Burns' Pediatric Primary Care

Description

Get a comprehensive foundation in children’s primary care! Burns' Pediatric Primary Care, 7th Edition covers the full spectrum of health conditions seen in primary care pediatrics, emphasizing both prevention and management. This in-depth, evidence-based textbook is the only one on the market written from the unique perspective of the Nurse Practitioner. It easily guides you through assessing, managing, and preventing health problems in children from infancy through adolescence. Key topics include developmental theory, issues of daily living, the health status of children today, and diversity and cultural considerations. Updated content throughout reflects the latest research evidence, national and international protocols and standardized guidelines. Additionally, this 7th edition been reorganized to better reflect contemporary clinical practice and includes nine new chapters, revised units on health promotion, health protection, disease management, and much, much more! Four-part organization includes 1) an introductory unit on the foundations of global pediatric health, child and family health assessment, and cultural perspectives for pediatric primary care; 2) a unit on managing child development; 3) a unit on health promotion and management; and 4) a unit on disease management. UNIQUE! Reorganized Unit - Health Supervision: Health Promotion and Health Protection - includes health promotion and health protection for developmentally normal pediatric problems of daily living and provides the foundations for health problem management. UNIQUE! Reorganized Unit - Common Childhood Diseases/Disorders has been expanded to sharpen the focus on management of diseases and disorders in children. Comprehensive content provides a complete foundation in the primary care of children from the unique perspective of the Nurse Practitioner and covers the full spectrum of health conditions seen in the primary care of children, emphasizing both prevention and management. In-depth guidance on assessing and managing pediatric health problems covers patients from infancy through adolescence. UNIQUE! Practice Alertshighlight situations that may require urgent action, consultation, or referral for additional treatment outside the primary care setting. Content devoted to issues of daily living covers issues that are a part of every child's growth — such as nutrition and toilet training — that could lead to health problems unless appropriate education and guidance are given. Algorithms are used throughout the book to provide a concise overview of the evaluation and management of common disorders. Resources for providers and families are also included throughout the text for further information. Expert editor team is well-versed in the scope of practice and knowledge base of Pediatric Nurse Practitioners (PNPs) and Family Nurse Practitioners (FNPs). Cover Brief Content Title Page Burns’ Pediatric Primary Care Copyright Dedication Contributors Reviewers Preface Acknowledgments Contents Unit I Influences on Child Health and Child Health Assessment 1 - Health Status of Children: Global and National Perspectives Global Health Status of Children Progress on the Millennium Development Goals Sustainable Development Goals Health Status of Children in the United States Food and Housing Insecurity and Effect on Children’s Health 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 Access to Care Role of Primary Care Providers for Improving Child Health Health Promotion and Evidence-Based Clinical Preventive Services 2 - Unique Issues in Pediatrics Two-Generation or Dual Patient Looking Through a Developmental Lens Parents, Families, and Behavioral Economics Early Investment in Lifelong Health Health Literacy Transitioning to Adult Care 3 - Genetics and Genomics: The Basics for Child Health Basic Principles of Genetics Deoxyribonucleic Acid Chromosomes Genes Mutations Point Mutations Nucleotide Repeat Expansions Copy Number Variations Chromosome Mutations Genetics and Diseases Single Gene 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. When a disorder is classified as X-linked dominant, it means that a single abnormal gene on the X chromosome ... X-Linked Recessive. When a disorder is classified as X-linked recessive, it usually occurs in males (Fig 3.7). This pattern is s... Nontraditional Inheritance Patterns Mitochondrial Inheritance Codominant Inheritance Genomic Imprinting Uniparental Disomy Epigenetics Integration of Basic Genetics and Genomics into Pediatric Primary Care Assessment Family Health History and Pedigree Three-Generation Pedigree. The pedigree is a valuable visual record of genetic links and health-related information. It should i... Genetic Red Flags From the History. Genetic red flags indicate the potential for genetic risk. For some providers, it is easiest... Physical Findings Indicating Inherited or Congenital Disorders Minor and Major Anomalies Diagnostic Studies Screening Newborn Screening. Newborn screening is used to identify inherited and congenital disorders that can benefit from early diagnosi... Prenatal Screening. Screening and diagnostic tests to detect inherited and congenital disorders have become standard prenatal ca... Diagnostic Genetic Testing Carrier Testing Other Testing Ethical Issues 4 - Environment and Child Health Introduction Principles for Understanding Children’s Environmental Health Epidemiologic Model of Environmental Health Hazards: Assessment of Risk Principles of Toxicology Exposure Absorption Distribution Metabolism Tissue Sensitivity Toxic Effects Children’s Increased Risk for Environment-Related Illness Clinical Findings History Physical Examination and Clinical Findings Diagnostic Studies Approach to Management of Environmental Health Risks Ambient Air Pollution Outdoor Air Indoor Air Management of Outdoor and Indoor Air Pollution Endocrine Disruptors Climate Change Additional Resources 5 - Child and Family Assessment Child Assessment Assessment Basics Measurement Health Supervision, Surveillance, and Screening History and Physical Exam History Physical Exam Family Assessment Rethinking Family—Changing Composition Family Assessment—The Basics Assessing Family Composition/Structure Assessing the Family Lifecycle Assessing Family “Functioning” Assessing for Protective Factors Shared Decision-Making Additional Resources Bright Futures Strengthening Families 6 - Cultural Considerations for Pediatric Primary Care Culture Cultural Congruence Model The Provider Level of the Model The Client Level of the Model The System Level of the Model Best Practices for Providing Culturally Congruent Care Assessment Framework Relationship-Based Communication Immigrant Children, Refugees, and International Adoptees Overseas Health Assessment Domestic Health Assessment Mental Health Assessment Internationally Adopted Children Cultural Beliefs and Healing Practices Barriers to Health Care Access Language Barriers Primary Care Management Additional Resources 7 - Children With Special Health Care Needs Identifying the Population Levels of Complex Care Primary Care Subspecialty Care Tertiary Care Home-Care/Community Services Components of Care Technology Dependence and Medication Costs and Family Burden of Caring for Children With Special Health Care Needs Government Resources for Children With Special Health Care Needs Medicaid and Supplemental Security Income Durable Medical Equipment and Medicaid Reimbursement Community and School-Based Services Early Intervention and the Public School System Individual Education Plan and 504 Plan Care Coordination Health Issues for Primary Care Providers Strategies and Models to Improve Care for Children With Special Health Care Needs The Patient-Centered Healthcare Home Shared Plan of Care Supportive Care Needs for Children With Special Health Care Need Respite Care Support Groups and Services Transition of Care Legal Issues Additional Resources Patient-Centered Medical Home Letters of Medical Necessity Resources for Families Support Groups UNIT II Child Development 8 - Principles of Developmental Management of Children Developmental Principles Theories of Child Development 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) Psychoanalytic Theories: Personality and Emotions The Role of Social Interaction in Cognitive Development Behavioral Theories: Human Actions and Interactions Humanistic Theories Ecologic Theories Behavioral Economics Theories of Family and Parent Development Family Theories Parent Development Theory Cultural Influences on Development Management Strategies in Child Development Promoting Parent Development and Parent-Child Interaction: Anticipatory Guidance Family-Centered Care Concerns about Delayed Development and Developmental Red Flags Talking With Parents About Developmental Delays Additional Resources 9 - Developmental Management of Newborns Standards of Care Anatomy and Physiology Pathophysiology Assessment of the Neonate History Physical Examination After Stabilization Screening Management Strategies Initial Care Establishing Feeding Anticipatory Guidance Before Discharge Early Discharge and Follow-up Common Neonatal Conditions Skin Conditions Milia Sebaceous Hyperplasia Erythema Toxicum Transient Neonatal Pustular Melanosis Sucking Blisters Cutis Marmorata Harlequin Color Change Nevus Sebaceous Skin Dimpling Preauricular Sinus Tracts and Pits Supernumerary Nipples Head, Face, and Eye Conditions Caput Succedaneum Clinical Findings Differential Diagnosis Management Cephalohematoma Craniotabes Sudden Unexpected Infant Death Clinical Findings History Physical Examination Diagnostic Studies Differential Diagnosis Management and Prevention 10 - Developmental Management of Infants Infant Mortality Growth Weight Height Head Circumference Chest Circumference Vital Signs Maturation Body Systems Maturation Infant Development One Through Three Months Old Physical Development Gross and Fine Motor Skill Development Communication and Language Development Social and Emotional Development Cognitive Development Four Through Five Months Old Physical Development Gross and Fine Motor Skills Development Communication and Language Development Social and Emotional Development Cognitive Development Six Through Eight Months Old Physical Development Gross and Fine Motor Skills Development Communication and Language Development Social and Emotional Development Cognitive Development Nine Through Twelve Months Old Physical Development Gross and Fine Motor Skills Development Communication and Language Development Social and Emotional Development Cognitive Development Developmental Assessment of Infants Developmental Screening in Infants Periodic Wellness Visits The Prenatal Visit One Through Three Months Old Regulation and Sleep-Awake Patterns Strength and Motor Coordination Nutrition Communication and Language Social and Emotional Growth Cognitive and Environmental Stimulation Four Through Five Months Old Regulation and Sleep-Awake Patterns Strength and Motor Coordination Nutrition Communication and Language Social and Emotional Growth Cognitive and Emotional Stimulation Six Through Eight Months Old Regulation and Sleep-Wake Patterns Strength and Motor Coordination Nutrition 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 Nutrition Communication and Language Social and Emotional Growth Cognitive and Environmental Stimulation Common Developmental Issues for Infants and Families Sleep Nutrition Crying Postpartum Psychiatric Disorders Red Flags for Infant Development 11 - Developmental Management of Early Childhood Development of Early Childhood Physical Development Motor Skills Development Communication and Language Development Articulation Lexicon Syntax Semantics Bilingualism Social and Emotional Development Peer Relationships Morality 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 and Intellectual Development Anticipatory Guidance for Early Childhood Regulation and Sleep-Wake Patterns Strength and Motor Coordination Nutrition, Self-Care, and Safety Communication and Language Social and Emotional Growth Cognitive and Environmental Stimulation Common Developmental Issues in Early Childhood Sibling Rivalry Assessment Management Temper Tantrums Toilet Training Child Care and Preschools Child Care Preschool Safety Developmental Red Flags in Early Childhood Physical Disorders Cognitive Disorders Language Disorders 12 - Developmental Management of Middle Childhood Developmental Approach to Health Assessment and Health Promotion for Middle Childhood Physical Development History Physical Examination Anticipatory Guidance Gross and Fine Motor Development History Physical Examination Anticipatory Guidance Communication and Language Development History Physical Examination Anticipatory Guidance Cognitive Development History Physical Examination Anticipatory Guidance Social Development History Physical Examination Anticipatory Guidance Emotional Development History Physical Examination Anticipatory Guidance Developmental Assessment of Middle Childhood Nutrition Oral Health Sleep Safety Common Developmental Issues for Middle Childhood School Adjustment Learning Challenges School Refusal Management Overview of the Preventive Health Visit in Middle Childhood History Physical Examination Diagnostic Screening Anticipatory Guidance Developmental Red Flags for Middle Childhood 13 - Developmental Management of Adolescents and Young Adults Adolescent and Young Adult Development Physical Development Sexual Maturity Rating Psychosocial, Emotional, and Cognitive Development Influences on Psychosocial, Emotional, and Cognitive Development Principles of Behavior Changes Emotional Changes of Adolescence Developmental Screening and Assessment Principles and Approaches to Assessment 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 Assessment Management Risk Behavior: Tobacco Use Description Assessment Management Risk Behavior: Self-Injurious Behaviors Description Assessment Management Risk Behavior: Technology and Social Media Use Description Assessment Management UNIT III Child Health Supervision: Health Promotion and Health Protection 14 - Introduction to Health Promotion and Health Protection Pediatric Nurse Practitioners—Then and Now Pediatric Primary Care The Pediatric Medical Home/Neighborhood Bright Futures—Health Promotion and Preventive Care Initiative Primary Care Versus Primary Prevention SECTION A Behavioral-Mental Health Wellness 15 - Behavioral and Mental Health Promotion Mental Health Foundations Emotional Well-Being: The Foundation for Health, Behavior, and Learning Theories of Well-Being The Science of Early Childhood Development Concept 1: Responsive Relationships and Positive Experiences Build Strong Brain Architecture Concept 2: Adversity Disrupts the Foundations of ­Learning, Behavior, and Health Concept 3: Protective Factors in Early Years Strengthen Resilience Protective, Promotive, and Risk Factors Relationships and Attachment Safe, Stable, Nurturing Relationships Patterns of Attachment Temperament Family Assets Connectedness and Developmental Relationships Social-Emotional and Spiritual Development Resilience and Self-Regulation Spiritual and Moral Development Family and Community Influences on Mental Health of Children Parent Well-Being and Parenting Style Family Functioning and Dynamics Assessment of Mental Health Principles of Conducting a Psychosocial Assessment Approaches to Behavioral Assessment of Children of Different Ages Infants and Early Childhood School-Age Children and Adolescents History Relationship as a Vital Sign, and PRN The Symptom Analysis: Behavioral Manifestations Family Stress History Social-Emotional Development and Behavioral Screening Physical Examination and Diagnostic Studies Mental Health Management Strategies Mental Health Promotion Strategies to Build Relationships Strategies to Promote Family Functioning and Parenting Social and Emotional Strategies Prevent and Mitigate Effects of Stress Violence Prevention Counseling and Brief Evidence-Based Interventions Mindfulness Parent-Focused Interventions Collaborative Problem-Solving: The Nurtured Heart Motivational Interviewing Common Factors Intervention (HELP) Cognitive Behavioral Therapy Strategies Parent Training Models/Behavioral Therapies Referral and Follow-Up Behavioral Issues Difficulties in Relationship: Attachment and Parenting Style Management Social Difficulties: The Shy Child, the Fearful Child, the Child with Lack of Moral Integrity Management Emotional Difficulties: The Upset, Angry Child With Underdeveloped Coping Skills Management Bereavement—Loss and Grief Management Difficulties with Sensory Processing Management Recurrent Physical Symptoms Management Bullying Management Parenting Challenges and Special Circumstances Separation, Divorce, and Remarriage Management Deployment Management Adolescent Parent(s) Management Premature or Multiple Birth Management Adoption Management Foster Care Management SECTION B Biophysical Health Management 16 - Breastfeeding Breastfeeding Recommendations Hospital-Based Support Baby-Friendly Hospital Initiative Benefits of Breastfeeding Contraindications to Breastfeeding Special Situations Induced Lactation and Relactation Lactation Consultants Stages of Milk Production Colostrum Transitional Milk Mature Milk Characteristics of Human 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 and Cross Cradle Position Football Hold Side-Lying Position Physiologic Laid-back Position Ending a Feeding Session Dynamics of Breastfeeding Early Feedings Frequency and Duration of Feedings Hand Expression and 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 Complications Sore Nipples Clinical Findings Differential Diagnosis Management Severe Engorgement Clinical Findings Differential Diagnosis Management Mastitis Clinical Findings Differential Diagnosis Management Complications Nipple Preference Clinical Findings Differential Diagnosis Management Complications Breast Milk Jaundice Clinical Findings Differential Diagnosis Management Oral Candidiasis (Thrush) Poor Weight Gain Clinical Findings Infant Factors Technique Factors Maternal Factors Differential Diagnosis Management Complications 17 - Nutrition Pediatric Dietary Guidelines Nutritional Requirements and Dietary Reference Intakes Energy Water Electrolytes Sodium Potassium Chloride Macronutrients Protein Carbohydrates Fats Micronutrients Fat-Soluble Vitamins. Several characteristics of fat-soluble vitamins (A, D, E, and K) have implications for dietary assessment ... Water-Soluble Vitamins. In contrast to fat-soluble vitamins, water-soluble vitamins (C and B vitamins) are stored in very small ... 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 Habits Nutrition Education MyPlate, MyPlate for Kids, and SuperTracker Age-Specific Nutritional Considerations Newborns and Infants Energy. Rapid infant growth requires high caloric intake. Adequate intake of breast milk or infant formula meets all energy need... Fat. For proper myelination to occur, infants must have adequate fat intake. Children younger than 2 years old require more than... Vitamins. Vitamin D (400 IU daily) is recommended for all breastfed infants and infants who receive an unfortified formula from ... Iron. Iron deficiency is the leading cause of anemia in children, and iron supplements are necessary in some cases. Term infants... Fluoride. The American Dental Association (ADA) recommends fluoride treatment starting at 6 months old in nonfluoridated communi... Infant Formulas. Breast milk is the ideal food for newborns and infants and should be promoted unless it is medically harmful to... Gastroesophageal Reflux. All babies “spit up,” especially directly after a feeding or when burped. A small regurgitation of undi... Introduction of Solid Foods. Introduction of solid foods is recommended when the child is 6 months old. Development in a term in... Eating Habits. Feeding on demand in early infancy is important, and neonates should not be allowed to sleep for long periods of ... Early Childhood Energy and Protein. The growth rate in early childhood is slower than that of infants, resulting in decreased energy needs per u... Vitamin and Mineral Supplements. Vitamin D supplementation is recommended in early childhood for all children. Children who tole... Eating Habits. In early childhood, children learn how and what to eat by observing adults around them and by responding to the f... Middle Childhood Energy and Protein. Energy and protein needs of school-age children vary depending on body size, growth patterns, and activity l... Vitamin and Mineral Supplements. Poor eating habits and irregular meal schedules place school-age children at risk for deficienc... Eating Habits. Food likes and dislikes carry over from early childhood. There is great variation in appetite and intake as a res... Adolescents Energy and Protein. The rapid growth rate of adolescents is remarkable. High levels of energy are needed to support this growth,... Vitamin and Mineral Supplements. Thiamin, riboflavin, niacin, folate, iron, zinc, and calcium needs increase during adolescence.... Eating Habits. Eating habits of adolescents are influenced by their increasing independence and social activity, perceptions of ... Pregnancy in Adolescence. Nutrition for the pregnant teenager can be easily compromised and must be carefully monitored. Provide... Physical Activity Vegetarian and Vegan Diets Clinical Findings Management Altered Patterns of Nutrition in Children Disorders Requiring Increased Caloric Intake Disorders Requiring Decreased Caloric Intake Disorders Requiring Restricted or Supplemental Diets Disorders Requiring Physical Alterations in Diet Management Eating Disorders Childhood Obesity and Overweight Risk Factors and Predictors for Obesity Biologic Mechanisms. Insulin and leptin are two major hormones that normally serve to control satiety and influence weight. Resi... Physical Activity and Screen Time. Decreased physical activity is a factor in the increased prevalence of childhood overweight a... Psychosocial and Environmental Factors. Numerous psychosocial and environmental factors put children at risk for being overweigh... Food Addiction. Addictive-like eating behaviors may play a role in obesity and overweight, although more research needs to be do... Clinical Findings History. The history should review patterns of eating and exercise for both the child and the family system. Also consider under... Physical Examination. Perform a complete physical examination to determine child’s level of fitness and anthropometric status Diagnostic Studies Differential Diagnosis Management Lifestyle Changes. Initially, lifestyle changes with active involvement of the entire family and regular monitoring by the PCP (... Medications. Medications should be used only after an intensive, formal trial of lifestyle change has proven ineffective and the... Bariatric Surgery. The Pediatric Endocrine Society recommends bariatric surgery only for adolescents who meet the following crit... Community Changes. Individual and family interventions may not be sufficient to deal with the causes of obesity. For example, if... Complications Adverse Food Reactions Clinical Findings History. The history should assess the following Physical Examination. Signs and symptoms of adverse food reactions vary by type and severity, from a mild local reaction to life... Diagnostic Studies. A double-blind, placebo-controlled food challenge is recognized as the “gold standard” for determining the p... Differential Diagnosis Management Elimination Diet. The standard of practice is to avoid the offending food or foods. Efforts to eliminate the food from the diet ... Oral Immunotherapy. Oral immunotherapy (OIT) has shown promise as an effective treatment for food allergy and may raise the thre... Revisiting the Food Challenge. The child’s allergic status should be reevaluated at regular intervals. Food allergies and food i... Medication. Self-administered epinephrine is prescribed for children with moderate or severe allergies. Children, their parents,... Education. Education of families, children, and adults who are responsible for the child’s well-being is critical. The provider ... Complications Toxic Exposures in Foods Effect of Medications on Nutritional Status Controversies in Pediatric Nutrition Sugar Consumption Gluten-Free Diets 18 - Elimination Normal Patterns of Elimination: Bowel and Urinary Assessment of Patterns Health History Description of Current Status Birth and Early Infancy History Review of Systems Family History Environmental and Psychosocial Issues Physical Examination Diagnostic Studies Management Strategies for Normal Patterns Toileting Skills Elimination Communication Altered Patterns of Elimination: Bladder and Bowel Dysfunction 19 - 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 Strategies to Support Physical Activity for Children and Adolescents Health Care Providers’ Influence on Lifestyle Behaviors Counseling Families About Organized Sports for Their Children Early Specialization in Sports Strength Training Preseason Conditioning and Injury Prevention Intentional Weight Loss Considerations of Climate and Environment Heat and Humidity Dehydration Sports Training Acclimatization for Prevention of Heat-Related Illnesses Recreational Activities: Safety Issues Use of Helmets for Cycling and Winter Sports Performance Enhancing Nutrition and Supplements Macronutrients: Important for Sports Participation Protein Fats Nutritional Supplements Sports Drinks Versus Energy Drinks Energy Drinks Use of Ergogenic Drugs and Supplements Anabolic-Androgenic Steroids Androstenedione and Dehydroepiandrosterone Growth Hormone Creatine and Other Supplements Ephedra The Preparticipation Sports Physical Examination for Sports Medical Clearance and Liability Issues Components of the Preparticipation Physical Examination Health History Physical Examination Diagnostic Studies Evaluation and Management of Sports Participation for Athletes With Chronic Health 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 Hernia Absence of Paired Organs Musculoskeletal and Overuse or Traumatic Injuries Overuse Injuries in Baseball/Softball. Young baseball/softball throwers and pitchers are at particular risk of overuse injury or... Neck Injury Burners and Stingers Head Injury/Concussions Special Considerations for the Female Athlete Injuries and the Female Athlete The Female Athlete Triad 20 - Sleep Sleep-Wake Cycle and Health Electronic Devices and Sleep Problems American Academy of Pediatrics Recommendations to Promote Adequate Sleep in Children Electronic Device Recommendations Infant Recommendations Adolescent Recommendations Normal Sleep Stages and Cycles Circadian Rhythm and Establishment of Normal Sleep Patterns Sleep Cycle Nonrapid Eye Movement Sleep Stage 1 (NREM1 or N1) Stage 2 (NREM1 or N2) Stage 3 (NREM3 or N3) Rapid Eye Movement Sleep Sleep Patterns by Age Group Newborns Sudden Unexpected Infant Death Protective Factors for Infant Sleep Health Professional Strategies to Reduce Sudden Infant Death Syndrome Early Childhood 3 to 5 Years of Age Middle Childhood 5 to 12 Years of Age Adolescents Assessment of Sleep History Chief Complaint Past Medical History and Review of Symptoms Family Assessment Physical Examination Diagnostic Studies Sleep in Children With Developmental and Neurologic Conditions Anxiety ADHD Autism Strategies for Prevention and Management of Sleep Problems Sleep Hygiene Promotion and Medications Primary Care Interventions for Dyssomnias Common Sleep Problems Parasomnias Nonrapid Eye Movement Parasomnias Confusional Arousals Sleep Walking Night Terrors Rapid Eye Movement Parasomnias Assessment of Parasomnias History Treatment of Parasomnias Circadian Rhythm Disorders Delayed Sleep Phase Advanced Sleep Phase Inappropriate or Unpredictable Schedules Chronic Health Conditions and Dyssomnias Nocturnal Enuresis Restless Legs Syndrome and Periodic Limb Movements Clinical Findings and Treatment Head Banging and Bruxism Epilepsy and Sleep Sleep Disordered Breathing Clinical Findings Surgical and Medical Treatment of Sleep Disordered Breathing Central Sleep Apnea Narcolepsy 21 - Sexuality, Sex, and Gender Identity Standards Patterns of Sexuality Historical and Cultural Context of Sexuality Contemporary Definitions Developmental Stages/Patterns of Sexuality Infancy to 2 Years Old 2 to 5 Years Old 5 to 9 Years Old Preadolescence Adolescence Sexuality in Individuals With Intellectual and Physical Developmental Disabilities Factors That Can Alter Sexual Behaviors Assessment of Patterns of Sexual Development Confidentiality History Types of Sexual Histories Approach to Taking a Sexual History Physical Examination Management Strategies Setting the Stage Sexuality Education Counseling of the Adolescent Contraceptive and Safer Sex Counseling Special Counseling Needs Lesbian, Gay, Bisexual, and Transgender Youth Management and Complications SECTION C Health Protection–Focused Care 22 - Immunizations Vaccine Preventable Diseases Barriers to Vaccination Family and Community Barriers Healthcare Providers System Barriers Strategies to Improve Immunization Rates Community Strategies Individual Provider Strategies System Strategies Eliminating Vaccine Shortages Understanding Vaccines Live and Inactivated Vaccines Safety of Childhood Vaccines Adverse Reactions to Vaccines Vaccine Safety and Resources for Providers Immunization Schedules in the United States Inactivated Vaccines Inactivated Vaccines in Current Use Diphtheria-Tetanus-Acellular Pertussis Vaccine Polio Vaccine Haemophilus Influenzae Type B Vaccine Hepatitis A Virus Vaccine Hepatitis B Virus Vaccine Human Papillomavirus Vaccine Influenza Vaccine Meningococcal Vaccine Pneumococcal Vaccines Live Virus Vaccines Precautions Regarding Administration of Live Vaccines Measles-Mumps-Rubella and Measles-Mumps-Rubella-Varicella Vaccines Measles Vaccine Measles Exposure or Epidemics Mumps Vaccine Rubella Vaccine Varicella Vaccine When to Consider Postexposure Prophylaxis for Varicella Disease Measles, Mumps, Rubella, and Varicella Vaccine Rotavirus Vaccine Bacille Calmette-Guérin Vaccine Smallpox Vaccine Passive Immunity The Immunoglobulins Respiratory Syncytial Virus Prophylaxis 23 - Dental Health and Oral Disorders Dental Care Standards and Guidelines Normal Growth and Development 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 Atypical Tooth Eruption Preeruption Cysts Bohn Nodules Professional Dental Care Fear of the Dentist Choosing a Dentist First Dental Visit Dental Health Education Bacterial Diseases of the Mouth Tooth Decay Clinical Findings Management and Prevention Strategies Periodontal Diseases Gingivitis Aggressive Periodontitis Necrotizing Periodontal Disease Pyogenic Granuloma Viral Diseases of the Mouth Herpes Stomatitis Idiopathic Oral Conditions Ankyloglossia (Tongue-Tie) Aphthous Ulcers (Canker sores) Benign Migratory Glossitis (Geographic Tongue; Erythema Migrans) Bruxism/Grinding Dental Erosion Diastema Gingival Hyperplasia Halitosis (“Bad Breath”) Malocclusion Mucocele Pericoronitis Ranula Temporomandibular Joint Disorder (TMJ) Traumatic Injuries to Oral Structures Clinical Findings History Complications Patient/Family Education Lifestyle Choices That Affect Dental Health Oral/Intraoral Piercings and Tattoos Smokeless Tobacco and Betel Nut Use Tooth Whitening (Bleaching) Eating Disorders Dental Care for Children With Special Health Care Needs 24 - Injury Prevention and Child Maltreatment Unintentional Injuries Principles of Injury Control Common Injury Mechanisms and Injury Control Methods Motor Vehicle–Related Injuries Falls Drowning Fires/Burns Poisoning Intentional Injuries General Assessment Guidelines General Management Strategies Neglect Clinical Findings Differential Diagnosis Management Psychological Maltreatment Clinical Findings Differential Diagnosis Management Patient and Family Education and Prevention Physical Abuse Clinical Findings Diagnostic Studies Differential Diagnosis Management Patient and Family Education and Prevention Sexual Abuse, Assault, and Human Trafficking Clinical Findings Diagnostic Studies Differential Diagnosis Management Patient and Family Education and Prevention Violence Clinical Findings Management Youth Violence Prevention Intimate Partner Violence (Domestic Violence) Clinical Findings Management Patient Education and Prevention UNIT IV Common Childhood Conditions and Disorders SECTION A Introduction to Child Disease Management 25 - Key Concepts, Assessment, and Management of Children With Acute or Chronic Disease Key Concepts in Disease Management of Children Shared Decision-Making as Part of Child- and Family-Centered Care Health Literacy Health Care Education Considerations for Care of Children With Illnesses Parents as Observers of Illness Parent Management of Illness Working with Non–English-Speaking Families Medication, Complementary Therapies, Pain, and Fever Urgent Care and Emergency Department Utilization Primary Care for Chronically Ill Children Assessment and Management of Children with Acute or Chronic Illnesses History and Physical Examination Considerations about Diagnostic Studies Determining an Accurate Diagnosis Referral and Consultations National and Local Organizations and Resources Documentation of Patient Visit Telehealth Management of Illnesses Telephone Triage Systems Texting and Email Social Media Office Telephone and Electronic Messaging Policy 26 - Prescribing Medications in Pediatrics National Safety Goals Regarding Prescribing Medications Regulation and Safety of Pharmaceuticals Safety Issues With Pharmaceutical Manufacturers 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 27 - Complementary Medicine in Pediatric Primary Care With an Introduction to Functional Medicine Standards and Guidelines Use of Complementary Therapies by Children and Adolescents Scientific Studies of Complementary Medicine Therapies Integrating Complementary/Integrative and Functional Medicine into Pediatric Primary Care Common Principles of an Integrative Care Practice Model Common Principles of a Functional Medicine Care Practice Model Patient-Provider Communication Regarding the Use of Complementary Medicine Pharmacovigilance of Dietary Supplements and Botanicals Use of Aromatherapy Professional Oversight Common Complementary Therapies for Some Health Conditions Irritable Bowel Syndrome With Constipation and Diarrhea Attention-Deficit/Hyperactivity Disorder Headaches/Migraines Insomnia Depression/Anxiety/Obsessive Compulsive Disorder Common Cold/Upper Respiratory Infection and Influenza Otitis Media The Allergic Triad (Allergies/Atopic Dermatitis/Asthma) 28 - Pediatric Pain and Fever Management Pediatric Pain Management Pediatric Pain Management Overview of Pain Factors Influencing Pediatric Pain Management Physiological Psychosocial Barriers to Effective Pain Management Patient and Family Healthcare Providers Healthcare Systems Pain Assessment Pain History Physical Exam Focus Points Behavioral Indicators Physiologic Indicators Laboratory and Imaging Studies Management of Pediatric Pain Pharmacologic Considerations Procedural Pain Management Prior to Procedure During the Procedure After the Procedure Acute Pain Management Persistent Pain Management Partnership in Care Overview of Pediatric Fever Factors Influencing Pediatric Fever Management Fever Assessment History and Physical Exam Management of Pediatric Fever Fever as a Friend Non-Pharmacologic Measures Pharmacologic Measures Fever Without Focus in Infants and Young Children Clinical Findings Management Fever of Unknown Origin Clinical Findings History Physical Examination Diagnostic Studies Management SECTION B Disease Management 29 - Perinatal Conditions Pathophysiology High-Risk Pregnancy Acquired Health Problems Perinatal Complications and Injuries Immediately After Birth Premature/Special Needs Newborns Common Neonatal Conditions Skin & HEENT Amniotic Band/Constriction Syndrome Branchial Cleft and Thyroglossal Cysts and Sinuses Cleft Lip and Palate Clinical Findings Management and Complications HEENT Congenital Cataracts, Glaucoma, and Retinopathy of Prematurity (Chapter 35) Cardiac Conditions (Chapter 38) Transient Tachypnea of the Newborn Respiratory Conditions Neonatal Respiratory Distress Syndrome History and Clinical Findings Physical Examination Diagnostic Studies Management, Prognosis, and Prevention History and Clinical Findings Diagnostic Studies Management and Prognosis Meconium Aspiration Syndrome Clinical Findings Diagnostic Studies Management, Prognosis, and Prevention Gastrointestinal and Abdominal Conditions Esophageal Atresia and Tracheoesophageal Fistula Duodenal Atresia Malrotation With Volvulus Pyloric Stenosis Hirschsprung Disease (Congenital Aganglionic Megacolon) Imperforate Anus Omphalocele and Gastroschisis Necrotizing Enterocolitis Meconium Ileus Diaphragmatic Hernia Management and Prognosis Umbilical Hernia Genitourinary and Renal Conditions Hydrocele and Inguinal Hernia Acute Renal Failure Hydronephrosis Cystic Kidney Disease Renal Artery or Vein Thrombosis Neuroblastoma Renal Agenesis Endocrine Conditions Congenital Hypothyroidism and Congenital Adrenal Hyperplasia Metabolic Conditions Hypoglycemia Infant of a Diabetic Mother Hematologic Conditions Polycythemia Hemorrhagic Disease in the Newborn Anemia Blood in Vomitus or Stool Orthopedic Conditions Fractured Clavicle and Brachial Palsy Polydactyly and Syndactyly Central Nervous System Conditions Congenital Hydrocephalus Intraventricular Hemorrhage Hypoxic-Ischemic Insults Myelomeningocele Infections of the Newborn Toxoplasmosis Congenital Rubella Cytomegalovirus Group B Streptococcus Listeriosis Congenital Varicella Sexually Transmitted Infections Gonorrhea Chlamydia Syphilis Herpes Simplex Virus Human Immunodeficiency Virus Drug Exposure Neonatal Abstinence Syndrome Cocaine (Crack) Exposure Heroin and Methadone Exposure Fetal Alcohol Syndrome 30 - Neurodevelopmental, Behavioral, and Mental Health Disorders Assessment and Management of Behavioral Health Disorders Making Mental Health and Behavioral Diagnoses Management Strategies Common Behavioral Health Disorders Anxieties Anxiety Separation Anxiety Disorder Generalized Anxiety Disorder Obsessive-Compulsive Disorder Clinical Findings Differential Diagnosis Management Tic Disorders Clinical Findings and Diagnostic Studies Management Posttraumatic Stress Disorder Clinical Findings Differential Diagnosis Management Mood Disorders Depression Bipolar Disorder Attention-Deficit/Hyperactivity Disorder Definition and Diagnostic Criteria Clinical Findings and Assessment Management Follow-up and Referral Specific Learning Disorders Definition and Diagnostic Criteria Clinical Findings and Assessment Screening and Specialty Referral for Diagnosis Management Follow-up and Referral Intellectual disability and Global Developmental Delay Definition and Diagnostic Criteria Clinical Findings and Assessment Screening and Specialty Referral for Diagnosis Management Follow-up and Referral Aggression and Disruptive Behavior Disorders Social Aggression Conduct Disorder Oppositional Defiant Disorder Autism Spectrum Disorder Definition and Diagnostic Criteria Clinical Findings and Assessment Screening and Specialty Referral for Diagnosis Management Follow-up and Referral Eating Disorders Clinical Findings Differential Diagnosis Diagnostic Studies Management Complications Substance Abuse Disorder Clinical Findings Differential Diagnosis Diagnostic Studies Management 31 - Infectious Diseases Pathogenesis of Infectious Diseases Clinical Findings History Physical Examination Diagnostic Aids Laboratory and Imaging Studies Complete Blood Count Platelet Count 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 Infections in Children in Child Care Settings Specific Viral Diseases Enteroviruses Nonpolio Enteroviruses Clinical Findings Poliomyelitis Virus Hepatoviruses Hepatitis A Virus Clinical Findings Hepatitis B Virus Hepatitis C Virus Hepatitis D Virus Hepatitis E Virus Herpes Family of Viruses Herpes Simplex Virus Patient and Family Education Infectious Mononucleosis Syndrome Roseola Infantum (Exanthem Subitum) Varicella Clinical Findings Patient and Family Education Influenza Viral Infections Typical Influenza Highly Pathogenic Avian Influenza Other Viral Diseases Human Immunodeficiency Virus Measles (Rubeola) Clinical Findings. The clinical manifestations include Complications Mumps Erythema Infectiosum Parainfluenza Virus Rubella (German or 3-Day Measles) Mosquito-Borne Viruses Zika Virus West Nile Virus Dengue Virus 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 Ehrlichiosis and Anaplasmosis Rocky Mountain Spotted Fever Bacterial Infections Community-Acquired Methicillin-Resistant Staphylococcus aureus Other Emerging Drug-Resistant Bacterial Infections Cat-Scratch Disease Kingella kingae Infection Meningococcal Disease Streptococcal Disease Group A Streptococcus Non–Group A or B Streptococci Tuberculosis Clinical Findings Primary Pulmonary Tuberculosis Helminthic Zoonoses Toxocariasis The Child Presenting With Fever Fever Without Focus in Infants and Young Children Clinical Findings Management Fever of Unknown Origin Clinical Findings Infectious Agents Used in Bioterrorism 32 - Congenital and Inherited Disorders Genetics Referral Creating an Emergency Plan Primary Care for Children with Congenital and Inherited Disorders General Guidelines for Primary Care Providers Caring for Children With Congenital and/or Inherited Disorders 33 - Atopic, Rheumatic, and Immunodeficiency Disorders Pathophysiology and Defense Mechanisms Allergic and Atopic Disorders Rheumatic Disorders Immune Deficiency General Management Strategies Atopic Disorders Asthma Overview of Asthma Guidelines and Tools Clinical Findings 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. History, including an evaluation of risk factors, and characteristic clinical findings a... Differential Diagnosis Management Allergy Immunotherapy and Other Treatments Complications and Prognosis Patient and Parent Education and Prevention Atopic Dermatitis Clinical Findings Diagnostic Studies. The diagnosis of AD is based on characteristic clinical findings. A chronic or recurring rash that is prurit... Differential Diagnosis Management Pharmacotherapy Non-Pharmacological Therapy Other Therapies Environmental Management Dietary Management Complications and Prognosis Patient and Parent Education and Prevention Rheumatologic Disorders Juvenile Idiopathic Arthritis Clinical Findings Differential Diagnosis Management Complications and Prognosis Patient and Parent Education and Prevention Systemic Lupus Erythematosus Clinical Findings Differential Diagnosis Management Complications and Prognosis Juvenile Fibromyalgia Syndrome Clinical Findings Differential Diagnosis Management Prognosis Patient and Parent Education Clinical Finding History Physical Examination. Exam findings may be normal or painful lymph nodes may be present Diagnostic Studies 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 Management Primary and Secondary Prevention of Acute Rheumatic Fever Complications Pediatric Vasculitis Henoch-Schönlein Purpura Clinical Findings Differential Diagnosis Management Complications and Prognosis Kawasaki Disease Clinical Findings Differential Diagnosis Management Complications and Prognosis Pediatric Primary Immunodeficiency Disorders Physiology of the Immune System Primary and Secondary Immunodeficiency Disorders Clinical Presentation Management 34 - Dermatologic Disorders Anatomy and Physiology Pathophysiology and Defense Mechanisms Normal Variations and/or Common Skin Problems Assessment of the Skin and Subcutaneous Tissue History Physical Examination Diagnostic Studies Management Strategies Hydration and Lubrication Bathing and Moisturizers Other Considerations Dressings Wet Dressings Occlusive Dressings Sunscreens and Sunblocks Medications General Considerations Antibacterial Agents Antifungal Agents Antiviral Agents Anti-Inflammatory Agents Antipruritic Agents Calcineurin Inhibitors Scabicides and Pediculicides Hair and Scalp Preparations Bacterial Infections of the Skin and Subcutaneous Tissue Impetigo Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Cellulitis Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Folliculitis and Furuncle Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Paronychia Clinical Findings Differential Diagnosis Management Fungal Infections of the Skin Candidiasis (Moniliasis) Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Tinea Tinea Capitis Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Tinea Corporis Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Tinea Cruris Clinical Findings Differential Diagnosis Management Tinea Pedis Clinical Findings Differential Diagnosis Management Patient and Family Education Complications Onychomycosis Clinical Findings Differential Diagnosis Management Patient and Family Education Tinea Versicolor Clinical Findings Differential Diagnosis Management Patient and Family Education Viral Infections of the Skin Herpes Simplex Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Herpes Zoster Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Molluscum Contagiosum Clinical Findings Differential Diagnosis Management Patient and Family Education Complications Patient and Family Education Warts Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Infestations of the Skin Pediculosis Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Scabies Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Allergic and Inflammatory Skin Conditions Acne Vulgaris Clinical Findings Differential Diagnosis Management Patient and Family Education Complications Atopic Dermatitis Contact Dermatitis Clinical Findings Differential Diagnosis Management Diaper Dermatitis Clinical Findings Differential Diagnosis Management Complications Seborrheic Dermatitis Clinical Findings Differential Diagnosis Management Complications Drug Eruptions Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Vascular Skin Conditions Urticaria and Angioedema Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Erythema Multiforme, Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Papulosquamous Eruptions of the Skin Pityriasis Rosea Clinical Findings Differential Diagnosis Management Patient and Family Education Psoriasis Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Lichen Striatus Clinical Findings Differential Diagnosis Management Patient and Family Education Keratosis Pilaris Clinical Findings Differential Diagnosis Management Patient and Family Education Congenital Skin Conditions Vascular and Pigmented Nevi Clinical Findings History Physical Examination. Findings include the following (Box 34.8) 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 Vitiligo and Hypopigmentation Disorders Clinical Findings Differential Diagnosis Management Complications Hair Loss Traumatic Alopecia Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Alopecia Areata Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Body Modifications Tattoos, Body Piercing, and Scarification Clinical Findings Differential Diagnosis Management Complications Patient and Family Education 35 - 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 Prevention of Eye Injury Sunglasses Sports Protection Laser Pointers Computer Use Vision Therapy, Lenses, and Prisms Visual Disorders Refractive Errors and Amblyopia Clinical Findings Management Strabismus Clinical Findings 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 Screening Guidelines Clinical Findings Management Complications and Prognosis Infections Conjunctivitis Conjunctivitis in the Newborn (Ophthalmia Neonatorum) Inclusion Conjunctivitis (Chlamydia) Bacterial Conjunctivitis Viral Conjunctivitis Allergic Conjunctivitis Blepharitis Clinical Findings Differential Diagnosis Management Hordeolum (Stye) Clinical Findings Differential Diagnosis Management Chalazion Clinical Findings Management Complications Nasolacrimal Duct Conditions: Dacryostenosis and Dacryocystitis Management Preseptal (Periorbital) Cellulitis Clinical Findings 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 Subconjunctival Hemorrhage Eyelid Contusion (“Black Eye”) Corneal Abrasion Clinical Findings Management Foreign Body Clinical Findings 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 Management Deformities of the Eyelids Entropion Ectropion Euryblepharon Pterygium Visual Impairment Clinical Findings and Developmental and Behavioral Effects Assessment Management 36 - Ear and Hearing Disorders Embryonic Development Anatomy and Physiology Pathophysiology Defense Mechanisms Assessment of the Ear Clinical Findings History Physical Examination Cerumen Removal Standards for Hearing Screening Diagnostic Studies Hearing Impairment: Sensorineural, Conductive, and Mixed Hearing Loss Clinical Findings History Physical Examination Diagnostic Studies Differential Diagnosis Management Complications Developmental and Behavioral Effects Prevention of Noise-Induced Hearing Loss Clinical Findings History Physical Examination Management Foreign Body in the Ear Canal Clinical Findings History Physical Examination Management Complications Ear Conditions in Children Otitis Externa Clinical Findings History Physical Examination Diagnostic Studies Differential Diagnosis Management Complications Prevention Acute Otitis Media Clinical Findings History Physical Examination Diagnostic Studies Differential Diagnosis Management Management of Persistent and Recurrent Acute Otitis Media Other Treatment Issues Complications Prevention and Education Otitis Media With Effusion Clinical Findings History Physical Examination Diagnostic Studies Differential Diagnosis Management Complications Perforated Tympanic Membrane Clinical Findings History, Physical Examination, and Diagnostic Studies Differential Diagnosis Management Medications Other Treatment Considerations Auricular Hematoma Clinical Findings History and Physical Examination Differential Diagnosis Management and Complications Cholesteatoma Clinical Findings History and Physical Examination Differential Diagnosis Management and Complications Mastoiditis Clinical Findings History, Physical Examination, and Diagnostic Studies Differential Diagnosis Management Tympanostomy or Pressure-Equalizing Tubes Management 37 - Respiratory Disorders Anatomy and Physiology Upper Respiratory Tract Lower Respiratory Tract Pathophysiology Obstructive Processes Upper Airway Obstruction Lower Airway Obstructions Restrictive Processes Defense Systems Assessment of the Respiratory System History Physical Examination Diagnostic Studies Basic Respiratory Management Strategies General Measures Medications Patient and Family Education Disorders of Respiratory Function Upper Respiratory Tract Infection Clinical Findings Differential Diagnosis Management Complications Pharyngitis, Tonsillitis, and Tonsillopharyngitis Clinical Findings Physical Examination Diagnostic Studies Management Complications Indications for Tonsillectomy and Adenoidectomy Rhinosinusitis Clinical Findings Differential Diagnosis Management Complications Prevention Diphtheria Clinical Findings Management Complications and Prevention Recurrent Epistaxis Clinical Findings Differential Diagnosis Management Prevention Nasal Foreign Body Clinical Findings Physical Examination Differential Diagnosis Management Airway Disorders Croup (Laryngotracheobronchitis) and Spasmodic Croup Clinical Finding Differential Diagnosis Management Indications for Hospitalization Complications Acute Spasmodic Croup Epiglottitis Clinical Findings Management Complications Prevention Bronchiolitis Clinical Findings Differential Diagnosis Management Complications Prevention Foreign Body Aspiration Clinical Findings Management Complications Bronchitis Clinical Findings Differential Diagnosis Management Complications Common Types of Childhood Pneumonia Clinical Findings in Infants and Young Children Differential Diagnosis Management Prognosis Complications Prevention Valley Fever (Coccidioidomycosis) Clinical Findings in Infants and Children Differential Diagnosis Management Indications for Hospitalization Prevention Pertussis Clinical Findings Diagnostic Studies Differential Diagnosis Management Care of Exposed Children Complications Prevention Cystic Fibrosis Clinical Findings Management Pectus Deformity Clinical Findings Diagnostic Studies Brief Resolved Unexplained Events Clinical Findings Diagnostic Studies Differential Diagnosis Management 38 - 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 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 Management Right-to-Left Shunting Congenital Heart Disease (Cyanotic) Tetralogy of Fallot Clinical Findings Management Transposition of the Great Arteries Clinical Findings Management Prognosis Tricuspid Atresia, Hypoplastic Left Heart Syndrome, and Other Single Ventricle Defects Clinical Findings Management Complications. Complications include development of collateral arterial and venous vessels, protein-losing enteropathy, arrhythm... Obstructive Cardiac Lesions Aortic Stenosis and Insufficiency Clinical Findings Management Pulmonic Stenosis Clinical Findings History Physical Examination Diagnostic Studies Management Coarctation of the Aorta Clinical Findings Management Sudden Cardiac Death Clinical Findings Diagnostic Studies Management Long-Term Complications for Children and Young Adults With Congenital Heart Disease: Transitioning to Adult Care Acquired Heart Disease Chest Pain Clinical Findings Differential Diagnosis Management Hypertension Clinical Findings History. Inquire about Physical Examination. Note the following Diagnostic Studies Management Complications Patient and Family Education Infective Endocarditis Clinical Findings Differential Diagnosis Management and Complications Patient and Family Education Myocarditis Clinical Findings Differential Diagnosis Management Complications and Prognosis Pericarditis Heart Conduction Disturbances Cardiac Arrhythmias Clinical Findings Management and Complications Syncope Clinical Findings Management and Differential Diagnosis 39 - Hematologic Disorders Anatomy and Physiology Erythrocytes Hemoglobin Structural Variations Normal Values Antigenic Properties of Red Blood Cells (Blood Type) Leukocyte Granulocytes Agranulocytes: Lymphocytes and Monocytes Platelet Cells and Coagulation Factors Pathophysiology Assessment of Erythrocyte Disorders History Physical Examination Erythrocyte Disorders Anemia Assessment Microcytic Anemia: Iron Deficiency Anemia Effects of Iron Deficiency Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Thalassemias α Thalassemias Management β Thalassemia Minor/Minima Clinical Findings Management β Thalassemia Intermedia β Thalassemia Major Clinical Findings Management Complications Macrocytic Anemia Clinical Findings Management Normocytic Anemias Transient Erythroblastopenia of Childhood Clinical Findings Differential Diagnosis Management Hemolytic Anemia Sickle Cell Anemia and Trait Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Hereditary Spherocytosis Clinical Findings Management Complications Glucose-6-Phosphate Dehydrogenase Deficiency Clinical Findings Management Patient and Family Education Platelet and Coagulation Disorders Overview of Diagnostic Studies Immune or Idiopathic Thrombocytopenic Purpura Clinical Findings Differential Diagnosis Management Complications Hemophilia A and B and von Willebrand Disease Clinical Findings Management Complications Thrombophilia Pancytopenia White Blood Cell Disorders White Blood Cell Count White Blood Cell Dysfunction Alterations of Granulocytes Lymphocytosis Cancer Leukemias Clinical Findings Management Lymphomas Non-Hodgkin Lymphoma Hodgkin Lymphoma Late Effects of Childhood Cancers 40 - Gastrointestinal Disorders Anatomy and Physiology Pathophysiology Assessment History Physical Examination Common Diagnostic Studies Laboratory tests Radiography Abdominal Ultrasonography Magnetic Resonance Imaging Computed Tomography Management Strategies Medications Probiotics and Prebiotics Upper Gastrointestinal Tract Disorders Dysphagia Clinical Findings History Physical Examination Diagnostic Studies Diagnostic tests may include Differential Diagnosis Management Vomiting Clinical Findings Differential Diagnosis Management Vomiting Dehydration Complications Patient and Family Education Cyclic Vomiting Syndrome Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Abdominal Migraine Clinical Findings Differential Diagnosis Management Prognosis Gastroesophageal Reflux Disease Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Pyloric Stenosis Clinical Findings Physical Examination Eosinophilic Esophagitis Clinical Findings Management Peptic Ulcer Disease Clinical Findings Diagnostic Studies Laboratory Studies Imaging Studies Procedures Studies to Detect Helicobacter Pylori Differential Diagnosis Management Complications Patient and Family Education Lower Gastrointestinal Tract Disorders Foreign Body Ingestion Esophageal Foreign Bodies Clinical Findings Management Complications Appendicitis Clinical Findings History Differential Diagnosis Management Complications Intussusception Clinical Findings History Physical Examination Diagnostic Studies Differential Diagnosis Management Complications Hirschsprung Disease (Congenital Aganglionic Megacolon) Clinical Findings Childhood Functional Abdominal Pain and Functional Abdominal Pain Syndrome Clinical Findings Differential Diagnosis Management Prognosis and Complications Irritable Bowel Syndrome Clinical Findings Differential Diagnosis Management Malabsorption Syndromes: Celiac Disease, Lactose Intolerance, Cow’s-Milk Protein Intolerance or Allergy, Food Protein Immunologi... Clinical Findings Diagnostic Studies Specific Tests for Celiac Disease Specific Tests for Lactose Intolerance Differential Diagnosis Management Complications and Prognosis Rectal and Intestinal Polyps Clinical Findings History Physical Examination Diagnostic Studies Management Complications Anal Fissure Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Inflammatory Bowel Disease Crohn Disease Clinical Findings Differential Diagnosis Management Complications Prevention and Prognosis Ulcerative Colitis Clinical Findings History Physical Examination Diagnostic Studies Differential Diagnosis Management Complications Prevention and Prognosis Failure to Thrive Clinical Findings and Risk Factors Physical Examination Diagnostic Studies Differential Diagnosis Management Prognosis Encopresis/Constipation Physiologic Psychosocial Clinical Findings Differential Diagnosis Management Complications Patient and Family Education Toilet Refusal Syndrome Clinical Findings History Physical Examination Differential Diagnosis Management Complications Patient and Family Education Diarrhea Acute Diarrhea Clinical Findings History Physical Examination 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 41 - Genitourinary Disorders Standards of Care Anatomy and Physiology Pathophysiology and Defense Mechanisms Assessment of the Genitourinary System History and Clinical Findings Physical Examination Diagnostic Studies Management Strategies Education and Counseling Referral Dysfunctional Voiding History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Patient and Family Education Enuresis History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Patient and Family Education Genitourinary Tract Disorders Urinary Tract Infection and Pyelonephritis History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Infants 2 to 24 Months Old Asymptomatic Bacteriuria Uncomplicated Cystitis Patient and Family Education, Prevention, and Prognosis Vesicoureteral Reflux History and Clinical Findings Diagnostic Studies Management Patient and Family Education, Prevention, and Prognosis Hematuria History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Patient and Family Education, Prevention, and Prognosis Proteinuria History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Patient and Family Education, Prevention, and Prognosis Nephrotic Syndrome History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Complications Patient and Family Education, Prevention, and Prognosis Nephritis and Glomerulonephritis History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Complications Patient and Family Education, Prevention, and Prognosis Myoglobinuria History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Patient and Family Education, Prevention and Prognosis Renal Tubular Acidosis History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Complications Patient and Family Education, Prevention, and Prognosis Nephrolithiasis and Urolithiasis History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Patient and Family Education, Prevention, and Prognosis Wilms Tumor History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Complications Patient and Family Education, Prevention, and Prognosis Chronic Genitourinary Conditions in Males Hypospadias History and Clinical Findings Physical Examination Differential Diagnosis Management Complications Patient and Family Education, Prevention, and Prognosis Cryptorchidism (Undescended Testes) History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Complications Patient and Family Education, Prevention, and Prognosis Hydrocele History and Clinical Findings Physical Examination Differential Diagnosis Management Patient and Family Education, Prevention, and Prognosis Spermatocele History and Clinical Findings Differential Diagnosis Management Patient and Family Education, Prevention, and Prognosis Varicocele History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Complications Patient and Family Education, Prevention, and Prognosis Inguinal Hernia History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Complications Patient and Family Education, Prevention, and Prognosis Testicular Masses History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Patient and Family Education, Prevention, and Prognosis Acute Male Genitourinary Conditions Scrotal Trauma Clinical Findings Differential Diagnosis Management Patient and Family Education, Prevention, and Prognosis Testicular Torsion History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Patient and Family Education, Prevention, and Prognosis Torsion of the Appendix Testis History and Clinical Findings Differential Diagnosis Management Epididymitis History and Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management Patient and Family Education, Prevention, and Prognosis Phimosis and Paraphimosis History and Clinical Findings Physical Examination Management Patient and Family Education, Prevention, and Prognosis Balanitis and Balanoposthitis History and Clinical Findings Management Patient and Family Education, Prevention, and Prognosis 42 - Pediatric and Adolescent Gynecology Anatomy, Physiology, and Assessment of the Female Reproductive System The External Genitalia and Vagina Before Puberty External Genitalia and Vagina After the Onset of Puberty Internal Reproductive Organs Female Pubertal Development and the Menstrual Cycle Physiology of Menstrual Bleeding Ovulatory and Anovulatory Menstrual Cycles Coagulation Pathway and the Menstrual Cycle Early Pregnancy: Key Concepts for Adolescent Providers Physiology of Early Pregnancy Addressing Common Misperceptions About Pregnancy Vulvar and Vaginal Concerns Evaluation Prepubertal Vulvar and Vaginal Concerns Lichen Sclerosis Prepubertal Vaginal Bleeding Labial Adhesions Imperforate Hymen Adolescent Vulvar and Vaginal Concerns Vulvovaginitis in Adolescents Nonsexual Genital Ulcers Concerns About Labial Appearance Menstrual Concerns Amenorrhea History and Physical Additional Testing Causes of Amenorrhea Abnormal Uterine Bleeding Heavy Menstrual Bleeding Causes of Abnormal Uterine Bleeding Treatment of Abnormal Uterine Bleeding Treating the Underlying Cause of Abnormal Uterine Bleeding Pelvic Pain Acute Pelvic Pain Chronic and Recurrent Pelvic Pain Dysmenorrhea Mittelschmerz Ovarian Cysts Endometriosis Premenstrual Syndrome Breast Concerns Asymmetric Breasts Mastalgia Breast Cyst or Mass Nipple Discharge Gynecologic Concerns in Adolescents With Physical and Developmental Disabilities Sexual Health Best Practices in Contraceptive Counseling Address Confidentiality Concerns Use Tools and Techniques That Reflect Best Practices Follow Updated Clinical Recommendations Contraceptive Methods The Implant Intrauterine Devices Depot Medroxyprogesterone Acetate Combined Hormonal Contraception Managing Common Expected Side Effects Progestin-Only Pills Emergency Contraception Condoms Coitus Interruptus and Other Less Effective Methods Teen pregnancy Understanding Teen Pregnancy Diagnosis of Teen Pregnancy After Diagnosing Pregnancy Preconceptual Counseling Ectopic Pregnancy Sexually Transmitted Infections STI: Adolescent Health Disparity STI: Prevention and Screening Common Sexually Transmitted Infections Treatment and Counseling Pelvic Inflammatory Disease 43 - Musculoskeletal Disorders Anatomy and Physiology Pathophysiology and Defense Mechanisms Pathophysiology Systemic Problems Genetic Disorders 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 Hip Examinations Galeazzi Maneuver Barlow Maneuver Ortolani Maneuver Klisic Test Trendelenburg Sign Medial (Internal) and Lateral (External) Rotation 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 Conditions Specific to Children Annular Ligament Displacement Clinical Findings Brachial Plexus Injuries Clinical Findings Clavicular Fracture Clinical Findings Costochondritis and Sternochondritis Back Pain Scoliosis Idiopathic Scoliosis Kyphosis Lumbar Lordosis Developmental Dysplasia of the Hip Clinical Findings Legg-Calvé-Perthes Disease Clinical Findings Management Slipped Capital Femoral Epiphysis Femoral Anteversion Genu Varum Genu Valgum Clinical Findings History Physical Examination Tibial Torsion Clinical Findings Diagnostic Studies. Radiographs are usually not necessary Popliteal Cysts Sports-Related Injuries Knee Injuries Pes Planus Talipes Equinovarus Overriding Toes In-Toeing and Out-Toeing Rotational Problems Clinical Findings History Physical Examination Management. See the individual diagnoses for management strategies Toe Walking Clinical Findings Management Leg Aches of Childhood Clinical Findings Differential Diagnosis Management Limps Clinical Findings History. A careful history is needed, including Physical Examination Diagnostic Studies. A CBC with differential and measurement of ESR and CRP levels should be obtained to rule out infection, infl... Differential Diagnosis Management Overuse Syndromes of Childhood and Adolescence Clinical Findings Differential Diagnosis Management Muscle Diseases Clinical Findings History Physical Examination Management Ganglions of the Hands Clinical Findings Management 44 - Common Pediatric Injuries and Toxic Exposures Trauma to the Skin and Soft Tissue Abrasions Clinical Findings Management Puncture Wounds Clinical Findings Management Patient and Parent Education Ingrown Toenail (Onychocryptosis) and Nail Hematoma Management Lacerations Clinical Findings Management Patient and Parent Education Burns Clinical Findings Differential Diagnosis Patient and Parent Education Contusions and Hematomas Clinical Findings Differential Diagnosis Management and Complications Patient and Parent Education Bites and Stings Animal and Child Bites Clinical Findings Hymenoptera (Bees, Wasps, and Ants) Clinical Findings Differential Diagnosis and Management Patient and Parent Education Mosquitoes, Fleas, and Chiggers (Red Bug or Harvest Mites) Clinical Findings Differential Diagnosis and Management Patient and Parent Education Spiders and Scorpions Clinical Findings Differential Diagnosis and Management Patient and Parent Education Snakebites Clinical Findings Management Patient and Parent Education Heat and Cold Injuries Frostbite Clinical Findings History. The provider should assess the following Physical Examination. Typical initial findings include the following Differential Diagnosis and Management Patient and Parent Education Hypothermia Clinical Findings Patient and Parent Education Hyperthermia: Common Heat-Related Illness Acute Pediatric Poisoning Clinical Findings History Physical examination Management and Patient/Family Education Common Environmental Toxins: Heavy Metals and Pesticides Lead Clinical Findings Differential Diagnosis Management Patient and Family Education Mercury Clinical Findings Differential Diagnosis Management Patient and Family Education Arsenic Clinical Findings Management Patient and Family Education Pesticides Clinical Findings Management Patient and Family Education 45 - 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 Constitutional Growth Delay Clinical Findings Growth Excess Pubertal Disorders Early Puberty/Precocious Puberty Delayed Puberty Clinical Findings Complications Adrenal Disorders Anatomy and Physiology Adrenal Insufficiency Clinical Findings Hyperadrenal States Clinical Findings Disorders of Sex Development Management Thyroid Disorders Anatomy and Physiology Hypothyroidism Clinical Findings Hyperthyroidism Clinical Findings Diabetes Mellitus Type 1 Diabetes Type 2 Diabetes Clinical Findings 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 Management Metabolic Emergencies Stable Metabolic Disorders Complications Specific Metabolic Disorders of Children Disorders of Carbohydrate Metabolism Glycogen Storage Diseases Clinical Findings Management Galactosemia Clinical Findings Complications Management Classic Homocystinuria Disorders of Fatty Acid Oxidation Complications Lysosomal Storage Disorders Dyslipidemia: Hypercholesterolemia and Hyperlipidemia Management 46 - 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, Functional Health, and Social Context Physical Examination Specifics of the Neurologic Examination Behavior and Mental Status Cranial Nerve Function Motor Examination Sensory Examination Reflexes Coordination Cranium Examination Autonomic Nervous System Meningeal Signs Diagnostic Studies Management Strategies Neurologic Development Educational Needs Referrals for Other Key Assessments Medications Specific Neurologic Problems of Children: Headaches and Head Injury Headaches Clinical Findings Head Injury or Concussion Clinical Findings Prevention Disturbances of Head Growth Macrocephaly Hydrocephalus Microcephaly Craniosynostosis Clinical Findings Epilepsy, Febrile Seizures and Benign Paroxysmal Vertigo Epilepsy Clinical Findings Differential Diagnosis Management Febrile Seizures Clinical Findings Differential Diagnosis Management Patient and Parent Education Complications Benign Paroxysmal Vertigo Cerebral Palsy and Hypotonia Cerebral Palsy Clinical Findings Physical Examination Diagnostic Studies Differential Diagnosis Management The Hypotonic Infant Injuries and Congenital Conditions Brachial Palsy Clinical Findings Differential Diagnosis Management Prognosis Bell Palsy Clinical Findings Differential Diagnosis Management Complications Tethered Cord Arnold-Chiari Malformation Myelomeningocele Clinical Findings Management and Complications Prognosis Prevention Infection and Immune Disorders Central Nervous System Infections Clinical Findings Management and Complications Zika Virus Reye Syndrome Myasthenia Gravis Clinical Findings Physical Examination. The key findings of this disorder include Diagnostic Studies Differential Diagnosis Management Complications Neurofibromatosis Guillain-Barré Syndrome Clinical Findings History. The following are reported Physical Examination Diagnostic Studies Differential Diagnosis Management Complications Neurodegenerative Disorders Rett Syndrome Multiple Sclerosis Appendix A - Growth Charts B - Body Measurements C - Nutrition D - Gesell Figures Index