The Harriet Lane Handbook: The Johns Hopkins Hospital, 23rd Edition

Description

Every three years, The Harriet Lane Handbook is carefully updated by residents, edited by chief residents, and reviewed by expert faculty at The Johns Hopkins Hospital. Easy to use, concise, and complete, this essential manual keeps you current with new guidelines, practice parameters, pharmacology, and more. The 23rd Edition of this portable reference continues to be the most widely used and most recognized pediatric reference worldwide―an indispensable resource for pediatric residents, students, nurses, and all healthcare professionals who treat young patients. Trusted for 70 years for fast, accurate information on pediatric diagnosis and treatment. New audio case files: Listen to residents and faculty at The Johns Hopkins Hospital discuss case studies and healthcare disparities based on topics from this bestselling book. The popular and comprehensive Pediatric Drug Formulary, updated by Carlton K. K. Lee, PharmD, MPH, provides the latest in pharmacologic treatment of pediatric patients. Outline format ensures you’ll find information quickly and easily, even in the most demanding circumstances. An eBook version is included with purchase. The eBook allows you to access all of the text, figures and references, with the ability to search, customize your content, make notes and highlights, and have content read aloud. Audio Case Studies: Listen to residents and faculty at The Johns Hopkins Hospital discuss Case Studies and Healthcare Disparities based on topics from this best-selling book! Est. 30-50 audio cases Est. 20-minutes each 2-4 participants (mix of interns, residents, faculty), conversation-style Scripts will be written ahead of time and submitted so we can use as transcripts Possibly Videos: Editor team is discussing possibly adding videos around procedures/acute care chapters. Using their simulation center, their thoughts are to show process of inserting an oropharyngeal airway or how to do a head tilt/chin lift, showing a monitor that displays pulsus paradoxus) Front Cover IFC Pediatric Parameters and Equipment Title Page The Harriet Lane Handbook, 23rd edition Copyright Dedication Preface Contents I - PEDIATRIC ACUTE CARE 1. Emergency and Critical Care Management I. Approach to the Unresponsive Child A Circulation1-3,5-11 B Airway and Breathing1,7,8,13-19 II. Management of Shock3,5,7,12,13 A Definition: Physiologic state characterized by inadequate oxygen and nutrient delivery to meet tissue demands B Etiology: Categorized into four basic types: C Management III. Management of Common Emergencies A Anaphylaxis20 B Upper Airway Obstruction C Status Asthmaticus26-31 D Pulmonary Hypertensive Crisis13,32 E Hypertensive Crisis13,33 F Pulmonary Embolism34 G Hypercyanotic Crisis (“Tet Spell”)22,35 H Altered Level of Consciousness22,36 I Status Epilepticus37-38 J Increased Intracranial Pressure39-41 IV. Critical Care Reference Data References References 2. Traumatic Injuries I. Components of the Trauma Assessment A Primary Survey B Secondary Survey (Fig. 2.1) C Labs/Workup to Consider in the Emergent Setting II. Head and Neck Trauma A Head Imaging B Cervical Spine and Neck Imaging C Specific Imaging Studies III. Concussion A Concussion Evaluation B Return-to-School and Return-to-Play Guidelines (Table 2.1) IV. Intrathoracic, Abdominal, and Pelvic Trauma16 A Assessment and Management Pearls B Imaging Studies to Consider V. Limb and Long Bone Trauma16 A Assessment and Management Pearls B Imaging C Traumatic Fractures in Children D Fractures Requiring Urgent Orthopedic Surgeon Consultation E Fractures That Are Appropriate to Manage Acutely With Outpatient Referral to Orthopedics (Table 2.2) VI. Dental Trauma A Components of a Tooth (Fig. 2.4) B Differences Between Primary and Permanent Teeth (Fig. 2.5) C Dental Injuries D Anticipatory Guidance Following Dental Trauma VII. Ophthalmologic Trauma16 A Chemical Injury to the Eye B Ruptured Globe C Corneal Abrasion D Eyelid Glued Shut due to Cyanoacrylate (Superglue) E Eyelid Laceration F Orbital Floor Fractures G Other Instances Requiring Ophthalmologic Consultation VIII. Animal Bites16 A Risk of Infection and Antibiotic Prophylaxis B Physical Exam Assessment C Imaging D Decision to Suture and Infection Risk IX. Burns27,28 A First Aid and Emergency Management B Other Special Considerations With Burns X. Nonaccidental Trauma16 A Physical Abuse B Sexual Abuse32 References References Color Plates Chapter 2 3. Toxicology I. Initial Evaluation A History B Workup and Laboratory Investigation C Clinical Diagnostic Aids: Table With Clinical Signs and Possible Intoxicants (eTable 3.1) II. Toxidromes III. Ingestions and Antidotes A Decontamination B Enhanced Removal C Other Considerations IV. Acetaminophen Overdose8 A Four Phases of Intoxication B Treatment Criteria C Antidote: N-Acetylcysteine (See Formulary in Chapter 30) D Consider Referral to Liver Transplant Center if Patient Meets King’s College Criteria V. Lead Poisoning9 A Definition B Sources of Exposure C Overview of Symptoms by Blood Lead Level D Management VI. Web Resources References References 4. Procedures I. General Guidelines A Consent B Documentation C Risks D Attending to the Needs of a Fearful Child2 II. Ultrasound for Procedures2a A Introduction to Ultrasound B Ultrasound Basics III. Neurologic Procedures: Lumbar Puncture3-5 A Indications B Complications C Cautions and Contraindications D Procedure E A video on lumbar punctures is available on the New England Journal of Medicine’s website IV. Otolaryngologic Procedures A Cerumen Impaction Removal6,7 B Foreign Body Removal From Ear3,8 C Foreign Body Removal From Nose9,10,3 D Management of Epistaxis9,11 V. Cardiovascular procedures A Vagal Maneuvers for Supraventricular Tachycardia (SVT)12-14 B Heelstick and Fingerstick15 C Peripheral Intravenous Access15 D External Jugular Puncture and Catheterization (See Section XI [Online Content]) F Intraosseous (IO) Access3,4,17 (Fig. 4.4) G Umbilical Artery and Umbilical Vein Catheterization3,18 VI. Pulmonary Procedures A Use of Metered-Dose Inhalers and Spacers9 B Needle Cricothyrotomy9,19 C Needle Thoracostomy3,20 D Bag-Valve-Mask Ventilation21,22 E Endotracheal intubation: Please refer to Chapter 1 VII. Gastrointestinal Procedures A Nasogastric Tube Placement3,9,23 B Gastrostomy Tube Replacement3,9,24 VIII. Genitourinary Procedures A Urinary Bladder Catheterization9,25 B Suprapubic Bladder Aspiration3,4 IX. Musculoskeletal Procedures A Basic Splinting3 B Selected Splints and Indications (Fig. 4.8) C Radial Head Subluxation (Nursemaid’s Elbow) Reduction26,27 D Finger/Toe Dislocation Reduction3 E Knee Arthrocentesis3 F Hematoma Blocks28 X. Skin/Dermatologic Procedures A Immunization and Medication Administration9,29 B Basic Laceration Repair3,9 C Incision and Drainage (I&D) of Abscess3 D Tuberculin Skin Test Placement37 E Tick Removal38,39 References XI. Online Content A Ultrasound-Guided Lumbar Puncture B External Jugular Puncture and Catheterization3 References II - DIAGNOSTIC AND THERAPEUTIC INFORMATION 5. Adolescent Medicine I. Theory of Adolescence/Introduction II. Structural Factors Impacting Adolescents and Their Health A Examples B Role Clinicians Can Play5 III. Confidentiality A Consent Laws B Breach of Confidentiality C Documentation and Billing IV. Health Maintenance Elements Unique to the Adolescent Patient A History (HEEADSSS Assessment) and Screenings15 B Physical Examination Elements Unique to the Adolescent46,47 V. Sexual Health A Sexually Transmitted Infection Screening Guidelines by Sexual Behaviors15,52-55 B Sexually Transmitted Infection Evaluation and Management (Tables 5.5 to 5.7)52 C Contraception60,61 D Pregnancy92,93 VI. Transitioning Adolescents into Adult Care94 VII. Web Resources A Websites for Clinicians B Websites for Patients References References 6. Analgesia and Procedural Sedation I. Types of Pain A Definition B Types of Pain: Table 6.1 II. Pain Assessment A Infant5 B Preschooler C School-Age and Adolescent D Children With Significant Neurological Impairment (SNI)4 III. Analgesics5 A Medications to Avoid in Children B Nonopioid Analgesics C Opioids (Table 6.5) D Local Anesthetics14–17 E Nonpharmacologic Measures of Pain Relief19,20 IV. Patient-Controlled Analgesia (PCA) A Definition B Indications C Routes of Administration D Agents (Table 6.8) E Adjuvants F Side Effects of Opioid Patient-Controlled Analgesia V. Opioid Tapering A Indications B Withdrawal C Recommendations for Tapering VI. Procedural Sedation5,14–17,25–27 A Definitions B Preparation C Monitoring31 D Pharmacologic Agents E Discharge Criteria26 F Examples of Sedation Protocols (Table 6.12 and eTable 6.1) VII. Web Resources References References 7. Cardiology I. Physical Examination A Heart Rate B Blood Pressure C Heart Sounds D Systolic and Diastolic Sounds E Murmurs II. Electrocardiography A Basic Electrocardiography Principles B ECG Abnormalities C ECG Findings Secondary to Electrolyte Disturbances, Medications, and Systemic Illnesses (Table 7.8)5,7 D Long QT E Hyperkalemia III. Congenital Heart Disease A Pulse Oximetry Screening for Critical Congenital Heart Disease B Common Syndromes Associated With Cardiac Lesions (Table 7.9) C Acyanotic Lesions (Table 7.10) D Cyanotic Lesions (Table 7.11) IV. Acquired Heart Disease A Myocardial Infarction (MI) in Children (Box 7.4; Fig. 7.9) B Endocarditis C Bacterial Endocarditis Prophylaxis D Myocardial Disease E Pericardial Disease F Kawasaki Disease17 G Multisystem Inflammatory Syndrome in Children H Rheumatic Heart Disease V. Imaging A Chest Radiograph (Fig. 7.11) B Echocardiography (eTable 7.3) VI. Procedures A Cardiac Surgery (Fig. 7.12, Table 7.12) B Cardiac Catheterization9,10 (Table 7.13) VII. Common Cardiac Complaints A Nontraumatic Chest Pain18 B Syncope19 VIII. Exercise Recommendations for Patients with Congenital Heart Disease IX. Lipid Monitoring Recommendations A Screening of Children and Adolescents28 B Goals for Lipid Levels in Childhood28 X. Cardiovascular Screening A Sports29,30 B Attention–Deficit/Hyperactivity Disorder (ADHD)31 XI. Web Resources References References 8. Dermatology I. Evaluation and Clinical Descriptions of Skin Findings A Primary Skin Lesions B Secondary Skin Lesions C Shapes and Arrangements II. Vascular Anomalies1 A Vascular Tumors B Vascular Malformations III. Infections A Viral B Parasitic C Fungal (Figs. 8.15 to 8.19, Color Plates) D Bacterial IV. Hair Loss (Fig. 8.22, Color Plates ) A Telogen Effluvium B Alopecia Areata C Traction Alopecia (Fig. 8.22, Color Plates) D Trichotillomania and Hair Pulling V. Acne Vulgaris A Pathogenetic Factors B Risk Factors C Clinical Presentation D Treatment14-16 (Table 8.2) VI. Common Neonatal Dermatologic Conditions (Fig. 8.21; Figs. 8.23 To 8.30, Color Plates) A Erythema Toxicum Neonatorum (Fig. 8.23, Color Plates) B Transient Neonatal Pustular Melanosis (Figs. 8.24 to 8.25, Color Plates) C Miliaria (Heat Rash) (Fig. 8.26, Color Plates) D Milia (Fig. 8.27, Color Plates) E Neonatal Acne (Fig. 8.28, Color Plates) F Seborrheic Dermatitis (Figs. 8.29 to 8.30, Color Plates) G Congenital Dermal Melanocytosis H Diaper Dermatitis19 VII. Autoimmune and Allergic Dermatologic Conditions (Figs. 8.32 To 8.38, Color Plates) A Contact Dermatitis B Atopic Dermatitis (Eczema) (Figs. 8.33 to 8.36, Color Plates) C Papular Urticaria (Fig. 8.37, Color Plates) D Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis VIII. Nail Disorders28 IX. Disorders of Pigmentation29 X. Rashes of Unknown or Inflammatory Etiology References XI. Online Content A Autoimmune and Allergic Lesions References Color Plates Chapter 8 9. Development, Behavior, and Developmental Disability I. Developmental Definitions1,2 A Developmental Streams B Developmental Quotient C Abnormal Development II. Guidelines for Normal Development and Behavior A Developmental Milestones B Age-Appropriate Behavioral Issues in Infancy and Early Childhood: See Table 9.2 III. Developmental Screening and Evaluation of Developmental Disorders A Developmental Screening and Screening Guidelines B Commonly Used Developmental Screening and Assessment Tools: See Table 9.3 C Identification of Developmental “Red Flags”: See Table 9.4 D Evaluation of Abnormal Development IV. Specific Disorders of Development A Overview B Intellectual Disability (ID) C Communication Disorders D Learning Disability9 E Cerebral Palsy (CP) F Autism Spectrum Disorder (ASD) G Attention Deficit/Hyperactivity Disorder (ADHD): See Chapter 24 V. Longitudinal Care of Children with Developmental Disorders and Disabilities A Interdisciplinary Involvement B Relevant Laws and Regulation C Head Start and Early Head Start VI. Transitions from Pediatric to Adult Care for Youth with Developmental Disabilities A The Need B The Role of the Pediatric Provider C Transition Domains VII. Social Determinants of Health and Adversity Significantly Impact Child Development, Attainment of Developmental Milestones, ... A Social Determinants of Health (SDOHs) B Adverse Childhood Experiences (ACEs) E Relationship Between Adversity and Resilience F Diversity and Equity in Adversity and Resilience VII. Web Resources References References 10. Endocrinology I. Diabetes A Diagnosis of Diabetes Mellitus1-3 B Definition of Increased Risk (Prediabetes) C Interpreting Hemoglobin A1c1,2 D Etiology: Distinguishing Between Types of Diabetes Mellitus1,2 E Screening for Type 2 Diabetes Mellitus1,6 F Additional Testing in New-Onset Diabetes G Management of Diabetes6-8 H Diabetes Management Devices9 I Monitoring6,8-10 J Diabetic Emergencies11,12 II. Thyroid Gland13-15 A Thyroid Tests14,16,17 B Hypothyroidism C Hyperthyroidism III. Parathyroid Gland and Vitamin D22-24 A Parathyroid Hormone Function B Distinguishing Between Abnormalities Related to Parathyroid Hormone and Vitamin D C Vitamin D Supplementation IV. Adrenal Gland25-29 A Adrenal Insufficiency B Adrenal Cortex Hormone Excess29 C Adrenal Medulla Hormone Excess: Pheochromocytoma32-34 V. Disorders of Sodium and Water Regulation35 A Distinguishing Between Disorders of Sodium and Water Regulation: See Table 10.16 B Correction of Hypo- and Hypernatremia: See Chapter 11 D Interpretation of Water Deprivation Test Results: See Table 10.17 E Differentiating Between Central Versus Nephrogenic Causes of Diabetes Insipidus VI. Growth35-37 A Assessing Height B Short Stature VII. Sexual Development39-45 A Puberty B Lab Evaluation C Polycystic Ovarian Syndrome48 D Ambiguous Genitalia49 E Cryptorchidism50 VIII. Neonatal Hypoglycemia Evaluation51,52 A Definition B Treatment Goals C Management D Further Workup E Interpretation of Results F Hyperinsulinemia IX. Additional Normal Values X. Web Resources References References 11. Fluids and Electrolytes I. Introduction II. Fluid Resuscitation A Calculating Maintenance Fluid Volume B Calculating Fluid Loss C Maintenance Fluid Choice in Hospitalized Children D Volume Replacement Strategy9,15,16 III. Fluid Removal A Diuretics B Indications for Acute Dialysis: Please refer to Chapter 19, Section IX. IV. Electrolyte Management A Serum Osmolality and Tonicity2,9,17 B Sodium C Potassium D Calcium E Magnesium F Phosphate V. Algorithm for Evaluating Acid-Base Disturbances9,20,21 A Determine the pH. B Calculate the anion gap (AG). C Calculate the delta gap (DG).20 D Calculate the osmolal gap. E Calculate expected compensatory response (Table 11.14). F Determine the likely etiology. G If there is not appropriate compensation, consider an additional acid-base derangement (Fig. 11.2). References References 12. Gastroenterology I. Gastrointestinal Emergencies A Gastrointestinal Bleeding B Acute Abdomen4 II. Conditions of the Gastrointestinal Tract A Vomiting B Gastrointestinal Reflux Disease5 C Eosinophilic Esophagitis8,9 (EOE) D Celiac Disease11 E Inflammatory Bowel Disease13,14 F Constipation22,23 G Diarrhea24 III. Conditions of the Liver A Liver Laboratory Studies: Table 12.6 B Acute Liver Failure30,31 C Nonalcoholic Fatty Liver Disease32 D Hyperbilirubinemia33-35 IV. Pancreatitis36-38 A Acute Pancreatitis39 B Chronic Pancreatitis40,41 V. Web Resources References References 13. Genetics: Metabolism and Conditions With Distinctive Appearance I. Metabolism1-8 A Clinical Presentation of Metabolic Disease (Box 13.1) B Evaluation C Categories of Metabolic Disorders D Management of Metabolic Crisis E Commonly Used Medications II. Newborn Metabolic Screening7 A Timing B Abnormal Result C Results Affected by Transfusion III. Dysmorphology7,11-14 A History B Family History C Physical Examination D Workup: Tailor to individual patient and existing information, including effective chart review, prior genetic testing, and ... IV. Patterns of Genetic Conditions with Distinctive Appearance11,14 A Cardiac Conditions B Ciliopathies C Cleft Lip and Palate (CLP) D Connective Tissue Disorders E Developmental Delay, Intellectual Disability F Deafness, Hard of Hearing G Hypotonia H Limb and Stature Conditions I Liver Disease J Oncologic Conditions19 K Overgrowth L Conditions Associated With Seizures M Skin Pigmentation Alterations N Vascular Anomalies V. Etiologies of Dysmorphic Features (FIG. 13.4)11,14,29 A Aneuploidy B Copy Number Variation (Deletions and Duplications) C Disorders of Methylation/Epigenetics D Repeat Expansion E Mendelian/Single Gene Disorders F Teratogen Exposure (Table 13.10) G In utero Forces25 VI. Consent and Disclosure of Genetic Testing A Ethics of Genetic Testing in Pediatrics B Informed Consent C Professional Disclosure of Familial Genetic Information D Disclosure of Incidental Findings VII. Web Resources A Specific Genetic Disorders B Guidelines for Genetic Conditions C Molecular Testing Resources D Teratogen Evaluation References VIII. Online Content A Patterns of Inheritance References 14. Hematology I. Anemia A Screening for Anemia B Definition of Anemia C Causes of Anemia D Evaluation of Anemia E Management of Anemia II. Erythrocytosis12,48 A Definition of Erythrocytosis B Causes of Erythrocytosis C Evaluation of Erythrocytosis D Management of Erythrocytosis III. Neutropenia A Definition of Neutropenia B Causes and Evaluation of Neutropenia11 C Management of Neutropenia IV. Leukocytosis12 A Definition of Leukocytosis B Causes of Neutrophilia C Causes of Eosinophilia D Causes of Monocytosis E Causes of Basophilia V. Thrombocytopenia and Impaired Platelet Function A Definition of Thrombocytopenia B Bleeding Risk With Thrombocytopenia C Evaluation of Thrombocytopenia15,16 D Causes of Thrombocytopenia and Impaired Platelet Function E Management of Thrombocytopenia VI. Thrombocytosis12 A Definition of Thrombocytosis B Causes of Thrombocytosis C Evaluation of Thrombocytosis D Management of Thrombocytosis VII. Coagulation A Evaluation of Coagulation and Platelet Function B Definition of Abnormal Coagulation C Causes and Management of Coagulopathy D Causes of Hypercoagulability E Thrombus Management VIII. Blood Component Replacement A Calculating Estimated Blood Volume (Table 14.17) B Indications for and Expected Response Following Blood Transfusions C Diagnosis and Management of Transfusion Reactions (Table 14.19) D Infectious Risks of Blood Transfusion IX. Additional Resources C Anemia Algorithm App: Created for Adult Patients but Provides Useful Framework for Anemia Differential References X. Online Content A Specific PRBC Types B Directed-Donor Transfusions References 15. Immunology and Allergy I. Allergic Rhinitis1-6 A Epidemiology B Diagnosis C Differential Diagnosis D Management II. Food Allergy7-18 A Epidemiology B Diagnosis (Fig. 15.1) C Differential Diagnosis D Management E Natural History F Prevention III. Drug Allergy19-21 A Definition B Diagnosis C Management (Fig. 15.2) IV. Immunodeficiency22-27 A Clinical Presentation B Evaluation (Table 15.2) V. Immunoglobulin Therapy28-34 A Intravenous Immunoglobulin (IVIG) B Intramuscular Immunoglobulin (IMIG) C Subcutaneous Immunoglobulin D Specific Immunoglobulins E Vaccination Timing VI. Immunologic Reference Values A Serum IgG, IgM, IgA, and IgE Levels (Table 15.3) B Serum IgG, IgM, IgA, and IgE Levels for Low Birth Weight Preterm Infants (Table 15.4) C Lymphocyte Enumeration (Table 15.5) D Serum Complement Levels (Table 15.6) 16. Immunoprophylaxis I. Common Types of Vaccines Administered to Children1 A Inactivated Vaccines B Live, Attenuated Vaccines C Subunit, Recombinant, Polysaccharide, and Conjugate Vaccines D Toxoid Vaccines E mRNA Vaccines2,3 II. Immunization Schedules A Routine Vaccines for Children in the United States B Nonroutine Vaccines for Children in the United States6 III. Immunization Guidelines A Vaccine Informed Consent B Vaccine Administration C Live, Attenuated Vaccines D Timing and Spacing of Vaccine Doses E Contraindications and Precautions IV. Postexposure Prophylaxis (Table 16.5) V. Special Patient Populations9 A Altered Immunocompetence10,11 B Disease-Specific Considerations C Preterm Infants D Pregnant Women E Immigration, Emigration, and Travel VI. Counseling and Communication About Vaccines22-34 A Vaccine Hesitant versus Vaccine Refusal33 B Countering Vaccine Hesitancy26 VII. Web Resources35-40 References VIII. Online Content A Additional Vaccine Information B The 3C Model: Key Barriers to Vaccine Use Worldwide22 C Provider Resources for Vaccine Communication: See eBox 16.2. References 17. Microbiology and Infectious Disease I. Common Neonatal and Pediatric Infections: Guidelines for Diagnosis and Initial Management A Congenital, Perinatal, and Neonatal Infections (Table 17.1) B Pediatric Infections by System (Table 17.2) C Pediatric Viral Illnesses (Table 17.3) D Pediatric Tickborne Diseases (Table 17.4) E Pediatric Parasitic Infections (Table 17.5) F Pediatric Fungal Infections (Table 17.6) G Febrile Infants H Tuberculosis: Diagnosis and Treatment2,3 I Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome6 II. Microbiology A Collection of Specimens for Blood Culture B Rapid Microbiologic Identification of Common Aerobic Bacteria (Fig. 17.4) and Anaerobic Bacteria (Fig. 17.5) III. Antibiotic Therapy And Stewardship A Spectra of Activity for Commonly Used Antibiotics (Fig. 17.6) References B. Antibiotic Stewardship C. Resistance in Common Organisms IV. Exposures to Bloodborne Pathogens and Prophylaxis A General Practice23 B Disease-Specific Postexposure Management References 18. Neonatology I. Newborn Resuscitation A Algorithm for Neonatal Resuscitation (Fig. 18.1) B Endotracheal Tube Size and Depth of Insertion (Table 18.1) C Vascular Access (See Chapter 4 for Umbilical Venous/Artery Catheter Placement) II. Routine Newborn Care of a Term Infant A General Care for the Full-Term Healthy Newborn With Uncomplicated Delivery B Prior to Discharge6 III. Newborn Assessment A Vital Signs and Birth Weight B APGAR Scores (Table 18.2) C Gestational Age Estimation D Birth Trauma E Selected Anomalies, Syndromes, and Malformations (see Chapter 13 for genetic disorders) IV. Fluids, Electrolytes, and Nutrition A Fluids B Glucose C Electrolytes, Minerals, and Vitamins D Nutrition V. Cyanosis in the Newborn A Differential Diagnosis B Evaluation VI. Respiratory Diseases A General Respiratory Considerations B Respiratory Distress Syndrome (RDS) C Persistent Pulmonary Hypertension of the Newborn (PPHN) D Transient Tachypnea of the Newborn E Pneumothorax VII. Apnea and Bradycardia A Apnea B Bradycardia Without Central Apnea VIII. Cardiac Diseases A Patent Ductus Arteriosus B Cyanotic Heart Disease (See Chapter 7) IX. Hematologic Diseases A Unconjugated Hyperbilirubinemia in the Newborn15,16 B Conjugated Hyperbilirubinemia (See Chapter 12) C Polycythemia X. Gastrointestinal Diseases A Necrotizing Enterocolitis B Bilious Emesis C Abdominal Wall Defects (Table 18.10) D Gastroesophageal Reflux Disease (See Chapter 12) XI. Neurologic Diseases A Neonatal Hypoxic-Ischemic Encephalopathy B Intraventricular Hemorrhage C Periventricular White Matter Injury24 D Neonatal Seizures (See Chapter 20) E Neonatal Abstinence Syndrome26 F Peripheral Nerve Injuries XII. Urologic Disorders A Lower Urinary Tract Obstruction B Bladder Exstrophy-Epispadias-Cloacal Exstrophy Complex XIII. Retinopathy of Prematurity29 A Definition B Etiology C Diagnosis D Timing of Screening30 E Classification F Management29-30 XIV. Commonly Used Medications in the Neonatal Intensive Care Unit XV. Web Resources References XVI. Prenatal Assessment of Fetal Health A Fetal Anomaly Screening B Fetal Health C Estimation of Gestational Age References 19. Nephrology I. Urinalysis1: See Table 19.1 II. Kidney Function Tests A Tests of Glomerular Function B Tests of Kidney Tubular Function III. Blood Pressure (BP) and Chronic Hypertension6-11 A Definition B Measurement of Blood Pressure in Children C Etiologies of Hypertension in Neonates, Infants, and Children (Table 19.7) D Evaluation of Chronic Hypertension E Classification and Treatment of Hypertension (Table 19.8) F Antihypertensive Drugs for Outpatient Management of Primary Hypertension in Children 1 to 17 Years of Age IV. Urinary Tract Infections12-17 A History B Physical Examination C Risk Factors D Methods of Urine Collection E Diagnosis F Classification G Imaging H Treatment of Culture-Positive Urinary Tract Infection V. Proteinuria19-21 A Definitions B Methods of Detection C Etiologies (Box 19.1) D Evaluation20 E Nephrotic Syndrome21 VI. Hematuria19,24 A Definition B Etiologies: See Table 19.11 C Evaluation (Fig. 19.2) D Management (Fig. 19.3) VII. Acute Kidney Injury25,26 A Definition B Etiology (Table 19.12) C Clinical Presentation D Acute Tubular Necrosis E Treatment Considerations F Complications G Radiographic Imaging Considerations in AKI/CKD VIII. Chronic Kidney Disease32,33 A Definition B Etiology C Clinical Manifestations (Table 19.14) D General Management IX. Dialysis34-36 A Indications for Acute Dialysis B Techniques C Complications (Table 19.15) X. Tubular Disorders A Renal Tubular Acidosis (Table 19.16)37 B Fanconi Syndrome C Nephrogenic Diabetes Insipidus XI. Nephrolithiasis38-44 A Risk Factors B Presentation C Diagnostic Imaging D Management E Workup F Prevention XII. Web Resources References References 20. Neurology I. Neurologic Examination A Mental Status: Alertness, Orientation (Person, Place, Time, Situation), Language, Cognition B Cranial Nerves (eTable 20.1) C Motor D Sensory E Reflexes F Coordination and Gait II. Neurologic Emergencies A Stroke1-4 B Status Epilepticus and Breakthrough Seizures C Encephalopathy7-10 D Hydrocephalus with Increased Intracranial Pressure11-13 E Weakness F Ataxia19,20 III. Chronic Or Gradually Progressive Conditions A Headaches21-33 B Seizures5,6,34-48 C Neuromuscular Disorders49-57 D Functional Neurologic Disorders (FNDs)59-62 IV. Web Resources References References 21. Nutrition and Growth I. Assessment of Growth A Types of Growth Charts B Interpretation of Growth Charts9,10 C General Guidelines Regarding Appropriate Growth12,13 II. Management of Overweight and Obese Children A AAP Recommendations for the Prevention of Obesity14-16 B Prevention and Management of Obesity in the Primary Care Setting (Table 21.1) C Conditions Associated With Obesity14 III. Malnutrition in Infants and Children A Defining Malnutrition15 B Classifying the Degree to Which a Patient Is Malnourished (Table 21.2)16 C Resources for Determining Z-scores17 D Differential Diagnosis of Malnutrition18 E Physical Exam Findings Consistent With Malnutrition19-21 F Diagnostic Evaluation of Malnutrition23-26 G Red Flags That Suggest a Medical Cause of Malnutrition27 H Approach to the Management of Malnourished Patients28,29 (Box 21.1) IV. Re-Feeding Syndrome A Patients at Risk of Developing Re-feeding Syndrome19 B Management of Re-feeding Syndrome20 V. Nutritional Needs of Healthy Children A Dietary Allowances for Carbohydrates and Protein (Table 21.3) B Fat Requirements (Table 21.4) C Vitamin Requirements (Tables 21.5 and 21.6) D Mineral Requirements (Table 21.7) E Fiber Requirements (Table 21.8) VI. Breastfeeding and the Use of Human Milk A Benefits of Breast Milk31 B Contraindications to Breastfeeding31 (Box 21.2) C Use of Milk Bank Donor Human Milk32 D Safe Handling of Breast Milk33 E Breastfeeding Resources VII. Enteral Nutrition A Feeding the Healthy Infant B Available Formulas for Patients With Specific Clinical Conditions or for Those Requiring Special Diets (Tables 21.12 and 21.13) C Use of Enteral Tube Feeds35 D Features of the Most Common Oral Rehydration Solutions (Table 21.14) VIII. Parenteral Nutrition A Indications for the Use of Parenteral Nutrition36-38 B Starting and Advancing Parenteral Nutrition (Table 21.15) C Frequency of Monitoring Growth Parameters and Laboratory Studies in Patients on Parenteral Nutrition (Table 21.16) D Recommended Formulations of Parenteral Nutrition (Table 21.17) IX. Web Resources A Professional and Government Organizations B Infant and Pediatric Formula Company Websites C Breastfeeding Resources References References 22. Oncology I. Nonspecific Symptoms in the Primary Care Setting (TABLE 22.1)1,2 II. Pediatric Hematologic Malignancies (TABLE 22.2)3-4 III. Pediatric Solid Tumor Malignancies (TABLE 22.3)3-4 IV. Pediatric Central Nervous System (CNS) Tumors3-4,7-10 (TABLE 22.4) A Epidemiology B Clinical Presentation C Initial Workup D Management Principles V. Oncologic Emergencies4,11-18,19 A Fever and Neutropenia (Fig. 22.1) B Hyperleukocytosis/Leukostasis C Tumor Lysis Syndrome D Spinal Cord Compression E Increased Intracranial Pressure (ICP) F Other Neurologic Emergencies: Cerebrovascular Accident (CVA), Seizures G Superior Vena Cava Syndrome/Superior Mediastinal Syndrome H Typhlitis (Neutropenic Enterocolitis) I Cytokine Release Syndrome (CRS) VI. Commonly Used Chemotherapeutic Drugs, Associated Acute and Long-Term Toxicities (TABLE 22.5) VII. Common Chemotherapy Complications and Supportive Care3,13 A Cytopenias: Anemia, Thrombocytopenia, Neutropenia B Mucositis C Nausea and Emesis VIII. Antimicrobial Prophylaxis in Oncology Patients20-22 (TABLE 22.7) IX. Hematopoietic Stem Cell Transplantation (HSCT) (Also Called Bone Marrow or Stem Cell Transplantation)3,4,23 A Goal B Preparative Regimens C Types of HSCT D Engraftment X. Complications of HSCT3,4,23-26 A Graft-Versus-Host Disease (GVHD) B Sinusoidal Obstructive Syndrome (SOS); Previously Known as Venoocclusive Disease (VOD) XI. Cancer Survivorship5,27-29 A Understand the Diagnosis B Monitoring A. Vaccinations in Oncology and HSCT Patients: See Chapter 16 XII. Fertility Preservation30 A. Resources for Patients and Families XIII. Web Resources References XIV. Online Content A Complications of HSCT3,4,22-24,29-35 References 23. Palliative Care I. Introduction to Hospice and Palliative Medicine A Definition of Palliative Care1,2 B Definition of Hospice C Concurrent Care for Children3 D Team Composition E Timing of Palliative Care Consults II. Communication and Decision-Making A Decision-Making Tools4 B Structuring Family Meetings5 C Breaking Bad News6 D Other Tools for Difficult Conversations III. Care of the Dying Child A Limiting Interventions B Involving the Child in Conversations About Death9-12 C Outpatient Care D Supporting Patients Throughout the Dying Process13-16, 22 E Pronouncing Death17 F Explaining Autopsies18 G Organ Donation H Completing Death Certificates17 I Interacting with Loved Ones After a Child’s Death IV. Web Resources 24. Psychiatry I. Overview A General Approach B Mental Status Exam C Behavioral Interventions II. Postpartum Depression A Diagnosis B Epidemiology C Evaluation D Management III. Common Psychiatric Conditions of Children and Adolescents A Attention-Deficit/Hyperactivity Disorder (ADHD) B Oppositional Defiant Disorder (ODD) C Anxiety Disorders D Depressive and Mood Disorders E Eating Disorders F Substance Use Disorders IV. Psychiatric Emergencies A Suicide B Aggression or Impulsivity26,27 V. Web Resources 25. Pulmonology and Sleep Medicine I. Evaluation of Pulmonary Gas Exchange A Pulse Oximetry1-3 B Capnography4,5 C Blood Gases6-8 D Analysis of Acid–Base Disturbances9-11 II. Pulmonary Function Tests (PFT) A Peak Expiratory Flow Rate (PEFR)12,13 B Maximal Inspiratory and Expiratory Pressures14,15 C Spirometry (for Children ≥6 Years)16,17 III. Asthma12-13,19 A Definition B Clinical Presentation C Treatment D Prevention of Exacerbations19 IV. Bronchiolitis20-27 A Definition B Clinical Presentation C Treatment V. Bronchopulmonary Dysplasia (BPD)28-33 A Definition B Clinical Presentation C Diagnosis D Treatment VI. Cystic Fibrosis (CF)34-46 A Definition B Clinical Manifestations (Fig. 25.9) C Diagnosis (Fig. 25.10) D Treatment VII. Obstructive Sleep Apnea Syndrome (OSAS)47-53 A Definition B Clinical Presentation C Diagnosis D Treatment VIII. Infant and Child Sleep53-54 A Sleep Duration B Sleep-Related Infant Death55-58 IX. Brief Resolved Unexplained Event (BRUE)58-59 A Definition B Differential Diagnosis C Management X. Web Resources References XI. Online Content A Evaluation of Pulmonary Gas Exchange B Asthma C Childhood Sleep Disorders44,45 26. Radiology I. General Pediatric Principles A Use Imaging Judiciously B Terminology II. Choosing the Right Study III. Head A Head Trauma B CSF Shunt Malfunction C Orbital Cellulitis IV. Neck and Airway A Normal Anatomy B Cervical Spine Trauma C Classic Findings of Upper Airway Conditions on Conventional Radiographs D Foreign Body E Tracheoesophageal Fistula and Esophageal Atresia F Vascular Rings, Aortic Arch Variants, and Pulmonary Sling V. Chest A Normal Anatomy (Fig. 26.4 and eFig. 26.6) B Pulmonary Infections C Neonatal Lung Disease D Mediastinal Masses VI. Heart VII. Abdomen A Normal Abdominal X-Ray and Bowel Gas Pattern B Pneumoperitoneum (Free Intraperitoneal Air) C Neonatal Enterocolitis (NEC, see Chapter 18) D Neonatal Intestinal Obstruction E Pyloric Stenosis F Intussusception G Ileus H Bowel Obstruction I Appendicitis J Esophageal Foreign Bodies K Abdominal Trauma L Gallbladder Disease M Pancreatitis VIII. Genitourinary Tract A Urinary Tract Infection B Nephrolithiasis/Urolithiasis C Testicular Pathology D Ovarian Pathology E Congenital Hydronephrosis IX. Musculoskeletal A Fractures and Trauma B Osteomyelitis C Hip Disorders D Scoliosis E Bone Lesions F Skeletal Survey in Suspected Nonaccidental Trauma X. Confirming Tube Placement and Line Insertion A Central Venous Catheter B Umbilical Lines (Fig. 26.12) C Nasogastric Tube D Nasoduodenal Tube E Endotracheal Tube XI. Web Resources 27. Rheumatology I. Brief Overview of Clinical Characteristics of Rheumatologic Diseases A Juvenile Idiopathic Arthritis (JIA)1-4 B Systemic Lupus Erythematosus (SLE)1,2,7-10 C Drug-Induced SLE11 D Neonatal SLE12-14 E Vasculitis1,2,15,16 F Sarcoidosis2,26,27 G Scleroderma2,28 H Sjögren Syndrome2,29 I Juvenile Dermatomyositis (JDM)2,30 J Other Rheumatologic Disorders2,31,32 K Multisystem Inflammatory Syndrome in Children (MIS-C)33-35 II. Interpretation of Lab Studies Used In The Diagnosis and Monitoring of Rheumatologic Disorders1 A Acute Phase Reactants: Indicate presence of inflammation when elevated. Elevation is nonspecific and can result from trauma ... B Autoantibodies (See Table 27.3 for Association With Rheumatologic Diseases)36,39-43 C Complement: The complement system is composed of a series of plasma proteins and cellular receptors that function together ... III. Medications: Mechanisms of Action, Toxicities, and Recommended Surveillance2 (SEE TABLE 27.4) IV Primary Care Management of Rheumatologic Diseases54-57 A. Vaccination (See Chapter 16) B Weight Management C Bone and Skin Health D Reproductive Health E Ophthalmologic F Laboratory Monitoring References References III - REFERENCE 28. Blood Chemistry and Body Fluids I. Reference Values II. Evaluation of Body Fluids A Evaluation of Cerebrospinal Fluid: See Table 28.2. B Evaluation of Urine: See Table 28.3. C Evaluation of Transudate/Exudate: See eTable 28.1. D Evaluation of Synovial Fluid: See eTable 28.2. III. Conversion Formulas A Temperature B Length and Weight References References 29. Biostatistics and Evidence-Based Medicine I. Biostatistics and Evidence-Based Medicine (EBM)1-3 II. Biostatistics and Epidemiology A Statistical Tests B Statistical Terminology C Types of Study Designs9 (see Table 29.2) D Measurement of Disease Occurrence and Treatment Effects5 E Measurements of Test Performance5 III. Web Resources A Evidence-Based Resources B Biostatistics and Epidemiology Resources References References IV - FORMULARY 30. Drug Dosages I. Note to Reader II. Sample Entry III. Explanation of Breastfeeding Categories IV. Explanation of Pregnancy Categories V. Nomogram and Equation for Body Surface Area VI. Drug Index References 31. Drugs in Kidney Failure I. Dose Adjustment Methods A Maintenance Dose B Dialysis C Glomerular Filtration Rate Estimation II. Antimicrobials Requiring Adjustment in Kidney Failure III. Non-Antimicrobials Requiring Adjustment in Kidney Failure References References Index A B C D E F G H I J K L M N O P Q R S T U V W X Y Z IBC