CURRENT Diagnosis and Treatment Pediatrics-25판

Cover
Title Page
Copyright Page
Contents
Authors
Preface
Milestone 25th Silver Anniversary Edition

1. Advancing the Quality & Safety of Care
Introduction
Current Context
Strategies & Models for Quality Improvement (QI)
Principles of Patient Safety (Incident Reporting, Just Culture, Disclosure, FMEA, RCA, Reliability, Data, & Checklists)

2. The Newborn Infant
Introduction
The Neonatal History
Assessment of Growth & Gestational Age
Examination at Birth
Examination in the Nursery
Care of the Well Neonate
Feeding the Well Neonate
Early Discharge of the Newborn Infant
Hearing Screening
Common Problems in the Term Newborn
Neonatal Jaundice
Hypoglycemia
Respiratory Distress in the Term Newborn Infant
Heart Murmurs
Birth Trauma
Infants of Mothers Who Abuse Drugs
Multiple Births
Neonatal Intensive Care
Perinatal Resuscitation
The Preterm Infant
The Late Preterm Infant
Cardiac Problems in the Newborn Infant
Structural Heart Disease
Persistent Pulmonary Hypertension
Arrhythmias
Gastrointestinal & Abdominal Surgical Conditions in the Newborn Infant
Esophageal Atresia & Tracheoesophageal Fistula
Intestinal Obstruction
Abdominal Wall Defects
Diaphragmatic Hernia
Gastrointestinal Bleeding
Gastroesophageal Reflux
Infections in the Newborn Infant
Bacterial Infections
Fungal Sepsis
Congenital Infections
Perinatally Acquired Infections
Hematologic Disorders in the Newborn Infant
Bleeding Disorders
Anemia
Polycythemia
Renal Disorders in the Newborn Infant
Renal Failure
Urinary Tract Anomalies
Renal Vein Thrombosis
Neurologic Problems in the Newborn Infant
Seizures
Intracranial Hemorrhage
Metabolic Disorders in the Newborn Infant
Hyperglycemia
Hypocalcemia
Inborn Errors of Metabolism
Quality Assessment & Improvement in the Newborn Nursery & NICU

3. Child Development & Behavior
Introduction
Normal Development
The First 2 Years
Ages 2–4 Years
Early School Years: Ages 5–7 Years
Middle Childhood: Ages 7–11 Years
Behavioral & Developmental Variations
Normality & Temperament
Enuresis & Encopresis
Enuresis
Encopresis
Common Developmental Concerns
Colic
Feeding Disorders in Infants & Young Children
Sleep Disorders
Parasomnias
Insomnia
Sleep-Disordered Breathing
Restless Legs Syndrome & Periodic Limb Movement Disorder
Temper Tantrums & Breath-Holding Spells
Well-Child Surveillance & Screening
Developmental Disorders
Attention-Deficit/Hyperactivity Disorder
Autism Spectrum Disorders
Intellectual Disability
Specific Forms of Intellectual Disability & Associated Treatment Issues
References

4. Adolescence
Introduction
Epidemiology
Mortality Data
Morbidity Data
Providing A Medical Home for Adolescents
Relating to the Adolescent Patient
The Structure of the Visit
Guidelines for Adolescent Preventive Services
Adolescent Screening
Promoting Healthy Behaviors
Transition to Adult Care
Growth & Development
Puberty
Physical Growth
Sexual Maturation
Psychosocial Development
Adolescent Gynecology & Reproductive Health
Breast Examination
Breast Masses
Nipple Discharge & Galactorrhea
Gynecomastia
Gynecologic Care & Gynecologic Disorders in Adolescence
Contraception
Pregnancy

5. Adolescent Substance Abuse
Scope of the Problem
Morbidity Data
Predicting the Progression From Use to Abuse
Evaluation of Substance Abuse
Treatment & Referral
Prevention
References

6. Eating Disorders
Introduction
Etiology
Incidence
Predisposing Factors & Clinical Profiles
Anorexia Nervosa
Bulimia Nervosa
Binge-Eating Disorder
Avoidant/Restrictive Food Intake Disorder
Prognosis, Quality Assessment, & Outcomes Metrics
Resources for Practitioners & Families

7. Child & Adolescent Psychiatric Disorders & Psychosocial Aspects of Pediatrics
Introduction
Models of Care Encompassing Behavioral Health in the Primary Care Setting
Prevention, Early Identification, & Developmental Context
Lifestyle Recommendations
Identification & Assessment During Health Supervision Visits
Tools for Mental Health Screening in the Primary Care Office Setting
Psychiatric Disorders of Childhood & Adolescence
Anxiety Disorders
Obsessive-Compulsive & Related Disorders
Attention-Deficit/Hyperactivity Disorder
Mood Disorders
Suicide in Children & Adolescents
Disruptive, Impulse-Control, & Conduct Disorders
High-Risk Patients & Homicide
Somatic Symptom & Related Disorders
Adjustment Disorders
Psychotic Disorders
Other Psychiatric Conditions
References

8. Child Abuse & Neglect
Introduction
Prevention
Clinical Findings
Differential Diagnosis
Treatment
Prognosis

9. Ambulatory & Office Pediatrics
Introduction
Pediatric History
Pediatric Physical Examination
Health Supervision Visits
Developmental & Behavioral Assessment
Growth Parameters
Blood Pressure
Vision & Hearing Screening
Anticipatory Guidance
Nutrition Counseling
Counseling About Television & Other Media
Immunizations
Acute-Care Visits
Prenatal Visits
Sports Physicals
Chronic Disease Management
Medical Home
Mental & Behavioral Health
Telephone Management & Web-Based Information
Advocacy & Community Pediatrics
Toxic Stress
Common General Pediatric Issues
Fever
Growth Deficiency

10. Immunization
Standards for Pediatric Immunization Practices
Routine Childhood & Adolescent Immunization Schedules
Vaccine Safety
Vaccination in Special Circumstances
Communicating with Parents About Vaccines
Hepatitis B Vaccination
Rotavirus Vaccination
Diphtheria-Tetanus-Acellular Pertussis Vaccination
Haemophilus Influenzae Type B Vaccination
Pneumococcal Vaccination
Poliomyelitis Vaccination
Influenza Vaccination
Measles, Mumps, & Rubella Vaccination
Varicella Vaccination
Hepatitis A Vaccination
Meningococcal Vaccination
Tetanus-Reduced Diphtheria-Acellular Pertussis Vaccination (Adolescents & Adults)
Human Papillomavirus Vaccination
Vaccinations for Special Situations
Rabies Vaccination
Typhoid Fever Vaccination
Cholera Vaccination
Japanese Encephalitis Vaccination
Tuberculosis Vaccination
Yellow Fever Vaccination
Passive Prophylaxis

11. Normal Childhood Nutrition & Its Disorders
Nutritional Requirements
Nutrition & Growth
Energy
Protein
Lipids
Carbohydrates
Major Minerals
Trace Elements
Vitamins
Infant Feeding
Breast-Feeding
Special Dietary Products for Infants
Nutrition for Children 2 Years & Older
Pediatric Undernutrition
Pediatric Overweight & Obesity
Nutrition Support
Enteral
Parenteral Nutrition
Nutrient Requirements & Delivery

12. Emergencies & Injuries
Introduction to Pediatric Emergencies & Injuries
Initial Approach to the Acutely Ill Infant or Child
The ABCs of Resuscitation
Management of Shock
Summary of Initial Approach to the Acutely Ill Infant or Child
Emergency Pediatric Drugs
Approach to the Pediatric Trauma Patient
Mechanism of Injury
Initial Assessment & Management
Primary Survey
Secondary Survey
Head Injury
Burns
Thermal Burns
Electrical Burns
Disorders Due to Extremes of Environment
Heat-Related Illnesses & Heat Stroke
Hypothermia
Submersion Injuries
Lacerations
Animal & Human Bites
Dog Bites
Cat Bites
Human Bites
Pain Management & Procedural Sedation

13. Poisoning
Introduction
Pharmacologic Principles of Toxicology
Preventing Childhood Poisonings
General Treatment of Poisoning
Initial Telephone Contact
Initial Emergency Department Contact
Definitive Therapy of Poisoning
Management of Specific Common Poisonings
Acetaminophen (Paracetamol)
Alcohol, Ethyl (Ethanol)
Amphetamines & Related Drugs (Stimulants, Methamphetamine, 3,4-Methylenedioxy-N-Methylamphetamine)
Anesthetics, Local
Antihistamines & Cough & Cold Preparations
Barbiturates & Benzodiazepines
Belladonna Alkaloids (Atropine, Jimsonweed, Potato Leaves, Scopolamine, Stramonium)
β-Blockers & Calcium Channel Blockers
Carbon Monoxide
Caustics
Central α2-Adrenergic Agonist
Cocaine
Cosmetics & Related Products
Cyclic Antidepressants
Digitalis & Other Cardiac Glycosides
Diphenoxylate with Atropine (Lomotil) & Loperamide (Imodium)
Disinfectants & Deodorizers
Disk-Shaped “Button” Batteries
Ethylene Glycol & Methanol
γ-Hydroxybutyrate, γ-Butyrolactone, Butanediol, Flunitrazepam, & Ketamine
Hydrocarbons (Benzene, Charcoal Lighter Fluid, Gasoline, Kerosene, Petroleum Distillates, Turpentine)
Ibuprofen
Insect Stings (Bee, Wasp, & Hornet)
Insecticides
Iron
Lead
Magnets
Marijuana
Mushrooms
Nitrites, Nitrates, Aniline, Pentachlorophenol, & Dinitrophenol
Opioids & Opiates
Oral Anti-Diabetics (Sulfonylureas, Metformin)
Antipsychotics (Typical & Atypical)
Plants
Psychotropic Drugs
Salicylates
Scorpion Stings
Serotonin Reuptake Inhibitors
Snakebite
Soaps & Detergents
Spider Bites
Vitamins
Warfarin (Coumadin) & Newer Oral Anticoagulants (NOAC)

14. Critical Care
Introduction
Respiratory Critical Care
Acute Respiratory Failure
Conventional Mechanical Ventilation
Other Modes of Respiratory Support
Major Respiratory Diseases in the Pediatric ICU
Acute Respiratory Distress Syndrome
Status Asthmaticus
Cardiovascular Critical Care
Shock
Sepsis
Neurocritical Care
Traumatic Brain Injury
Hypoxic-Ischemic Encephalopathy
Status Epilepticus
Acute Kidney Injury & Renal Replacement Therapy
Fluid Management & Nutritional Support of the Critically Ill Child
Sedation & Analgesia in the Pediatric ICU
End-of-Life Care & Death in the PICU
Quality Improvement Initiatives in the PICU

15. Skin
General Principles
Diagnosis of Skin Disorders
Treatment of Skin Disorders
Disorders of the Skin in Newborns
Transient Diseases in Newborns
Pigment Cell Birthmarks, Nevi, & Melanoma
Melanocytic Nevi
Vascular Birthmarks
Epidermal Birthmarks
Connective Tissue Birthmarks (Juvenile Elastoma, Collagenoma)
Hereditary Skin Disorders
Common Skin Diseases in Infants, Children, & Adolescents
Acne
Bacterial Infections of the Skin
Fungal Infections of the Skin
Viral Infections of the Skin
Virus-Induced Tumors
Insect Infestations
Dermatitis (Eczema)
Common Skin Tumors
Papulosquamous Eruptions
Hair Loss (Alopecia)
Reactive Erythemas
Miscellaneous Skin Disorders Seen in Pediatric Practice

16. Eye
Introduction
Common Nonspecific Signs & Symptoms
Red Eye
Tearing
Discharge
Pain & Foreign-Body Sensation
Photophobia
Abnormal Red Reflex
Refractive Errors
Myopia (Nearsightedness)
Hyperopia (Farsightedness)
Astigmatism
Ophthalmic Examination
History
Visual Acuity
External Examination
Pupils
Alignment & Motility Evaluation
Ophthalmoscopic Examination
Ocular Trauma
Prevention of Ocular Injuries
Corneal Abrasion
Ocular Foreign Bodies
Intraocular Foreign Bodies & Perforating Ocular Injuries
Blunt Orbital Trauma
Lacerations
Burns
Hyphema
Abusive Head Trauma & Nonaccidental Trauma
Disorders of the Ocular Structures
Diseases of the Eyelids
Viral Eyelid Disease
Miscellaneous Eyelid Infections
Eyelid Ptosis
Horner Syndrome
Eyelid Tics
Disorders of the Nasolacrimal System
Nasolacrimal Duct Obstruction
Congenital Dacryocystocele
Dacryocystitis
Diseases of the Conjunctiva
Ophthalmia Neonatorum
Bacterial Conjunctivitis
Viral Conjunctivitis
Allergic Conjunctivitis
Mucocutaneous Diseases
Disorders of the Iris
Iris Coloboma
Aniridia
Albinism
Miscellaneous Iris Conditions
Glaucoma
Uveitis
Anterior Uveitis/Iridocyclitis/Iritis
Posterior Uveitis
Intermediate Uveitis
Disorders of the Cornea
Cloudy Cornea
Viral Keratitis
Corneal Ulcers
Disorders of the Lens
Cataracts
Dislocated Lenses/Ectopia Lentis
Disorders of the Retina
Retinal Hemorrhages in the Newborn
Retinopathy of Prematurity (ROP)
Retinoblastoma
Retinal Detachment
Diabetic Retinopathy
Diseases of the Optic Nerve
Optic Neuropathy
Optic Nerve Hypoplasia
Papilledema
Optic Neuritis
Optic Atrophy
Diseases of the Orbit
Periorbital & Orbital Cellulitis
Craniofacial Anomalies
Orbital Tumors
Nystagmus
Amblyopia
Strabismus
Esotropia (Crossed Eyes)
Exotropia (Wall-Eyed, Drifting of Eyes)
Unexplained Decreased Vision in Infants & Children
Learning Disabilities & Dyslexia

17. Oral Medicine & Dentistry
Pediatric Oral Health
Oral Examination of Children
Dental Caries
Periodontal Disease
Dental Emergencies
Special Patient Populations
Orthodontic Referral

18. Ear, Nose, & Throat
The Ear
Infections of the Ear
Acute Trauma to the Middle Ear
Ear Canal Foreign Body & Cerumen Impaction
Auricular Hematoma
Congenital Ear Malformations
Identification & Management of Hearing Loss
The Nose & Paranasal Sinuses
Acute Viral Rhinitis
Rhinosinusitis
Choanal Atresia
Recurrent Rhinitis
Epistaxis
Nasal Infection
Nasal Trauma
Foreign Bodies in the Nose
The Throat & Oral Cavity
Acute Stomatitis
Pharyngitis
Peritonsillar Cellulitis or Abscess (Quinsy)
Retropharyngeal Abscess
Ludwig Angina
Acute Cervical Adenitis
Tonsillectomy & Adenoidectomy
Disorders of the Lips
Disorders of the Tongue
Halitosis
Salivary Gland Disorders
Congenital Oral Malformations

19. Respiratory Tract & Mediastinum
Respiratory Tract
Growth & Development
Diagnostic Aids
Physical Examination of the Respiratory Tract
Pulmonary Function Tests
Assessment of Oxygenation & Ventilation
Diagnosis of Respiratory Tract Infections
Imaging of the Respiratory Tract
Laryngoscopy & Bronchoscopy
General Therapy for Pediatric Lung Diseases
Oxygen Therapy
Inhalation of Medications
Airway Clearance Therapy
Avoidance of Environmental Hazards
Disorders of the Conducting Airways
Laryngomalacia & Congenital Disorders of the Extrathoracic Airway
Laryngomalacia
Other Causes of Congenital Extrathoracic Obstruction
Acquired Disorders of the Extrathoracic Airway
Foreign-Body Aspiration in the Extrathoracic Airway
Croup Syndromes
Vocal Fold Immobility
Subglottic Stenosis
Congenital Causes of Intrathoracic Airway Obstruction
Malacia of Airways
Vascular Rings & Slings
Bronchogenic Cysts
Acquired Causes of Intrathoracic Airway Obstruction
Foreign-Body Aspiration in the Intrathoracic Airway
Disorders of Mucociliary Clearance
Cystic Fibrosis
Primary Ciliary Dyskinesia
Bronchiectasis
Congenital Malformations of the Lung Parenchyma
Pulmonary Agenesis & Hypoplasia
Pulmonary Sequestration
Congenital Lobar Overinflation
Congenital Pulmonary Airway Malformation (Previously Named Cystic Adenomatoid Malformation)
Acquired Abnormalities of the Lung Parenchyma
Bronchopulmonary Dysplasia
Community-Acquired Bacterial Pneumonia
Parapneumonic Effusion & Empyema
Atypical Pneumonias
Viral Pneumonia
Bronchiolitis
Mycoplasma Pneumonia
Aspiration Pneumonia
Pneumonia in the Immunocompromised Host
Lung Abscess
Bronchiolitis Obliterans
Children’s Interstitial Lung Disease Syndrome
Hypersensitivity Pneumonitis
Diseases of the Pulmonary Circulation
Pulmonary Hemorrhage
Pulmonary Embolism
Pulmonary Edema
Congenital Pulmonary Lymphangiectasia
Disorders of the Chest Wall
Scoliosis
Pectus Carinatum
Pectus Excavatum
Neuromuscular Disorders & Lung Disease
Disorders of the Pleura & Pleural Cavity
Hemothorax
Chylothorax
Pneumothorax & Related Air Leak Syndromes
Mediastinum
Mediastinal Masses
Sleep-Disordered Breathing
Primary Snoring & Obstructive Sleep Apnea
Periodic Breathing & Central Sleep Apnea
Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events)
Sudden Unexpected Infant Death & Sudden Infant Death Syndrome
Quality Assessment & Outcomes Metrics

20. Cardiovascular Diseases
Introduction
Diagnostic Evaluation
History
Physical Examination
Electrocardiography
Chest Radiograph
Echocardiography
Magnetic Resonance Imaging
Cardiopulmonary Stress Testing
Arterial Blood Gases & Pulse Oximetry
Cardiac Catheterization & Angiocardiography
Perinatal & Neonatal Circulation
Heart Failure
Genetic Basis of Congenital Heart Disease
Acyanotic Congenital Heart Disease
Defects in Septation
Patent (Persistent) Ductus Arteriosus
Right-Sided Obstructive Lesions
Left-Sided Lesions
Diseases of the Aorta
Coronary Artery Abnormalities
Cyanotic Congenital Heart Disease
Tetralogy of Fallot
Pulmonary Atresia with Ventricular Septal Defect
Pulmonary Atresia with Intact Ventricular Septum
Tricuspid Atresia
Hypoplastic Left Heart Syndrome
Transposition of the Great Arteries
Total Anomalous Pulmonary Venous Return
Truncus Arteriosus
Quality Improvement in Congenital Heart Disease
Acquired Heart Disease
Rheumatic Fever
Kawasaki Disease
Infective Endocarditis
Pericarditis
Cardiomyopathy
Myocarditis
Preventive Cardiology
Hypertension
Atherosclerosis & Dyslipidemias
Chest Pain
Cardiac Transplantation
Quality Improvement for Pediatric Heart Transplantation
Pulmonary Hypertension
Disorders of Rate & Rhythm
Disorders of the Sinus Node
Premature Beats
Supraventricular Tachycardia
Ventricular Tachycardia
Long QT Syndrome
Sudden Cardiac Death
Disorders of Atrioventricular Conduction
Syncope (Fainting)
Introduction
Diagnostic Evaluation
Vasovagal/Neurocardiogenic Syncope

21. Gastrointestinal Tract
Disorders of the Esophagus
Gastroesophageal Reflux & GERD
Eosinophilic Esophagitis
Achalasia of the Esophagus
Caustic Burns of the Esophagus
Foreign Bodies in the Alimentary Tract
Disorders of the Stomach & Duodenum
Hiatal & Paraesophageal Hernia
Pyloric Stenosis
Gastric & Duodenal Ulcer
Congenital Diaphragmatic Hernia
Congenital Duodenal Obstruction
Disorders of the Small Intestine
Intestinal Atresia & Stenosis
Intestinal Malrotation
Short Bowel Syndrome
Intussusception
Inguinal Hernia
Umbilical Hernia
Patent Omphalomesenteric Duct
Meckel Diverticulum
Acute Appendicitis
Duplications of the Gastrointestinal Tract
Disorders of the Colon
Congenital Aganglionic Megacolon (Hirschsprung Disease)
Constipation
Anal Fissure
Congenital Anorectal Anomalies
Clostridium Difficile Infection in Children
Disorders of the Peritoneal Cavity
Peritonitis
Chylous Ascites
Gastrointestinal Tumors & Malignancies
Juvenile Polyps
Cancers of the Esophagus, Small Bowel, & Colon
Mesenteric Cysts
Intestinal Hemangiomas & Vascular Malformations
Major Gastrointestinal Symptoms & Signs
Acute Diarrhea
Chronic Diarrhea
Gastrointestinal Bleeding
Vomiting
Abdominal Pain
Acute Abdomen
Malabsorption Syndromes
Inflammatory Bowel Disease

22. Liver & Pancreas
Liver Disorders
Neonatal Cholestatic Jaundice
Intrahepatic Cholestasis
Extrahepatic Neonatal Cholestasis
Other Neonatal Hyperbilirubinemic Conditions (Noncholestatic Nonhemolytic)
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D (Delta Agent)
Hepatitis E
Other Hepatitis Viruses
Acute Liver Failure
Autoimmune Hepatitis
Nonalcoholic Fatty Liver Disease
α1-Antitrypsin Deficiency Liver Disease
Wilson Disease (Hepatolenticular Degeneration)
Drug-Induced Liver Diseases
Cirrhosis
Portal Hypertension
Biliary Tract Disease
Pyogenic & Amebic Liver Abscess
Liver Tumors
Liver Transplantation
Pancreatic Disorders
Acute Pancreatitis
Chronic Pancreatitis
Gastrointestinal & Hepatobiliary Manifestations of Cystic Fibrosis
Syndromes with Pancreatic Exocrine Insufficiency
Isolated Exocrine Pancreatic Enzyme Defect
Pancreatic Tumors
References

23. Fluid, Electrolyte, & Acid–Base Disorders & Therapy
Regulation of Body Fluids, Electrolytes, & Tonicity
Acid–Base Balance
Fluid & Electrolyte Management
Dehydration
Hyponatremia
Hypernatremia
Potassium Disorders
Acid–Base Disturbances
Metabolic Acidosis
Metabolic Alkalosis
Respiratory Acidosis
Respiratory Alkalosis

24. Kidney & Urinary Tract
Evaluation of the Kidney & Urinary Tract
History
Physical Examination
Laboratory Evaluation of Renal Function
Laboratory Evaluation of Immunologic Function
Radiographic Evaluation
Renal Biopsy
Congenital Anomalies of the Urinary Tract
Renal Parenchymal Anomalies
Distal Urinary Tract Anomalies
Hematuria & Glomerular Disease
Microhematuria
Glomerulonephritis
Tubulointerstitial Disease
Acute Interstitial Nephritis
Proteinuria & Renal Disease
Congenital Nephrosis (Finnish Type)
Idiopathic Nephrotic Syndrome of Childhood
Focal Segmental Glomerulosclerosis
Membranous Nephropathy (Membranous Glomerulonephritis)
Diseases of the Renal Vessels
Renal Vein Thrombosis
Renal Arterial Disease
Hemolytic-Uremic Syndrome
Renal Failure
Acute Kidney Injury
Chronic Renal Failure
Hypertension
Inherited or Developmental Defects of the Kidneys
Disorders of the Renal Tubules
Cystinosis
Oculocerebrorenal Syndrome (Lowe Syndrome)
Hypokalemic Alkalosis (Bartter Syndrome, Gitelman Syndrome, & Liddle Syndrome)
Nephrogenic Diabetes Insipidus
Nephrolithiasis
Urinary Tract Infections
QA/QI in Pediatric Nephrology

25. Neurologic & Muscular Disorders
Neurologic Assessment & Neurodiagnostics
History & Examination
Diagnostic Testing
Pediatric Neuroradiologic Procedures
Disorders Affecting the Nervous System in Infants & Children
Altered States of Consciousness (Coma)
Seizures & Epilepsy
Sleep Disorders
Headaches
Pseudotumor Cerebri (Idiopathic Intracranial Hypertension)
Cerebrovascular Disease
Congenital Malformations of the Nervous System
Abnormal Head Size
Neurocutaneous Dysplasias
Central Nervous System Degenerative Disorders of Infancy & Childhood
Ataxias of Childhood
Acute Ataxias of Childhood
Chronic & Episodic Ataxias
Movement Disorders
Cerebral Palsy
Infections & Inflammatory Disorders of the Central Nervous System
Bacterial Meningitis
Brain Abscess
Viral Infections
Encephalopathy of Human Immunodeficiency Virus Infection
Other Infections
Noninfectious Inflammatory Disorders of the Central Nervous System
Syndromes Presenting as Acute Flaccid Weakness
Disorders of Childhood Affecting Muscles
Benign Acute Childhood Myositis
Disorders of Neuromuscular Transmission
Lesions of the Peripheral Nerve
Peripheral Neuropathy
Motor Neuron Disorders
Miscellaneous Neuromuscular Disorders
Floppy Infant Syndrome

26. Orthopedics
Introduction
Disturbances of Prenatal Origin
Congenital Amputations & Limb Deficiencies
Deformities of the Extremities
Common Foot Problems
Genu Varum & Genu Valgum
Tibial Torsion & Femoral Anteversion
Developmental Dysplasia of the Hip Joint
Slipped Capital Femoral Epiphysis
Common Spine Conditions
Back Pain
Torticollis
Scoliosis
Kyphosis
Inflammatory Conditions
Syndromes with Musculoskeletal Involvement
Arthrogryposis Multiplex Congenita (Amyoplasia Congenita)
Neurologic Disorders Involving the Musculoskeletal System
Trauma
Traumatic Subluxations & Dislocations
Fractures
Infections of the Bones & Joints
Vascular Lesions & Avascular Necrosis (Osteochondroses)
Neoplasia of the Musculoskeletal System
Miscellaneous Diseases of Bone & Joint
Fibrous Dysplasia
Bone Cysts, Baker Cyst, & Ganglions
Quality Assurance/Improvement Initiatives in Orthopedics

27. Sports Medicine
Basic Principles
Fitness & Conditioning
Sports Nutrition
Preparticipation Physical Evaluation
Rehabilitation of Sports Injuries
Common Sports Medicine Issues & Injuries
Infectious Diseases
Head & Neck Injuries
Spine Injuries
Shoulder Injuries
Elbow Injuries
Hand & Wrist Injuries
Hip Injuries
Knee Injuries
Foot & Ankle Injuries
Prevention

28. Rehabilitation Medicine
Pediatric Brain Injury
Spinal Cord Injury
Brachial Plexus Lesions & Typical Features
Common Rehabilitation Problems
Quality Assurance/Improvement Initiatives in Rehabilitation Medicine

29. Rheumatic Diseases
Juvenile Idiopathic Arthritis
Systemic Lupus Erythematosus
Dermatomyositis
Vasculitis
Raynaud Phenomenon
Noninflammatory Pain Syndromes

30. Hematologic Disorders
Normal Hematologic Values
Bone Marrow Failure
Constitutional Aplastic Anemia (Fanconi Anemia)
Acquired Aplastic Anemia
Anemias
Approach to the Child with Anemia
Pure Red Cell Aplasia
Nutritional Anemias
Anemia of Chronic Disorders
Congenital Hemolytic Anemias: Red Cell Membrane Defects
Congenital Hemolytic Anemias: Hemoglobinopathies
Congenital Hemolytic Anemias: Disorders of Red Cell Metabolism
Acquired Hemolytic Anemia
Polycythemia & Methemoglobinemia
Methemoglobinemia
Disorders of Leukocytes
Neutropenia
Neutrophilia
Disorders of Neutrophil Function
Lymphocytosis
Eosinophilia
Bleeding Disorders
Abnormalities of Platelet Number or Function
Inherited Bleeding Disorders
Von Willebrand Disease
Acquired Bleeding Disorders
Vascular Abnormalities Associated with Bleeding
Thrombotic Disorders
Splenic Abnormalities
Splenomegaly & Hypersplenism
Asplenia & Splenectomy
Transfusion Medicine
Donor Screening & Blood Processing: Risk Management
Storage & Preservation of Blood & Blood Components
Pretransfusion Testing
Transfusion Practice
References

31. Neoplastic Disease
Major Pediatric Neoplastic Diseases
Acute Lymphoblastic Leukemia
Acute Myeloid Leukemia
Myeloproliferative Diseases
Brain Tumors
Lymphomas & Lymphoproliferative Disorders
Neuroblastoma
Wilms Tumor (Nephroblastoma)
Bone Tumors
Rhabdomyosarcoma
Retinoblastoma
Hepatic Tumors
Langerhans Cell Histiocytosis
Blood & Marrow Transplant & Cellular Therapeutics
General Considerations
BMT Complications
Cellular Therapeutics
Late Effects of Pediatric Cancer Therapy
Growth Complications
Endocrine Complications
Cardiopulmonary Complications
Renal Complications
Neuropsychological Complications
Second Malignancies

32. Pain Management & Pediatric Palliative & End-of-Life Care
Introduction
Pain Assessment
Acute Pain
Chronic Pain Management
Pediatric Palliative & End-of-Life Care
Introduction
Children Who May Benefit From Palliative Care Interventions
Pain Management in Pediatric Palliative Care
Quality-of-Life Adjuncts & Symptom Management in Pediatric Palliative Care
Psychosocial Aspects of Pediatric Palliative Care
Children’s Concept of Death
Spiritual & Cultural Support
Withdrawal of Medical Life Support
Advance Care Planning
References

33. Immunodeficiency
Introduction
Immunodeficiency Evaluation: Primary Considerations
Severe Combined Immunodeficiency Diseases
SCID Classification
Other Combined Immunodeficiencies
Antibody Deficiency Syndromes
Phagocyte Disorders
Deficiencies of the Innate Immune System
Immunodeficiency Diseases That Present with Autoimmunity
Immunodeficiency Diseases That Overlap with Allergy

34. Endocrine Disorders
General Concepts
Hormone Types
Feedback Control of Hormone Secretion
Disturbances of Growth
Target Height & Skeletal Maturation
Short Stature
Tall Stature
Disorders of the Posterior Pituitary Gland
Arginine Vasopressin (Antidiuretic Hormone) Physiology
Central Diabetes Insipidus
Thyroid Gland
Fetal Development of the Thyroid
Physiology
Hypothyroidism (Congenital & Acquired)
Thyroiditis
Hyperthyroidism
Thyroid Cancer
Disorders of Calcium & Phosphorus Metabolism
Hypocalcemic Disorders
Pseudohypoparathyroidism (Resistance to Parathyroid Hormone Action)
Hypercalcemic States
Familial Hypocalciuric Hypercalcemia (Familial Benign Hypercalcemia)
Hypervitaminosis D
Williams Syndrome
Immobilization Hypercalcemia
Hypophosphatasia
Gonads (Ovaries & Testes)
Development
Disorders of Sexual Development
Abnormalities in Female Pubertal Development & Ovarian Function
Polycystic Ovarian Syndrome
Abnormalities in Male Pubertal Development & Testicular Function
Adrenal Cortex
Adrenocortical Insufficiency
Congenital Adrenal Hyperplasias
Adrenocortical Hyperfunction
Primary Hyperaldosteronism
Uses of Glucocorticoids & Adrenocorticotropic Hormone in Treatment of Nonendocrine Diseases
Adrenal Medulla Pheochromocytoma

35. Diabetes Mellitus
Quality Assessment & Outcomes Metrics
Associated Autoimmune Diseases in Type 1 Diabetes
Associated Conditions with Type 2 Diabetes
References

36. Inborn Errors of Metabolism
Introduction
Diagnosis
Suspecting Inborn Errors
Laboratory Studies
Common Clinical Situations
Management of Metabolic Emergencies
Newborn Screening
Disorders of Carbohydrate Metabolism
Glycogen Storage Diseases
Galactosemia
Hereditary Fructose Intolerance
Disorders of Energy Metabolism
Disorders of Amino Acid Metabolism
Disorders of the Urea Cycle
Phenylketonuria & the Hyperphenylalaninemias
Hereditary Tyrosinemia
Maple Syrup Urine Disease (Branched-Chain Ketoaciduria)
Homocystinuria
Nonketotic Hyperglycinemia
Organic Acidemias
Propionic & Methylmalonic Acidemia (Ketotic Hyperglycinemias)
Carboxylase Deficiency
Glutaric Acidemia Type I
Disorders of Fatty Acid Oxidation & Carnitine
Fatty Acid Oxidation Disorders
Carnitine
Purine Metabolism Disorders
Lysosomal Diseases
Peroxisomal Diseases
Congenital Disorders of Glycosylation
Smith-Lemli-Opitz Syndrome & Disorders of Cholesterol Synthesis
Disorders of Brain Specific Metabolism: Neurotransmitters, Synthesis of Amino Acids & Glucose Transport
Creatine Synthesis Disorders
Quality Initiatives in the Field of Metabolic Disease

37. Genetics & Dysmorphology
Foundations of Genetic Diagnosis
Cytogenetics
Molecular Genetics
Principles of Inherited Human Disorders
Mendelian Inheritance
Multifactorial Inheritance
Nonmendelian Inheritance
Family History & Pedigree
Dysmorphology & Human Embryology
Mechanisms
Clinical Dysmorphology
Chromosomal Disorders: Abnormal Number
Trisomies
Sex Chromosome Abnormalities
Chromosomal Abnormalities: Abnormal Structure
Chromosome Deletion Disorders
Contiguous Gene Disorders
Mendelian Disorders
Autosomal Dominant Disorders
Autosomal Recessive Disorders
X-Linked Disorders
Nonmendelian Disorders
Disorders of Imprinting
Disorders Associated with Anticipation
Disorders of Multifactorial Inheritance
Cleft Lip & Cleft Palate
Neural Tube Defects
Common Recognizable Disorders with Variable or Unknown Cause
Genetic Evaluation of the Child with Developmental Disabilities
Perinatal Genetics
Teratogens
Assisted Reproduction
Prenatal Diagnosis

38. Allergic Disorders
Introduction
Asthma
Allergic Rhinoconjunctivitis
Atopic Dermatitis
Urticaria & Angioedema
Anaphylaxis
Adverse Reactions to Drugs & Biologicals
Food Allergy
Insect Allergy

39. Antimicrobial Therapy
Principles of Antimicrobial Therapy
Concepts for Judicious Use of Antimicrobials
Susceptibility Testing & Drug Dosing Properties
Pharmacodynamic Concepts
Use of Antimicrobial Agents to Prevent Disease
Choice of Antimicrobial Agents
Specific Antimicrobial Agents
β-Lactam Antibiotics
β-Lactam: Penicillins
β-Lactam: Cephalosporins
β-Lactam: Monobactams
β-Lactam: Carbapenems
Glycopeptide Agents
Daptomycin
Trimethoprim/Sulfamethoxazole
Metronidazole
Macrolides
Lincosamides
Oxazolidinones
Tetracyclines
Aminoglycosides
Rifamycins
Fluoroquinolones
Antifungals
Antivirals
References

40. Infections: Viral & Rickettsial
Viral Infections
Respiratory Infections
Viruses Causing the Common Cold
Infections Due to Adenoviruses
Influenza
Parainfluenza (Croup)
Respiratory Syncytial Virus Disease
Human Metapneumovirus Infection
Infections Due to Human Coronaviruses
Infections Due to Enteroviruses & Parechoviruses
Acute Febrile Illness
Respiratory Tract Illnesses
Rashes (Including Hand-Foot-&-Mouth Disease)
Central Nervous System Illnesses
Infections Due to Herpesviruses
Herpes Simplex Infections
Varicella & Herpes Zoster
Roseola Infantum (Exanthem Subitum)
Cytomegalovirus Infections
Infectious Mononucleosis (Epstein-Barr Virus)
Viral Infections Spread by Insect Vectors
Encephalitis
Dengue
Chikungunya
Zika
Colorado Tick Fever
Other Major Viral Childhood Exanthems
Erythema Infectiosum
Measles (Rubeola)
Rubella
Infections Due to Other Viruses
Hantavirus Cardiopulmonary Syndrome
Mumps
Rabies
Rickettsial Infections and Q Fever
Human Ehrlichiosis & Anaplasmosis
Rocky Mountain Spotted Fever
Endemic Typhus (Murine Typhus)
Q Fever

41. Human Immunodeficiency Virus Infection
Pathogenesis & Epidemiology
Prevention
Perinatally HIV-Exposed Infant
Adolescents & Youth with HIV Exposure
Progressive HIV Disease
Treatment
Quality Assurance & Outcome Metrics

42. Infections: Bacterial & Spirochetal
Bacterial Infections
Group A Streptococcal Infections
Group B Streptococcal Infections
Streptococcal Infections with Organisms Other Than Group A or B
Pneumococcal Infections
Staphylococcal Infections
Meningococcal Infections
Gonococcal Infections
Botulism
Tetanus
Gas Gangrene
Diphtheria
Infections Due to Enterobacteriaceae
Pseudomonas Infections
Salmonella Gastroenteritis
Typhoid Fever & Paratyphoid Fever
Shigellosis (Bacillary Dysentery)
Cholera
Campylobacter Infection
Tularemia
Plague
Haemophilus Influenzae Type B Infections
Pertussis (Whooping Cough)
Listeriosis
Tuberculosis
Infections with Nontuberculous Mycobacteria
Legionella Infection
Chlamydophila & Chlamydia Infections (Psittacosis, C Pneumoniae, & C Trachomatis)
Cat-Scratch Disease
Spirochetal Infections
Syphilis
Relapsing Fever
Leptospirosis
Lyme Disease

43. Infections: Parasitic & Mycotic
Parasitic Infections
Protozoal Infections
Systemic Infections
Gastrointestinal Infections
Trichomoniasis
Metazoal Infections
Nematode Infections
Cestode Infections (Flukes)
Trematode Infections
Mycotic Infections
Pneumocystis & Other Opportunistic Fungal Infections
Pneumocystis Jiroveci Infection

44. Sexually Transmitted Infections
Introduction
Adolescent Sexuality
Risk Factors
Prevention of Sexually Transmitted Infections
Screening for Sexually Transmitted Infections
Signs & Symptoms
The Most Common Antibiotic-Responsive Sexually Transmitted Infections
Chlamydia Trachomatis Infection
Neisseria Gonorrhoeae Infection
The Spectrum of Signs & Symptoms of Sexually Transmitted Infections
Cervicitis
Pelvic Inflammatory Disease
Urethritis
Epididymitis
Proctitis, Proctocolitis, & Enteritis
Vaginal Discharge
Genital Ulcerations
Genital Warts & Human Papillomavirus
Other Viral Infections
Ectoparasitic Infections
References

45. Travel Medicine
Introduction
Preparing Children & Infants for Travel
Vaccinations—Routine Childhood Vaccines Modified for Travel
Vaccinations—Travel-Specific
Traveler’s Diarrhea
Malaria Prophylaxis & Prevention
Visits to Friends & Relatives (VFR) in High-Risk Areas
HIV & Sexually Transmitted Diseases
Fever in the Returned Traveler
References

46. Chemistry & Hematology Reference Intervals
Challenges in Determining & Interpreting Pediatric Reference Intervals
Guidelines for Use of Data in a Reference Range Study
Statistical Computation of Reference Intervals
Why Reference Intervals Vary
Sensitivity, Specificity, & Predicitive Values
Pediatric Reference Intervals
Index