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 (ISBN-13: 9780511275746)




Pediatrics

Edited by

HOWARD BAUCHNER, MD
Professor of Pediatrics and Public Health
Director, Division of General Pediatrics
Department of Pediatrics
Boston Medical Center
Boston University School of Medicine
Boston, MA

ROBERT J. VINCI, MD
Professor of Pediatrics
Program Director
Boston Combined Residency Program
Department of Pediatrics
Boston Medical Center
Boston University School of Medicine
Boston, MA

MELANIE KIM, MD
Associate Professor of Pediatrics
Associate Program Director
Boston Combined Residency Program
Department of Pediatrics
Boston Medical Center
Boston University School of Medicine
Boston, MA





CAMBRIDGE UNIVERSITY PRESS
Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo, Delhi

Cambridge University Press
32 Avenue of the Americas, New York, NY 10013–2473, USA

www.cambridge.org
Information on this title: www.cambridge.org/9780521709361

© 2007, 2003, Pocket Pediatrics by PocketMedicine.com, Inc.

This publication is in copyright. Subject to statutory exception
and to the provisions of relevant collective licensing agreements,
no reproduction of any part may take place without
the written permission of Cambridge University Press.

First published 2007

Printed in the United States of America

A catalog record for this publication is available from the British Library.

Library of Congress Cataloging in Publication Data
Pediatrics / [edited by] Howard Bauchner, Robert Vinci, Melanie Kim.
   p. cm.
ISBN-13: 978-0-521-70936-1 (pbk.)
ISBN-10: 0-521-70936-9 (pbk.)
1. Pediatrics – Handbooks, manuals, etc. I. Bauchner, Howard, 1951–
II. Vinci, Robert J. III. Kim, Melanie, 1952–
[DNLM: 1. Pediatrics – Handbooks. WS 39 P37191 2007]
RJ48.P428  2007
618.92–dc22      2007016912

ISBN 978-0-521-70936-1 paperback

Cambridge University Press has no responsibility for
the persistence or accuracy of URLs for external or
third-party Internet Web sites referred to in this publication
and does not guarantee that any content on such
Web sites is, or will remain, accurate or appropriate.

Every effort has been made in preparing this book to provide accurate and up-to-date information that is in accord with accepted standards and practice at the time of publication. Nevertheless, the authors, editors, and publisher can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors, and publisher therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use.





NOTICE



Because of the dynamic nature of medical practice and drug selection and dosage, users are advised that decisions regarding drug therapy must be based on the independent judgment of the clinician, changing information about a drug (e.g., as reflected in the literature and manufacturer’s most current product information), and changing medical practices.

While great care has been taken to ensure the accuracy of the information presented, users are advised that the authors, editors, contributors, and publisher make no warranty, express or implied, with respect to, and are not responsible for, the currency, completeness, or accuracy of the information contained in this publication, nor for any errors, omissions, or the application of this information, nor for any consequences arising therefrom. Users are encouraged to confirm the information contained herein with other sources deemed authoritative. Ultimately, it is the responsibility of the treating physician, relying on experience and knowledge of the patient, to determine dosages and the best treatment for the patient. Therefore, the author(s), editors, contributors, and the publisher make no warranty, express or implied, and shall have no liability to any person or entity with regard to claims, loss, or damage caused, or alleged to be caused, directly or indirectly, by the use of information contained in this publication.

Further, the author(s), editors, contributors, and the publisher are not responsible for misuse of any of the information provided in this publication, for negligence by the user, or for any typographical errors.





Contents



Preface page xiii
Acetaminophen poisoning 1
Acne vulgaris 3
Acute abdominal pain 5
Acute asthma 7
Acute lymphoblastic leukemia (ALL) 11
Acute otitis media 14
Acute renal failure (ARF) 16
Acute rheumatic fever (ARF) 20
Adolescent contraception 22
Adrenal insufficiency 26
Alopecia (hair loss) 28
Altered mental status 30
Amenorrhea 32
Anaphylaxis 34
Anemia 36
Animal bites 39
Ankle injuries 41
Anorexia 44
Aortic stenosis (AS) 47
Aplastic anemia 49
Apparent life-threatening events (ALTE) 51
Appendicitis 54
Approach to ingestions 56
Aspirin overdose 59
Ataxia 61
Atopic dermatitis 63
Atrial septal defect (ASD) 65
Attention-deficit hyperactivity disorder (ADHD) 66
Back pain 68
Bell’s palsy/facial palsy 71
Beta-blocker overdose 72
Brain tumors 74
Breast disorders 77
Breastfeeding basics 81
Bronchiolitis 84
Bulimia 87
Campylobacter infections 89
Carbon monoxide poisoning 91
Cardiac arrhythmias 94
Cat-scratch disease 97
Cellulitis 99
Chest pain 101
Child abuse 104
Chronic asthma 107
Chronic renal failure 112
Coarctation of the aorta 115
Colic 117
Congenital adrenal hyperplasia (CAH) 119
Congenital syphilis 122
Congestive heart failure (CHF) 124
Conjunctivitis 126
Constipation 128
Croup (laryngotracheobronchitis) 131
Cyanotic heart disease 133
Cystic fibrosis 135
Depression 137
Developmental dysplasia of the hip 140
Diabetes insipidus (DI) 142
Diabetes mellitus (DM) 145
Diabetic ketoacidosis (DKA) 148
Diaper dermatitis 150
Disseminated intravascular coagulation (DIC) 152
Down syndrome 154
Dysfunctional uterine bleeding 155
Dysmenorrhea 158
EBV disease/infectious mononucleosis 160
Electrical injuries 162
Endocarditis and prophylaxis 164
Enuresis 167
Epididymitis 169
Epiglottitis 171
Ethanol poisoning 172
Evaluation of dysmorphic child 174
External otitis (swimmer’s ear) 176
Failure to thrive 178
Febrile infants 180
Febrile seizures 183
Fever and bacteremia 185
Foreign body aspiration (FBA) 188
Fragile X 189
GI foreign body 191
Gastroesophageal reflux (GERD) 192
General approach to burns 194
Giardia 196
Glomerulonephritis 198
Gonococcal infection 201
Guillain-Barré syndrome 203
HIV infection in children 205
Head trauma 209
Headaches 211
Hemolytic uremic syndrome 213
Hemophilia 216
Hemoptysis 219
Henoch-Schönlein purpura 221
Hernias and hydroceles 223
Herpes simplex viral infections 226
Hirschsprung’s disease 228
Human bites 229
Hypercoagulable state 231
Hypertension (HTN) 234
Hyperthyroidism, acquired (Graves’ disease) 237
Hypogammaglobulinemia syndromes 239
Hypoglycemia in children 241
Hypothermia 243
Hypothyroidism 245
Hypotonia 248
Ibuprofen poisoning 250
Idiopathic thrombocytopenic purpura (ITP) 252
Impetigo 254
Inborn errors of metabolism 256
Inflammatory bowel disease (IBD): Crohn’s disease and ulcerative colitis (UC) 259
Intussusception 262
Iron deficiency 264
Iron poisoning 266
Jaundice, post-infantile 269
Juvenile rheumatoid arthritis (JRA) 271
Kawasaki disease (KD) 274
Kidney stones 276
Knee injury 279
Language delay 282
Lead poisoning 284
Legg-Calve-Perthes disease 286
Lice 287
Lower GI bleeding 290
Lyme disease 293
Lymphoma 295
Malabsorption 298
Malaria 300
Malrotation and volvulus 303
Meningococcal diseases 305
Mitral valve prolapse (MVP) 307
Molluscum contagiosum 308
Mumps/parotitis 310
Murmurs 312
Mycobacterium tuberculosis 315
Mycoplasma pneumonia 318
Myocarditis 320
Narcotic abstinence syndrome 322
Near drowning 325
Nephrotic syndrome 327
Neuroblastoma 329
Neurofibromatosis (NF) 332
Neutropenia 334
Nontuberculous mycobacteria (NTM) 336
Nursemaid’s elbow 339
Obstructive sleep apnea (OSA) 340
Osgood-Schlatter disease 343
Osteomyelitis 344
Osteosarcoma 346
Otitis media with effusion (chronic otitis) 349
Pancreatitis 350
Pelvic inflammatory disease (PID) 352
Peptic ulcer disease 355
Peritonsillar and pharyngeal abscesses 357
Pertussis (whooping cough) 360
Pharyngitis 362
Pinworms 364
Pityriasis rosea 365
Pneumonia 367
Proteinuria 370
Psoriasis 373
Psychosis 376
Pulmonary embolism (PE) 378
Puncture wounds of the foot 381
Pyloric stenosis 383
Rabies 384
Recurrent abdominal pain 386
Respiratory syncytial virus (RSV) 388
Retinoblastoma 390
Rickets 392
Rocky Mountain spotted fever (RMSF) 395
Salmonella infections 397
Scabies 401
Scoliosis 403
Seizures/epilepsy 405
Septic arthritis 409
Serum sickness 412
Severe combined immunodeficiency disorders (SCID) 413
Shigella infections 415
Short stature 418
Shoulder injuries 420
Sickle cell disease 422
Sinusitis 426
Slipped capital femoral epiphysis (SCFE) 428
Street drugs 430
Stridor 432
Suicide 434
Sunburn 436
Supraventricular tachycardia (SVT) 437
Syncope 440
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) 442
Systemic lupus erythematosus (SLE) 443
Testicular torsion 446
Tetralogy of Fallot 448
Thalassemia 451
Tics/Tourette syndrome 454
Tinea infections 456
Torticollis 458
Toxic shock syndrome 461
Toxic synovitis 463
Transfusion medicine 465
Transposition of the great arteries 468
Tricyclic antidepressant (TCA) ingestion 469
Tuberous sclerosis (TS) 472
Turner syndrome 473
Undescended testicle 475
Upper GI bleeding 477
Urinary tract infection 479
Urticaria 483
Vaginal bleeding 484
Vaginal discharge 487
Varicella zoster virus (VZV): chickenpox and shingles 490
Ventricular septal defects 493
Vertigo 495
Vesicoureteral reflux (VUR) 497
Viral hepatitis 499
Von Willebrand’s disease (VWD) 503
Warts 504
Wilms tumor 506
Wiskott-Aldrich syndrome 509
Yersinia infections. 511




Preface



The way that physicians care for patients is changing. The time spent with patients has become shorter, so that busy clinicians both need and want authoritative information in a quick, easy-to-use format.

   Pediatrics has been designed to provide a comprehensive re-view of clinical pediatrics, with advice for appropriate diagnostic and therapeutic interventions for the most common pediatric problems en-countered in the clinical setting. The topics are organized under headings on differential diagnosis, evaluation, treatment, complications and prognosis so that the user will find the desired information quickly and easily.

   It is our hope that Pediatrics will provide clinicians in any setting with a text that will help them feel comfortable managing both the most common and clinically challenging presentations of acutely ill children.

Howard Bauchner, Robert J. Vinci, and Melanie Kim


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