Additional Information
Book Details
Abstract
Thoroughly revised and updated, the fifth edition of this prize-winning title retains the high level of illustration and accessibility that has made it so popular worldwide with medical students and trainees approaching clinical specialty exams. Illustrated Textbook of Paediatrics has been translated into eight languages over its life.
- Case studies.
- Summary boxes.
- Tips for patient education.
- Highly illustrated with 100s of colour images.
- Diseases consistently presented by Clinical features; Investigations; Management; Prognosis; and, where appropriate, Prevention.
Separate chapters on
- Accidents
- Child protection
- Diabetes and endocrinology
- Inborn Errors of Metabolism
New chapter on Global child health
New co-editor, Will Carroll, Chair of MRCPCH Theory Examinations.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Illustrated Textbook of Paediatrics | i | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Foreword | vi | ||
| Preface | vii | ||
| List of Contributors | viii | ||
| Acknowledgements | xii | ||
| 1 The child in society | 1 | ||
| The child’s world | 1 | ||
| The child | 1 | ||
| Immediate social environment | 1 | ||
| Family structure | 1 | ||
| Parenting styles | 3 | ||
| Siblings and extended family | 3 | ||
| Cultural attitudes to child-rearing | 3 | ||
| Peers | 4 | ||
| Socioeconomic status | 4 | ||
| Local social fabric | 4 | ||
| Neighbourhood | 4 | ||
| Health service delivery | 4 | ||
| Schools | 4 | ||
| Travel | 5 | ||
| National and international environment | 5 | ||
| Economic wealth | 5 | ||
| Media and technology | 5 | ||
| War and natural disasters | 5 | ||
| Well-being | 5 | ||
| Important public health issues for children and young people | 5 | ||
| Child mortality (Fig. 1.4) | 5 | ||
| Comparison with other European countries | 6 | ||
| Inequalities in child heath | 7 | ||
| What causes inequalities? | 7 | ||
| Child protection and variation in outcomes | 7 | ||
| Obesity | 7 | ||
| Emotional and behavioural difficulties | 7 | ||
| Disability | 7 | ||
| Smoking, alcohol, and drugs | 7 | ||
| Major public child health initiatives | 7 | ||
| National Service Framework | 7 | ||
| Every Child Matters | 7 | ||
| The Healthy Child Programme and Family Nurse Partnership | 7 | ||
| Sure Start | 8 | ||
| Conclusion | 8 | ||
| Acknowledgements | 8 | ||
| Further reading | 8 | ||
| Websites (Accessed November 2016) | 8 | ||
| Child health initiatives | 8 | ||
| 2 History and examination | 9 | ||
| Taking a history | 10 | ||
| Introduction | 10 | ||
| Presenting symptoms | 10 | ||
| General enquiry and systems review | 11 | ||
| Past medical history | 11 | ||
| Medication | 11 | ||
| Family history | 11 | ||
| Social history | 11 | ||
| Development | 12 | ||
| An approach to examining children | 12 | ||
| Adapting to the child’s age | 12 | ||
| Obtaining the child’s cooperation | 13 | ||
| Undressing children | 13 | ||
| Warm, clean hands | 13 | ||
| Developmental skills | 13 | ||
| Examination | 13 | ||
| Initial observations – watch before you examine | 13 | ||
| Severity of illness | 13 | ||
| Measurements | 13 | ||
| Approach to examination | 14 | ||
| General appearance | 14 | ||
| Respiratory system | 14 | ||
| 3 Normal child development, hearing and vision | 27 | ||
| Influence of heredity and environment | 27 | ||
| Fields of development | 28 | ||
| Developmental milestones | 28 | ||
| Median and limit ages | 29 | ||
| Variation in the pattern of development | 29 | ||
| Why motor development is most rapid in the first years of life | 29 | ||
| Adjusting for prematurity | 29 | ||
| Is development normal? | 29 | ||
| Pattern of child development | 30 | ||
| Cognitive development | 30 | ||
| Analysing developmental progress | 36 | ||
| Detailed assessment | 36 | ||
| The short-cut approach | 36 | ||
| Observation during questioning | 37 | ||
| Equipment for developmental testing | 37 | ||
| Developmental screening and assessment | 37 | ||
| Child health surveillance | 38 | ||
| Hearing | 39 | ||
| Hearing tests | 39 | ||
| Newborn | 39 | ||
| Distraction testing | 39 | ||
| Visual reinforcement audiometry | 39 | ||
| Performance and speech discrimination testing | 39 | ||
| Audiometry | 42 | ||
| Parental concern | 42 | ||
| Vision | 42 | ||
| Vision testing | 42 | ||
| Acknowledgements | 43 | ||
| Further reading | 43 | ||
| Websites (accessed November 2016) | 43 | ||
| 4 Developmental problems and the child with special needs | 44 | ||
| Abnormal development – key concepts | 46 | ||
| Developmental delay | 47 | ||
| Abnormal motor development | 47 | ||
| Cerebral palsy | 48 | ||
| Causes | 49 | ||
| Clinical presentation | 49 | ||
| Spastic cerebral palsy | 49 | ||
| Dyskinetic cerebral palsy | 51 | ||
| Ataxic (hypotonic) cerebral palsy | 51 | ||
| Management | 51 | ||
| Disordered speech and language development | 53 | ||
| Abnormal development of social/communication skills (autism spectrum disorders) | 53 | ||
| Management | 54 | ||
| Slow acquisition of cognitive skills/general learning difficulty | 54 | ||
| Specific learning difficulty | 54 | ||
| Developmental coordination disorder or dyspraxia | 54 | ||
| Dyslexia | 55 | ||
| Dyscalculia, dysgraphia | 55 | ||
| Disorder of executive functions | 55 | ||
| Associated comorbidities of specific learning disorders | 55 | ||
| Management of specific learning disorders | 55 | ||
| Problems with concentration and attention | 55 | ||
| Attention deficit hyperactivity disorder | 55 | ||
| Hearing impairment | 56 | ||
| Sensorineural hearing loss | 56 | ||
| Conductive hearing loss | 56 | ||
| Abnormalities of vision and the ocular system | 58 | ||
| Nystagmus | 58 | ||
| Squint (strabismus) | 58 | ||
| Corneal light reflex test | 59 | ||
| Cover test | 59 | ||
| Refractive errors | 59 | ||
| Hypermetropia (long sight) | 59 | ||
| Myopia (short sight) | 59 | ||
| Astigmatism (abnormal corneal curvature) | 59 | ||
| Amblyopia | 59 | ||
| Severe visual impairment | 59 | ||
| Multidisciplinary child development services | 60 | ||
| Education | 62 | ||
| Transition of care to adult services | 62 | ||
| The rights of disabled children | 63 | ||
| Acknowledgements | 63 | ||
| Further reading | 63 | ||
| Websites (Accessed November 2016) | 63 | ||
| 5 Care of the sick child and young person | 64 | ||
| Primary care | 64 | ||
| Secondary care | 65 | ||
| Emergency and urgent care | 65 | ||
| Hospital admission rates | 65 | ||
| Children in hospital | 67 | ||
| Putting the family and child at the centre of care | 67 | ||
| Child-orientated environment | 67 | ||
| Information and psychosocial support | 67 | ||
| Skilled staff | 67 | ||
| Multidisciplinary care – coordinating care across boundaries | 67 | ||
| Tertiary care and networks | 67 | ||
| Discharge from hospital | 68 | ||
| Pain in children | 69 | ||
| Acute pain | 69 | ||
| Chronic pain | 69 | ||
| Management | 69 | ||
| Recognizing pain | 69 | ||
| Responding to pain | 69 | ||
| Reassessing pain | 70 | ||
| Prescribing medicines for children | 70 | ||
| Absorption | 70 | ||
| Biology | 70 | ||
| Clearance | 70 | ||
| Distribution | 70 | ||
| Communicating serious problems | 71 | ||
| Initial interview | 71 | ||
| Palliative and end-of-life care | 71 | ||
| Care plan | 71 | ||
| Place of care | 71 | ||
| Care after death | 71 | ||
| Caring for staff | 71 | ||
| Ethics | 72 | ||
| Definitions of the principles of medical ethics | 72 | ||
| Application of ethical principles to paediatrics | 72 | ||
| Non-maleficence | 72 | ||
| Beneficence | 73 | ||
| Justice | 73 | ||
| Autonomy | 73 | ||
| Truth telling | 73 | ||
| Consent | 73 | ||
| Confidentiality | 73 | ||
| Best interests | 73 | ||
| The ethics of research in paediatrics | 73 | ||
| Evidence-based paediatrics | 75 | ||
| Why practise evidence-based paediatrics? | 75 | ||
| To what extent is paediatric practice based on sound evidence? | 78 | ||
| Acknowledgements | 79 | ||
| Further reading | 79 | ||
| Websites (Accessed November 2016) | 79 | ||
| 6 Paediatric emergencies | 80 | ||
| The seriously ill child | 80 | ||
| Cardiopulmonary resuscitation | 83 | ||
| Paediatric basic life support | 83 | ||
| Paediatric advanced life support | 83 | ||
| The seriously injured child | 83 | ||
| Respiratory failure | 83 | ||
| Assessment | 83 | ||
| Supportive therapy | 83 | ||
| Oxygen | 83 | ||
| Noninvasive ventilation | 83 | ||
| Invasive ventilatory support | 87 | ||
| Shock | 87 | ||
| Why are children so susceptible to fluid loss? | 87 | ||
| Clinical features | 87 | ||
| Management priorities | 88 | ||
| Fluid resuscitation | 88 | ||
| Subsequent management | 88 | ||
| Sepsis | 88 | ||
| Clinical features | 89 | ||
| Management priorities | 89 | ||
| Antibiotics | 89 | ||
| Fluids | 89 | ||
| Circulatory support | 89 | ||
| Disseminated intravascular coagulation | 89 | ||
| Anaphylaxis | 89 | ||
| Neurological emergencies | 90 | ||
| Convulsive status epilepticus | 90 | ||
| Other encephalopathic illness | 90 | ||
| Apparent life-threatening events | 94 | ||
| Unexpected death of a child | 94 | ||
| Sudden infant death syndrome | 94 | ||
| Acknowledgements | 96 | ||
| Further reading | 96 | ||
| Websites (Accessed November 2016) | 96 | ||
| 7 Accidents and poisoning | 97 | ||
| Accidents | 97 | ||
| Accident prevention | 98 | ||
| Head and neck injuries | 98 | ||
| Internal injuries | 100 | ||
| Choking, suffocation and strangulation | 101 | ||
| Drowning | 101 | ||
| Burns and scalds | 102 | ||
| Assessment | 102 | ||
| Further management | 102 | ||
| Poisoning | 103 | ||
| Investigation and management | 104 | ||
| Chronic environmental poisoning | 104 | ||
| Acknowledgements | 108 | ||
| Further reading | 108 | ||
| Websites (Accessed November 2016) | 108 | ||
| 8 Child protection | 109 | ||
| Types of child abuse and neglect | 110 | ||
| Physical abuse | 110 | ||
| Emotional abuse | 110 | ||
| Sexual abuse and sexual exploitation | 111 | ||
| Neglect | 111 | ||
| Fabricated or induced illness | 111 | ||
| Intimate partner violence | 111 | ||
| Female genital mutilation | 111 | ||
| Prevalence of child maltreatment | 111 | ||
| Safeguarding children | 113 | ||
| Risk factors | 113 | ||
| Presentation | 113 | ||
| Child abuse and neglect | 113 | ||
| Neglect | 116 | ||
| Emotional abuse | 116 | ||
| Sexual abuse | 116 | ||
| Recognition | 116 | ||
| Physical symptoms | 116 | ||
| Behavioural symptoms | 116 | ||
| Signs | 116 | ||
| Investigation | 116 | ||
| Management | 118 | ||
| Acknowledgements | 120 | ||
| Further reading | 120 | ||
| Websites (Accessed November 2016) | 120 | ||
| 9 Genetics | 121 | ||
| Chromosomal abnormalities | 121 | ||
| Disorders of chromosome number | 122 | ||
| Down syndrome (trisomy 21) | 122 | ||
| Clinical features | 122 | ||
| Cytogenetics | 122 | ||
| Meiotic nondisjunction (94%) | 122 | ||
| Translocation (5%) | 124 | ||
| Mosaicism (1%) | 124 | ||
| Edwards syndrome (trisomy 18) and Patau syndrome (trisomy 13) | 125 | ||
| Turner syndrome (45, X) | 125 | ||
| Klinefelter syndrome (47, XXY) | 126 | ||
| Structural chromosome anomalies | 126 | ||
| Reciprocal translocations | 126 | ||
| Deletions | 126 | ||
| Duplications | 126 | ||
| Testing for submicroscopic copy number variants | 126 | ||
| Mendelian inheritance | 127 | ||
| Autosomal dominant inheritance | 128 | ||
| Variation in expression | 128 | ||
| Non-penetrance | 128 | ||
| De novo mutation | 128 | ||
| Homozygosity | 128 | ||
| Knudson two-hit hypothesis | 128 | ||
| Autosomal recessive inheritance | 129 | ||
| Consanguinity | 129 | ||
| X-linked inheritance | 130 | ||
| Y-linked inheritance | 132 | ||
| Unusual genetic mechanisms | 132 | ||
| Trinucleotide repeat expansion mutations | 132 | ||
| Fragile X syndrome | 132 | ||
| Mitochondrial or cytoplasmic inheritance | 132 | ||
| Imprinting and uniparental disomy | 133 | ||
| Polygenic, multifactorial or complex inheritance | 134 | ||
| Dysmorphology | 135 | ||
| Pathogenic mechanisms | 135 | ||
| Malformation | 135 | ||
| Deformation | 135 | ||
| Disruption | 135 | ||
| Dysplasia | 135 | ||
| Clinical classification of birth defects | 135 | ||
| Single-system defects | 135 | ||
| Sequence | 135 | ||
| Association | 136 | ||
| Syndrome | 136 | ||
| Syndrome diagnosis | 136 | ||
| Gene-based therapies | 137 | ||
| Genetic services | 138 | ||
| Genetic investigations | 138 | ||
| Mutation analysis | 138 | ||
| Next-generation sequencing | 139 | ||
| Genetic counselling | 139 | ||
| Presymptomatic (predictive) testing | 140 | ||
| Acknowledgements | 140 | ||
| Further reading | 140 | ||
| Website (Accessed November 2016) | 140 | ||
| Online resources | 140 | ||
| 10 Perinatal medicine | 142 | ||
| Pre-pregnancy care | 142 | ||
| Antenatal diagnosis | 143 | ||
| Fetal medicine | 143 | ||
| Fetal surgery | 146 | ||
| Obstetric conditions affecting the fetus | 146 | ||
| Pre-eclampsia | 146 | ||
| Placental insufficiency and intrauterine growth restriction (IUGR) | 146 | ||
| Preterm delivery | 146 | ||
| Multiple births | 147 | ||
| Maternal conditions affecting the fetus | 148 | ||
| Diabetes mellitus | 148 | ||
| Hyperthyroidism | 148 | ||
| Systemic lupus erythematosus | 149 | ||
| Autoimmune thrombocytopenic purpura | 149 | ||
| Maternal drugs affecting the fetus | 149 | ||
| Alcohol and smoking | 149 | ||
| Drug abuse | 150 | ||
| Drugs given during labour | 150 | ||
| Congenital infections | 150 | ||
| Rubella | 150 | ||
| Cytomegalovirus | 151 | ||
| Toxoplasmosis | 151 | ||
| Varicella zoster | 151 | ||
| Syphilis | 151 | ||
| Adaptation to extrauterine life | 152 | ||
| Neonatal resuscitation | 153 | ||
| Meconium aspiration | 158 | ||
| Resuscitation of the preterm infant | 158 | ||
| Post-resuscitation care | 158 | ||
| Failure to respond to resuscitation | 158 | ||
| Size at birth | 158 | ||
| Definitions | 158 | ||
| Patterns of growth restriction | 158 | ||
| Monitoring the growth-restricted fetus | 159 | ||
| The growth-restricted infant | 159 | ||
| Large for gestational age infants | 160 | ||
| Routine examination of the newborn infant | 160 | ||
| Red reflex to identify eye abnormalities | 160 | ||
| Detection of undescended testes in boys | 160 | ||
| Checking for developmental dysplasia of the hip (DDH) | 160 | ||
| Vitamin K therapy | 161 | ||
| Newborn hearing screening | 165 | ||
| Oxygen saturation screening for critical congenital heart disease | 165 | ||
| Biochemical screening | 165 | ||
| Acknowledgements | 165 | ||
| Further reading | 165 | ||
| Websites (Accessed November 2016) | 165 | ||
| 11 Neonatal medicine | 166 | ||
| Hypoxic-ischaemic encephalopathy | 167 | ||
| Management | 167 | ||
| Prognosis | 167 | ||
| Birth injuries | 169 | ||
| Soft-tissue injuries | 169 | ||
| Nerve palsies | 169 | ||
| Fractures | 170 | ||
| Clavicle | 170 | ||
| Humerus/femur | 170 | ||
| Stabilizing the preterm or sick infant | 171 | ||
| The preterm infant | 171 | ||
| Respiratory distress syndrome | 171 | ||
| Pneumothorax | 171 | ||
| Apnoea and bradycardia and desaturation | 174 | ||
| Temperature control | 174 | ||
| Patent ductus arteriosus | 174 | ||
| Fluid balance | 175 | ||
| Nutrition | 175 | ||
| Infection | 176 | ||
| Necrotizing enterocolitis | 176 | ||
| Preterm brain injury | 176 | ||
| Retinopathy of prematurity | 178 | ||
| Bronchopulmonary dysplasia | 178 | ||
| Problems following discharge | 178 | ||
| Jaundice | 181 | ||
| Kernicterus | 181 | ||
| Clinical evaluation | 181 | ||
| Age at onset | 181 | ||
| Jaundice <24 hours of age | 181 | ||
| Haemolytic disorders | 181 | ||
| Rhesus haemolytic disease | 181 | ||
| ABO incompatibility | 181 | ||
| G6PD (glucose-6-phosphate dehydrogenase) deficiency (see Ch. 23) | 183 | ||
| Spherocytosis | 183 | ||
| Congenital infection | 183 | ||
| Jaundice at 2 days–2 weeks of age | 183 | ||
| Physiological jaundice | 183 | ||
| Breast milk jaundice | 183 | ||
| Dehydration | 183 | ||
| Infection | 183 | ||
| Other causes | 183 | ||
| Severity of jaundice | 183 | ||
| Rate of change | 183 | ||
| Gestation | 183 | ||
| Clinical condition | 183 | ||
| Management | 183 | ||
| Phototherapy | 184 | ||
| Exchange transfusion | 184 | ||
| Jaundice at >2 weeks of age | 185 | ||
| Respiratory distress in term infants | 185 | ||
| Transient tachypnoea of the newborn | 185 | ||
| Meconium aspiration | 186 | ||
| Pneumonia | 186 | ||
| Pneumothorax | 186 | ||
| Milk aspiration | 186 | ||
| Persistent pulmonary hypertension of the newborn | 186 | ||
| Diaphragmatic hernia | 186 | ||
| Other causes | 187 | ||
| Infection | 187 | ||
| Early-onset infection | 187 | ||
| Late-onset infection | 187 | ||
| Some specific infections | 188 | ||
| Group B streptococcal infection | 188 | ||
| L. monocytogenes infection | 188 | ||
| Gram-negative infections | 188 | ||
| Conjunctivitis | 188 | ||
| Umbilical infection | 188 | ||
| Herpes simplex virus infections | 189 | ||
| Hepatitis B | 189 | ||
| Hypoglycaemia | 189 | ||
| Neonatal seizures | 189 | ||
| Perinatal stroke | 190 | ||
| Craniofacial disorders | 190 | ||
| Cleft lip and palate | 190 | ||
| Pierre Robin sequence | 191 | ||
| Gastrointestinal disorders | 191 | ||
| Oesophageal atresia | 191 | ||
| Small bowel obstruction | 191 | ||
| Large bowel obstruction | 192 | ||
| Exomphalos/gastroschisis | 192 | ||
| Child protection and the newborn | 192 | ||
| Acknowledgements | 193 | ||
| Further reading | 193 | ||
| Websites (Accessed November 2016) | 193 | ||
| 12 Growth and puberty | 194 | ||
| Normal growth | 194 | ||
| Fetal | 194 | ||
| Infantile phase | 194 | ||
| Childhood phase | 194 | ||
| Pubertal growth spurt | 194 | ||
| Measurement | 194 | ||
| Puberty | 196 | ||
| Short stature | 199 | ||
| Familial | 199 | ||
| Constitutional delay in growth and puberty | 199 | ||
| Small for gestational age and extreme prematurity | 199 | ||
| Chromosomal disorder/syndromes | 199 | ||
| Nutritional/long-term illness | 199 | ||
| Psychosocial deprivation | 202 | ||
| Endocrine | 202 | ||
| Hypothyroidism | 202 | ||
| Growth hormone deficiency | 202 | ||
| Corticosteroid excess, Cushing syndrome | 202 | ||
| Extreme short stature | 202 | ||
| Disproportionate short stature | 202 | ||
| Examination and investigation | 202 | ||
| Growth hormone treatment of short stature | 203 | ||
| Tall stature | 204 | ||
| Abnormal head growth | 204 | ||
| Microcephaly | 205 | ||
| Macrocephaly | 205 | ||
| Asymmetric heads | 205 | ||
| Craniosynostosis | 205 | ||
| Premature sexual development | 206 | ||
| Precocious puberty | 206 | ||
| Females | 206 | ||
| Males | 207 | ||
| Management | 208 | ||
| Premature breast development (thelarche) | 208 | ||
| Premature pubarche (adrenarche) | 208 | ||
| Delayed puberty | 209 | ||
| Acknowledgements | 210 | ||
| Further reading | 210 | ||
| Websites (Accessed November 2016) | 210 | ||
| 13 Nutrition | 211 | ||
| The nutritional vulnerability of infants and children | 211 | ||
| Low nutritional stores | 211 | ||
| High nutritional demands for growth | 211 | ||
| Rapid brain growth and development | 212 | ||
| Effects of acute illness or surgery | 212 | ||
| Long-term outcome of early nutritional deficiency | 212 | ||
| Linear growth of populations | 212 | ||
| Disease in adult life | 213 | ||
| Infant feeding | 213 | ||
| Breastfeeding | 213 | ||
| Advantages | 214 | ||
| Potential complications | 214 | ||
| Establishing breastfeeding | 214 | ||
| Formula feeding | 215 | ||
| Introduction of whole, pasteurized cow’s milk | 216 | ||
| Specialized infant formula | 217 | ||
| Weaning | 217 | ||
| Weight faltering | 217 | ||
| Identifying weight faltering | 218 | ||
| Causes of weight faltering | 218 | ||
| Clinical features and investigation | 218 | ||
| Management | 219 | ||
| Outcome | 221 | ||
| Malnutrition | 221 | ||
| Assessment of nutritional status | 221 | ||
| Dietary assessment | 221 | ||
| Anthropometry | 222 | ||
| Laboratory investigations | 222 | ||
| Consequences of malnutrition | 222 | ||
| The role of intensive nutritional support | 222 | ||
| Enteral nutrition | 222 | ||
| Parenteral nutrition (PN) | 223 | ||
| Severe malnutrition | 223 | ||
| Management | 224 | ||
| Stunting | 224 | ||
| Vitamin D deficiency | 225 | ||
| Rickets | 226 | ||
| Aetiology | 226 | ||
| Clinical manifestations | 226 | ||
| Diagnosis | 226 | ||
| Management | 226 | ||
| Other vitamin deficiencies | 227 | ||
| Obesity | 227 | ||
| Definitions | 227 | ||
| Aetiology | 228 | ||
| Prevention | 229 | ||
| Endogenous causes | 231 | ||
| Management | 231 | ||
| Drug treatment and surgery | 231 | ||
| Early childhood caries | 232 | ||
| Prevention of early childhood caries | 232 | ||
| Acknowledgements | 232 | ||
| Further reading | 233 | ||
| Websites (Accessed November 2016) | 233 | ||
| 14 Gastroenterology | 234 | ||
| Vomiting | 234 | ||
| Gastro-oesophageal reflux | 235 | ||
| Investigation | 236 | ||
| 15 Infection and immunity | 256 | ||
| The febrile child | 256 | ||
| Clinical features | 256 | ||
| Management | 259 | ||
| Serious life-threatening infections | 259 | ||
| Sepsis | 259 | ||
| Meningitis | 259 | ||
| Bacterial meningitis | 259 | ||
| Pathophysiology | 259 | ||
| Organisms | 259 | ||
| Presentation | 259 | ||
| Investigations | 261 | ||
| Management | 261 | ||
| Cerebral complications | 261 | ||
| Prophylaxis | 261 | ||
| Partially treated bacterial meningitis | 261 | ||
| Viral meningitis | 261 | ||
| Uncommon pathogens and other causes | 261 | ||
| Neonatal meningitis | 261 | ||
| Encephalitis/encephalopathy | 261 | ||
| Toxic shock syndrome | 262 | ||
| Necrotizing fasciitis/cellulitis | 263 | ||
| Specific bacterial infections | 263 | ||
| Meningococcal infection | 263 | ||
| Pneumococcal infections | 264 | ||
| H. influenzae infection | 264 | ||
| Staphylococcal and group A streptococcal infections | 264 | ||
| Impetigo | 264 | ||
| Boils | 265 | ||
| Periorbital cellulitis | 265 | ||
| Staphylococcal scalded skin syndrome | 265 | ||
| Common viral infections | 265 | ||
| The human herpesviruses | 266 | ||
| Herpes simplex virus infections | 266 | ||
| Asymptomatic | 266 | ||
| Gingivostomatitis | 266 | ||
| Skin manifestations | 267 | ||
| Eye disease | 267 | ||
| Disseminated infection | 267 | ||
| Chickenpox (primary varicella zoster infection) | 267 | ||
| Clinical features | 267 | ||
| Treatment and prevention | 267 | ||
| Shingles (herpes zoster) | 268 | ||
| Epstein–Barr virus: infectious mononucleosis (glandular fever) | 269 | ||
| Cytomegalovirus | 269 | ||
| Human herpesvirus 6 and human herpesvirus 7 | 270 | ||
| Human parvovirus B19 | 270 | ||
| Enteroviruses | 270 | ||
| Hand, foot, and mouth disease | 270 | ||
| Herpangina | 270 | ||
| Meningitis/encephalitis | 270 | ||
| Pleurodynia (Bornholm disease) | 271 | ||
| Myocarditis and pericarditis | 271 | ||
| Enteroviral neonatal sepsis syndrome | 271 | ||
| Uncommon viral infections | 271 | ||
| Measles | 271 | ||
| Clinical features | 271 | ||
| Treatment | 271 | ||
| Prevention | 271 | ||
| Mumps | 272 | ||
| Clinical features | 272 | ||
| Viral meningitis and encephalitis | 272 | ||
| Orchitis | 272 | ||
| Rubella (German measles) | 272 | ||
| Prolonged fever | 273 | ||
| Kawasaki disease | 273 | ||
| Tuberculosis | 275 | ||
| Clinical features | 275 | ||
| Diagnosis | 275 | ||
| Treatment | 277 | ||
| Prevention and contact tracing | 277 | ||
| Nontuberculous mycobacterial infections | 277 | ||
| Tropical infections | 277 | ||
| HIV infection | 279 | ||
| Diagnosis | 280 | ||
| Clinical features | 280 | ||
| Treatment | 280 | ||
| Reduction of vertical transmission | 281 | ||
| Lyme disease | 281 | ||
| Clinical features | 281 | ||
| Diagnosis | 281 | ||
| Treatment | 281 | ||
| Immunization | 281 | ||
| Rationale behind the immunization programme | 282 | ||
| Complications and contraindications | 284 | ||
| Immunodeficiency | 284 | ||
| Primary immunodeficiencies | 284 | ||
| Investigation | 284 | ||
| Management | 286 | ||
| Acknowledgements | 286 | ||
| Further reading | 286 | ||
| Websites (Accessed November 2016) | 287 | ||
| 16 Allergy | 288 | ||
| Mechanisms of allergic disease | 288 | ||
| The hygiene hypothesis | 289 | ||
| The allergic march | 289 | ||
| Prevention of allergic diseases | 289 | ||
| History and examination | 289 | ||
| Management | 290 | ||
| Food allergy and food intolerance | 290 | ||
| Clinical features | 290 | ||
| Diagnosis | 291 | ||
| Management | 292 | ||
| Eczema | 292 | ||
| Allergic rhinitis and conjunctivitis (rhinoconjunctivitis) | 292 | ||
| Asthma | 292 | ||
| Urticaria and angioedema | 293 | ||
| Drug allergy | 293 | ||
| Insect sting hypersensitivity | 293 | ||
| Anaphylaxis | 293 | ||
| Acknowledgements | 293 | ||
| Further reading | 293 | ||
| Websites (Accessed December 2016) | 293 | ||
| 17 Respiratory disorders | 294 | ||
| Physiology of stridor and wheeze | 295 | ||
| Upper respiratory tract infection | 295 | ||
| The common cold (coryza) | 296 | ||
| Sore throat (pharyngitis and tonsillitis) | 296 | ||
| Acute otitis media | 296 | ||
| Sinusitis | 297 | ||
| Tonsillectomy and adenoidectomy | 297 | ||
| Stridor | 297 | ||
| Croup | 298 | ||
| Acute epiglottitis | 298 | ||
| Bacterial tracheitis (pseudomembranous croup) | 299 | ||
| Other causes of stridor | 299 | ||
| Wheeze | 300 | ||
| Bronchiolitis | 300 | ||
| Investigations and decision to admit | 301 | ||
| Management | 301 | ||
| Prevention of bronchiolitis | 301 | ||
| Asthma | 301 | ||
| Viral episodic wheeze | 302 | ||
| Multiple trigger wheeze and asthma | 302 | ||
| Pathophysiology of asthma | 302 | ||
| Clinical features | 303 | ||
| Investigations | 303 | ||
| Management | 303 | ||
| Bronchodilator therapy | 303 | ||
| Preventer therapy | 304 | ||
| Inhaled corticosteroids | 304 | ||
| Add-on therapy | 304 | ||
| Other therapies | 304 | ||
| Allergen avoidance and other nonpharmacological measures | 304 | ||
| Acute asthma | 305 | ||
| Assessment | 305 | ||
| Criteria for admission to hospital | 305 | ||
| Management | 306 | ||
| Patient education | 308 | ||
| Other causes of acute wheezing | 309 | ||
| Cough | 310 | ||
| Acute cough | 310 | ||
| Whooping cough (pertussis) | 310 | ||
| Persistent or recurrent cough | 310 | ||
| Pneumonia | 311 | ||
| Clinical features | 311 | ||
| Management | 311 | ||
| Prognosis and follow-up | 312 | ||
| Chronic lung infection | 313 | ||
| Cystic fibrosis | 313 | ||
| Epidemiology, genetics, and basic defect | 313 | ||
| Pathophysiology | 314 | ||
| Clinical features | 314 | ||
| Diagnosis | 315 | ||
| Management | 315 | ||
| Respiratory management | 315 | ||
| Nutritional management | 316 | ||
| Teenagers and adults | 316 | ||
| Primary ciliary dyskinesia | 317 | ||
| Immunodeficiency | 317 | ||
| Tuberculosis | 317 | ||
| Sleep-disordered breathing | 317 | ||
| Tracheostomy | 318 | ||
| Long-term ventilation | 318 | ||
| Acknowledgements | 319 | ||
| Further reading | 319 | ||
| Websites (Accessed November 2016) | 319 | ||
| 18 Cardiac disorders | 320 | ||
| Epidemiology | 320 | ||
| Aetiology | 321 | ||
| Circulatory changes at birth | 321 | ||
| Presentation | 322 | ||
| Antenatal diagnosis | 322 | ||
| Heart murmurs | 322 | ||
| Heart failure | 322 | ||
| Symptoms | 322 | ||
| Signs | 322 | ||
| Cyanosis | 323 | ||
| Diagnosis | 323 | ||
| Nomenclature | 325 | ||
| Left-to-right shunts | 325 | ||
| Atrial septal defect | 325 | ||
| Clinical features | 325 | ||
| Symptoms | 325 | ||
| Physical signs | 325 | ||
| Investigations | 325 | ||
| Chest radiograph | 325 | ||
| ECG | 325 | ||
| Echocardiography | 325 | ||
| Management | 325 | ||
| Ventricular septal defects | 326 | ||
| Small VSDs | 326 | ||
| Clinical features | 326 | ||
| Symptoms | 326 | ||
| Physical signs | 326 | ||
| Investigations | 327 | ||
| Chest radiograph | 327 | ||
| ECG | 327 | ||
| Echocardiography | 327 | ||
| Management | 327 | ||
| Large VSDs | 327 | ||
| Clinical features | 327 | ||
| Symptoms | 327 | ||
| Physical signs (Fig. 18.5b) | 327 | ||
| 19 Kidney and urinary tract disorders | 344 | ||
| Assessment of the kidneys and urinary tract | 344 | ||
| Congenital abnormalities | 344 | ||
| Anomalies detectable on antenatal ultrasound screening | 344 | ||
| Antenatal treatment | 348 | ||
| Postnatal management | 348 | ||
| Urinary tract infection | 349 | ||
| Clinical features | 349 | ||
| Collection of samples | 350 | ||
| Bacterial and host factors that predispose to infection | 350 | ||
| Infecting organism | 350 | ||
| Antenatally diagnosed renal or urinary tract abnormality | 351 | ||
| Incomplete bladder emptying | 351 | ||
| Vesicoureteric reflux | 351 | ||
| Investigation | 351 | ||
| Management | 352 | ||
| Medical measures for the prevention of UTI | 352 | ||
| Follow-up of children with recurrent UTIs, renal scarring, or reflux | 352 | ||
| Enuresis | 353 | ||
| Primary nocturnal enuresis | 353 | ||
| Daytime enuresis | 353 | ||
| Secondary (onset) enuresis | 354 | ||
| Proteinuria | 355 | ||
| Nephrotic syndrome | 355 | ||
| Steroid-sensitive nephrotic syndrome | 355 | ||
| Management | 355 | ||
| Prognosis | 356 | ||
| Steroid-resistant nephrotic syndrome | 357 | ||
| Congenital nephrotic syndrome | 357 | ||
| Haematuria | 357 | ||
| Acute nephritis | 358 | ||
| Post-streptococcal and post-infectious nephritis | 358 | ||
| Henoch–Schönlein purpura | 358 | ||
| Clinical findings | 359 | ||
| IgA nephropathy | 359 | ||
| Familial nephritis | 359 | ||
| Vasculitis | 359 | ||
| Systemic lupus erythematosus (SLE) | 359 | ||
| Hypertension | 360 | ||
| Renal masses | 360 | ||
| Renal calculi | 360 | ||
| Renal tubular disorders | 361 | ||
| Generalized proximal tubular dysfunction (Fanconi syndrome) | 361 | ||
| Specific transport defects | 361 | ||
| Acute kidney injury | 361 | ||
| Management | 361 | ||
| Prerenal failure | 361 | ||
| Renal failure | 361 | ||
| Postrenal failure | 361 | ||
| Dialysis | 363 | ||
| Haemolytic uraemic syndrome | 363 | ||
| Chronic kidney disease | 363 | ||
| Clinical features | 363 | ||
| Management | 364 | ||
| Diet | 364 | ||
| Prevention of renal osteodystrophy | 364 | ||
| Control of salt and water balance and acidosis | 364 | ||
| Anaemia | 364 | ||
| Hormonal abnormalities | 364 | ||
| Dialysis and transplantation | 364 | ||
| Acknowledgements | 365 | ||
| Further reading | 366 | ||
| Websites (Accessed November 2016) | 366 | ||
| 20 Genital disorders | 367 | ||
| Inguinoscrotal conditions | 367 | ||
| Embryology | 367 | ||
| Inguinal hernia | 367 | ||
| Hydrocele | 367 | ||
| Varicocele | 368 | ||
| Undescended testis | 368 | ||
| Investigations and management | 369 | ||
| Acute inguinoscrotal conditions (‘the acute scrotum’) | 370 | ||
| Torsion of the testis | 370 | ||
| Torsion of appendix testis | 370 | ||
| Other acute inguinoscrotal conditions | 371 | ||
| Abnormalities of the penis | 371 | ||
| The foreskin | 371 | ||
| Non-retractile foreskin and phimosis | 371 | ||
| Paraphimosis | 372 | ||
| Circumcision | 372 | ||
| Hypospadias | 372 | ||
| Management | 372 | ||
| Other conditions of the penis | 372 | ||
| Genital disorders in girls | 374 | ||
| Normal anatomy | 374 | ||
| Vulvovaginitis/vaginal discharge | 374 | ||
| Labial adhesions | 374 | ||
| Other conditions | 374 | ||
| Acknowledgements | 374 | ||
| Further reading | 374 | ||
| 21 Liver disorders | 375 | ||
| Neonatal cholestasis | 375 | ||
| Biliary atresia | 375 | ||
| Investigations | 376 | ||
| Treatment | 376 | ||
| Choledochal cysts | 376 | ||
| Neonatal hepatitis syndrome | 376 | ||
| Alagille syndrome | 376 | ||
| Progressive familial intrahepatic cholestasis | 376 | ||
| Neonatal metabolic liver disease | 378 | ||
| α1-Antitrypsin deficiency | 378 | ||
| Galactosaemia | 378 | ||
| Other causes | 378 | ||
| Viral hepatitis | 378 | ||
| Hepatitis A | 378 | ||
| Hepatitis B | 378 | ||
| Chronic hepatitis B | 378 | ||
| Prevention | 379 | ||
| Hepatitis C | 379 | ||
| Hepatitis D virus | 379 | ||
| Hepatitis E virus | 379 | ||
| Seronegative (non-A to G) hepatitis | 380 | ||
| Epstein–Barr virus | 380 | ||
| Acute liver failure (fulminant hepatitis) | 380 | ||
| Diagnosis | 380 | ||
| Management | 380 | ||
| Liver disease in older children | 380 | ||
| Autoimmune hepatitis and sclerosing cholangitis | 380 | ||
| Cystic fibrosis | 381 | ||
| Wilson disease | 381 | ||
| Fibropolycystic liver disease (ciliopathies) | 381 | ||
| Non-alcoholic fatty liver disease | 381 | ||
| Complications of chronic liver disease | 382 | ||
| Nutrition | 382 | ||
| Fat-soluble vitamins | 382 | ||
| Pruritus | 382 | ||
| Encephalopathy | 382 | ||
| Cirrhosis and portal hypertension | 382 | ||
| Oesophageal varices | 383 | ||
| Ascites | 383 | ||
| Spontaneous bacterial peritonitis | 383 | ||
| Renal failure | 384 | ||
| Liver transplantation | 384 | ||
| Acknowledgements | 384 | ||
| Further reading | 384 | ||
| 22 Malignant disease | 385 | ||
| Aetiology | 386 | ||
| Clinical presentation | 386 | ||
| Investigations | 386 | ||
| Radiology | 386 | ||
| Tumour marker studies | 387 | ||
| Pathology | 387 | ||
| Management | 387 | ||
| Teenagers and young adults | 387 | ||
| Treatment | 387 | ||
| Chemotherapy | 387 | ||
| High-dose therapy with stem cell rescue | 387 | ||
| Targeted therapies | 387 | ||
| Radiotherapy | 387 | ||
| Surgery | 388 | ||
| Supportive care and side-effects of treatment | 388 | ||
| Infection from immunosuppression | 388 | ||
| Bone marrow suppression | 388 | ||
| Gastrointestinal damage, nausea and vomiting, and nutritional compromise | 388 | ||
| Drug-specific side-effects | 388 | ||
| Other supportive care issues | 389 | ||
| Fertility preservation | 389 | ||
| Venous access | 389 | ||
| Psychosocial support | 389 | ||
| Leukaemia | 390 | ||
| Clinical presentation | 390 | ||
| Investigations | 390 | ||
| Management of acute lymphoblastic leukaemia | 390 | ||
| Remission induction | 390 | ||
| Intensification | 391 | ||
| Central nervous system | 391 | ||
| Continuing therapy | 391 | ||
| Treatment of relapse | 391 | ||
| Brain tumours | 391 | ||
| Clinical features | 392 | ||
| Investigations | 392 | ||
| 23 Haematological disorders | 401 | ||
| Haemoglobin production in the fetus and newborn | 401 | ||
| Haematological values at birth and the first few weeks of life | 402 | ||
| Anaemia | 402 | ||
| Anaemia due to impaired red cell production | 403 | ||
| Diagnosis of ineffective erythropoiesis | 403 | ||
| Iron deficiency | 403 | ||
| Clinical features | 404 | ||
| Diagnosis | 405 | ||
| Management | 405 | ||
| Treatment of iron deficiency with normal Hb | 405 | ||
| Red cell aplasia | 405 | ||
| Increased red cell destruction (haemolytic anaemia) | 406 | ||
| Hereditary spherocytosis | 406 | ||
| Clinical features | 406 | ||
| 24 Child and adolescent mental health | 424 | ||
| How to ask about emotional and behavioural problems | 424 | ||
| How mental health problems evolve in childhood | 425 | ||
| Biological/developmental factors | 425 | ||
| Psychological factors | 425 | ||
| Self-esteem | 425 | ||
| Cognitive style | 426 | ||
| Social factors | 426 | ||
| Early relationships and attachment | 426 | ||
| Adversities in the family | 427 | ||
| Adversities outside the family | 427 | ||
| Resilience | 427 | ||
| Putting it together: the biopsychosocial formulation | 427 | ||
| Specific paediatric mental health problems | 428 | ||
| Problems of the preschool years | 428 | ||
| Meal refusal | 428 | ||
| Sleep-related problems | 429 | ||
| Difficulty in settling to sleep at bedtime | 429 | ||
| Waking at night | 429 | ||
| Nightmares | 429 | ||
| Night (sleep) terrors | 429 | ||
| Disobedience, defiance, and tantrums | 430 | ||
| Aggressive behaviour | 431 | ||
| Autism spectrum disorder and attention deficit hyperactivity disorder | 431 | ||
| Problems of middle childhood | 431 | ||
| Nocturnal enuresis | 431 | ||
| Explanation | 431 | ||
| Star chart | 431 | ||
| Enuresis alarm | 431 | ||
| Desmopressin | 432 | ||
| Self-help groups | 432 | ||
| Faecal soiling | 432 | ||
| Recurrent unexplained somatic symptoms/somatisation | 432 | ||
| Tics | 433 | ||
| Antisocial behaviour | 433 | ||
| Anxiety | 434 | ||
| School refusal | 434 | ||
| Educational underachievement | 435 | ||
| Problems of adolescence | 435 | ||
| Cognitive style | 435 | ||
| Anorexia nervosa and other eating disorders | 435 | ||
| Management | 436 | ||
| Medical aspects | 436 | ||
| Prognosis | 436 | ||
| Chronic fatigue syndrome | 437 | ||
| Depression | 437 | ||
| Deliberate self-harm | 438 | ||
| How to ask about self-harm | 438 | ||
| Drug misuse | 438 | ||
| Psychosis | 439 | ||
| Management of emotional and behavioural problems | 439 | ||
| Cultural considerations | 439 | ||
| Treatment | 439 | ||
| Acknowledgements | 441 | ||
| Further reading | 441 | ||
| Websites (Accessed November 2016) | 441 | ||
| 25 Dermatological disorders | 442 | ||
| The newborn | 442 | ||
| Bullous impetigo | 442 | ||
| Melanocytic naevi (moles) | 442 | ||
| Albinism | 444 | ||
| Epidermolysis bullosa | 444 | ||
| Collodion baby | 444 | ||
| Rashes of infancy | 444 | ||
| Nappy rashes | 444 | ||
| Infantile seborrhoeic dermatitis | 445 | ||
| Atopic eczema (atopic dermatitis) | 445 | ||
| Diagnosis | 445 | ||
| Clinical features | 446 | ||
| Complications | 446 | ||
| Management | 446 | ||
| Avoiding irritants and precipitants | 446 | ||
| Emollients | 446 | ||
| Topical corticosteroids | 446 | ||
| Immunomodulators | 446 | ||
| Occlusive bandages | 447 | ||
| Antibiotics, antiviral agents, and antihistamines | 447 | ||
| Dietary elimination | 447 | ||
| Psychosocial support | 447 | ||
| Infections and infestations | 448 | ||
| Viral infections | 448 | ||
| Viral warts | 448 | ||
| Molluscum contagiosum | 448 | ||
| Fungal infections | 448 | ||
| Ringworm | 448 | ||
| Parasitic infestations | 449 | ||
| Scabies | 449 | ||
| Complications | 449 | ||
| Treatment | 449 | ||
| Pediculosis | 449 | ||
| Other childhood skin disorders | 450 | ||
| Psoriasis | 450 | ||
| Pityriasis rosea | 450 | ||
| Alopecia areata | 450 | ||
| Granuloma annulare | 450 | ||
| Acne vulgaris | 451 | ||
| Rashes and systemic disease | 451 | ||
| Urticaria | 452 | ||
| Acknowledgements | 452 | ||
| Further reading | 452 | ||
| Website (Accessed November 2016) | 452 | ||
| 26 Diabetes and endocrinology | 453 | ||
| Diabetes mellitus | 453 | ||
| Aetiology of type 1 diabetes | 454 | ||
| Clinical features | 454 | ||
| Diagnosis | 455 | ||
| Initial management of type 1 diabetes | 455 | ||
| Insulin | 455 | ||
| Diet | 456 | ||
| Blood glucose monitoring | 457 | ||
| Acute complications | 458 | ||
| Hypoglycaemia | 458 | ||
| Diabetic ketoacidosis | 459 | ||
| Long-term management | 459 | ||
| Problems in diabetes control | 459 | ||
| Management at school | 459 | ||
| Puberty and adolescence | 461 | ||
| Hypoglycaemia | 462 | ||
| Causes | 463 | ||
| Treatment | 463 | ||
| Thyroid disorders | 464 | ||
| Congenital hypothyroidism | 464 | ||
| Acquired hypothyroidism | 465 | ||
| Hyperthyroidism | 465 | ||
| Parathyroid disorders | 466 | ||
| Pituitary disorders | 466 | ||
| Adrenal disorders | 466 | ||
| Congenital adrenal hyperplasia | 466 | ||
| Diagnosis | 467 | ||
| Management | 468 | ||
| Primary adrenal insufficiency (Addison disease) | 468 | ||
| Presentation | 468 | ||
| Diagnosis | 469 | ||
| Management | 469 | ||
| Cushing syndrome | 469 | ||
| Disorders of sex development | 469 | ||
| Acknowledgements | 470 | ||
| Further reading | 471 | ||
| Websites (Accessed November 2016) | 471 | ||
| 27 Inborn errors of metabolism | 472 | ||
| Overview | 472 | ||
| Classification | 472 | ||
| Frequency | 472 | ||
| Presentation | 472 | ||
| Genetics | 473 | ||
| Investigations | 473 | ||
| Management | 474 | ||
| Newborn screening | 474 | ||
| Metabolic disease and acid-base disturbance | 475 | ||
| The anion gap | 475 | ||
| Hyperammonaemia | 476 | ||
| Hypoglycaemia | 476 | ||
| Glycogen storage disorders | 476 | ||
| Lysosomal storage disorders | 477 | ||
| Mucopolysaccharidoses (MPS) | 477 | ||
| Mitochondrial disease | 477 | ||
| Lipid storage disorders | 477 | ||
| Disorders of lipid metabolism | 479 | ||
| Acknowledgements | 481 | ||
| Further reading | 481 | ||
| Websites (Accessed December 2016) | 481 | ||
| 28 Musculoskeletal disorders | 482 | ||
| Assessment of the musculoskeletal system | 482 | ||
| Variations of normal posture | 482 | ||
| Bow legs (genu varum) | 482 | ||
| Knock-knees (genu valgum) | 482 | ||
| Flat feet (pes planus) | 482 | ||
| In-toeing | 482 | ||
| Toe walking | 483 | ||
| Abnormal posture | 484 | ||
| Talipes equinovarus (clubfoot) | 484 | ||
| Vertical talus | 484 | ||
| Talipes calcaneovalgus | 485 | ||
| Tarsal coalition | 485 | ||
| Pes cavus | 485 | ||
| Developmental dysplasia of the hip (DDH) | 485 | ||
| Scoliosis | 485 | ||
| Torticollis | 485 | ||
| The painful limb, knee, and back | 486 | ||
| Growing pains | 486 | ||
| Hypermobility | 486 | ||
| Complex regional pain syndromes | 486 | ||
| Acute-onset limb pain | 487 | ||
| Osteomyelitis | 487 | ||
| Presentation | 487 | ||
| Investigation | 487 | ||
| Treatment | 487 | ||
| Malignant disease | 487 | ||
| Bone tumours | 487 | ||
| The painful knee | 488 | ||
| Osgood–Schlatter disease | 488 | ||
| Chondromalacia patellae | 488 | ||
| Osteochondritis dissecans (segmental avascular necrosis of the subchondral bone) | 489 | ||
| Subluxation and dislocation of the patella | 489 | ||
| Injuries | 489 | ||
| Back pain | 489 | ||
| Limp | 489 | ||
| Transient synovitis (‘irritable hip’) | 489 | ||
| Perthes disease | 489 | ||
| Slipped capital femoral epiphysis | 491 | ||
| Arthritis | 491 | ||
| Reactive arthritis | 491 | ||
| Septic arthritis | 492 | ||
| Presentation | 492 | ||
| Investigation | 492 | ||
| Juvenile idiopathic arthritis (JIA) | 493 | ||
| Complications | 493 | ||
| Chronic anterior uveitis | 493 | ||
| Flexion contractures of the joints | 493 | ||
| Growth failure | 493 | ||
| Constitutional problems | 495 | ||
| Osteoporosis | 495 | ||
| Amyloidosis | 495 | ||
| Management | 495 | ||
| Prognosis | 496 | ||
| Henoch–Schönlein purpura | 496 | ||
| Systemic lupus erythematosus (SLE) | 496 | ||
| Juvenile dermatomyositis | 496 | ||
| Genetic skeletal conditions | 497 | ||
| Achondroplasia | 497 | ||
| Thanatophoric dysplasia | 497 | ||
| Cleidocranial dysostosis | 498 | ||
| Arthrogryposis | 498 | ||
| Osteogenesis imperfecta (brittle bone disease) | 498 | ||
| Osteopetrosis (marble bone disease) | 498 | ||
| Marfan syndrome | 499 | ||
| Acknowledgements | 499 | ||
| Further reading | 499 | ||
| Websites (Accessed December 2016) | 499 | ||
| 29 Neurological disorders | 500 | ||
| Headache | 500 | ||
| Primary headaches | 500 | ||
| Tension-type headache | 500 | ||
| Migraine | 500 | ||
| Migraine without aura | 500 | ||
| Migraine with aura | 501 | ||
| Uncommon forms of migraine | 501 | ||
| Secondary headaches | 502 | ||
| Raised intracranial pressure and space-occupying lesions | 502 | ||
| Medication overuse headache | 503 | ||
| Other causes | 503 | ||
| Management | 503 | ||
| Rescue treatments | 503 | ||
| Prophylactic treatments | 503 | ||
| Psychosocial support | 503 | ||
| Seizures | 503 | ||
| Epileptic seizures | 503 | ||
| Convulsions | 503 | ||
| Epilepsies | 503 | ||
| Acute symptomatic epileptic seizures | 503 | ||
| Febrile seizures | 503 | ||
| Paroxysmal disorders | 504 | ||
| Epilepsies of childhood | 506 | ||
| Diagnosis | 506 | ||
| Investigation | 506 | ||
| ECG | 506 | ||
| EEG (electroencephalogram) | 506 | ||
| Brain imaging | 507 | ||
| Other investigations | 507 | ||
| Management | 509 | ||
| Antiepileptic drug therapy | 509 | ||
| Other treatment options | 510 | ||
| Advice and prognosis | 510 | ||
| Status epilepticus | 510 | ||
| Motor disorders | 510 | ||
| Central motor disorders | 511 | ||
| Cerebral palsy | 511 | ||
| Peripheral motor disorders: the neuromuscular disorders | 511 | ||
| Investigations | 512 | ||
| Disorders of the anterior horn cell | 512 | ||
| Spinal muscular atrophy | 512 | ||
| Spinal muscular atrophy type 1 (Werdnig–Hoffmann disease) | 513 | ||
| Peripheral neuropathies | 513 | ||
| Charcot–Marie–Tooth disease (the hereditary motor sensory neuropathies) | 513 | ||
| Guillain–Barré syndrome (acute post-infectious polyneuropathy) | 513 | ||
| Bell palsy and facial nerve palsies | 513 | ||
| Disorders of neuromuscular transmission | 514 | ||
| Myasthenia gravis | 514 | ||
| Juvenile myasthenia | 514 | ||
| Congenital myasthenic syndromes | 514 | ||
| Muscle disorders | 514 | ||
| The muscular dystrophies | 514 | ||
| Duchenne muscular dystrophy | 514 | ||
| Management | 515 | ||
| Becker muscular dystrophy | 515 | ||
| Limb girdle muscular dystrophies | 515 | ||
| Congenital muscular dystrophies | 515 | ||
| Congenital myopathies | 515 | ||
| Metabolic myopathies | 515 | ||
| The inflammatory myopathies | 515 | ||
| Benign acute myositis | 515 | ||
| Dermatomyositis | 516 | ||
| Myotonic disorders | 516 | ||
| Dystrophia myotonica type I | 516 | ||
| The hypotonic or ‘floppy” infant | 516 | ||
| Ataxia | 517 | ||
| Friedreich ataxia | 517 | ||
| Ataxia telangiectasia | 517 | ||
| Other hereditary cerebellar ataxias | 517 | ||
| Cerebrovascular disease | 517 | ||
| Intracranial haemorrhage | 517 | ||
| Extradural haemorrhage | 517 | ||
| Subdural haematoma | 517 | ||
| Subarachnoid haemorrhage | 518 | ||
| Stroke | 518 | ||
| Microcephaly and macrocephaly | 518 | ||
| Neural tube defects and hydrocephalus | 518 | ||
| Neural tube defects | 518 | ||
| Anencephaly | 518 | ||
| Encephalocele | 519 | ||
| Spina bifida occulta | 519 | ||
| Meningocele and myelomeningocele | 519 | ||
| Management | 520 | ||
| Hydrocephalus | 520 | ||
| Clinical features | 520 | ||
| The neurocutaneous syndromes | 521 | ||
| Neurofibromatosis | 521 | ||
| Tuberous sclerosis | 521 | ||
| Sturge–Weber syndrome | 522 | ||
| Neurodegenerative disorders | 522 | ||
| Adrenoleukodystrophy | 523 | ||
| Acknowledgements | 524 | ||
| Further reading | 524 | ||
| Websites (Accessed November 2016) | 524 | ||
| Systematic reviews | 524 | ||
| 30 Adolescent medicine | 525 | ||
| Communicating with adolescents | 525 | ||
| Consent and confidentiality | 527 | ||
| Consent | 527 | ||
| Confidentiality | 527 | ||
| Range of health problems | 528 | ||
| Mortality | 528 | ||
| Impact of chronic conditions | 529 | ||
| Adherence | 529 | ||
| Fatigue, headache, and other somatic symptoms | 530 | ||
| Mental health problems | 531 | ||
| Health-risk behaviour | 531 | ||
| Sexual health | 531 | ||
| Management of sexually transmitted infections | 531 | ||
| Contraception | 532 | ||
| Emergency contraception | 532 | ||
| Teenage parenthood | 532 | ||
| Health promotion | 532 | ||
| Transition to adult services | 533 | ||
| Acknowledgements | 533 | ||
| Further reading | 534 | ||
| Websites (Accessed November 2016) | 534 | ||
| 31 Global child health | 535 | ||
| Child mortality | 535 | ||
| Where deaths occur | 535 | ||
| Determining child mortality rates and health outcomes in different countries | 535 | ||
| Why is child mortality so high? | 536 | ||
| Reducing child mortality | 537 | ||
| Improving neonatal survival | 538 | ||
| Maternal health and obstetric care | 539 | ||
| Saving newborn lives | 539 | ||
| Improving the survival of children | 540 | ||
| Infection | 540 | ||
| Nutrition | 540 | ||
| Trauma and road traffic injuries | 540 | ||
| Mental health | 540 | ||
| Coexisting multiple pathologies: a major threat to child survival | 540 | ||
| Children affected by conflict | 542 | ||
| Future developments | 542 | ||
| Sustainable development goals | 542 | ||
| Acknowledgements | 543 | ||
| Further reading | 543 | ||
| Websites (Accessed November 2016) | 543 | ||
| Appendix | 544 | ||
| Growth charts | 544 | ||
| Gestational age assessment of newborn infants | 555 | ||
| Management action plan for asthma | 556 | ||
| Blood pressure chart | 557 | ||
| Peak flow chart | 557 | ||
| Imaging in children | 557 | ||
| Blood tests | 558 | ||
| Taking blood from children | 558 | ||
| Index | 560 | ||
| A | 560 | ||
| B | 562 | ||
| C | 563 | ||
| D | 565 | ||
| E | 566 | ||
| F | 568 | ||
| G | 568 | ||
| H | 569 | ||
| I | 571 | ||
| J | 572 | ||
| K | 572 | ||
| L | 573 | ||
| M | 573 | ||
| N | 575 | ||
| O | 576 | ||
| P | 576 | ||
| Q | 578 | ||
| R | 578 | ||
| S | 579 | ||
| T | 581 | ||
| U | 582 | ||
| V | 582 | ||
| W | 583 | ||
| X | 583 | ||
| Y | 583 | ||
| Z | 583 |