BOOK
Essentials of Paediatrics E-Book
Nandu Thalange | Richard Beach | David Booth | Lisa Jackson
(2012)
Additional Information
Book Details
Abstract
The perfect portable companion for trainees and medical students on clinical placements in paediatrics.
New to this edition:
- Two new editors
- Thoroughly updated and revised throughout
Key features:
- Part of the Kumar & Clark family of revision titles
- Cases throughout
- Key points boxes included
- Includes self-assessment questions
- Appendices cover resuscitation, practical procedures, prescribing, fluids and electrolytes, and common syndromes
- Ideal for revision and examination preparation
The perfect portable companion for trainees and medical students on clinical placements in paediatrics.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Essentials of Paediatrics | iii | ||
| Copyright | iv | ||
| Series preface | v | ||
| Preface | vii | ||
| Contributors | ix | ||
| Contents | xi | ||
| Abbreviations | xiii | ||
| Chapter 1: Assessing childhood illness | 1 | ||
| Talking to children and their families | 1 | ||
| What do families want? | 1 | ||
| The paediatric history | 1 | ||
| Be prepared | 1 | ||
| Environment | 2 | ||
| General principles | 2 | ||
| Greeting | 2 | ||
| Presenting complaint | 2 | ||
| History of presenting complaint | 2 | ||
| Past medical history | 2 | ||
| Drug history | 2 | ||
| Family and social history | 3 | ||
| Developmental history | 3 | ||
| Systems review | 3 | ||
| Respiratory: | 3 | ||
| Cardiovascular: | 3 | ||
| Gastrointestinal: | 3 | ||
| Neurological: | 3 | ||
| Genitourinary: | 4 | ||
| Ent: | 4 | ||
| Skin: | 4 | ||
| Child protection | 4 | ||
| Examining children | 4 | ||
| First impressions | 4 | ||
| Making friends | 5 | ||
| Adolescents | 5 | ||
| A practical approach | 5 | ||
| Documentation | 6 | ||
| Principles of defensible documentation | 6 | ||
| Summary | 6 | ||
| Chapter 2: Children's place in society | 7 | ||
| Introduction | 7 | ||
| The United Nations Convention on the Rights of the Child | 7 | ||
| Rights of protection | 8 | ||
| Rights of participation | 8 | ||
| Rights of provision | 9 | ||
| Parents' and doctors' responsibilities and the child's best interests | 9 | ||
| Parents' rights and responsibilities | 9 | ||
| Physical punishment of children | 10 | ||
| Duties of medical confidentiality | 10 | ||
| Consent | 10 | ||
| Children living in poverty and marginalized groups | 11 | ||
| An international view | 11 | ||
| Inequalities in child health | 12 | ||
| Marginalized groups of children | 12 | ||
| Ethnic minorities | 12 | ||
| Children in lone-parent families | 12 | ||
| Refugee and asylum-seeking children | 12 | ||
| Separation from, or loss of parents | 12 | ||
| Under-nutrition | 12 | ||
| Infections or parasitic infestations | 14 | ||
| Torture and physical abuse | 14 | ||
| Rape | 14 | ||
| Witness to murder, rape or violence towards others, including family members | 14 | ||
| Involvement in conflict | 14 | ||
| Why is this important? | 14 | ||
| Conclusion | 14 | ||
| Chapter 3: The child with chronic disease | 15 | ||
| Introduction | 15 | ||
| Chronic disease | 15 | ||
| The child's perspective | 15 | ||
| An approach to chronic illness | 16 | ||
| Medical | 16 | ||
| The family's agenda | 16 | ||
| Diagnosis | 16 | ||
| Systematic review | 16 | ||
| Medication | 16 | ||
| Monitoring progress | 17 | ||
| Prognosis | 17 | ||
| Information | 17 | ||
| Education | 17 | ||
| Medical needs in school | 17 | ||
| Therapy in school | 17 | ||
| Access to the curriculum | 17 | ||
| Care needs | 17 | ||
| Educational issues | 17 | ||
| Social | 18 | ||
| Development | 18 | ||
| Emotional | 19 | ||
| Initial management of chronic childhood illness – breaking bad news | 19 | ||
| Caring for siblings | 20 | ||
| Working together for children with chronic disease | 20 | ||
| Chapter 4: Child development | 23 | ||
| Introduction | 23 | ||
| Pitfalls | 24 | ||
| The assessment | 24 | ||
| Environment | 24 | ||
| Taking a history | 24 | ||
| The motor skills | 25 | ||
| The motor milestones | 26 | ||
| Newborn to 3 months | 26 | ||
| Chapter 5. Safeguarding children | 33 | ||
| What is meant by ‘child abuse’? | 33 | ||
| Physical harm | 33 | ||
| Neglect | 33 | ||
| Emotional harm | 33 | ||
| Sexual harm | 33 | ||
| Physical harm | 34 | ||
| What might make you suspect a child has suffered a non-accidental injury? | 34 | ||
| 1. Factors in the history | 34 | ||
| 2. Factors on examination | 34 | ||
| 3. Investigation of suspected child abuse | 35 | ||
| What should you do if you have child protection concerns? | 35 | ||
| 1. Accurate documentation is essential | 35 | ||
| 2. Inform your senior colleagues | 36 | ||
| 3. Follow your local safeguarding children procedures | 36 | ||
| What should happen once someone has raised the possibility of abuse? | 36 | ||
| Other types of abuse | 37 | ||
| Neglect | 37 | ||
| Emotional harm | 38 | ||
| Sexual harm | 38 | ||
| Fabricated or induced illness | 38 | ||
| The case conference | 39 | ||
| Information sharing and confidentiality | 39 | ||
| The common law duty of confidence | 39 | ||
| The Human Rights Act | 39 | ||
| The Data Protection Act | 39 | ||
| Chapter 6: Locomotion | 41 | ||
| Introduction | 41 | ||
| History | 41 | ||
| Examination | 41 | ||
| Investigations | 42 | ||
| Principles of management | 44 | ||
| Packaging defects | 44 | ||
| ‘My baby's feet aren't right’ | 44 | ||
| Talipes equinovarus (club foot) ( Figure 6.1) | 44 | ||
| ‘Funny toes’ | 44 | ||
| Gait abnormalities | 45 | ||
| ‘My child doesn't walk properly’ | 45 | ||
| Bow legs (genu varum) | 45 | ||
| Knock knees (genu valgum) | 45 | ||
| Pigeon toed (in-toeing) | 46 | ||
| Out-toeing | 46 | ||
| Toe-walking | 46 | ||
| Flat feet (pes planus) | 46 | ||
| The limping child | 46 | ||
| Transient synovitis of the hip | 46 | ||
| Legg–Calv é –Perthes disease ( Figure 6.3) | 48 | ||
| Slipped upper femoral epiphysis ( Figure 6.4) | 49 | ||
| Developmental dysplasia of the hip | 49 | ||
| Barlow test: | 51 | ||
| Ortolani manoeuvre: | 51 | ||
| The painful leg | 51 | ||
| Acutely painful limb – trauma | 51 | ||
| Acutely painful limb – infection | 51 | ||
| Osteomyelitis | 51 | ||
| Investigations. | 51 | ||
| Treatment. | 52 | ||
| Septic arthritis | 52 | ||
| Presentation. | 52 | ||
| Investigations and treatment. | 52 | ||
| ‘Growing pains’ | 52 | ||
| Arthritis | 52 | ||
| ‘My child has swollen, painful joints’ | 52 | ||
| Reactive arthritis | 53 | ||
| Juvenile idiopathic arthritis | 53 | ||
| History | 53 | ||
| Examination | 53 | ||
| Investigation | 54 | ||
| Treatment | 55 | ||
| Complications | 55 | ||
| Henoch–Schönlein purpura | 55 | ||
| Scoliosis | 56 | ||
| ‘I'm concerned about my daughter's back’ | 56 | ||
| Back pain | 56 | ||
| Other patterns of limb pain | 56 | ||
| Chronic limb pain | 56 | ||
| Chronic pain syndrome | 56 | ||
| Osgood–Schlatter disease | 57 | ||
| Rheumatic fever | 57 | ||
| Chapter 7: Blood and cancer | 59 | ||
| Introduction | 59 | ||
| Key concepts | 59 | ||
| Anaemia | 59 | ||
| Iron deficiency anaemia | 59 | ||
| Haemolytic anaemia | 60 | ||
| Haemolytic disease of the newborn | 60 | ||
| Haemolytic disorders of childhood | 61 | ||
| General principles of treatment of haemolytic anaemias | 61 | ||
| Hereditary spherocytosis | 62 | ||
| Thalassaemia | 62 | ||
| Sickle-cell disease | 63 | ||
| Bruising and bleeding | 65 | ||
| Idiopathic thrombocytopenic purpura | 65 | ||
| Haemophilia | 65 | ||
| von Willebrand disease | 66 | ||
| Bone marrow failure | 66 | ||
| Aplastic anaemia | 66 | ||
| Malignant disease | 67 | ||
| Risk factors | 67 | ||
| Radiation. | 67 | ||
| Genetic factors. | 67 | ||
| Infection. | 68 | ||
| Environmental factors. | 68 | ||
| Symptoms and signs | 68 | ||
| Visible or palpable mass. | 68 | ||
| Headaches and neurological symptoms and signs. | 68 | ||
| Local effects. | 68 | ||
| Distant tumour effects. | 68 | ||
| Bone marrow failure (see above). | 68 | ||
| Surveillance | 69 | ||
| Diagnosis and staging | 69 | ||
| Treatment | 69 | ||
| Presentations of principal childhood malignancies | 69 | ||
| Leukaemia | 69 | ||
| Innocent cervical lymphadenopathy | 70 | ||
| Lymphoma | 72 | ||
| Hodgkin's lymphoma. | 72 | ||
| Non-Hodgkin's lymphoma. | 72 | ||
| Brain tumours | 73 | ||
| Glioma | 73 | ||
| Medulloblastoma | 74 | ||
| Craniopharyngioma | 74 | ||
| Neuroblastoma | 74 | ||
| Wilms' tumour | 75 | ||
| Osteosarcoma and Ewing's sarcoma | 76 | ||
| Supportive and palliative care | 77 | ||
| Late sequelae of cancer and their treatment | 77 | ||
| Chapter 8: Skin | 79 | ||
| Introduction | 79 | ||
| Inflammation | 79 | ||
| Atopic eczema | 79 | ||
| Treatment: | 81 | ||
| Seborrhoeic dermatitis | 82 | ||
| Psoriasis | 82 | ||
| Pityriasis rosea | 83 | ||
| Urticaria and angio-oedema | 83 | ||
| Erythema multiforme | 84 | ||
| Erythema nodosum | 84 | ||
| Skin infections | 84 | ||
| Bacterial infections | 84 | ||
| Impetigo | 84 | ||
| Erysipelas and cellulitis | 84 | ||
| Staphylococcal scalded-skin syndrome | 85 | ||
| Acne | 85 | ||
| Treatment: | 85 | ||
| Viral infections | 85 | ||
| Herpes simplex | 85 | ||
| Molluscum contagiosum | 85 | ||
| Viral warts | 86 | ||
| Fungal infections | 86 | ||
| Candidiasis | 86 | ||
| Dermatophytes | 86 | ||
| Scabies | 86 | ||
| Haemangiomas | 87 | ||
| ‘Strawberry’ naevus | 87 | ||
| Port wine stains | 87 | ||
| Alopecia | 87 | ||
| Diffuse hair loss | 87 | ||
| Patchy hair loss | 88 | ||
| Alopecia areata | 88 | ||
| Head lice | 88 | ||
| Treatment: | 88 | ||
| Chapter 9: Circulation | 89 | ||
| Introduction | 89 | ||
| History | 89 | ||
| Examination | 89 | ||
| Inspection | 90 | ||
| Palpation | 91 | ||
| Auscultation | 91 | ||
| Investigations | 91 | ||
| Heart disease in infants | 92 | ||
| The neonate with a heart murmur | 92 | ||
| Changes in the circulation at birth ( Figure 9.2) | 92 | ||
| Heart disease in children | 95 | ||
| The older child with a heart murmur | 95 | ||
| The innocent murmur | 95 | ||
| Left-to-right shunts | 96 | ||
| Outflow tract obstruction | 96 | ||
| Arrhythmias | 97 | ||
| Chest pain in children | 97 | ||
| Rare problems | 97 | ||
| Hypertension in childhood | 97 | ||
| Infective endocarditis | 98 | ||
| Rheumatic fever | 98 | ||
| Sudden cardiac death in childhood | 98 | ||
| Chapter 10: Respiration | 99 | ||
| Introduction | 99 | ||
| History | 99 | ||
| Examination | 100 | ||
| Ears, nose and throat | 102 | ||
| Ears | 102 | ||
| Throat | 102 | ||
| Investigations | 102 | ||
| Chest X-ray | 102 | ||
| Blood gas | 103 | ||
| Other blood tests | 104 | ||
| Respiratory secretions | 104 | ||
| Lung function testing | 104 | ||
| Upper respiratory tract infections | 104 | ||
| Influenza | 105 | ||
| Mortality | 105 | ||
| Prevention and treatment | 105 | ||
| Tonsillitis | 105 | ||
| Otitis media | 106 | ||
| Upper airways obstruction | 106 | ||
| Differential diagnosis of stridor | 106 | ||
| Anaphylaxis | 108 | ||
| Chronic upper airways obstruction | 108 | ||
| Snoring and obstructive sleep apnoea | 108 | ||
| Chronic cough | 109 | ||
| Pertussis | 109 | ||
| The wheezy child | 110 | ||
| Acute wheezing | 110 | ||
| Bronchiolitis | 110 | ||
| Persistent wheezing | 111 | ||
| Episodic wheeze | 111 | ||
| Chronic wheeze | 111 | ||
| Lower respiratory tract infections | 112 | ||
| Uncommon serious infections | 114 | ||
| Tuberculosis | 114 | ||
| HIV infection | 115 | ||
| Children with special needs | 115 | ||
| Cystic fibrosis | 115 | ||
| Respiratory management | 116 | ||
| Nutritional management | 116 | ||
| Prognosis | 117 | ||
| Chapter 11: Homeostasis and the kidney | 119 | ||
| Introduction | 119 | ||
| The Kidney And Urinary Tract | 119 | ||
| History | 119 | ||
| Examination | 120 | ||
| Investigations | 120 | ||
| Urine microscopy and culture | 120 | ||
| Imaging the urinary tract | 120 | ||
| Genitourinary defects | 121 | ||
| Undescended testes | 121 | ||
| Hypospadias | 122 | ||
| Inguinal hernia and hydrocele | 122 | ||
| Congenital anomalies of the urinary tract | 122 | ||
| Urinary tract infection | 124 | ||
| Investigation | 126 | ||
| Treatment | 126 | ||
| Haematuria | 127 | ||
| Incidental haematuria | 127 | ||
| Management of haematuria | 130 | ||
| Glomerular disorders | 130 | ||
| Nephrotic syndrome | 130 | ||
| Nephritis | 131 | ||
| Renal tubular disorders | 132 | ||
| Water homeostasis | 133 | ||
| Syndrome of inappropriate ADH secretion | 134 | ||
| Polyuria | 134 | ||
| Kidney failure | 134 | ||
| Introduction | 134 | ||
| Management of renal failure | 135 | ||
| Dialysis and transplantation | 136 | ||
| Gastroenteritis and renal failure | 137 | ||
| Haemolytic-uraemic syndrome | 137 | ||
| Regulating calcium and bone metabolism | 137 | ||
| Introduction | 137 | ||
| Hypocalcaemia | 138 | ||
| Hypercalcaemia | 138 | ||
| Chapter 12: Endocrinology and metabolism | 139 | ||
| Introduction | 139 | ||
| Regulating blood glucose | 139 | ||
| Hypoglycaemia | 140 | ||
| Diabetes | 140 | ||
| Diet | 141 | ||
| Control | 141 | ||
| Complications and co-morbidity | 142 | ||
| Diabetes in adolescence | 142 | ||
| Type 2 diabetes and MODY | 143 | ||
| Secondary diabetes | 143 | ||
| The hypothalamus and pituitary | 143 | ||
| Cushing's syndrome | 143 | ||
| Adrenal insufficiency | 143 | ||
| Thyroid gland | 144 | ||
| Thyrotoxicosis | 145 | ||
| Hypothyroidism | 146 | ||
| Neonatal screening | 147 | ||
| Phenylketonuria | 147 | ||
| Growth | 148 | ||
| History | 148 | ||
| Examination | 148 | ||
| Investigations | 149 | ||
| Bone age | 149 | ||
| Phases of growth | 149 | ||
| Fetal growth | 149 | ||
| Intrauterine growth retardation | 149 | ||
| Large birth weight (macrosomia) | 149 | ||
| Infant growth | 150 | ||
| Faltering growth (failure-to-thrive) | 150 | ||
| Growth in childhood | 150 | ||
| Short stature | 150 | ||
| Psychosocial growth failure | 151 | ||
| Use of growth hormone in children | 151 | ||
| Sexual development | 153 | ||
| Disorders of sexual development | 153 | ||
| Congenital adrenal hyperplasia | 153 | ||
| Puberty | 155 | ||
| Precocious puberty | 156 | ||
| Delayed puberty | 157 | ||
| Chapter 13: Digestion and nutrition | 159 | ||
| History | 159 | ||
| Examination | 161 | ||
| General points | 161 | ||
| Inspection | 161 | ||
| Palpation | 161 | ||
| Percussion | 161 | ||
| Assessment of growth | 162 | ||
| Infant feeding | 162 | ||
| Breast-feeding | 162 | ||
| Alternative milks | 163 | ||
| Infant weaning | 163 | ||
| Diet for older children | 164 | ||
| Vitamins | 164 | ||
| Iron deficiency | 164 | ||
| Obesity | 165 | ||
| Parenteral nutrition | 165 | ||
| The vomiting infant | 165 | ||
| Gastro-oesophageal reflux | 166 | ||
| Investigation (rarely indicated) | 166 | ||
| Pyloric stenosis | 166 | ||
| Bilious vomiting in infancy | 167 | ||
| Feeding problems | 168 | ||
| Gastroenteritis | 168 | ||
| Dehydration | 168 | ||
| Intussusception | 169 | ||
| Systemic disease | 170 | ||
| Abdominal pain | 170 | ||
| Acute appendicitis | 170 | ||
| Infantile colic | 171 | ||
| Non-specific abdominal pain | 172 | ||
| Mesenteric adenitis | 172 | ||
| Constipation | 172 | ||
| Chronic diarrhoea | 173 | ||
| Toddler diarrhoea | 173 | ||
| Food intolerance | 174 | ||
| Allergy | 174 | ||
| Sugar intolerance | 174 | ||
| Coeliac disease | 174 | ||
| Crohn's disease | 176 | ||
| Ulcerative colitis | 177 | ||
| Jaundice in children | 177 | ||
| Congenital causes of jaundice | 177 | ||
| The infant with obstructive jaundice | 178 | ||
| Hepatitis | 179 | ||
| Acute hepatitis | 179 | ||
| Chronic hepatitis | 179 | ||
| Obstructive jaundice in childhood | 182 | ||
| Fulminant hepatic failure | 182 | ||
| Chapter 14: Neurology and the senses | 183 | ||
| Introduction | 183 | ||
| History | 183 | ||
| Examination | 184 | ||
| Neck stiffness | 184 | ||
| Movement and coordination | 184 | ||
| Limb examination | 184 | ||
| Tone | 184 | ||
| Power | 184 | ||
| Reflexes | 184 | ||
| Muscle bulk | 185 | ||
| Cranial nerve examination | 185 | ||
| I – Olfactory nerve | 185 | ||
| II – Optic nerve | 185 | ||
| III, IV and VI – Occulomotor, trochlear and abducens nerves | 185 | ||
| V – Trigeminal nerve | 186 | ||
| VII – Facial nerve | 186 | ||
| VIII – Auditory or vestibulocochlear nerve | 186 | ||
| IX–Glossopharyngeal nerve | 186 | ||
| X – Vagus nerve | 186 | ||
| XI – Accessory nerve | 186 | ||
| XII – Hypoglossal nerve | 186 | ||
| Neurological investigations | 186 | ||
| MRI scan | 186 | ||
| CT scan | 186 | ||
| Eeg | 186 | ||
| Headaches | 187 | ||
| Tension headache | 187 | ||
| Migraine | 188 | ||
| Migraine variants | 189 | ||
| Complicated migraine – | 189 | ||
| Basilar migraine – | 189 | ||
| Confusional migraine – | 189 | ||
| Raised intracranial pressure | 189 | ||
| Management of raised intracranial pressure | 190 | ||
| Epileptic and non-epileptic seizures | 191 | ||
| History | 192 | ||
| Antecedents | 192 | ||
| Context | 192 | ||
| Onset | 192 | ||
| Progression. | 192 | ||
| Ending. | 192 | ||
| Aftermath. | 192 | ||
| Diagnosis | 192 | ||
| Epilepsy | 195 | ||
| Management of epilepsy | 199 | ||
| Chronic neurological disability | 199 | ||
| Introduction | 199 | ||
| Difficulties with movement | 199 | ||
| Abnormalities of central motor control – cerebral palsy | 199 | ||
| Progressive intellectual and neurological deterioration | 202 | ||
| Abnormalities of peripheral motor control – the weak and floppy child | 203 | ||
| Neurocutaneous syndromes | 205 | ||
| Bell's palsy | 207 | ||
| Guillain–Barré syndrome | 207 | ||
| Spinal cord tumours | 208 | ||
| Hearing | 208 | ||
| Causes of permanent hearing loss | 208 | ||
| Genetic causes | 208 | ||
| Antenatal causes (10–15%). | 209 | ||
| Perinatal causes (10–15%). | 209 | ||
| Postnatal causes (10–20%). | 209 | ||
| The baby | 209 | ||
| The infant | 209 | ||
| The child at school | 209 | ||
| Chronic secretory otitis media (glue ear) | 210 | ||
| Supporting deaf children | 210 | ||
| Hearing aids | 210 | ||
| Vision | 211 | ||
| Refractive errors | 211 | ||
| Myopia (short-sightedness) | 211 | ||
| Hypermetropia (long-sightedness) | 211 | ||
| Astigmatism | 211 | ||
| Squint | 211 | ||
| Paralytic | 211 | ||
| Non-paralytic | 211 | ||
| Diagnosing squints | 212 | ||
| Managing non-paralytic squints | 212 | ||
| Progressive loss of vision | 213 | ||
| The white eye | 213 | ||
| Retinoblastoma | 213 | ||
| Cataracts | 213 | ||
| The red eye | 214 | ||
| Conjunctivitis | 214 | ||
| Neonatal eye infection | 214 | ||
| Glaucoma | 214 | ||
| Orbital cellulitis | 214 | ||
| Iritis | 214 | ||
| Chapter 15:The mind | 215 | ||
| Introduction | 215 | ||
| History | 215 | ||
| Examination | 216 | ||
| Tantrums | 216 | ||
| What are tantrums? | 216 | ||
| Management | 217 | ||
| Is advice necessary? | 217 | ||
| Are you the best person to advise? | 217 | ||
| What advice has been given before? | 217 | ||
| Specific strategies | 217 | ||
| Reasonable expectations | 217 | ||
| Ignore bad, praise good | 217 | ||
| Time out | 217 | ||
| Consistency | 217 | ||
| Win sometimes | 218 | ||
| Support | 218 | ||
| Hyperactivity | 218 | ||
| What is attention deficit hyperactivity disorder? | 218 | ||
| The triad of impairments | 218 | ||
| Inattention. | 218 | ||
| Impulsivity. | 218 | ||
| Hyperactivity. | 219 | ||
| What is not ADHD? | 219 | ||
| Family history | 219 | ||
| Making a diagnosis | 219 | ||
| Management | 219 | ||
| Understanding ADHD | 219 | ||
| Behavioural therapies | 220 | ||
| Medication | 220 | ||
| Other | 220 | ||
| Diet. | 220 | ||
| Long chain fatty acids. | 220 | ||
| Autistic spectrum disorders | 220 | ||
| Key features of autistic spectrum disorders | 221 | ||
| Impaired social functioning | 221 | ||
| Impaired communication | 221 | ||
| Repetitive and restricted behaviours | 221 | ||
| Stereotyped behaviours | 221 | ||
| The autistic spectrum | 221 | ||
| Asperger's syndrome | 222 | ||
| Assessment and diagnosis | 222 | ||
| Causes of autism | 222 | ||
| Intervention | 222 | ||
| Depression | 222 | ||
| What is depression? | 222 | ||
| Management | 223 | ||
| Deliberate self-harm | 223 | ||
| School refusal | 223 | ||
| Truancy | 224 | ||
| Chronic fatigue syndrome/myalgic encephalomyelitis | 224 | ||
| Definition | 225 | ||
| Causes of CFS/ME | 225 | ||
| Diagnosis | 225 | ||
| Musculoskeletal: | 225 | ||
| Headache: | 225 | ||
| Sore throat: | 225 | ||
| Investigation | 225 | ||
| Management | 225 | ||
| General principles | 225 | ||
| Graded exercise therapy | 225 | ||
| Cognitive behavioural therapy | 226 | ||
| Outcome | 226 | ||
| Substance abuse | 226 | ||
| Smoking | 226 | ||
| Alcohol | 227 | ||
| Cannabis | 227 | ||
| Advice and support | 227 | ||
| Eating disorders | 227 | ||
| Food refusal | 227 | ||
| Anorexia nervosa | 227 | ||
| Bulimia and binge eating disorder | 228 | ||
| Tics | 228 | ||
| Chapter 16: Infectious disease and immunity | 231 | ||
| Introduction | 231 | ||
| History | 231 | ||
| Examination | 232 | ||
| Investigations | 232 | ||
| Acute fever | 233 | ||
| Possible meningitis | 233 | ||
| Investigation | 233 | ||
| Encephalitis | 235 | ||
| Fever and a rash | 235 | ||
| Non-blanching rash | 235 | ||
| Meningococcal septicaemia | 235 | ||
| Generalized maculopapular rash | 236 | ||
| Measles | 236 | ||
| Rubella | 237 | ||
| Roseola infantum | 237 | ||
| Slapped-cheek disease | 237 | ||
| Urticaria | 238 | ||
| Generalized vesicular rash | 238 | ||
| Chicken pox | 238 | ||
| Rash restricted to one site | 239 | ||
| Fever and rash associated with sore throat or oral lesions | 239 | ||
| Sore throat | 239 | ||
| Glandular fever | 239 | ||
| Scarlet fever | 240 | ||
| Kawasaki's disease | 240 | ||
| Fever and rash associated with mouth ulcers and lesions on the lips | 241 | ||
| Herpes simplex | 241 | ||
| Fever and rash affecting the palms or soles | 241 | ||
| Fever and specific symptoms | 241 | ||
| Parotid swelling | 242 | ||
| Mumps | 242 | ||
| Fever of unknown origin | 242 | ||
| Malaria | 242 | ||
| Lyme disease | 242 | ||
| Immune deficiency | 243 | ||
| Human immunodeficiency virus | 244 | ||
| Diagnosis | 245 | ||
| Infants. | 245 | ||
| Children >18 months. | 245 | ||
| Treatment | 245 | ||
| Anti-retroviral therapy. | 245 | ||
| Immunizations. | 245 | ||
| Infection prophylaxis. | 245 | ||
| Complications | 245 | ||
| Serious bacterial sepsis. | 245 | ||
| Pcp. | 245 | ||
| Progressive multifocal leucoencephalopathy. | 245 | ||
| Lymphocytic interstitial pneumonitis. | 245 | ||
| Disseminated infection: | 245 | ||
| Non-Hodgkin's lymphoma, | 246 | ||
| Prognosis | 246 | ||
| Chapter 17: Pregnancy, birth and the newborn | 247 | ||
| Introduction | 247 | ||
| The healthy pregnancy | 247 | ||
| Antenatal screening | 248 | ||
| Birth | 249 | ||
| Neonatal resuscitation | 249 | ||
| The Apgar score | 249 | ||
| Adaptation to extra-uterine life | 250 | ||
| The newborn | 250 | ||
| Examination of the newborn | 250 | ||
| Birth injuries | 250 | ||
| Feeding | 250 | ||
| Breast-feeding | 250 | ||
| Formula milks | 252 | ||
| Preventing illness | 252 | ||
| Vitamin K | 252 | ||
| Newborn screening | 252 | ||
| The ill neonate | 253 | ||
| Neonatal encephalopathy | 253 | ||
| Aetiology | 253 | ||
| Before birth: | 253 | ||
| After birth: | 253 | ||
| Hypothermia for hypoxic-ischaemic encephalopathy | 253 | ||
| Respiratory distress | 253 | ||
| Jaundice | 254 | ||
| Investigation of neonatal jaundice | 254 | ||
| Harmful jaundice | 255 | ||
| Treatment. | 255 | ||
| Hypoglycaemia | 256 | ||
| Congenital infection | 256 | ||
| Group B Streptococcus infection | 257 | ||
| The preterm infant | 257 | ||
| Respiratory distress syndrome | 258 | ||
| Periventricular haemorrhage | 260 | ||
| Infection | 260 | ||
| Nutrition | 261 | ||
| Congenital anomalies | 261 | ||
| Cleft lip and palate | 261 | ||
| Congenital gut abnormalities | 261 | ||
| Oesophageal atresia | 261 | ||
| Tracheo-oesophageal fistula | 261 | ||
| Duodenal atresia | 262 | ||
| Meckel's diverticulum | 262 | ||
| Lower gastrointestinal obstruction | 262 | ||
| Diaphragmatic hernia | 262 | ||
| Gastroschisis and exomphalos | 262 | ||
| Neural tube defects | 263 | ||
| Chapter 18: Congenital and genetic disorders | 265 | ||
| Introduction | 265 | ||
| Congenital abnormalities | 265 | ||
| Malformations | 266 | ||
| Disruptions | 266 | ||
| Deformations | 266 | ||
| Syndromes | 266 | ||
| Environmental factors | 266 | ||
| Congenital infection, | 266 | ||
| Hyperthermia | 266 | ||
| Radiation | 266 | ||
| Environmental chemicals | 266 | ||
| Alcohol | 266 | ||
| Prescribed drugs | 266 | ||
| Recreational drugs | 266 | ||
| Maternal disease | 267 | ||
| Maternal diabetes | 267 | ||
| Congenital adrenal hyperplasia | 267 | ||
| Phenylketonuria (PKU) | 267 | ||
| Fetal alcohol syndrome | 267 | ||
| Impaired growth | 268 | ||
| Characteristic morphological abnormalities: | 268 | ||
| Cognitive impairment | 268 | ||
| Inheritance of genetic disease | 268 | ||
| Autosomal inheritance | 269 | ||
| Autosomal recessive inheritance | 269 | ||
| Autosomal dominant inheritance | 269 | ||
| Sex-linked inheritance | 269 | ||
| Mitochondrial inheritance | 269 | ||
| Imprinting disorders | 270 | ||
| Genetic investigations | 270 | ||
| Chromosome analysis | 270 | ||
| Antenatal testing | 270 | ||
| Neonatal testing | 270 | ||
| Genetic investigation of older children | 271 | ||
| Common genetic syndromes | 272 | ||
| Appendix I: Paediatric resuscitation | 281 | ||
| Introduction | 281 | ||
| Basic life support | 281 | ||
| Airway | 281 | ||
| Breathing | 281 | ||
| Circulation | 281 | ||
| Infants. | 282 | ||
| Child < 8. | 282 | ||
| Child > 8. | 282 | ||
| Choking | 283 | ||
| Advanced life support | 283 | ||
| Weight | 283 | ||
| Asystole | 284 | ||
| Ventricular fibrillation and pulseless ventricular tachycardia | 284 | ||
| Pulseless electrical activity | 284 | ||
| Discontinuing resuscitation | 284 | ||
| Newborn life support | 285 | ||
| Paediatric emergencies | 286 | ||
| Shock | 286 | ||
| How to recognize shock | 286 | ||
| Managing the shocked child | 286 | ||
| Airway. | 286 | ||
| Breathing. | 286 | ||
| Circulation. | 287 | ||
| Treatment. | 287 | ||
| Glucose. | 287 | ||
| Anaphylaxis | 287 | ||
| How to recognize anaphylaxis | 288 | ||
| Managing anaphylaxis | 288 | ||
| Cardiac arrhythmias | 288 | ||
| How to recognize a cardiac arrhythmia | 288 | ||
| Managing a cardiac arrhythmia | 288 | ||
| Supraventricular tachycardia | 288 | ||
| Ventricular tachycardia | 289 | ||
| Bradycardia | 289 | ||
| Meningococcal septicaemia | 290 | ||
| How to recognize meningococcal sepsis | 290 | ||
| Managing meningococcal sepsis | 291 | ||
| Diabetic ketoacidosis | 292 | ||
| How to recognize diabetic ketoacidosis | 292 | ||
| Managing diabetic ketoacidosis | 292 | ||
| Status epilepticus | 293 | ||
| How to recognize status epilepticus | 293 | ||
| Causes of status epilepticus | 293 | ||
| Managing status epilepticus | 293 | ||
| Coma | 294 | ||
| Causes of coma | 294 | ||
| How to assess a child in coma | 294 | ||
| AVPU score | 294 | ||
| The Glasgow Coma Scale | 294 | ||
| Pupillary changes | 294 | ||
| Managing the child in coma | 294 | ||
| Emergency child protection | 296 | ||
| Recognition | 296 | ||
| Discussion | 297 | ||
| Referral | 297 | ||
| Social services | 297 | ||
| The police | 297 | ||
| Support and reflection | 297 | ||
| Acute stridor | 298 | ||
| How to recognize acute stridor | 298 | ||
| Managing acute stridor | 298 | ||
| Head injury | 298 | ||
| Assessment | 298 | ||
| Management | 298 | ||
| Types of intracranial haemorrhage | 300 | ||
| Extradural haematoma | 300 | ||
| Subarachnoid haemorrhage | 300 | ||
| Subdural haematoma | 300 | ||
| Intracerebral haemorrhage | 300 | ||
| Burns | 300 | ||
| Approach | 300 | ||
| Use the ABC sequence | 300 | ||
| Airway | 300 | ||
| Breathing | 300 | ||
| Circulation | 300 | ||
| Further management | 301 | ||
| Depth | 301 | ||
| Superficial | 301 | ||
| Partial thickness | 301 | ||
| Full thickness | 301 | ||
| Acute severe asthma | 301 | ||
| Poisoning | 301 | ||
| Paracetamol | 301 | ||
| Aspirin | 302 | ||
| Iron | 303 | ||
| Tricyclic antidepressants | 305 | ||
| Sudden death in infancy and childhood | 305 | ||
| Informing the family of the death and subsequent events | 305 | ||
| Examination of the child | 305 | ||
| Specimen collection for investigations | 306 | ||
| History | 306 | ||
| Appendix II: Practical procedures | 307 | ||
| Introduction | 307 | ||
| Competence, confidence and success | 307 | ||
| Analgesia for procedures | 307 | ||
| Preparation | 308 | ||
| Basic procedures | 308 | ||
| Blood sampling and cannulation | 308 | ||
| Requirements | 308 | ||
| Venepuncture | 308 | ||
| Cannulation | 308 | ||
| Capillary samples | 310 | ||
| Appendix III: Prescribing | 321 | ||
| Documentation | 321 | ||
| Doses | 321 | ||
| Preparations | 321 | ||
| Prescribing errors in paediatrics | 321 | ||
| Appedix IV: Fluids and electrolytes | 323 | ||
| Volume | 323 | ||
| Electrolytes | 323 | ||
| Dehydration | 323 | ||
| Fluid and electrolyte replacement | 323 | ||
| Example | 323 | ||
| Electrolyte balance | 325 | ||
| Glossary: Important paediatric definitions and concepts | 353 | ||
| Index | 357 |