Pediatric primary care

✍ Scribed by Catherine E. Burns (editor)

• Publisher: Elsevier Inc.
• Year: 2017
• Tongue: English
• Leaves: 1435
• Edition: 6
• Category: Library

✦ Table of Contents

Front Cover
Inside Front Cover
Pediatric Primary Care
Copyright Page
Contributors
Reviewers
Preface
Special Features of the Sixth Edition
Organization of the Book
Acknowledgments
Contributors to the Fifth Edition
Our Thanks to Family and Friends
References
Table Of Contents
Unit 1 Pediatric Primary Care Foundations
1 Health Status of Children
Global Health Status of Children
Global Food Insecurity and Effect on Children’s Health
United Nations Millennium Development Goals: Project Goals
Progress on the Millennium Development Goals
Health Status of Children in the United States
Food Insecurity in Children in the United States
Addressing Children’s Health in the United States
Healthy People 2020
Social Determinants of Health and Health Equity
Adverse Childhood Events and Impact on Child Health Outcomes
Child Health and Quality Improvement Measures
The Role of Advanced Practice Nurses for Improving Child Health
Health Promotion and Evidence-Based Clinical Preventive Services
Health Supervision Guidelines
American Academy of Pediatrics Guidelines
Bright Futures
References
2 Child and Family Health Assessment
Foundations for Child and Family Assessment
Child Health Assessment Foundations
Domains of Health Care Problems
Developmental Problems
Functional Health Problems
Diseases
Problem Interactions
Developmental Assessment Foundations
Developmental Monitoring (Surveillance)
Developmental Screening and Assessment
Screening
Developmental Assessment
Strategies Specific to Developmental Assessment
Family Assessment Foundations
The Family’s Role in Health Care of Children
Family Assessment Basic Elements
Family Structure and Roles
Family Social Network
Genograms
Genogram Construction
The Environment for Data Collection
Setting up the Assessment Environment
Communication with Children and Families
Redesigning Primary Care to Achieve Assessment Goals
The Database
The Child Health History
The Initial (Complete) Health History
Patient-Identifying Information
Adolescent Health History Adaptations
The Physical Examination
Other Data
Laboratory and Radiographic Data
Data from Other Disciplines
Creating the Problem List
Avoiding Diagnostic Errors
Creating the Management Plan
Shared Decision-Making with Child and Family
Communicating Assessment Data
Informatics and Child Health Care
References
3 Cultural Considerations for Pediatric Primary Care
Culture
Essentialist and Constructivist Concepts of Culture
Individualism and Collectivism
Culture, Privilege, and Health Care
Biomedicine and the Culture of Client, Family, and Community
Cultural Humility and Cultural Competence
Cultural Humility
Cultural Competence
Best Practices for Developing Cultural Humility and Cultural Competence
Awareness
Engagement
Application
Intrapersonal Domain
Awareness
Engagement and Application
Interpersonal Domain
Awareness
Engagement and Application
Communication
Conflict Negotiation
System/Organization Domain
Awareness
Engagement and Application
Intra-Organizational Standards
Global Domain
Awareness
Engagement and Application
Health Care for Immigrant and Refugee Populations
Immigrants, Refugees, and Settlement Processes
Prearrival Health Requirements
Postarrival Health Care
Initial Health Visit, Screening, and Assessment
Assessment
References
Additional Resources
Unit 2 Management of Development
4 Developmental Management in Pediatric Primary Care
Developmental Principles
Theories of Child Development
Ethology: Animal Studies
Maturational Theories: Developmental Milestones
Cognitive-Structural Theories: Language and Thought
Sensorimotor Stage (Birth to 2 Years)
Preoperational Stage (2 to 7 Years)
Concrete Operational Stage (7 to 12 Years)
Formal Operational Stage (13 Years through Adulthood)
The Role of Social Interaction in Cognitive Development
Psychoanalytic Theories
Personality and Emotions
Behavioral Theories: Human
Actions and Interactions
Humanistic Theories
Innermost Self
Ecologic Theories
Temperament
Self-Regulation
Early Brain Development
Theories of Family and Parenting Development
Family Theories
Parent Development Theory
Cultural Influences on Development
Management Strategies in Child Development
Promoting Parent Development and Parent-Child Interaction: Anticipatory Guidance
Discipline
Concerns about Delayed Development
Developmental Red Flags
Talking with Parents about Developmental Delays
Implementing Individualized Interventions
Early Intervention Programs
Family-Centered Care
References
Additional Resources
5 Developmental Management of Infants
Birth Rates and Infant Mortality
Development of Infants
Birth to One Month Old
Physical Development
Motor Skills Development
Communication and Language Development
Social and Emotional Development
Cognitive-Sensory Development
One through Three Months Old
Physical Development
Motor Skills Development
Communication and Language Development
Social and Emotional Development
Cognitive Development
Four through Five Months Old
Physical Development
Motor Skills Development
Communication and Language Development
Social and Emotional Development
Cognitive Development
Six through Eight Months Old
Physical Development
Motor Skills Development
Communication and Language Development
Social and Emotional Development
Cognitive Development
Nine through Twelve Months Old
Physical Development
Motor Skills Development
Communication and Language Development
Social and Emotional Development
Cognitive Development
Developmental Assessment of Infants
Screening Strategies for Infants
Anticipatory Guidance for Infants
The Prenatal Visit
The Neonatal Visit
Birth to One Month Old
Regulation and Sleep-Wake Patterns
Strength and Motor Coordination
Feeding and Self-Care
Communication and Language
Social and Emotional Growth
Cognitive and Environmental Stimulation
One through Three Months Old
Regulation and Sleep-Wake Patterns
Strength and Motor Coordination
Feeding and Self-Care
Communication and Language
Social and Emotional Growth
Cognitive and Environmental Stimulation
Four through Five Months Old
Regulation and Sleep-Wake Patterns
Strength and Motor Coordination
Feeding and Self-Care
Communication and Language
Social and Emotional Growth
Cognitive and Environmental Stimulation
Six through Eight Months Old
Regulation and Sleep-Wake Patterns
Strength and Motor Coordination
Feeding and Self-Care
Communication and Language
Social and Emotional Growth
Cognitive and Environmental Stimulation
Nine through Twelve Months Old
Regulation and Sleep-Wake Patterns
Strength and Motor Coordination
Feeding and Self-Care
Communication and Language
Social and Emotional Growth
Cognitive and Environmental Stimulation
Common Developmental Issues for Infants and Families
Sleep
Feeding
Crying
Postpartum Depression
Red Flags for Infant Development
References
Additional Resources
6 Developmental Management of Early Childhood
Development of Early Childhood
Physical Development
Motor Development
Communication and Language Development
Articulation
Lexicon
Syntax
Semantics
Bilingualism
Social and Emotional Development
Morality
Peer Relationships
Body Image
Cognitive Development
Developmental Assessment of Early Childhood
Screening Strategies During Early Childhood
Physical Development
Motor Skills Development
Communication and Language Development
Social and Emotional Development
Cognitive Development
Anticipatory Guidance for Early Childhood
Regulation and Sleep-Wake Patterns
Strength and Motor Coordination
Feeding and Self-Care
Communication and Language
Social and Emotional Growth
Cognitive and Environmental Stimulation
Common Developmental Issues in Early Childhood
Sibling Rivalry
Assessment
Management
Temper Tantrums
Child Care and Preschools
Child Care
Preschool
Toileting
Safety
Early Childhood Developmental Red Flags
Physical Disorders
Cognitive Disorders
Language Disorders
References
7 Developmental Management of School-Age Children
Development of School-Age Children
Physical Development
Motor Skills Development
Communication and Language Development
Social and Emotional Development
Peer Relationships
Morality
Body Image
Coping Skills
Cognitive Development
Developmental Assessment of School-Age Children
Screening Strategies for School-Age Children
Physical Development
Motor Skills Development
Communication and Language Development
Social and Emotional Development
Cognitive Development
Diagnostic Studies
Anticipatory Guidance for School-Age Children
Parent Development
Regulation and Sleep-Wake Patterns
Strength and Motor Coordination
Nutrition, Self-Care, and Safety
Nutrition
Self-Care
Safety
Communication and Language
Social and Emotional Growth
Cognitive and Environmental Stimulation
Common Developmental Issues for School-Age Children
School Readiness
Clinical Findings
History
Diagnostic Studies
Management
Learning Problems
Clinical Findings
History
Differential Diagnosis
Management
School Refusal (Phobia)
Description
Clinical Findings
History
Differential Diagnosis
Management
Recurrent Physical Symptoms
Clinical Findings
History
Differential Diagnosis
Management
Red Flags for School-Age Children
References
Additional Resources
Resources for Screening Tools
8 Developmental Management of Adolescents
Adolescent Development
Physical Development
Tanner Stages
Female Stages
Male Stages
Psychosocial, Emotional, and Cognitive Development
Influences on Psychosocial, Emotional, and Cognitive Development
Principles of Behavior Changes
Smooth Transition
Cognitive Changes
Emotional Changes of Adolescence
Egocentrism of Adolescents
Developmental Screening and Assessment
Principles and Approaches to Assessment
Focus of Assessment
Physical Development
Cognitive Development
Social and Emotional Development
Parent Assessment
Anticipatory Guidance During Adolescence
Phases of Adolescence
Early Adolescence (11 to 14 Years Old)
Physical Development
Cognitive Development
Social and Emotional Development
Health Supervision
Anticipatory Guidance
Middle Adolescence (15 to 17 Years Old)
Physical Development
Cognitive Development
Social and Emotional Development
Health Supervision
Anticipatory Guidance
Late Adolescence (18 to 21 Years Old)
Physical Development
Cognitive Development
Social and Emotional Development
Health Supervision
Anticipatory Guidance
Common Developmental Issues for Adolescents
Risk Behavior: General
Description
Factors that Contribute to Risk-Taking
Assessment
Management
Risk Behavior: Tobacco Use
Description
Assessment
Management
Risk Behavior: Self-Injurious Behaviors
Description
Assessment
Management
Risk Behavior: Social Media Use
Description
Assessment
Management
References
Additional Resources
Unit 3 Approaches to Health Management in Pediatric Primary Care
9 Introduction to Functional Health Patterns and Health Promotion
Functional Health Patterns— The Behaviors of Health
Health Perception and Health Management Functional Health Pattern
Health Perception
Components of Health Perception
Children’s Conceptualizations of Health and Illness
Assessment Foundations: Health Behavior Prediction Models
Health Belief and Self-Efficacy Models
Health Promotion Model
Health Management
Assessment of Health Management Pattern
Clinical Findings Indicating Health Perception and Health Management Functional Health Pattern Problems
Management Strategies for Functional Health Patterns
The Provider-Child-Family Triad: Family-Centered Collaborative Negotiations
Health Promotion Care
Behavioral Counseling Interventions
The Five As
Motivational Interviewing
Health Education
Assessing and Fostering Health Literacy
Patient Education Process
Patient Education Strategies
Health System Interventions
Skills to Access Resources: Referrals, Email, and Telephone Communication
Management Strategies for Children with Special Needs
Evaluating Health Promotion Interventions
References
Additional Resources
10 Nutrition
Standards for Preventive Care
Nutritional Requirements and Dietary Reference Intakes
Energy
Water and Electrolytes
Water
Sodium
Potassium
Chloride
Macronutrients
Protein
Carbohydrates
Fats
Micronutrients
Vitamins
Fat-Soluble Vitamins
Minerals and Elements
Use of Vitamin and Mineral Supplements
Assessment of Nutritional Status
History
Physical Examination
Diagnostic Studies
Management Strategies for Optimal Nutrition
Developing Healthy Eating Behaviors
Parents Decide What Foods to Eat
Parents Create an Environment Conducive to Healthy Eating
Children Decide How Much of Healthful Foods to Eat
Nutritional Education
MyPlate, MyPlate for Kids, and SuperTracker
Age-Specific Considerations
Newborns and Infants
Toddlers and Preschoolers
School-Age Children
Physical Activity
Vegetarian Diets
Management
Complications
Altered Patterns of Nutrition
Disorders Requiring Increased Caloric Intake
Clinical Findings
History
Physical Examination
Management
Complications
Disorders Requiring Decreased Caloric Intake
Clinical Findings
History
Management
Disorders Requiring Restricted or Supplemental Diets
Clinical Findings
Management
Complications
Disorders Requiring Physical Alterations in Diet Management
Clinical Findings
History
Physical Examination
Management
Complications
Eating Disorders
Obesity and Overweight
Risk Factors and Predictors for Obesity
Biological Mechanisms
Temperament
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Lifestyle Changes
Community Changes
Surgery
Complications
Adverse Food Reactions
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Elimination Diet
Immunotherapy
Complications
Effect of Medications on Nutritional Status
Clinical Findings
Management
Complications
Toxic Exposures in Foods
Controversies in Pediatric Nutrition
Effects of Sugar or Food Additives on Behavior
Gluten-Free Diets
References
Additional Resources
11 Breastfeeding
Breastfeeding Recommendations
Hospital-Based Support
The Baby-Friendly Hospital Initiative
Benefits of Breastfeeding
Contraindications to Breastfeeding
Special Situations
Characteristics of Human Milk
Colostrum
Transitional Milk
Mature Milk
Water
Lipid (Fat) Content
Protein
Carbohydrates
Vitamins and Minerals
Anatomy and Physiology
Assessment of the Breastfeeding Dyad
Maternal History
Infant History
Maternal Examination
Infant Examination
Positions for Breastfeeding
Principles of Correct Positioning
Cradle Position
Side-Lying Position
Football Hold
Dynamics of Breastfeeding
Early Feedings
Frequency and Duration of Feedings
Pumping
Collection and Storage of Breast Milk
Growth Spurts
Breastfeeding Toddlers
Weaning
Clinical Indications of Successful Breastfeeding
Infant Weight Gain
Urine Output Guidelines
Stool Output Guidelines
Maternal Nutritional Needs during Breastfeeding
Medications for Breastfeeding Mothers
Returning to Work
Common Breastfeeding Problems
Flat or Inverted Nipples
Differential Diagnosis
Management
Prenatal
Complications
Sore Nipples
Clinical Findings
Differential Diagnosis
Management
Severe Engorgement
Clinical Findings
Differential Diagnosis
Management
Mastitis
Clinical Findings
Management
Complications
Nipple Confusion
Clinical Findings
Differential Diagnosis
Management
Complications
Breast Milk Jaundice
Clinical Findings
Physical Examination
Differential Diagnosis
Management
Thrush
Poor Weight Gain
Clinical Findings
Infant Factors
Differential Diagnosis
Management
Complications
References
Additional Resources
12 Elimination Patterns
Standards
Normal Patterns of Elimination: Bowel and Urinary
Infants
Bowel Patterns
Urinary Patterns
Toddlers and Preschoolers
Bowel Patterns
Urinary Patterns
School-Age Children
Bowel Patterns
Urinary Patterns
Adolescents
Bowel and Urinary Patterns
Assessment of Patterns
Health History
Description of Current Status
Birth and Early Infancy History
Review of Systems
Family History
Environment and Psychosocial Issues
Physical Examination
Diagnostic Studies
Management Strategies for Normal Patterns
Toilet Training
Altered Patterns of Elimination: Bowel and Bladder Dysfunction
Encopresis/Constipation
Physiologic
Psychosocial
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
Stool Toileting Refusal
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
Dysfunctional Voiding
Clinical Findings
History
Differential Diagnosis
Management
Patient and Family Education
Enuresis
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Complications
Patient and Family Education
References
Additional Resources
Enuresis
Encopresis
General
13 Physical Activity and Sports for Children and Adolescents
Physical Activity: Overview
Promoting Physical Activity: Guidelines and Standards
Health Benefits of Physical Activity
Physical Activity and Children with Special Health Care Needs
Special Consideration: Atlantoaxial or Atlanto-Occipital Instability (AAI)
Strategies to Support Physical Activity for Children and Adolescents
Motivation and Barriers to Maintaining Physical Activity
Can Health Care Providers Influence Lifestyle Behaviors?
Counseling Families about Organized Sports for Their Children
Strength Training
Preseason Conditioning and Injury Prevention
Use of Helmets for Cycling and Winter Sports
Basic Metabolic and Nutritional Needs and Abuses in Athletes
Carbohydrates
Protein
Fats
Intentional Weight Loss
Is There a Role for Sports Drinks?
The Preparticipation Sports Physical Examination for Sports
Benefits of the Preparticipation Sports Physical Examination
Frequency of Preparticipation Examinations
Medical Clearance and Liability Issues
Where the Preparticipation Physical Examination Should Take Place
Components of the Preparticipation Physical Examination
Health History
Physical Examination
Diagnostic Studies
Evaluation and Management of Sports Participation for Athletes with Specific Health Conditions
Chronic Medical Conditions
Asthma
Cardiac Conditions
Cardiac Murmurs
Diabetes Mellitus
Hypertension
Seizures
Sickle Cell Trait
Acute Infectious Conditions
Infectious Mononucleosis
Skin Infections
Human Immunodeficiency Virus and Other Blood-Borne Viral Pathogens
Exercise-Induced Dyspnea
High-Risk Conditions for Sports Participation
Sudden Cardiac Death in Young Athletes
Musculoskeletal
Overuse or Traumatic Injuries
Baseball/Softball
Burners and Stingers
Neck Injury
Head Injury/Concussions
Transient Quadriplegia
Hernia
Absence of Paired Organs
Special Considerations for the Female Athlete
Injuries and the Female Athlete
The Female Athlete Triad
Heat and Humidity
Sports Training Acclimatization for Prevention of Heat-Related Illnesses
Dehydration
Use of Ergogenic Drugs and Supplements
Recognition and Prevention of Ergogenic Substance Use
Anabolic-Androgenic Steroids
Androstenedione and Dehydroepiandrosterone
Growth Hormone
Creatine and Other Supplements
Ephedra
Energy Drinks
Nutritional Supplements
Recreational Activities: Safety Issues
References
Additional Resources
14 Sleep and Rest
Normal Sleep Stages and Cycles
Circadian Rhythm and Establishment of Normal Sleep Patterns
Sleep Cycle
Non-Rapid Eye Movement Sleep
Stage 1 (NREM1 or N1)
Rapid Eye Movement Sleep
Sleep Cycle Processes
Sleep Patterns by Age Group
Newborns
Sudden Infant Death Syndrome and Sleep Positioning
Toddlers
Preschoolers (3 to 5 Years Old)
School-Age Children (5 to 12 Years Old)
Older Children and Adolescents
Sleep Across Cultures
Assessment of Sleep
History
Chief Complaint
General Health History
Past Medical History and Review of Systems
Family Assessment
Physical Examination
Diagnostic Studies
Strategies for Prevention and Management of Sleep Problems
Sleep Hygiene Promotion
Dyssomnia Interventions
Primary Care Interventions for Dyssomnias
Unmodified Extinction
Sleep in Children with Developmental and Neurologic Conditions
Medications
Common Sleep Problems
Parasomnias: Night Terrors, Sleepwalking, and Nightmares
Non-Rapid Eye Movement Parasomnias
Confusional Arousals
Rapid Eye Movement Parasomnias
Assessment of Parasomnias
History
Treatment of Parasomnias
Sleep Cycle Problems (Circadian Rhythm Disorders)
Delayed Sleep Phase
Differential Diagnoses
Advanced Sleep Phase
Management
Inappropriate or Unpredictable Schedules
Management
Nocturnal Enuresis
Restless Legs Syndrome and Periodic Limb Movements
Clinical Findings and Diagnosis
Laboratory Studies
Treatment
Head Banging and Bruxism
Fear and Anxiety Dyssomnias
Depression and Sleep
Epilepsy and Sleep
Sleep Disordered Breathing
Clinical Findings
Diagnostic Studies
Surgical and Medical Treatment of Sleep Disordered Breathing
Central Sleep Apnea
Narcolepsy
References
Additional Resources
15 Sexuality
Standards
Normal Patterns of Sexuality
Historical and Cultural Context of Sexuality
Contemporary Definitions
Sexual Health
Stages of Developmental Patterns of Sexuality
Infancy to 2 Years Old
Two to 5 Years Old
Five to 9 Years Old
Preadolescence
Adolescence
Sexuality in Individuals With Intellectual and Physical Developmental Disabilities
Factors That Can Alter Sexual Behaviors
Assessment of Normal Patterns of Sexual Development
Confidentiality
History
Functions of the Sexual History
Types of Sexual Histories
Approach to Taking a Sexual History
Physical Examination
Management Strategies
Setting the Stage
Sex Education
Counseling of the Adolescent
Contraceptive and Safer Sex Counseling
Special Counseling Needs
Lesbian, Gay, Bisexual, Transgendered, and Questioning Youth
Clinical Findings
Management
Complications
References
Additional Resources
16 Values, Beliefs, and Spirituality
Standards of Practice
Normal Patterns of Behavior
Definitions of Values, Beliefs, Faith, Spirituality, and Morality
Development of Moral Integrity or Conscience
Development of Spirituality
Assessment of Normal Patterns
History
Moral Integrity or Conscience
Physical Examination
Management of Normal Patterns
Altered Patterns
Lack of Moral Integrity or Conscience
Assessment
Clinical Findings
Differential Diagnosis
Management
Complications
Moral and Spiritual Distress
Assessment
Clinical Findings
Differential Diagnosis
Management
Complications
References
Additional Resources
17 Role Relationships
Standards of Care
Family Functioning
Dimensions of Family Functioning
Family Life Dynamics
The Interactive Family
Assessment of Family Relationships and Dynamics
Management for Health Promotion and Disease Prevention
Family Units
Two-Parent Families
Single-Parent Families
Clinical Findings
Management
Patient and Family Education and Prevention
Children Living with Grandparents or Extended Family Members
Children Living with Two Unmarried Parental Figures—Cohabitation
Children Living with Homosexual Parents
Adolescent Parents
Clinical Findings
Infancy
Management
Families with Special Circumstances
Adoptive Parent Families
Assessment
Management
Patient and Family Education and Prevention
Children Living in Foster or Group Homes
Families with a Premature Infant
Families with Multiple Births
Children with Chronic Illness or Special Needs
Dynamics Affecting Family Life
Working Parents
Separation and Divorce
Clinical Findings
Management
Patient Education and Prevention
Remarriage: The Blended Family
Clinical Findings
Management
Patient and Family Education and Prevention
Military Deployment
Children Living in Poverty
Displaced or Homeless Children and Their Families
Disaster Affecting the Family
Death in the Family
Role-Relationship Problems
Violence
Clinical Findings
Management
Prevention of Youth Violence
Primary Prevention
Secondary Prevention
Intimate Partner Violence (Domestic Violence)
Clinical Findings
Management
Patient Education and Prevention
Bullying
Clinical Findings
Management
Patient and Family Education and Prevention
Child Maltreatment
General Assessment Guidelines
General Management Strategies
Neglect
Clinical Findings
Differential Diagnosis
Management
Psychological Maltreatment
Clinical Findings
History
Differential Diagnosis
Management
Patient and Family Education and Prevention
Physical Abuse
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Patient and Family Education and Prevention
Sexual Abuse, Assault, and Date Rape
Clinical Findings
Diagnostic Studies
Differential Diagnosis
Management
Patient and Family Education and Prevention
References
Additional Resources
18 Self-Perception Issues
Standards of Care
Normal Patterns of Self-Perception
Components of Self-Perception
Developmental Stages
Developmental Assets, Family Assets, Sparks, and Developmental Relationships
Developmental Assets
Family Assets
Sparks
Developmental Relationships
Factors Influencing Self-Perception
Significant Relationships
Parent-Child Attachment, Temperament, and Stress and Trauma
Health and Chronic Conditions
Cultural Identity, Race, and Ethnicity
Social Experiences
Media and Technology
Red Flags and Risk Factors for Self-Perception
Assessment of Self-Perception
History
Observations During the History and Examination
Management Strategies for Developing Positive Self-Perception
Facilitate Good Parenting
Maintain Appropriate Expectations of the Child
Use Discipline Techniques That Enhance Self-Perception
Communicate Positively and with Respect
Provide Helpful Strategies for the Child, Adolescent, and Parent
Encourage Asset Building, Sparks, and Developmental Relationships
Complications of Self-Perception
Specific Self-Perception Problems in Children
Self-Esteem Problems
Description
Assessment
Differential Diagnosis
Management
Complications
Personal Identity Problems
Description
Clinical Findings
Differential Diagnosis
Management
Complications
Role Performance Problems
Description
Clinical Findings
Differential Diagnosis
Management
Complications
Body Image Problems
Description
Clinical Findings
Differential Diagnosis
Management
References
Additional Resources
19 Coping and Stress Tolerance
Mental Health Influences
Neurobiologic Context
Mental Health in Primary Care
Prevention
Primary Prevention
Secondary Prevention
Tertiary Prevention
Approaches to Children by Developmental Level
Special Approaches from Infancy Through Early Childhood
Special Approaches During the School-Age Years Through Adolescence (Level 3)
Temperament Influences on Mental Health
Temperament as a Risk Factor
Temperament Management
Assessment and Management of Mental Health Disorders
Assessment
Approaches to Children of Different Ages
Infants
History
The Symptom Analysis: Behavioral Manifestations
Disease Domain
Physical Examination
Diagnostic Studies
Behavioral/Developmental Screening and Assessment Tools
Making Mental Health and Behavioral Diagnoses
Management Strategies
Common Mental Health Problems
Special Problems of Infancy and Early Childhood
The Shy Child
Differential Diagnosis
Management
Bereavement
Clinical Findings
Fears, Phobias, and Anxieties
Fears and Phobias
Clinical Findings
Anxiety
Separation Anxiety Disorder
Clinical Findings
Generalized Anxiety Disorder
Clinical Findings
Obsessive-Compulsive Disorder
Clinical Findings
Management
Tic Disorders
Clinical Findings
Diagnostic Studies
Posttraumatic Stress Disorder
Clinical Findings
Differential Diagnosis
Mood Disorders
Depression
Clinical Findings
Depression Scales
Management
Prognosis
Bipolar Disorder
Clinical Findings
Attention-Deficit/Hyperactivity Disorder
The Aggressive Child
Social Aggression
Clinical Findings
Conduct Disorder
Clinical Findings
Oppositional Defiant Disorder
Clinical Findings
Autism Spectrum Disorder
Eating Disorders
Clinical Findings
Differential Diagnosis
Diagnostic Studies
Management
Complications
Substance Abuse
Clinical Findings
Differential Diagnosis
Diagnostic Studies
Management
References
Additional Resources
20 Cognitive-Perceptual Disorders
Standards for Care
Cognitive-Perceptual Development
Piaget: Cognitive Development
Information Processing Theories
Social Cognition
Neurodevelopmental Framework
Multiple Intelligences
Executive Functions and the Prefrontal Cortex
Sensory Processing
Social and Emotional Skills that Lead to Academic Success
Elements of Learning
Assessment of Cognitive-Perceptual Development
History
Screening
Management Strategies for Cognitive-Perceptual Development
Primary Care Strategies and Interprofessional Collaboration
Educational Strategies
Family Support Strategies
Social and Adaptive Strategies
Cognitive-Perceptual Problems of Children
Attention-Deficit/Hyperactivity Disorder
Prevalence in the United States
Cross-Cultural Considerations
Effect of Attention-Deficit/Hyperactivity Disorder on Individuals, Families, and Communities
Genetics and Neurobiologic Pathophysiology
Environmental Factors
Clinical Findings
History and Physical Examination
Attention-Deficit/Hyperactivity Disorder Standardized Assessment (Behavior) Scales and Other Diagnostic Tools
Differential Diagnosis and Comorbidities
Management
Diagnostic Formulation and Initial Meeting with Family and Child
Plan of Care, Special Health Needs Status, and Medical Home
Behavior Management
Supports and Services: Family, Home, Friends, Activities, and Self-Esteem
Complementary Therapies
Learning Disorders and Neurodevelopmental Dysfunctions
Clinical Findings
Assessment
Screening
Differential Diagnosis
Management
Educational and Adaptive Support
Complications
Patient and Family Education and Prevention
Sensory Processing Disorder
Clinical Findings
Assessment
History and Physical Examination
Differential Diagnosis and Comorbidities
Management
Complications
Autistic Spectrum Disorder
Clinical Findings
Infants
Toddlers
Assessment
Screening and Specialty Referral for Diagnosis
Differential Diagnosis
Management
Behavior/Mental Health
Educational System
Hearing Impairment
Clinical Findings and Developmental and Behavioral Effects
Assessment
Management
Habilitation and Assistive Devices and Amplification Devices
Educational System and Family Support
Visual Impairment
Clinical Findings and Developmental and Behavioral Effects
Assessment
Management
Habilitation and Assistive Devices
References
Additional Resources
Unit 4 Approaches to Disease Management
21 Introduction to Disease Management
Key Concepts in Illness Management in Children
Shared Decision-Making as Part of Child- and Family-Centered Care
Overview of Parent and Child Education: Illness Management and Prevention
Health Literacy
Health Care Education
Discharge Education
Education for Chronic Illnesses of Children
Provider Considerations for Care of Children with Illnesses
Parents as Observers of Illness
Medications and Illness
Day Care and Illnesses
Working with Non–English-Speaking Families
Emergency Department Utilization
Chronic Disease Management Issues
Children and Youth with Special Health Care Needs
Legislative and Governmental Support for Children and Youth with Special Health Care Needs
Emotional Support for Children and Youth with Special Health Care Needs and Their Families
Family-Centered Care for Children with Chronic Conditions
Challenges in the Patient-Centered Health Care Model
Primary Care for Chronically Ill Children
Child and Family Issues about Quality of Life
Chronic Care of Children and the Health Care System
Common Concerns of Children and Families Related to Chronic Illness Care
Assessment and Management of Children with Acute or Chronic Illnesses
History and Physical Examination
Considerations about Diagnostic Studies
Laboratory Studies
Imaging Studies
Determining an Accurate Diagnosis
Management Considerations
Acute Illness
Medication Management
Prescribing Pharmacologic Agents
Parental Education Related to Medication Use
Referral and Consults
Referral to National and Local Organizations and Resources for Chronic Medical Issues
Tips Regarding Documentation: Patient Visit and Follow-Up
Telehealth Management of Illnesses
Telephone Triage Systems
Steps of an Effective Triage System
Documentation of Triage Telephone Calls
Texting
Social Media Websites
Email
Educating Parents about Office Telephone and Electronic Messaging Policy
Illness Prevention
Child Care Settings and Infectious Diseases
Fever in Children
Fever Assessment
Types of Thermometers and Measurement Sites
Fever Management
References
Additional Resources
Computer-Aided Diagnostic Decision Support
Health Literacy Information
Hand Washing Guidelines
Transitions from Pediatric to Adult Health Care
Patient Education and Choices
Chronic Illness–Information About Medical Home Model
Miscellaneous
Shared Decision-Making Programs
Support Groups for Families and Patients
22 Prescribing Medications in Pediatrics
National Safety Goals Regarding Prescribing Medications
Regulation and Safety of Pharmaceuticals
Safety Issues with Pharmaceutical Manufacturers
Ethical Issues with Pharmaceutical Testing
Guidelines for Writing a Prescription
General Prescribing Guidelines
Prescribing Medications for Children
Pharmaceuticals Used In Pediatrics: Off-Label Prescribing
Perils of Prescribing Off-Label
Other Factors to Consider in Medication Management
Medication Adherence
Overprescribing Antibiotics; a Continuing Problem
Advances in Pharmacologic Research: Maximizing Therapeutic Efficacy
Disposal of Pharmaceuticals
References
Additional Resources
Mobile Phone Applications
Text Messaging
Mobile Games: Available as Mobile Applications
23 Pediatric Pain Management
Pain in Children
Barriers to Treatment of Pain in Children
Overview of Pain
Pain Assessment
Clinical Findings
History
Behavioral Indicators
Physiologic Indicators
Management
Acute Pain Management
Infants
Children and Adolescents
Pharmacologic Considerations
Factors that Produce Age-Related Differences in Analgesia Responses
Chronic Pain Management
Pharmacologic Measures
Nonpharmacologic Measures
Additional Measures
Partnership in Care
References
Additional Resources
24 Infectious Diseases and Immunizations
Pathogenesis of Infectious Diseases
Clinical Findings
History
Physical Examination
Diagnostic Aids
Laboratory and Imaging Studies
Complete Blood Count
Platelet Count/Mean Platelet Volume
C-Reactive Protein
Procalcitonin
Erythrocyte Sedimentation Rate
Cultures, Stains, and Antimicrobial Susceptibility Testing
Other Technologies
Immunoserology
Imaging Techniques
General Management Strategies
Preventing the Spread of Infection
Use of Antibiotics
Prevention of Infection Through the Use of Vaccines
Barriers to Vaccination
Adverse Reactions to Vaccines
Vaccines for Children Program
Vaccine Shortages
Vaccine Safety and Resources for Providers
Vaccines on the Horizon
Acetaminophen Prophylaxis after Vaccination?
Active Immunity
General Principles
Considerations When Choosing Inactive Vaccines
Inactivated Vaccines
Diphtheria-Tetanus-Acellular Pertussis Vaccine
Hepatitis A Virus Vaccine
Human Papillomavirus Vaccine
Pneumococcal Vaccines
Live Vaccines
Precautions Regarding Administration of Live Vaccines
Measles-Mumps-Rubella Vaccine
Measles, Mumps, Rubella, and Varicella Vaccine
Passive Immunity: The Immunoglobulins
Respiratory Syncytial Virus Prophylaxis
Infections in Children in Child Care Settings
Specific Viral Diseases
Enteroviruses
Nonpolio Enteroviruses
Clinical Findings
Differential Diagnosis and Management
Poliomyelitis Virus
Differential Diagnosis and Management
Hepatoviruses
Hepatitis A Virus
Clinical Findings
Hepatitis B Virus
Clinical Findings
Complications and Prevention
Hepatitis C Virus
Clinical Findings
Hepatitis D Virus
Hepatitis E Virus
Herpes Family of Viruses
Herpes Simplex Virus
Clinical Findings
Diagnostic Studies
Differential Diagnosis and Management
Complications
Patient and Family Education
Infectious Mononucleosis Syndrome
Clinical Findings
Diagnostic Studies
Differential Diagnosis and Management
Complications and Patient and Family Education
Roseola Infantum (Exanthem Subitum)
Clinical Findings
Diagnostic Studies
Differential Diagnosis, Management, and Complications
Varicella
Clinical Findings
Diagnostic Studies
Differential Diagnosis and Management
Complications
Patient and Family Education
Influenza Viral Infections
Typical Influenza
Clinical Findings
Differential Diagnosis, Management, and Complications
Highly Pathogenic Avian Influenza
Other Viral Diseases
Human Immunodeficiency Virus
Clinical Findings
Diagnostic Studies
Differential Diagnosis
Management and Complications
Prevention and Reduction of Perinatal Transmission of Human Immunodeficiency Virus
Preexposure Prophylaxis for Certain High Risk Individuals
Postexposure Prophylaxis After Nonoccupational Exposure
Measles (Rubeola)
Clinical Findings
Diagnostic Studies
Differential Diagnosis and Management
Care of Exposed Individuals
Complications
Mumps
Clinical Findings
Diagnostic Studies
Differential Diagnosis, Management, and Complications
Erythema Infectiosum
Clinical Findings
Diagnostic Studies
Differential Diagnosis, Management, and Complications
Parainfluenza Virus
Clinical Findings
Diagnostic Studies
Differential Diagnosis, Management, and Complications
Rubella (German or 3-Day Measles)
Clinical Findings
Diagnostic Studies
Differential Diagnosis, Management, and Complications
Mosquito-Borne Viruses
West Nile Virus
Clinical Findings
Differential Diagnosis, Management, and Complications
Dengue Virus
Clinical Findings
Differential Diagnosis, Management, and Complications
Hantavirus Pulmonary Syndrome
Additional Noteworthy Viruses in Circulation
Human Pneumovirus (Metapneumovirus)
Human Calicivirus Infections (Norovirus and Sapovirus)
Coronaviruses
Potential Emerging and Reemerging Viruses on the Horizon
Middle Eastern Respiratory Syndrome
Monitoring the Global Spread of Viruses
Parasitic-Caused Disease: Malaria
Tick-Borne Diseases
Lyme Disease
Clinical Findings
Diagnostic Studies
Differential Diagnosis, Management, and Complications
Patient and Family Education
Ehrlichiosis and Anaplasmosis
Rocky Mountain Spotted Fever
Clinical Findings
Diagnostic Studies
Differential Diagnoses
Management
Complications and Patient and Family Education
Bacterial Infections
Community-Acquired Methicillin-Resistant Staphylococcus Aureus
Other Emerging Drug-Resistant Bacterial Infections
Cat-Scratch Disease
Clinical Findings
Diagnostic Studies
Differential Diagnosis, Management, and Complications
Kingella Kingae Infection
Meningococcal Disease
Clinical Findings
Diagnostic Studies
Differential Diagnosis
Management, Control Measures, and Complications
Streptococcal Disease
Group A Streptococcus
Clinical Findings and Diagnostic Studies
Non–Group A or B Streptococci
Tuberculosis
Clinical Findings Primary Pulmonary Tuberculosis
Screening Tests for Infection
Mantoux Tuberculin Skin Test.
Diagnostic Studies
Differential Diagnosis
Management
Monitoring Response to Treatment
Complications
Helminthic Zoonoses
Toxocariasis
Clinical Findings
Physical Examination
Differential Diagnosis
Management and Complications
Patient and Family Education
The Child Presenting with Fever
Fever Without Focus in Infants and Young Children
Clinical Findings
History and Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Applying Risk Criteria
Fever of Unknown Origin
Clinical Findings
History
Physical Examination
Differential Diagnosis and Management
Infectious Agents Used in Bioterrorism
References
Additional Resources
Vaccines
Centers for Disease Control and Prevention
European Society of Pediatric Gastroenterology, Hepatology and Nutrition
World Health Organization
25 Atopic, Rheumatic, and Immunodeficiency Disorders
Pathophysiology and Defense Mechanisms
Atopic and Allergic Disorders
Immune Deficiency
Rheumatic Disorders
Overview of Laboratory Diagnostic Studies in Rheumatic Diseases
General Management Strategies
Rheumatologic Disorders
Juvenile Idiopathic Arthritis
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Complications and Prognosis
Patient and Parent Education and Prevention
Systemic Lupus Erythematosus
Clinical Findings
History
Differential Diagnosis
Management
Complications and Prognosis
Fibromyalgia Syndrome
Clinical Findings
History
Differential Diagnosis
Management
Patient and Parent Education
Prognosis
Chronic Fatigue Syndrome
Clinical Findings
Differential Diagnosis
Management
Reactive Arthritis Related to Streptococcal Infection: Acute Rheumatic Fever and Post-Streptococcal Reactive Arthritis
Post-Streptococcal Reactive Arthritis
Acute Rheumatic Fever
Clinical Findings and History
Major Manifestations
Minor Manifestations
Management
Prevention of Acute Rheumatic Fever
Complications
Pediatric Vasculitis
Henoch-Schönlein Purpura
Clinical Findings
History
Differential Diagnosis
Management
Complications and Prognosis
Patient and Parent Education
Kawasaki Disease
Clinical Findings
Stage 1: Acute Phase
Differential Diagnosis
Management
Complications and Prognosis
Atopic Disorders
Asthma
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Chronic Asthma
Acute Exacerbations of Asthma
Complications
Patient and Parent Education and Prevention
Prognosis
Allergic Rhinitis
Clinical Findings
Diagnostic Studies and Allergy Testing
Differential Diagnosis
Management
Avoidance Strategies
Pharmacologic Therapy
Allergy Immunotherapy and Other Treatments
Complications and Prognosis
Patient and Parent Education and Prevention
Atopic Dermatitis
Clinical Findings
Diagnostic Studies
Differential Diagnosis
Management
Pharmacotherapy
Non-Pharmacological Therapy
Environmental Management
Complications and Prognosis
Patient and Parent Education and Prevention
Pediatric Immunodeficiency Disorders
Physiology of the Immune System
Primary and Secondary Immunodeficiency Disorders
Clinical Presentation
History
Physical Assessment
Management
References
Additional Resources
26 Endocrine and Metabolic Disorders
Anatomy and Physiology
Pathophysiology
Assessment
History
Physical Examination
Diagnostic Studies
Management Strategies
General Measures
Genetic Counseling
Medications
Dietary Considerations
Patient and Family Education
Disorders of Endocrine Function
Growth Disorders
Growth Hormone Deficiency
Clinical Findings
Differential Diagnosis
Constitutional Growth Delay
Clinical Findings
Management
Growth Excess
Pubertal Disorders
Early Puberty/Precocious Puberty
Clinical Findings
Management
Delayed Puberty
Clinical Findings
Adrenal Disorders
Anatomy and Physiology
Adrenal Insufficiency
Clinical Findings
Hyperadrenal States
Clinical Findings
Differential Diagnosis
Disorders of Sex Development
Clinical Findings
Management
Thyroid Disorders
Anatomy and Physiology
Hypothyroidism
Clinical Findings
Management
Hyperthyroidism
Clinical Findings
Diabetes Mellitus
Type 1 Diabetes
Clinical Findings
Complications
Type 2 Diabetes
Clinical Findings
Differential Diagnosis
Complications
Obesity
Diagnostic Studies
Management
Posterior Pituitary Gland Disorders
Introduction to Inborn Errors of Metabolism
Classification of Inborn Errors of Metabolism
Pathophysiology
Assessment of Inborn Errors of Metabolism
Clinical Findings
History
Management
Metabolic Emergencies
Complications
Specific Metabolic Disorders of Children
Disorders of Carbohydrate Metabolism
Glycogen Storage Diseases
Galactosemia
Urea Cycle Disorders
Clinical Findings and Diagnostic Studies
Amino Acid Metabolism Disorders: Aminoacidopathies and Organic Acidurias and Acidemias
Phenylketonuria
Classic Homocystinuria
Disorders of Fatty Acid Oxidation
Medium-Chain Acyl-Coenzyme A Dehydrogenase Deficiency
Lysosomal Storage Disorders
Dyslipidemia: Hypercholesterolemia and Hyperlipidemia
Clinical Findings
Management
References
Additional Resources
Organizations and Resources for Endocrine and Metabolic Disease
27 Hematologic Disorders
Anatomy and Physiology
Erythrocytes
Hemoglobin
Erythrocyte Development
Structural Variations
Normal Values
Antigenic Properties of Red Blood Cells
Leukocytes
Granular Leukocytes (Polymorphonuclear Leukocytes, Polys)
Neutrophils, Basophils, and Eosinophils
Agranulocytes—Leukocytes
Lymphocytes
Monocytes
Platelet Cells and Coagulation Factors
Pathophysiology
Assessment of Disorders of Erythrocytes
History
Physical Examination
Pancytopenia
Erythrocyte Disorders
Anemia
Classification of the Anemias
Epidemiology
Workup for Anemia
Microcytic Anemia
Iron Deficiency Anemia
Effects of Iron Deficiency
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Iron Requirements
Complications
Patient and Family Education
Thalassemias
Alpha-Thalassemias
Management
Beta-Thalassemia Minor/Minima
Clinical Findings
Management
Beta-Thalassemia, Intermedia
Beta-Thalassemia Major
Clinical Findings
Management
Complications
Megaloblastic Anemias
Clinical Findings
History
Management
Normocytic Anemias
Transient Erythroblastopenia of Childhood
Clinical Findings
History
Differential Diagnosis
Management
Hemolytic Anemia
Sickle Cell Anemia and Trait
Clinical Findings
Physical Examination
Differential Diagnosis
Management
Complications
Patient and Family Education
Hereditary Spherocytosis
Clinical Findings
Diagnostic Studies
Management
Complications
Glucose-6-Phosphate Dehydrogenase Deficiency
Clinical Findings
History
Management
Patient and Family Education
Platelet and Coagulation Disorders
Overview of Diagnostic Studies
Immune or Idiopathic Thrombocytopenic Purpura
Clinical Findings
Diagnostic Studies
Differential Diagnosis
Management
Complications
Hemophilia A and B and von Willebrand Disease
Clinical Findings
Management
Complications
Thrombophilia
White Blood Cell Disorders
White Blood Cell Count
White Blood Cell Dysfunction
Alterations of Granulocytes
Lymphocytosis
Cancer
Leukemias
Clinical Findings
Diagnostic Studies
Management
Lymphomas
Non-Hodgkin Lymphoma
Clinical Findings
Hodgkin Lymphoma
Clinical Findings
Diagnostic Studies
Late Effects of Childhood Cancers
References
Additional Resources
28 Neurologic Disorders
Anatomy and Physiology
Anatomy
Autonomic Nervous System
Physiology
Pathophysiology and Defense Mechanisms
Assessment of the Nervous System
History
History of Present Illness
Medical History
Family Disease History
Developmental History
Functional Health
Social Context
Review All Systems
Physical Examination
Specifics of the Neurologic Examination
Behavior and Mental Status
Autonomic Nervous System
Diagnostic Studies
Management Strategies Involving Anticipatory Guidance
Neurologic Development
Educational Needs
Referrals for Other Key Assessments
Medications
Specific Neurologic Problems of Children
Neurodegenerative Disorders
Rett Syndrome
Multiple Sclerosis
Clinical Findings
Management
Nondegenerative Disorders
Benign Paroxysmal Vertigo
Cerebral Palsy
Clinical Findings
Complications
Prevention and Screening
Bell Palsy
Clinical Findings
Epilepsy and Seizure Disorders
Clinical Findings
Differential Diagnosis
Complications
Febrile Seizures
Clinical Findings
Prophylaxis for Recurrent Febrile Seizures
Brachial Palsy
Clinical Findings
Prognosis
Guillain-Barré Syndrome
Clinical Findings
Headaches
Clinical Findings
Differential Diagnosis
Complications
Head Injury
Clinical Findings
Differential Diagnosis
Complications
Prevention
Disturbances of Head Growth
Macrocephaly
Central Nervous System Infections
Clinical Findings
The Hypotonic Infant
Reye Syndrome
Tethered Cord
Arnold-Chiari Malformation
Myelomeningocele
Clinical Findings
Myasthenia Gravis
Clinical Findings
References
Additional Resources
29 Eye Disorders
Standards for Visual Screening and Care
Development, Physiology, and Pathophysiology of the Eye
Development of the Ocular Structures
Anatomy and Physiology of the Eye
Pathophysiology of the Eyes
Assessment
History
Physical Examination
Screening Tests
Conducting Screening Tests
Red Reflex
Visual Acuity Testing
Color Vision Testing
Peripheral Vision Testing
Testing for Ocular Mobility and Alignment
Assessment of Visual Loss
Diagnostic Studies
Photoscreening and Autorefractors
Laboratory and Imaging Studies
Fluorescein Staining
Management Strategies
Referral for Ophthalmologic and Specialty Management
Occlusion
Corrective Lenses
Ophthalmic Medications
Topical Antibiotics
Ophthalmic Corticosteroids
Other Topical Preparations
Systemic Medications
Eye Injury Prevention
Sunglasses
Sports Protection
Laser Pointers
Computer Use
Vision Therapy, Lenses, and Prisms
Visual Disorders
Refractive Errors and Amblyopia
Clinical Findings
Management
Strabismus
Clinical Findings
Diagnostic Techniques
Management
Complications
Blepharoptosis
Management
Nystagmus
Clinical Findings
Management and Prognosis
Cataracts
Clinical Findings
Management
Complications
Prognosis and Prevention
Glaucoma
Clinical Findings
Management
Complications and Prognosis
Retinopathy of Prematurity
Clinical Findings
Management
Complications
Prevention
Retinoblastoma
Clinical Findings
Management
Complications and Prognosis
Infections
Conjunctivitis
Conjunctivitis in the Newborn (Ophthalmia Neonatorum)
Clinical Findings
Management
Inclusion Conjunctivitis (Chlamydia)
Clinical Findings
Complications
Bacterial Conjunctivitis
Clinical Findings
Patient Education
Viral Conjunctivitis
Clinical Findings
Allergic Conjunctivitis
Clinical Findings
Blepharitis
Clinical Findings
Differential Diagnosis
Management
Hordeolum
Clinical Findings
Differential Diagnosis
Management
Chalazion
Clinical Findings
Management
Complications
Nasolacrimal Duct Conditions: Dacryostenosis and Dacryocystitis
Clinical Findings
Diagnostic Studies
Differential Diagnosis
Management
Periorbital Cellulitis
Clinical Findings
Diagnostic Studies
Differential Diagnosis
Management
Complications
Keratitis and Corneal Ulcers
Clinical Findings
Management
Inflammation of the Uveal Tract
Clinical Findings
Management
Complications
Trachoma
Clinical Findings
Management
The Injured Eye
Corneal Abrasion
Clinical Findings
Management
Foreign Body
Clinical Findings
Diagnostic Studies
Management
Complications
Burns
Clinical Findings
Management
Lacerations of the Orbit
Clinical Findings
Management
Traumatic Hyphema
Clinical Findings
Management
Complications
Retinal Detachment
Clinical Findings
Management
Orbital Hematoma and Contusion of the Globe
Clinical Findings
Management
Complications
Orbital Fractures
Clinical Findings
Diagnostic Studies
Management
Pterygium
Subconjunctival Hemorrhage
Eyelid Contusion (“Black Eye”)
Deformities of the Eyelids
Entropion
Ectropion
Euryblepharon
References
Additional Resources
30 Ear Disorders
Standards for Hearing Screening
Development, Anatomy, and Physiology
Pathophysiology and Defense Mechanisms
Assessment
History
Physical Examination
Common Diagnostic Studies
Management Strategies
Medications
Education and Counseling
Removal of Cerumen
Follow-Up and Referral
Pressure-Equalizing Tubes
Prevention of Noise-Induced Hearing Loss
Specific Ear Problems in Children
Otitis Externa
Clinical Findings
History
Differential Diagnosis
Management
Complications
Prevention
Foreign Body in the Ear Canal
Clinical Findings
History
Management
Complications
Acute Otitis Media
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Management of Persistent and Recurrent Acute Otitis Media
Other Issues in Treating Acute Otitis Media
Complications
Prevention and Education
Otitis Media with Effusion
Clinical Findings
History
Differential Diagnosis
Management
Prevention and Education
Perforated Tympanic Membrane
Clinical Findings
History, Physical Examination, and Diagnostic Studies
Differential Diagnosis
Management
Medications
Other Treatment Considerations
Cholesteatoma
Clinical Findings
History and Physical Examination
Differential Diagnosis
Management and Complications
Mastoiditis
Clinical Findings
History, Physical Examination, and Diagnostic Studies
Differential Diagnosis
Management
Prevention
Sensorineural and Conductive Hearing Loss
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Complications
Prevention
References
31 Cardiovascular Disorders
Anatomy and Physiology
Fetal Circulation
Neonatal Circulation
Normal Cardiac Structure and Function
Conduction System
Assessment of the Cardiovascular System
History
Physical Examination
Vital Signs
General Appearance and Growth Parameters
Palpation
Auscultation of Heart Sounds
Murmurs
Criteria for Describing a Heart Murmur
Innocent or Functional Murmurs
Common Diagnostic Studies
Primary Health Care Management Strategies
Referral
Genetic Testing
Family Support
Congenital Heart Disease: General Information
Specific Congenital Heart Diseases
Congestive Heart Failure
Left-to-Right Shunting Congenital Heart Disease (Acyanotic)
Atrial Septal Defect
Clinical Findings
Management
Ventricular Septal Defect
Clinical Findings
Management
Atrioventricular Septal Defect (Atrioventricular Canal Defect or Endocardial Cushion Defect)
Clinical Findings
Management
Patent Ductus Arteriosus
Clinical Findings
Right-to-Left Shunting Congenital Heart Disease (Cyanotic)
Transposition of the Great Arteries
Clinical Findings
Tetralogy of Fallot
Clinical Findings
Tricuspid Atresia, Hypoplastic Left Heart Syndrome, and Other Single Ventricle Defects
Clinical Findings
Obstructive Cardiac Lesions
Aortic Stenosis and Insufficiency
Clinical Findings
Pulmonic Stenosis
Clinical Findings
Management
Coarctation of the Aorta
Clinical Findings
Management
Long-Term Complications for Children and Young Adults with Congenital Heart Disease: Transitioning to Adult Care
Sudden Cardiac Death
Clinical Findings
Diagnostic Studies
Management
Acquired Heart Disease
Chest Pain
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Hypertension
Clinical Findings
History
Physical Examination
Management
Complications
Patient and Family Education
Infective Endocarditis
Clinical Findings
History and Physical Examination
Differential Diagnosis
Management and Complications
Patient and Family Education
Myocarditis and Cardiomyopathy
Clinical Findings
History
Differential Diagnosis
Management
Complications and Prognosis
Pericarditis
Heart Conduction Disturbances
Cardiac Arrhythmias
Clinical Findings
Diagnostic Studies
Management and Complications
Syncope
Clinical Findings
History
Physical Examination
Diagnostic Studies
Management and Differential Diagnosis
References
Additional Resources
Genetic Tests, Information About Genetic Defects or Syndromes, and Resources for Families
32 Respiratory Disorders
Anatomy and Physiology
Upper Respiratory Tract
Lower Respiratory Tract
Pathophysiology Involved in Airway Disease
Obstructive Processes
Restrictive Processes
Defense Systems
Assessment of the Respiratory System
History
Physical Examination
Diagnostic Studies
Basic Respiratory Management Strategies
General Measures
Medications
Patient and Parent Education
Indications for Tonsillectomy and Adenoidectomy
Upper Respiratory Tract Disorders
The Common Cold
Pathophysiology
Clinical Findings
History
Differential Diagnosis
Management
Complications
Pharyngitis, Tonsillitis, and Tonsillopharyngitis
Acute Viral Pharyngitis, Tonsillitis, or Tonsillopharyngitis
Clinical Findings
History
Management
Acute Bacterial Pharyngitis and Tonsillitis
Clinical Findings
History
Management
Complications
Rhinosinusitis
Clinical Findings
Diagnostic Studies
Differential Diagnosis
Management
Complications
Prevention
Diphtheria
Clinical Findings
History
Differential Diagnosis
Management
Complications and Prevention
Pertussis
Clinical Findings
Diagnostic Studies
Differential Diagnosis
Management
Care of Exposed Children
Complications
Prevention
Recurrent Epistaxis
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Prevention
Nasal Foreign Body
Clinical Findings
History
Differential Diagnosis
Management
Extrathoracic Airway Disorders
Croup (Laryngotracheitis and Spasmodic Croup)
Clinical Findings
History
Differential Diagnosis
Management
Indications for Hospitalization
Complications
Acute Spasmodic Croup
Epiglottitis
Clinical Findings
History
Management
Complications
Prevention
Intrathoracic Airway Disorders
Bronchiolitis
Clinical Findings
History
Differential Diagnosis
Management
Complications
Prevention
Foreign Body Aspiration
Laryngeal Foreign Body
Clinical Findings
Tracheal Foreign Body
Bronchial Foreign Body
Clinical Findings
Management
Bronchitis
Clinical Findings
History
Differential Diagnosis
Management
Complications
Valley Fever (Coccidioidomycosis)
Clinical Findings in Infants and Children
History
Differential Diagnosis
Management
Indications for Hospitalization
Prevention
Nonbacterial and Bacterial Pneumonia
Clinical Findings in Infants and Young Children
History
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Prognosis
Complications
Prevention
Cystic Fibrosis
Clinical Findings
Diagnostic Studies
Management
Pectus Deformity
Clinical Findings
Management
References
Additional Resources
33 Gastrointestinal Disorders
Anatomy and Physiology
Pathophysiology
Assessment
History
Physical Examination
Common Diagnostic Studies
Management Strategies
Medications
Probiotics and Prebiotics
Nutrition and Activity
Counseling and Education
Upper Gastrointestinal Tract Disorders
Dysphagia
Clinical Findings
History
Differential Diagnosis
Management
Vomiting and Dehydration
Dehydration
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Vomiting
Dehydration
Complications
Patient and Family Education
Cyclic Vomiting Syndrome
Clinical Findings
History
Differential Diagnosis
Management
Well Phase: Prevention and Prophylaxis
Referral
Complications
Patient and Family Education
Abdominal Migraine
Clinical Findings
History
Differential Diagnosis
Management
Prognosis
Gastroesophageal Reflux Disease
Clinical Findings
History
Differential Diagnosis
Management
Pharmacologic
Lifestyle
Surgical
Complications
Patient and Family Education
Eosinophilic Esophagitis
Clinical Findings
History and Physical Examination
Management
Peptic Ulcer Disease
Clinical Findings
History
Diagnostic Studies
Laboratory Studies
Studies to Detect Helicobacter Pylori
Differential Diagnosis
Management
Complications
Patient and Family Education
Lower Gastrointestinal Tract Disorders
Infantile Colic
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
Foreign Body Ingestion
Esophageal Foreign Bodies
Abdominal Foreign Bodies
Clinical Findings
History, Physical Examination, and Laboratory Studies
Imaging Studies
Management
Esophageal Foreign Bodies
Complications
Appendicitis
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Complications
Intussusception
Clinical Findings
History
Differential Diagnosis
Management
Complications
Childhood Functional Abdominal Pain and Functional Abdominal Pain Syndrome
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Prognosis and Complications
Irritable Bowel Syndrome
Clinical Findings
History
Differential Diagnosis
Management
Malabsorption Syndromes: Celiac Disease, Lactose Intolerance, Cow’s-Milk Protein Intolerance or Allergy
Clinical Findings
General History for Malabsorption Syndromes
Disease-Specific Physical Examination
Diagnostic Studies
Specific Tests for Celiac Disease
Specific Tests for Lactose Intolerance
Cow’s-Milk Protein Intolerance and Cow’s-Milk Allergy
Differential Diagnosis
Management
Celiac Disease
Complications and Prognosis
Celiac Disease
Polyps
Clinical Findings
History
Management
Complications
Anal Fissure
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
Inflammatory Bowel Disease
Crohn Disease
Clinical Findings
History
Differential Diagnosis
Management
Complications
Prevention and Prognosis
Ulcerative Colitis
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Complications
Prevention and Prognosis
Failure to Thrive
Clinical Findings and Risk Factors
History
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Prognosis
Lower Gastrointestinal Tract Infections and Infestations
Acute Diarrhea
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Complications
Prevention
Chronic Diarrhea
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Complications
Intestinal Parasites
Clinical Findings, Management, and Differential Diagnosis
Patient and Family Education
Congenital Gastrointestinal Conditions
References
Additional Resources
34 Dental and Oral Disorders
Standards and Guidelines for Dental Care in the United States
Access to Dental Care in the United States
Normal Growth and Development
The Teeth
Pattern of Tooth Eruption
Teething
Performing the Oral Examination
Clinical Findings
Oral Mucosa
Saliva
Teeth
Aberrations in Primary Tooth Eruption and Gums
Natal and Neonatal Teeth
Delayed Tooth Eruption
Preeruption Cysts
Congenital Epulis
Bohn Nodules
Professional Dental Care
Fear of the Dentist
Choosing a Dentist
The First Dental Visit
Dental Health Education
Preventive Intervention and Management Strategies
Bacterial Diseases of the Mouth
Tooth Decay (Cavities, Dental Caries, or Baby Bottle Tooth Decay)
Clinical Findings
Management and Prevention Strategies
Active Decay
Fluoride Varnish
Fluoride in Water, Infant Formulas, and Fluoride Supplementation
Toothpaste
Topical Iodine
Periodontal Diseases
Gingivitis
Aggressive Periodontitis
Periodontitis as a Manifestation of Systemic Disease (Prepubertal Periodontitis)
Necrotizing Periodontal Disease
Pyogenic Granuloma
Viral Diseases of the Mouth
Herpes Stomatitis
Idiopathic Oral Conditions
Ankyloglossia (“Tongue-Tie”)
Aphthous Ulcers
Benign Migratory Glossitis
Bruxism/Grinding
Dental Erosion
Diastema
Gingival Hyperplasia
Halitosis
Malocclusion
Mucocele
Non-Nutritive Sucking
Pericoronitis Associated with Partially Erupted Wisdom Teeth
Ranula
Temporomandibular Joint Disorder
Clinical Findings and Differential Diagnosis
Management
Traumatic Injuries to Oral Structures
Clinical Findings
History
Management and Complications
Patient and Family Education
Lifestyle Choices that Affect Dental Health
Piercings and Intraoral Tattoos
Smokeless Tobacco and Betel Nut Use
Tooth Whitening (Bleaching)
Dental Care of Children with Special Health Care Needs
Management Strategies
References
Additional Resources
Dental Health Information
Fluoride Varnish
Toothpaste and Toothbrushes
Professsional References
35 Genitourinary Disorders
Standards of Care
Anatomy and Physiology
Pathophysiology and Defense Mechanisms
Assessment of the Genitourinary System
History
Physical Examination
Diagnostic Studies
Management Strategies
Education and Counseling
Medication, Diet, and Activity
Referral
Genitourinary Tract Disorders
Urinary Tract Infection and Pyelonephritis
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Infants 2 to 24 Months Old
Patient and Family Education, Prevention, and Prognosis
Vesicoureteral Reflux
Clinical Findings
History
Diagnostic Studies
Management
Patient and Family Education, Prevention, and Prognosis
Hematuria
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Proteinuria
Clinical Findings
History
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Nephrotic Syndrome
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education, Prevention, and Prognosis
Nephritis and Glomerulonephritis
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education, Prevention, and Prognosis
Renal Tubular Acidosis
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education, Prevention, and Prognosis
Nephrolithiasis and Urolithiasis
Clinical Findings
History
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Wilms Tumor
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education, Prevention, and Prognosis
Common Genitourinary Conditions in Males
Hypospadias
Clinical Findings
History
Management
Complications
Patient and Family Education, Prevention, and Prognosis
Cryptorchidism (Undescended Testes)
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Complications
Patient and Family Education, Prevention, and Prognosis
Hydrocele
Clinical Findings
History
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Spermatocele
Clinical Findings
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Varicocele
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education, Prevention, and Prognosis
Inguinal Hernia
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education, Prevention, and Prognosis
Testicular Masses
Clinical Findings
History
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Phimosis and Paraphimosis
Clinical Findings
History
Management
Patient and Family Education, Prevention, and Prognosis
Balanitis and Balanoposthitis
Clinical Findings
Management
Patient and Family Education, Prevention, and Prognosis
Scrotal Trauma
Clinical Findings
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Testicular Torsion
Clinical Findings
History
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
Torsion of the Appendix Testis
Clinical Findings
Differential Diagnosis
Management
Epididymitis
Clinical Findings
History
Differential Diagnosis
Management
Patient and Family Education, Prevention, and Prognosis
References
Additional Resources
36 Gynecologic Disorders
Standards of Care
Anatomy and Physiology
Puberty
Menstrual Cycle
The Follicular Phase
Ovulation
The Luteal Phase
Luteal-Follicular Transition
Pathophysiology and Defense Mechanisms of the Gynecologic System
Assessment of the Gynecologic System: Health Supervision Visits for Female Adolescents
History
Physical Examination
Prepubertal Child
Adolescent
Diagnostic Studies
Cervical Cancer Screening
Management Strategies
Anticipatory Guidance, Counseling, and Education
Adolescent Pregnancy Prevention
Contraception
Contraceptive Counseling and Education
Initial Screening to Assess for Appropriate Contraception
History
Hormonal Methods of Contraception (Coitus-Independent Methods)
Oral Contraceptive Pills
Other Methods of Hormonal Contraception
Barrier Methods of Contraception (Coitus-Dependent Methods)
Condoms
Diaphragm
Female Condom
Less Useful Contraceptive Methods for Adolescents
Specific Gynecologic Conditions of Children
Labial Adhesions
Clinical Findings
History
Differential Diagnosis and Complications
Management
Patient and Family Education
Vulvovaginitis
Clinical Findings
History
Differential Diagnosis
Management
Prepubertal Nonspecific Etiology
Bacterial Infection
Complications
Patient and Family Education, Prognosis, and Prevention
Normal Gynecologic Variations
Mittelschmerz
Clinical Findings
History and Physical Examination
Differential Diagnosis
Management
Dysmenorrhea
Clinical Findings
History
Differential Diagnosis
Management
Primary Dysmenorrhea
Secondary Dysmenorrhea
Patient and Family Education and Prevention
Adolescent Pregnancy
Clinical Findings
History
Differential Diagnosis
Management and Education
Complications
Specific Gynecologic Problems of Adolescents
Breast Concerns: Mastalgia, Cysts, and Fibrocystic Changes
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Amenorrhea
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Abnormal Uterine Bleeding
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Mild Abnormal Uterine Bleeding
Severe Abnormal Uterine Bleeding
Complications
Patient and Family Education and Prognosis
Endometriosis
Clinical Findings
History
Differential Diagnosis
Management
Complications
Prognosis and Prevention
Vaginitis and Vaginal Discharge
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education, Prognosis, and Prevention
Sexually Transmitted Infections
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Complications
Patient Education and Family Education
Pelvic Inflammatory Disease
Clinical Findings
History
Differential Diagnosis
Management
Complications
Prevention
References
Additional Resources
37 Dermatologic Disorders
Anatomy and Physiology
Pathophysiology and Defense Mechanisms
Special Dermatologic Considerations in Children with Dark Skin or from Diverse Cultural or Ethnic Groups
Cutaneous Reaction Patterns
Normal Variations and Common Problems
Cultural or Ethnic Practices with Skin Sequelae
Assessment of the Skin and Subcutaneous Tissue
History
Physical Examination
Diagnostic Studies
Management Strategies
Hydration and Lubrication
Bathing
Environmental Considerations
Skin Care Agents
Soaps, Oils, and Colloids
Wet Dressings
Occlusive Dressings
Other Considerations
Sunscreens and Sunblocks
Medications
General Considerations
Antibacterial Agents
Antifungal Agents
Antiviral Agents
Antiacne Agents
Anti-Inflammatory Agents
Antipruritic Agents
Topical Calcineurin Inhibitors
Scabicides and Pediculicides
Hair and Scalp Preparations
Patient and Family Education
Bacterial Infections of the Skin and Subcutaneous Tissue
Impetigo
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Complications
Patient and Family Education
Cellulitis
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
Folliculitis and Furuncle
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Complications
Patient and Family Education
Fungal Infections of the Skin
Candidiasis (Moniliasis)
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Complications
Patient and Family Education
Tinea Capitis
Tinea Corporis
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
Tinea Cruris
Clinical Findings
History
Differential Diagnosis
Management
Tinea Pedis
Clinical Findings
History
Differential Diagnosis
Management
Complications
Tinea Versicolor
Clinical Findings
History
Differential Diagnosis
Management
Patient and Family Education
Viral Infections of the Skin
Herpes Simplex
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Complications
Patient and Family Education
Herpes Zoster
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
Molluscum Contagiosum
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
Warts
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
Infestations of the Skin
Pediculosis
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
Scabies
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
Allergic and Inflammatory Reactions of the Skin
Acne Vulgaris
Clinical Findings
History
Differential Diagnosis
Management
Complications
Atopic Dermatitis
Contact Dermatitis
Clinical Findings
History
Differential Diagnosis
Management
Diaper Dermatitis
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Complications
Seborrheic Dermatitis
Clinical Findings
History
Differential Diagnosis
Management
Complications
Drug Eruptions
Clinical Findings
History
Physical Examination
Diagnostic Studies
Differential Diagnosis
Management
Complications
Patient and Family Education
Vascular Reactions of the Skin
Urticaria and Angioedema
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
Erythema Multiforme, Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
Papulosquamous Eruptions of the Skin
Pityriasis Rosea
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Patient and Family Education
Psoriasis
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
Lichen Striatus
Clinical Findings
History
Differential Diagnosis
Management
Patient and Family Education
Keratosis Pilaris
Clinical Findings
History
Differential Diagnosis
Management
Patient and Family Education
Congenital Lesions of the Skin
Vascular and Pigmented Nevi
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management
Complications
Patient and Family Education
Cutaneous Manifestations of Underlying Disease
Acanthosis Nigricans
Clinical Findings
Differential Diagnosis
Management
Patient and Family Education
Lentigines
Other Common Dermatologic Issues in Pediatrics
Vitiligo and Hypopigmentation Disorders
Clinical Findings
History
Differential Diagnosis
Management
Complications
Hair and Nail Disorders
Tinea Capitis
Clinical Findings
History
Diagnostic Studies
Differential Diagnosis
Management
Complications
Patient and Family Education
Traumatic Alopecia
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
Alopecia Areata
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
Onychomycosis
Clinical Findings
History
Differential Diagnosis
Management
Patient and Family Education
Paronychia
Clinical Findings
History
Differential Diagnosis
Management
Body Art
Tattoos and Body Piercing
Clinical Findings
History
Differential Diagnosis
Management
Complications
Patient and Family Education
References
Additional Resources
38 Musculoskeletal Disorders
Anatomy and Physiology
Pathophysiology and Defense Mechanisms
Pathophysiology
Systemic Problems
Genetic Problems
Intrauterine Compression Deformations
Injuries
Defense Mechanisms
Fracture Healing
Growth Plate Fractures
Shaft Fractures
Assessment of the Orthopedic System
History
Physical Examination
Inspection and Palpation
Range of Motion Examination
Gait Examination
Posture
Special Examinations
Hip Examinations
Galeazzi Maneuver
Barlow Maneuver
Ortolani Maneuver
Klisic Test
Trendelenburg Sign
Medial (Internal) and Lateral (External) Rotations
Back Examination
Adams Test or the Adams Forward Bend Test
Diagnostic Studies
Management Strategies
Counseling
Anticipatory Guidance: Musculoskeletal Development
Shoes
Care of Children in Casts and Splints
Physical and Occupational Therapy
Orthopedic Problems Specific to Children
Arm Problems
Annular Ligament Displacement
Clinical Findings
Complications
Brachial Plexus Injuries
Clinical Findings
Shoulder Problems
Clavicle Fracture
Clinical Findings
Rib Problems
Costochondritis and Sternochondritis
Clinical Findings
Differential Diagnosis
Back Problems
Back Pain
Clinical Findings
Scoliosis
Clinical Findings
Differential Diagnosis
Idiopathic Scoliosis
Complications
Kyphosis
Management
Lumbar Lordosis
Management
Hip Problems
Developmental Dysplasia of the Hip
Clinical Findings
Complications
Legg-Calvé-Perthes Disease
Clinical Findings
Differential Diagnosis
Slipped Capital Femoral Epiphysis
Clinical Findings
Femoral Anteversion
Clinical Findings
Knee Problems
Genu Varum
Clinical Findings
Genu Valgum
Clinical Findings
Differential Diagnosis
Osgood-Schlatter Disease
Clinical Findings
Tibial Torsion
Clinical Findings
Complications
Popliteal Cysts
Clinical Findings
Knee Injuries
Foot Problems
Pes Planus
History
Patient Education
Metatarsus Adductus
Clinical Findings
Talipes Equinovarus
Clinical Findings
Overriding Toes
In-Toeing and Out-Toeing Rotational Problems
Clinical Findings
Other Common Musculoskeletal System Findings Needing Attention
Toe Walking
Clinical Findings
History
Management
Ganglions of the Hands
Clinical Findings
Management
Leg Aches of Childhood
Clinical Findings
History
Differential Diagnosis
Management
Limps
Clinical Findings
History
Differential Diagnosis
Management
Overuse Syndromes of Childhood and Adolescence
Clinical Findings
History
Differential Diagnosis
Management
Muscle Diseases
Clinical Findings
History
Physical Examination
Management
References
Additional Resources
39 Perinatal Disorders
Standards of Care
Anatomy and Physiology
Pathophysiology
High-Risk Pregnancy
Acquired Health Problems
Genetic Problems
Perinatal Complications and Injuries
Assessment of the Neonate
History
Physical Examination
Immediately After Birth
Apgar Score
Lungs
After Stabilization
Diagnostic Studies
Management Strategies
Initial Care
Establishing Feeding
Anticipatory Guidance Before Discharge
Physical Care
Umbilical Cord
Bathing, Oils, and Powders
Early Discharge and Follow-up
Premature Infants and Newborns with Special Needs
Common Neonatal Conditions
Skin Conditions
Milia
Sebaceous Hyperplasia
Erythema Toxicum
Transient Neonatal Pustular Melanosis
Sucking Blisters
Cutis Marmorata
Harlequin Color Change
Mongolian Spots, Café au Lait Spots, Salmon Patch (Nevus Simplex), and Port-Wine Stain (Nevus Flammeus, Port-Wine Nevus)
Nevus Sebaceous
Skin Dimpling
Preauricular Sinus Tracts and Pits
Amniotic Constriction Bands
Supernumerary Nipples
Branchial Cleft and Thyroglossal Cysts and Sinuses
Head, Face, and Eye Conditions
Caput Succedaneum
Clinical Findings
Cephalhematoma
Clinical Findings
Craniotabes
Clinical Findings
Cleft Lip and Palate
Clinical Findings
Congenital Cataracts, Glaucoma, and Retinopathy of Prematurity
Cardiac Conditions
Respiratory Conditions
Respiratory Distress Syndrome
Clinical Findings
Management, Prognosis, and Prevention
Transient Tachypnea of the Newborn
Clinical Findings
Meconium Aspiration Syndrome
Clinical Findings
Management, Prognosis, and Prevention
Gastrointestinal and Abdominal Conditions
Esophageal Atresia and Tracheoesophageal Fistula
Clinical Findings
Duodenal Atresia
Clinical Findings
Volvulus
Clinical Findings
Pyloric Stenosis
Clinical Findings
Hirschsprung Disease (Congenital Aganglionic Megacolon)
Clinical Findings
Differential Diagnosis
Imperforate Anus
Clinical Findings
Omphalocele and Gastroschisis
Clinical Findings
Necrotizing Enterocolitis
Clinical Findings
Meconium Ileus
Clinical Findings
Diaphragmatic Hernia
Clinical Findings
Management and Prognosis
Hydrocele and Inguinal Hernia
Umbilical Hernia
Clinical Findings
Renal Conditions
Acute Renal Failure
Clinical Findings
Management and Prognosis
Hydronephrosis
Clinical Findings
Cystic Kidney Disease
Clinical Findings
Renal Artery or Vein Thrombosis
Clinical Findings
Neuroblastoma
Clinical Findings
Renal Agenesis
Clinical Findings
Endocrine Conditions
Congenital Hypothyroidism and Congenital Adrenal Hyperplasia
Metabolic Conditions
Hypoglycemia
Clinical Findings
Infant of a Diabetic Mother
Clinical Findings
Orthopedic Conditions
Fractured Clavicle and Brachial Palsy
Polydactyly and Syndactyly
Clinical Findings
Central Nervous System Conditions
Congenital Hydrocephalus
Clinical Findings
Intraventricular Hemorrhage
Clinical Findings
Hypoxic-Ischemic Insults
Clinical Findings
Myelomeningocele
Clinical Findings
Management, Prognosis, and Prevention
Hematologic Conditions
Polycythemia
Clinical Findings
Hemorrhagic Disease in the Newborn
Clinical Findings
Anemia
Clinical Findings
Blood in Vomitus or Stool
Clinical Findings
Jaundice
Clinical Findings
Management and Prevention
Infections of the Newborn
Toxoplasmosis
Clinical Findings
Congenital Rubella
Clinical Findings
Cytomegalovirus
Clinical Findings
Group B Streptococcus
Clinical Findings
Differential Diagnosis
Listeriosis
Clinical Findings
Congenital Varicella
Clinical Findings
Sexually Transmitted Infections
Gonorrhea
Clinical Findings
Chlamydia
Clinical Findings
Syphilis
Clinical Findings
Herpes Simplex Virus
Clinical Findings
Human Immunodeficiency Virus
Neonatal Abstinence Syndrome
Cocaine (Crack) Exposure
Clinical Findings
Heroin and Methadone Exposure
Clinical Findings
Fetal Alcohol Syndrome
Sudden Infant Death Syndrome and Apparent Life-Threatening Events
Clinical Findings
History
Physical Examination
Differential Diagnosis
Management and Prevention
References
Additional Resources
40 Common Injuries
Principles of Injury Control
Approach to Trauma
Common Pediatric Injuries
Trauma to the Skin and Soft Tissue
Abrasions
Description and Epidemiology
Puncture Wounds
Description and Epidemiology
Differential Diagnosis
Patient and Parent Education
Ingrown Toenail and Nail Hematoma
Description and Epidemiology
Lacerations
Description and Epidemiology
Assessment
Patient and Parent Education
Burns
Description and Epidemiology
Assessment
Differential Diagnosis
Patient and Parent Education
Contusions and Hematomas
Description and Epidemiology
Bites and Stings
Animal and Child Bites
Description and Epidemiology
Complications
Hymenoptera
Description and Epidemiology
Differential Diagnosis
Mosquitoes, Fleas, and Chiggers (Red Bug or Harvest Mites)
Description and Epidemiology
Assessment
Ticks
Description and Epidemiology
Assessment
Spiders and Scorpions
Description and Epidemiology
Differential Diagnosis
Snakebites
Description and Epidemiology
Management
Heat and Cold Injuries
Frostbite
Description and Epidemiology
Patient and Parent Education
Hypothermia
Description and Epidemiology
Patient and Parent Education
Hyperthermia: Common Heat-Related Illness
Description and Epidemiology
Differential Diagnosis
Motor Vehicle Trauma
Description and Epidemiology
References
Additional Resources
41 Genetics Disorders
Basic Principles of Genetics
Deoxyribonucleic Acid
Chromosomes
Genes
Mutations
Point Mutations
Nucleotide Repeat Expansions
Copy Number Variations
Chromosome Mutations
Genetic Disorders
Monogenetic Disorders
Chromosome Disorders
Multifactorial Disorders
Teratogens
Mitochondrial Disorders
Patterns of Inheritance
Terminology
Mendelian Inheritance Patterns
Autosomal Dominant
Autosomal Recessive
X-Linked Inheritance
X-Linked Dominant
X-Linked Recessive
Nontraditional Inheritance Patterns
Mitochondrial Inheritance
Codominant Inheritance
Genomic Imprinting
Uniparental Disomy
Epigenetics
Genetic Implications for Pediatric Primary Care
Assessment
Family Health History and Pedigree
Three-Generation Pedigree
Genetic Red Flags from the History
Physical Findings Indicating Genetic Disorders
Minor and Major Anomalies
Diagnostic Studies
Screening
Newborn Screening
Prenatal Screening
Diagnostic Genetic Testing
Carrier Testing
Other Testing
Primary Care Management of Children with Genetic Disorders
Genetics Referral
Primary Care for Children with Genetic Disorders
Ethical Issues
References
Additional Resources
Resources for Newborn Screening
Resources to Hone Physical Assessment Skills
42 Environmental Health Issues
Principles for Understanding Children’s Environmental Health
Children’s Increased Risk for Environment-Related Illness
The Dynamics of Environmental Health Hazards
Epidemiologic Model: Assessment of Risk
Toxicologic Principles
Exposure
Absorption
Distribution
Metabolism
Tissue Sensitivity
Toxic Effects
Primary Care Approach to Children’s Environmental Health
Clinical Findings
History
Physical Examination
Diagnostic Studies
Management of Environmental Conditions
Common Environmental Agents and Adverse Effects
General Pediatric Poisoning
Clinical Findings
History
Differential Diagnosis
Management
Patient and Family Education
Heavy Metals
Lead
Clinical Findings
Patient and Family Education
Mercury
Clinical Findings
Management
Arsenic
Clinical Findings
Management
Ambient Air Pollution: Indoor and Outdoor
Environmental Tobacco Smoke
Clinical Findings
Carbon Monoxide
Clinical Findings
Radon
Clinical Findings
Management
Particulate Matter
Clinical Findings
Ammonia
Volatile Organic Compounds
Molds
Clinical Findings
Asbestos
Clinical Findings
Hypochlorites, Pesticides, Endocrine Disruptors, and Noise
Sodium and Calcium Hypochlorite: Laundry Detergent
Pesticides
Clinical Findings
Endocrine Disruptors
Polychlorinated Biphenyls
Phthalates
Noise
Clinical Findings
References
Additional Resources
43 Complementary Health Therapies in Pediatric Primary Care
Standards and Guidelines
Complementary Therapies Used in Infants, Children, and Adolescents
Why Parents Seek Complementary Therapies for Their Children
Patient Disclosure about Use of Complementary and Alternative Medicine
Moving toward an Integrated Health Care Model in Pediatrics
Increasing Acceptance of Integrative Health Care
Scientific Observation and Complementary Medicine
Media Marketing of Complementary Medicine
Integrating Complementary Medicine into a Primary Care Practice
Common Principles of Integrative Care
Talking with Patients about the Use of Complementary and Alternative Medicine
Role of Diet in a Complementary Practitioner’s Approach
Safety and Regulatory Issues
Safety and Efficacy of Dietary Supplements
Professional Oversight
Continuing Education Opportunities
Specific Complementary Therapies for Children and Adolescents
References
Additional Resources
Index
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