neonatal Alloimmune Thrombocytopenia 323
Thrombotic Thrombocytopenic Purpura 323
Heparin-Induced Thrombocytopenia 323
Clinical Presentation And Differential Diagnosis 323
Diagnostic Approach 323
Management and Therapy 324
Future Directions 325
Suggested Readings 325
53 Sickle Cell Disease 326
Etiology and Pathogenesis 326
Clinical Presentation 326
Diagnostic Approach 326
Management and Therapy 326
Acute Complications 326
Fever 326
Vaso-occlusive Episodes 326
Acute Chest Syndrome 327
Splenic Sequestration 328
Transient Red Blood Cell Aplasia 328
Acute Stroke 329
Priapism 329
Routine Health Maintenance 329
Immunizations 329
Penicillin Prophylaxis 329
Folic Acid 329
Nutrition and Growth 329
Stroke Screening 329
Eye Examinations 329
Chronic Issues 329
Transfusion and Chelation Therapy 329
Hydroxyurea 330
Avascular Necrosis 330
Future Directions 330
Suggested Readings 330
54 Disorders of Thrombosis and Hemostasis 331
Epidemiology 331
X Neoplastic Disorders 337
55 Leukemia 338
Etiology And Pathogenesis 338
Genetics 338
Clinical Presentation 340
Evaluation 340
Classification 342
Management And Prognosis 344
Acute Lymphoblastic Leukemia 344
Acute Myelogenous Leukemia 344
Chronic Myelogenous Leukemia 344
Relapse 344
Future Directions 344
Suggested Readings 344
56 Lymphomas 346
Hodgkin’s Lymphoma 346
Etiology and Pathogenesis 346
Clinical Presentation 346
Evaluation and Staging 346
Management 346
Future Directions 347
Non-Hodgkin’s Lymphoma 348
Etiology and Pathogenesis 348
Clinical Presentation 348
Evaluation and Staging 349
Management 349
Future Directions 350
Suggested Readings 350
57 Brain Tumors 351
Etiology And Pathogenesis 351
Clinical Presentation 351
Differential Diagnosis 351
Evaluation And Management 351
Future Directions 354
Suggested Readings 354
58 Neuroblastoma 355
Etiology and Pathogenesis 355
Clinical Presentation 355
Differential Diagnosis 356
Evaluation 356
Staging and Management 356
Staging 356
Surgery 358
Chemotherapy 358
Radiation Therapy 358
Treatment of Paraneoplastic Syndromes 358
Future Directions 358
Suggested Readings 359
59 Renal Neoplasms 360
Etiology and Pathogenesis 360
Wilms’ Tumor 360
Rare Renal Tumors 360
Clinical Presentation 361
Wilms’ Tumor 361
Rare Renal Tumors 361
Clear Cell Sarcoma of the Kidney 361
Rhabdoid Tumor of the Kidney 361
Renal Cell Carcinoma 361
Congenital Mesoblastic Nephroma 361
Evaluation and Management 362
Tumor-Specific Evaluations and Management 362
Wilms’ Tumor 362
Rare Renal Tumors 364
Clear Cell Sarcoma of the Kidney 364
Rhabdoid Tumor of the Kidney 364
Renal Cell Carcinoma 364
Congenital Mesoblastic Nephroma 364
Follow-Up 364
Future Directions 364
Suggested Reading 365
60 Bone Neoplasms 366
Bone Tumors 366
Osteosarcoma 366
Epidemiology and Pathogenesis 366
Clinical Presentation 366
Evaluation 366
Management 366
Prognosis 367
Ewing’s Sarcoma Family of Tumors 367
Epidemiology 367
Clinical Presentation 368
Evaluation 368
Management 369
Prognosis 369
Future Directions 369
Suggested Readings 369
XI Disorders of the Renal and Urologic Systems 371
61 Hematuria and Proteinuria 372
Hematuria 372
Etiology and Pathogenesis 372
Hypercalciuria and Urolithiasis 372
Medications 372
Glomerulonephritis 372
Trauma 372
Malignancy 372
Hematologic Causes 373
Alport Syndrome 373
Benign Familial Hematuria 373
Loin Pain-Hematuria Syndrome 373
Urethrorrhagia 373
Clinical Presentation 374
History 374
Physical Examination 374
Evaluation and Management 374
Diagnostic Modalities 376
Treatment of Hematuria 376
Proteinuria 376
Etiology and Pathogenesis 376
Benign Conditions 376
Transient Proteinuria 376
Orthostatic (Postural) Proteinuria 376
Persistent Asymptomatic Isolated Proteinuria 377
Pathologic Conditions 377
Glomerulonephritis 377
Nephrotic Syndrome 377
Tubular Diseases 377
Clinical Presentation and Detection 377
Phase I Workup 377
Qualitative Protein Detection 377
Quantitative Protein Detection 378
Evaluation and Management 378
Phase II Workup 378
Phase III Workup 378
Future Directions 378
Suggested Readings 379
62 Glomerulonephritis 380
Etiology and Pathogenesis 380
Differential Diagnosis 380
Acute Postinfectious Glomerulonephritis 380
IgA Nephropathy 380
Henoch-Schönlein Purpura Nephritis 380
Rapidly Progressive Glomerulonephritis 381
Membranoproliferative Glomerulonephritis 381
Antineutrophilic Cytoplasmic Antibody–Positive Vasculitis/Pauci-Immune Glomerulonephritis 381
Clinical Presentation 381
Evaluation 381
Recent Illnesses or Exposures 382
Other Symptoms and Review of Systems 383
Family History 383
Physical Examination 383
Intravascular Volume Status 383
Other Physical Examination Findings 383
Laboratory Evaluation 383
Imaging 383
Biopsy 383
Management 384
Therapies Targeting the Underlying Glomerulonephritis 384
Future Directions 384
Suggested Readings 384
63 Nephrotic Syndrome 385
Etiology and Pathogenesis 385
Clinical Presentation 385
Demographic Factors 385
Edema 385
Blood Pressure and Volume Status 385
Urine 386
Laboratory Findings 387
Complications 388
Evaluation and Management 389
Supportive Therapy 389
Glucocorticoids 389
Other 389
Suggested Readings 389
64 Hemolytic-Uremic Syndromes 390
Etiology and Pathogenesis 390
Shiga Toxin–Associated Hemolytic-Uremic Syndrome 390
Pneumococcal Hemolytic-Uremic Syndrome 392
Genetic Forms of Hemolytic-Uremic Syndrome 392
Thrombotic Thrombocytopenic Purpura 394
Secondary Hemolytic-Uremic Syndrome 394
Common Renal Pathology 394
Clinical Presentation 395
Hematologic Features 395
Renal Features 395
Extrarenal Features 395
Differential Diagnosis 396
Management 396
Suggested Readings 396
65 Acute and Chronic Renal Failure 397
Acute Renal Failure 397
Etiology and Pathogenesis 397
Prerenal 397
Renal 397
Postrenal 397
Clinical Presentation 397
Evaluation and Diagnosis 398
Serum Creatinine Concentration, Acute Kidney Injury Biomarkers, and Classification of Acute Kidney Injury 398
Urinalysis 398
Urine Sodium Excretion 398
Fractional Excretion of Sodium 399
Urine Osmolality 399
Urine Volume 399
Serologic and Biochemical Abnormalities 399
Complete Blood Count 399
Renal Imaging 399
Renal Biopsy 399
Prevention and Management 399
Hyperphosphatemia and Hypocalcemia 400
Hypertension 400
Nutrition 400
Renal Replacement Therapy 400
Future Directions 400
Chronic Kidney Disease 400
Etiology and Pathogenesis 401
Clinical Presentation 402
Complications 402
Evaluation 403
History 403
Physical Examination 403
Laboratory Testing 403
Urinalysis 404
Renal Ultrasonography 404
Kidney Biopsy 405
Management 405
Slowing Progression 405
Management of Complications 405
Renal Replacement Therapy 406
Future Directions 407
Suggested Readings 407
66 Congenital Anomalies of the Kidney and Urologic System 408
Polycystic Kidney Disease 408
Autosomal Recessive Polycystic Kidney Disease 408
Autosomal Dominant Polycystic Kidney Disease 408
Horseshoe Kidney 410
Urologic Malformations 411
Double Ureter 411
Ureteropelvic Junction Obstruction 412
Posterior Urethral Valves 412
Suggested Readings 413
XII Disorders of the Endocrine System 415
67 Puberty 416
Etiology And Pathogenesis 416
Hormonal Changes of Puberty 416
Normal Pubertal Timing 416
Clinical Presentation 416
Differential Diagnosis 417
Premature Sex Hormone Effects 417
Delayed Puberty (Box 67-2) 418
Evaluation And Management 421
Precocious Puberty 421
Delayed Puberty 421
Suggested Readings 421
68 Thyroid Disease 422
Thyroid Hormone Production 422
Congenital Hypothyroidism 422
Etiology and Pathogenesis 422
Clinical Presentation 422
Evaluation (Figure 68-3) 422
Treatment 423
Congenital Hyperthyroidism 423
Acquired Hypothyroidism 424
Etiology and Pathogenesis 424
Clinical Presentation (Figure 68-4) 424
Evaluation 425
Treatment 425
Acquired Hyperthyroidism 426
Etiology and Pathogenesis (Box 68-1) 426
Clinical Presentation (see Figure 68-4) 426
Evaluation 427
Treatment 427
Future Directions 428
Suggested Readings 428
69 Disorders of Calcium and Bone Metabolism 429
Regulation of Serum Calcium and Phosphorus 429
Dynamics of Bone Homeostasis 430
Osteomalacia and Rickets 430
Nutritional Rickets 430
Hypophosphatemic Rickets 431
X-Linked Hypophosphatemic Rickets 431
Autosomal Hypophosphatemic Rickets 432
Hereditary Hypophosphatemic Rickets with Hypercalciuria 432
Fanconi Syndrome 434
Future Directions 434
Suggested Readings 435
70 Disorders of the Adrenal Gland 436
Adrenal Gland Physiology 436
Functions of Adrenal Hormones 436
Adrenal Insufficiency 436
Etiology and Pathogenesis 436
Primary Adrenal Insufficiency 436
Secondary Adrenal Insufficiency 436
Iatrogenic Adrenal Insufficiency 436
Clinical Presentation 437
Evaluation and Management 438
Laboratory Studies 438
Treatment and Prognosis 438
Cushing’s Syndrome 439
Etiology and Pathogenesis 439
Clinical Presentation 439
Evaluation and Management 439
Congenital Adrenal Hyperplasia 440
Etiology and Pathogenesis 440
Clinical Presentation 440
Differential Diagnosis 440
Evaluation and Management 440
Future Directions 441
Suggested Readings 441
71 Diabetes Mellitus 442
Etiology and Pathogenesis 442
Type 1 Diabetes Mellitus 442
Type 2 Diabetes Mellitus 442
Clinical Presentation 443
Type 2 Diabetes 443
Evaluation and Management 443
Initial Evaluation 443
Well-Appearing Children 443
Ill Children 445
Post–Diabetic Ketoacidosis and Home Management 445
Type 1 Diabetes 445
Type 2 Diabetes Mellitus 448
Complications and Comorbidities 448
Future Directions 449
Suggested Readings 449
72 Hypoglycemia 450
Etiology and Pathogenesis 450
Clinical Presentation 450
Differential Diagnosis 450
Hypoglycemia Secondary to Excessive and Inappropriate Insulin 450
Infant of a Diabetic Mother 450
Prolonged Neonatal Hypoglycemia 450
Permanent Hypoglycemia (Congenital Hyperinsulinism) 451
Insulinoma 451
Other Causes of Hyperinsulinism 452
Factitious Hyperinsulinism 452
Beckwith-Wiedemann Syndrome 452
Congenital Disorders of Glycosylation 453
Hypoglycemia Caused by Nonhyperinsulinemic States 453
Disorders of Gluconeogenesis 453
Disorders of Glycogen Storage 453
Disorders of Fatty Acid Oxidation 453
Pituitary Hormone Deficiency 453
Adrenal Insufficiency (Addison’s Disease) 454
Medication-Induced Hypoglycemia 454
Postprandial Hypoglycemia (Dumping Syndrome) 454
Ketotic Hypoglycemia 454
Evaluation and Management 454
Treatment of Hyperinsulinism 454
Gluconeogenesis, Glycogenolysis, and Fat Oxidation 456
Specific Hormonal Replacement 456
Future Directions 456
Suggested Readings 456
73 Disorders of Growth 457
Etiology and Pathogenesis 457
Normal Growth Patterns 457
Longitudinal Growth and Mediating Factors 457
Abnormal Growth 457
Clinical Presentation 457
Familial Short Stature 458
Constitutional Delay of Growth and Puberty 459
Idiopathic Short Stature 461
Intrauterine Growth Retardation and Small for Gestational Age 461
Osteochondrodysplasias 461
Turner Syndrome (See Chapter 118, Figure 118-1) 461
Abnormalities of the Growth Hormone–Insulinlike Growth Factor Axis 462
Poor Nutrition 462
Psychosocial Deprivation 462
Chronic Systemic Illnesses 462
Hypothyroidism 462
Evaluation and Management 462
Measurement Techniques and Growth Charts 463
Specific Elements of the Physical Examination 463
Bone Age 463
Diagnosis of Growth Hormone Deficiency 463
Management 464
Future Directions 464
Suggested Readings 464
XIII Disorders of the Nervous System 465
74 Seizures 466
Etiology and Pathogenesis 466
Clinical Presentation 466
Seizure Classification 466
Febrile Seizures 466
Epilepsy Syndromes 466
Status Epilepticus 467
Differential Diagnosis 467
Evaluation 468
Management 468
Seizure First Aid 468
Antiepileptic Medications 469
Alternative Treatments 469
Future Directions 469
Suggested Readings 470
75 Headache 471
Etiology and Pathogenesis 471
Clinical Presentation 471
Evaluation and Management 471
Treatment 471
Abortive Medications 471
Preventive Medications 477
Nonpharmacologic Therapies 477
Future Directions 478
Suggested Readings 478
76 Neurocutaneous Disorders 479
Tuberous Sclerosis 479
Von Hippel–Lindau Disease 479
Neurofibromatosis Type 1 and 2 482
Sturge-Weber Syndrome 483
Suggested Readings 483
77 Cerebral Palsy 485
Etiology and Pathogenesis 485
Clinical Presentation 485
Spastic Cerebral Palsy 485
Dyskinetic Cerebral Palsy 486
Ataxic Cerebral Palsy 487
Differential Diagnosis 487
Evaluation and Management 487
Oromotor Dysfunction 488
Spasticity 488
Dyskinesias 489
Alternative and Complementary Therapies 489
Pain 489
Prognosis 489
Future Directions 490
Suggested Readings 490
78 Demyelinating Diseases 491
Etiology and Pathogenesis 491
Clinical Presentation and Differential Diagnosis 491
Acute Disseminated Encephalomyelitis 491
Clinically Isolated Syndrome 491
Optic Neuritis 491
Transverse Myelitis 491
Multiple Sclerosis 492
Neuromyelitis Optica 493
Evaluation and Management 493
Acute Therapy 494
Special Considerations 494
Multiple Sclerosis 494
Neuromyelitis Optica 494
Transverse Myelitis 494
Future Directions 494
Suggested Readings 494
79 Stroke 495
Etiology and Pathogenesis 495
Clinical Presentation 495
Differential Diagnosis 497
Evaluation 497
Management 499
Special Considerations 499
Perinatal Arterial Ischemic Stroke 499
Sickle Cell Disease 500
Focal Cerebral Arteriopathy of Childhood 500
Moyamoya Disease and Syndrome 501
Arterial Dissection 501
Vasculitis 501
Metabolic Stroke 501
Conclusions and Future Directions 501
Suggested Readings 501
80 Spinal Cord Disorders 503
Etiology and Pathogenesis 503
Clinical Presentation and Differential Diagnosis 503
Evaluation and Management 504
Future Directions 506
Suggested Readings 507
81 Neuromuscular Disorders 508
Anterior Horn Cell 508
Spinal Muscular Atrophy 508
Etiology and Pathogenesis 508
Clinical Presentation 508
Evaluation and Management 508
Future Directions 508
Peripheral Nerve 510
Guillain-Barré Syndrome 510
Etiology and Pathogenesis 510
XIV Adolescent Medicine 517
82 Substance Abuse 518
Epidemiology and Pathogenesis 518
Evaluation and Clinical Presentation 518
Screening Adolescents for Substance Use 518
Physical Examination Finding Related to Substance Use 520
Management 520
Future Directions 521
Suggested Readings 521
83 Menstrual Disorders 522
Eitology and Pathogenesis 522
Clinical Presentation 522
Differential Diagnosis 524
Treatment 524
Conclusion 524
Suggested Readings 525
84 Polycystic Ovarian Syndrome 526
Etiology and Pathogenesis 526
Clinical Presentation 526
Differential Diagnosis 526
Screening and Evaluation 526
Management 527
Conclusion 527
Suggested Readings 527
85 Eating Disorders 528
Etiology and Pathogenesis 528
Clinical Presentation 528
Differential Diagnosis 528
Management 528
Prognosis 529
Conclusion 529
Suggested Readings 530
XV Infectious Disease 531
86 Fever of Unknown Origin 532
Differential Diagnosis 532
Infection 532
Bacterial Infections 532
Viral Infections 532
Other Infections 532
Collagen Vascular and Autoimmune Disorders 533
Malignancy 534
Miscellaneous 534
Approach to the Patient 534
History 534
Physical Examination 534
Diagnostic Testing 535
Screening Evaluation 535
Laboratory Testing 535
Diagnostic Imaging 536
Invasive Testing 537
Conclusion 537
Suggested Readings 537
87 Infections of the Head and Neck 538
Cervical Lymphadenitis 538
Etiology and Pathogenesis 538
Clinical Presentation and Differential Diagnosis 538
Evaluation and Management 540
Deep Neck Infections 541
Etiology and Pathogenesis 541
Clinical Presentation and Differential Diagnosis 542
Evaluation and Management 543
Periorbital and Orbital Cellulitis 543
Etiology and Pathogenesis 543
Clinical Presentation and Differential Diagnosis 544
Evaluation and Management 545
Future Directions 545
Suggested Readings 545
Cervical Lymphadenitis 545
Deep Neck Infections 545
Periorbital and Orbital Cellulitis 546
88 Osteomyelitis and Other Bone and Joint Infections 547
Osteomyelitis 547
Etiology 547
Pathogenesis 547
Clinical Presentation 547
Diagnosis 548
Treatment and Prognosis 549
Septic Arthritis 549
Etiology 549
Pathogenesis 550
Clinical Presentation 550
Diagnosis 550
Treatment and Prognosis 551
Diskitis 552
Suggested Readings 552
89 Sexually Transmitted Infections 553
Vaginitis 553
Urethritis and Cervicitis 553
Epidemiology and Pathophysiology 553
Clinical Presentation 553
Pelvic Inflammatory Disease 553
Other Manifestations of Gonococcal and Chlamydial Infection 553
Evaluation and Management 556
Anogenital Lesions 556
Syphilis 556
Diagnosis 556
Treatment 558
Herpes Genitalis 558
Epidemiology and Pathophysiology 558
Clinical Presentation 558
Diagnosis and Management 558
Human Papillomavirus 559
Epidemiology and Pathophysiology 559
Clinical Presentation 559
Diagnosis and Management 560
Conclusion 560
Suggested Readings 561
90 Skin and Soft Tissue Infections 562
Etiology and Pathogenesis 562
Organisms 562
Clinical Presentation 562
Folliculitis 562
Furuncles and Carbuncles 562
Impetigo 563
Erysipelas 563
Cellulitis 563
Necrotizing Fasciitis 565
Evaluation and Management 566
Mild Infections 566
Moderate Infections 566
Severe Infections 567
Antimicrobials 567
Suggested Readings 567
91 Pneumonia and Respiratory Infections 568
Etiology and Pathogenesis 568
Epidemiology 568
Microbiology 568
Pathogenesis 568
Clinical Presentation and Differential Diagnosis 570
Evaluation and Management 571
Diagnostic Methods 571
Treatment 573
Future Directions 574
Suggested Readings 574
92 Infections of the Central Nervous System 575
Meningitis and Meningoencephalitis 575
Etiology, Epidemiology, and Pathogenesis 575
Clinical Presentation 575
Differential Diagnosis 575
Diagnostic Approach 576
Management and Therapy 577
Focal Suppurative Infections: Brain Abscess 578
Etiology, Epidemiology, and Pathogenesis 578
Clinical Presentation 578
Diagnostic Approach 579
Management and Therapy 579
Subdural Empyema 580
XVI Neonatal Medicine 633
100 Hyperbilirubinemia 634
Etiology and Pathogenesis 634
Clinical Presentation 634
Unconjugated Hyperbilirubinemia 634
Conjugated Hyperbilirubinemia 635
Evaluation and Management 635
Unconjugated Hyperbilirubinemia 635
Conjugated Hyperbilirubinemia 636
Future Directions 637
Suggested Readings 639
101 Disorders of the Nervous System 640
Etiology and Pathogenesis 640
XVII Disorders of the Digestive System 675
107 Disorders of the Esophagus 676
Developmental Anomalies 676
XVIII Genetic and Metabolic Disorders 731
116 Principles of Human Genetics 732
Chromosome Structure and Nomenclature 732
Methods Of Detecting Aneuploidy 732
Mitosis, Meiosis, and Gamete Formation 732
Gene Structure 734
Modes of Inheritance 734
Autosomal Dominant Inheritance 735
Autosomal Recessive Inheritance 735
Sex-Linked Inheritance 736
Mitochondrial Inheritance 736
Uniparental Disomy 736
Mosaicism 736
Polygenic-Multifactorial Inheritance 736
Evaluation and Diagnosis of Genetic Syndromes 736
Categories of Dysmorphic Disorders 736
Evaluation of Children with Dysmorphism 737
Future Directions 737
Suggested Readings 739
117 Trisomy 21 740
Etiology and Pathogenesis 740
Clinical Presentation and Differential Diagnois 740
Phenotypic Features 740
Developmental Impairment 740
Comorbidities 741
Heart Disease 741
Gastrointestinal Disease 742
Growth and Stature 742
Obesity 742
Disturbances of Vision 742
Disturbances of Hearing 742
Hematologic Disorders 742
Oncologic Disorders 742
Transient Leukemia 742
Acute Megakaryoblastic Leukemia 743
Acute Lymphoblastic Leukemia 743
Immune Deficiency 743
Endocrinologic Disorders 743
Reproductive Concerns 743
Atlantoaxial Instability 743
Sleep Apnea 743
Skin Disorders 743
Behavior Disturbances 744
Recent Advances and Future Directions 744
Learning and Memory 744
Alzheimer Disease 744
Cancer 744
Cognitive Ability 744
Suggested Readings 744
118 Chromosomal Abnormalities 745
Trisomy 18 (Edwards Syndrome) 745
XIX Dermatologic Disorders 781
122 Dermatologic Morphology 782
Basic Structure Of The Skin 782
Epidermis 782
Dermis 782
Subcutaneous Tissue 782
Approach To Dermatologic Morphology And Disease 782
Primary Lesions 782
Secondary Lesions 782
Color of Lesions 783
Configuration of Lesions 783
Distribution of Lesions 786
Suggested Readings 786
123 Vascular Disorders 787
Vascular Tumors 787
Infantile Hemangiomas 787
Etiology and Pathogenesis 787
Clinical Manifestations 787
Management 787
Congenital Hemangiomas 787
PHACES Syndrome 788
Tufted Angiomas 788
Kaposiform Hemangioendothelioma 788
Kasabach-Merritt Phenomenon 789
Pyogenic Granuloma 789
Vascular Malformations: Slow-Flow Lesions 789
Capillary Malformations 789
Nevus Flammeus 789
Sturge-Weber Syndrome 789
Nevus Simplex 789
Telangiectasias 790
Angiokeratoma 790
Venous Malformations 790
Glomuvenous Malformations 790
Lymphatic Malformations 790
VaScular Malformations: Fast-Flow Lesions 790
Arteriovenous Malformations 790
Suggested Readings 791
124 Hyperpigmented Skin Disorders 792
Etiology And Pathogenesis 792
Circumscribed Hyperpigmented Skin Lesions 792
Freckles (Ephelides) 792
Lentigines 792
Café-au-Lait Spots 792
Mastocytosis 793
Acanthosis Nigricans 795
Dermal Melanosis 795
Postinflammatory Hyperpigmentation 795
Linear Circumscribed Hyperpigmented Lesions 796
Incontinentia Pigmenti 796
Diffuse Hyperpigmentation 796
Suggested Readings 796
125 Acne 798
Etiology And Pathogenesis 798
Clinical Presentation 798
Management 798
Topical Retinoids 799
Topical Benzoyl Peroxide 799
Topical Antibiotics and Combination Products 799
Systemic Antibiotics and Other Systemic Therapies 801
Future Directions 802
Suggested Readings 802
126 Nevi 803
Etiology And Pathogenesis 803
Clinical Manifestation And Management 803
Common Acquired Melanocytic Nevi 803
Dysplastic or Atypical Nevi 803
Congenital Nevi 803
Special Nevi 805
Nevus Spilus or Speckled Lentiginous Nevus 805
Blue Nevus 805
Spitz Nevi 805
Halo Nevi 805
Suggested Readings 806
127 Nutritional Dermatoses 807
Etiology And Pathogenesis 807
Clinical Presentation 807
Protein-Energy Malnutrition 807
Zinc Deficiency 807
Essential Fatty Acid Deficiency 808
Biotin Deficiency 808
Niacin Deficiency 808
Other Vitamin B Complex Deficiencies 809
Vitamin C Deficiency 810
Evaluation And Management 810
Future Directions 811
Suggested Readings 811
Index 813
A 813
B 815
C 816
D 818
E 819
F 820
G 821
H 822
I 823
J 825
K 825
L 825
M 826
N 827
O 828
P 828
Q 830
R 830
S 831
T 833
U 834
V 834
W 835
X 835
Z 835

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