Practical Paediatrics: With Student Consult Online Access (Revised)

This is the seventh edition of a highly regarded, major textbook of paediatrics. Key features Empahasis on differential diagnosis from a presenting-problem point of view.. Covers the social and preventative aspects of child health Covers the common diseases of childhood and their treatment with a presenting-problem approach Contextualises the disease in description of social, genetic and epidemiological factors. Clinical example boxes throughout Key learning points in Practical Points boxes throughout Clearly sign-posted text Plus Free online access to the whole book through www.studentconsult.com, where you will also find: Over 500 interactive self-assessment questions Further reading suggetions Links to other helpful online resources Additional illustrations Empahasis on differential diagnosis from a presenting-problem point of view.. Covers the social and preventative aspects of child health Covers the common diseases of childhood and their treatment with a presenting-problem approach Contextualises the disease in description of social, genetic and epidemiological factors. Clinical example boxes throughout Key learning points in Practical Points boxes throughout Clearly sign-posted text Plus Free online access to the whole book through www.studentconsult.com, where you will also find: Nearly 400 interactive self-assessment questions Further reading suggetions Links to other helpful online resources Additional illustrations 51 new chapter authors New chapter on sleep problems New chapter on refugee health All chapters updated, with several major re-writes Plus Free online access to the whole book through www.studentconsult.com, where you will also find: Nearly 400 interactive self-assessment questions Further reading suggestions Helpful references Additional illustration Front Cover......Page 3 Practical Paediatrics......Page 6 Copyright......Page 7 Preface......Page 8 Contributors......Page 9 Contents......Page 17 Part 1: Current Paediatrics......Page 22 Where do Australian children live and why is this important?......Page 23 Australian children's experiences of child care and early education......Page 24 What affects child health?......Page 25 Individual and social determinants of health......Page 26 Spotlight on Indigenous children......Page 27 Infant mortality......Page 28 Causes of death between 1 and 14 years......Page 29 Causes of death between 15 and 19 years......Page 30 Burden of disease and long-term health conditions......Page 31 Children and adolescents presenting to specialized paediatric services......Page 33 Smoking-related disorders......Page 34 Future directions......Page 35 Child health inequity......Page 36 Causes of global child mortality......Page 37 Child disability and development......Page 38 Children in complex emergencies......Page 39 Evidence for effective interventions in reducing child mortality......Page 40 How can child health professionals in developed countries contribute to global child health?......Page 42 Part 2: Clinical assessment......Page 44 Acuity of the presentation......Page 45 Referral information......Page 46 The presenting problem......Page 47 Family and social history......Page 48 Immunization status......Page 49 Introduction......Page 50 General observation and behaviour......Page 51 Specific examination......Page 52 Abdomen......Page 53 Head and neck......Page 54 Note-taking......Page 55 The consultation as part of the therapy......Page 56 History is everything......Page 57 Any interaction is an opportunity to examine......Page 58 Team benefits......Page 60 Medical investigations......Page 61 Practical outcomes......Page 62 Part 3: Social and preventative paediatrics......Page 64 The emotional and social needs of the child......Page 65 The Australian family......Page 66 Economic disadvantage/poverty......Page 67 Families affected by mental health problems and drug abuse......Page 68 Services for the child and family......Page 69 Health care and cultural safety......Page 71 Mortality......Page 72 Implications for a health-care professional's practice......Page 73 Implications for a health-care professional's practice......Page 74 Family and kinship......Page 75 Language and communication styles......Page 76 Part 2 maori view of child health and illness......Page 77 The Treaty of Waitangi......Page 78 Socioeconomic and cultural contact issues......Page 79 Genetics and environment in clinical situations......Page 80 A way forward......Page 81 Dietary Guidelines for Children and Adolescents in Australia (National Health and Medical Research Council 2003)......Page 82 Body mass index......Page 83 Breastfeeding......Page 84 Composition of standard infant formulas......Page 85 Other milks......Page 88 Vegetarian diets......Page 89 Malnutrition......Page 90 Nutrition in the hospitalized child......Page 91 Routes of feeding......Page 92 Parenteral nutrition......Page 93 Refeeding syndrome......Page 94 Waist circumference and waist : height ratio – measures of fat distribution......Page 96 International prevalence rates and secular trends......Page 98 Psychosocial complications......Page 99 Hepatobiliary complications......Page 100 Risk factors for cardiovascular disease......Page 101 Long-term psychosocial complications......Page 102 Television viewing......Page 103 Other factors associated with obesity......Page 104 Physical examination......Page 105 Behaviour modification......Page 106 Physical activity and sedentary behaviour......Page 107 Primary prevention of child and adolescent obesity......Page 108 Requirements of vaccines......Page 110 Principles of vaccine selection......Page 111 Immunization schedule for routine childhood immunization......Page 112 Adverse effects of immunization......Page 113 Live virus vaccines......Page 114 Other vaccines......Page 115 Travel......Page 116 Future vaccines and vaccine development......Page 117 Initial care......Page 118 Ongoing care......Page 119 Prevention......Page 120 Summary......Page 121 Causes......Page 123 History......Page 124 Investigation......Page 125 Management......Page 126 General issues of management......Page 127 Medical assessment......Page 128 Fragile X syndrome......Page 129 Down syndrome......Page 130 Microdeletion syndromes......Page 131 Speech and language impairment......Page 132 Learning difficulty......Page 133 Development of current concepts......Page 134 Child protection and the concept of mandatory reporting......Page 135 Principles of interagency practice in relation to the management of suspected child abuse or neglect......Page 136 1. An allegation is made on behalf of a child to a professional by another person......Page 137 Presentations that of themselves should raise suspicions......Page 138 The injury history......Page 140 C. The forensic assessment in children in whom abuse or neglect is suspected......Page 141 E. The health professional's ongoing responsibility to the child and family when abuse or neglect is suspected......Page 142 The wellbeing of health professionals involved with child protection......Page 143 Definitions......Page 144 Explained SUDI......Page 145 The vulnerable infant......Page 146 The contribution of developmental age......Page 147 Parent support after an unexpected infant death......Page 148 Prevention......Page 149 Adolescent development......Page 151 Burden of illness in adolescence......Page 152 Risk and protective factors......Page 153 Medicolegal context and confidentiality......Page 154 Confidentiality......Page 155 Psychosocial screening (HEADSS)......Page 156 Chronic illness......Page 158 Towards self-management......Page 159 Transition to adult health care......Page 160 Labial fusion or adhesions......Page 162 Overview of puberty, adolescence and the menstrual cycle......Page 163 Delayed onset of menses – primary amenorrhoea......Page 164 Secondary amenorrhoea......Page 165 Endometriosis......Page 166 Emergency contraception......Page 167 Intellectual disability – menstrual and contraceptive management......Page 168 Behavioural aspects of children's sleep......Page 170 Sleep phenomena or parasomnias in children......Page 171 Spectrum of paediatric sleep disorders......Page 172 Complications of untreated OSA......Page 173 Rare conditions......Page 174 Conclusion......Page 175 Refugee health assessments......Page 176 Specific health issues......Page 177 Nutrition and growth......Page 178 Screening......Page 180 Tuberculosis screening......Page 181 Strongyloides infection......Page 182 Dental issues......Page 183 Assessment of development and learning......Page 184 Settlement considerations......Page 185 Part 4: Behaviour and mental healthneeds......Page 186 Developmental stages......Page 187 Early infancy (0–6 months)......Page 188 Common problems in the toddler period......Page 189 School years (over 5 years)......Page 190 Adolescence......Page 191 Conclusion......Page 192 Features of internalizing problems......Page 193 Features of externalizing problems......Page 194 Management......Page 195 Problems of infancy......Page 196 School refusal due to anxiety problems......Page 197 Nocturnal enuresis......Page 198 Encopresis......Page 199 Assessment......Page 200 Management......Page 201 Alternative/complementary therapies......Page 202 Prevention......Page 203 Reactive attachment disorders......Page 204 Pervasive developmental disorders......Page 205 Disruptive behaviour disorder......Page 206 Anxiety disorders......Page 207 Major depressive disorder......Page 208 Schizophrenia......Page 209 Post-traumatic stress disorder......Page 210 Eating disorders......Page 211 Part 5: Paediatric emergencies......Page 214 Breathing......Page 215 Effort of breathing......Page 216 Assessment of circulation......Page 217 Conscious level......Page 218 Putting it all together......Page 219 Life support......Page 221 Airway......Page 222 Breathing......Page 223 Circulation......Page 224 Ongoing resuscitation......Page 225 Resuscitation guide B......Page 226 Age 6–12 years......Page 229 Prevent absorption......Page 230 Gastric lavage......Page 231 Administer an antidote......Page 232 Prevention......Page 234 Envenomation......Page 235 Pressure–immobilization first aid......Page 236 Antivenom......Page 238 Spider bite......Page 239 Box jellyfish......Page 240 Irukandji syndrome......Page 241 Part 6: Fluid replacement......Page 242 Regulation of extracellular fluids......Page 243 Weight change......Page 245 Resuscitation for shock......Page 246 Replacing the fluid deficit......Page 247 Maintenance fluids......Page 248 Ongoing losses......Page 249 Management......Page 250 Metabolic acidosis......Page 251 Gastroenteritis......Page 252 Burns......Page 253 Bacterial meningitis......Page 254 Diabetic ketoacidosis......Page 255 Part 7: Principles of imaging......Page 256 Introduction......Page 257 Acute head trauma, all ages......Page 258 Spinal dysraphism......Page 259 First episode of wheezing......Page 261 Thoracic mass......Page 262 Notes......Page 263 Bilious vomiting......Page 264 Notes......Page 265 Urinary infection......Page 267 Notes......Page 268 Notes......Page 269 Inflicted injury (non-accidental injury)......Page 270 Abbreviations......Page 271 Part 8: Common orthopaedic problems and fractures......Page 272 Flat feet......Page 273 In-toe gait (pigeon toeing)......Page 275 Main risk factors......Page 276 Diagnosis in the older infant......Page 277 Scoliosis......Page 278 Adolescent idiopathic scoliosis......Page 279 Chondromalacia patellae......Page 280 Injuries in infancy and childhood......Page 281 Supracondylar fracture of the humerus......Page 282 Toddler fracture of the tibia......Page 283 Pulled elbow......Page 284 Part 9: Common paediatric surgical problems......Page 286 Hypospadias......Page 287 Circumcision......Page 288 Inguinal hernia......Page 289 Undescended testis......Page 290 Other causes of scrotal pathology......Page 291 Discharge from the umbilicus......Page 292 Midline neck swellings......Page 293 MAIS lymphadenitis......Page 294 Torticollis......Page 295 Part 10: Inherited and metabolic problems......Page 296 Genes......Page 297 Frequency......Page 298 Birth defect/congenital malformation registers......Page 299 Prenatal diagnosis......Page 300 Nuchal translucency screening......Page 301 Indications for diagnostic prenatal tests......Page 302 Imaging techniques......Page 303 Prenatal diagnosis for specific genetic conditions......Page 304 Timing of exposure......Page 305 Antiepileptic medication......Page 306 Vitamin A analogues: isotretinoin and acetretin......Page 307 Diethylstilbestrol (DES)......Page 308 Teratogen information services......Page 309 Nuclear DNA forms tightly coiled lengths of DNA called chromosomes......Page 310 One X chromosome is inactivated in females......Page 311 Protein-coding genes......Page 312 The regulation of human gene expression is incompletely understood......Page 313 Genes and networks......Page 314 Most genetic variations are common and do not cause disease......Page 315 What types of mutation cause disease?......Page 316 Triplet repeat mutations......Page 317 Mutations occurring after embryogenesis cause many of the features of ageing......Page 318 Autosomal dominant inheritance......Page 319 X-linked dominant inheritance......Page 320 Polygenic and multifactorial disorders......Page 321 Acknowledgements......Page 323 10.3 The dysmorphic child......Page 324 Putting it all together......Page 325 Investigations......Page 326 Trisomy 18 (Edwards syndrome)......Page 327 Velocardiofacial syndrome......Page 328 Trinucleotide repeat sequence disorders......Page 329 Noonan syndrome......Page 330 Achondroplasia......Page 331 Process of genetic counselling......Page 332 Obtaining and recording a family history......Page 333 Unknown diagnosis......Page 335 The burden......Page 336 Donor gametes......Page 337 Acknowledgements......Page 338 Decreased conscious state......Page 339 Hypoglycaemia......Page 340 Lactic acidosis......Page 341 Lysosomal storage disorders......Page 343 Congenital disorders of glycosylation......Page 345 Peri-mortem protocol......Page 346 Part 11: Neonatal problems......Page 348 Temperature control......Page 349 Gastrointestinal......Page 350 Neonatal stabilization and resuscitation......Page 351 Basic care and stabilization ( Fig. 11.1.3)......Page 352 Chest compressions......Page 354 When should it be done?......Page 355 Head and scalp......Page 356 Chest and heart......Page 357 Limbs......Page 358 Analgesia......Page 359 Vomiting......Page 360 List of (normal) newborn topics in other chapters......Page 361 Causes of preterm birth......Page 362 Patent ductus arteriosus......Page 363 Intraventricular haemorrhage......Page 364 Periventricular leukomalacia......Page 365 Infection......Page 366 The late preterm baby......Page 367 Prognosis......Page 368 History......Page 369 Physiological jaundice......Page 370 Complications of jaundice......Page 371 Treatment of jaundice......Page 372 General principles of management of respiratory distress......Page 373 Causes of respiratory distress......Page 374 Infection......Page 375 Respiratory distress syndrome or hyaline membrane disease......Page 376 Pulmonary air leaks......Page 377 Pulmonary hypoplasia......Page 378 Nasal obstruction......Page 379 Pharyngeal obstruction......Page 380 Apnoea......Page 381 Neuromuscular causes......Page 383 Cytomegalovirus......Page 384 Diagnosis......Page 385 Fetal risks following maternal infection......Page 386 Diagnosis......Page 387 Treponema pallidum (syphilis)......Page 388 Varicella-zoster virus......Page 389 Clinical features......Page 390 Treatment......Page 391 Clinical features......Page 392 Clinical features......Page 393 Hepatitis B virus......Page 394 Human immunodeficiency virus......Page 395 Hirschsprung disease......Page 396 Small bowel atresias......Page 397 Exomphalos......Page 398 Gastroschisis......Page 399 Sacrococcygeal teratoma......Page 400 Part 12: Infections......Page 402 Measles (rubeola, morbilli)......Page 403 Complications......Page 405 Epidemiology......Page 406 Clinical features ( Figs 12.1.4 , 12.1.5)......Page 407 Erythema infectiosum (slapped cheek disease, fifth disease)......Page 408 Prevention......Page 409 Scarlet fever and scarlatina......Page 410 Treatment......Page 411 Clinical features......Page 412 Diagnosis......Page 413 Microbiology......Page 414 Osteomyelitis......Page 415 Osteomyelitis......Page 416 Pus aspirated from bone......Page 417 Ultrasonography......Page 418 Septic arthritis......Page 419 Surgical management......Page 420 Discitis and vertebral osteomyelitis......Page 421 Human genetic factors......Page 423 Infants......Page 424 Antibiotic treatment......Page 425 Subdural effusion......Page 427 Primary prevention......Page 428 Infants aged 1–3 months and the immunocompromised......Page 429 Tuberculous meningitis......Page 430 Infectious encephalitis and myelitis......Page 431 Herpes simplex encephalitis......Page 432 Slow virus infection......Page 433 Prevention and disease control......Page 434 Invasive bacterial disease......Page 435 Tuberculosis......Page 436 Malaria......Page 437 Dengue virus infection......Page 438 Diarrhoeal disease......Page 439 Schistosomiasis (bilharzia)......Page 440 Hookworm......Page 442 Strongyloidiasis......Page 443 Specific infections of the Australian tropics......Page 444 Part 13: Allergy, immunity and inflammation......Page 446 History and examination......Page 447 Assessment......Page 448 Management of symptomatic atopic disease......Page 449 Specific atopic disorders......Page 451 Definition and clinical presentation......Page 452 Definition and clinical presentation......Page 453 Definition and clinical presentation......Page 454 Food allergy and intolerances......Page 455 Non-IgE-mediated food allergies......Page 456 Management......Page 457 Skin infection in atopic dermatitis......Page 458 Spasmodic croup......Page 459 Acquisition of immunological memory......Page 460 Defects associated with prematurity and delays in immunological development......Page 461 Investigations......Page 463 X-linked agammaglobulinaemia/Btk deficiency......Page 466 Common variable immunodeficiency......Page 468 Severe combined immunodeficiency......Page 469 Wiskott–Aldrich syndrome......Page 470 Hyper-IgE syndrome......Page 471 Chronic granulomatous disease......Page 472 Complement disorders......Page 473 Oligoarthritis......Page 474 Systemic arthritis......Page 476 Eye disease in juvenile arthritis......Page 477 Relief of pain......Page 478 Outcomes of juvenile arthritis......Page 479 Systemic lupus erythematosus......Page 480 Neonatal lupus syndrome......Page 481 Juvenile dermatomyositis......Page 482 Scleroderma......Page 483 Kawasaki disease......Page 484 Chronic recurrent multifocal osteomyelitis......Page 485 Chronic pain disorders......Page 486 Part 14: Respiratory disorders......Page 488 Identifiable URTI syndromes......Page 489 Common cold (uncomplicated viral URTI or ‘head cold’)......Page 490 Ulcerative pharyngotonsillitis......Page 491 Acute bacterial tonsillitis (‘streptococcal pharyngitis’)......Page 492 Acute sinusitis (rhinosinusitis)......Page 493 Prevention and treatment......Page 494 Summary......Page 495 Differential diagnosis......Page 496 Laryngomalacia......Page 497 Subglottic stenosis......Page 498 Investigations......Page 499 Management......Page 500 Recurrent (spasmodic) croup......Page 501 Pathogenesis......Page 503 Viruses......Page 504 Classification......Page 505 Investigations......Page 506 Chronic asthma......Page 508 Steroids......Page 509 Long-acting β -agonists......Page 510 Prognosis......Page 511 Infections......Page 512 Aspiration pneumonia......Page 513 Airway ‘malacia’......Page 514 Cardiac causes of wheeze......Page 515 Infection......Page 516 Vocal cord dysfunction......Page 517 Investigations......Page 519 Pneumococcal pneumonia......Page 520 Management......Page 521 Mycoplasma pneumonia......Page 522 Viral pneumonia......Page 523 Acute viral bronchiolitis......Page 524 Investigations......Page 525 Congenital lung abnormalities......Page 526 Congenital lower airway abnormalities......Page 527 Approach to diagnosis and management......Page 528 Management of non-specific cough......Page 530 Cough, gastro-oesophageal reflux and aspiration lung disease......Page 531 Bronchiectasis......Page 532 Diagnosis......Page 533 Principles of management of a child with cystic fibrosis......Page 534 Summary......Page 535 Acknowledgements......Page 536 Part 15: Cardiac disorders......Page 538 Blood pressure......Page 539 Auscultatory findings......Page 540 Characterization......Page 541 Venous hum......Page 542 Cardiac catheterization......Page 543 Prostaglandin......Page 545 Surgery......Page 546 Management......Page 547 Patent ductus arteriosus......Page 548 Atrioventricular septal defect......Page 549 Pulmonary stenosis......Page 550 Coarctation of the aorta......Page 551 Cyanotic defects......Page 552 Course and prognosis......Page 553 Clinical features......Page 554 Diagnosis......Page 555 Cardiomyopathy......Page 556 Infective endocarditis......Page 557 Heart block......Page 558 Part 16: Haematological disordersand malignancies......Page 560 Clinical presentations......Page 561 Fanconi anaemia......Page 563 Acquired aplastic anaemia......Page 567 Transient erythroblastopenia of childhood (TEC)......Page 568 Vitamin B 12 deficiency......Page 569 Folate deficiency......Page 570 Iron deficiency......Page 571 b -Thalassaemia major (Cooley anaemia)......Page 572 Sickle cell disease......Page 573 Anaemia due to increased red cell destruction (haemolysis)......Page 574 Intrinsic membrane defects......Page 575 Autoimmune haemolysis in children......Page 576 Non-viral risks associated with blood and blood products......Page 577 Where is the bleeding?......Page 579 Miscellaneous......Page 580 Immune thrombocytopenic purpura......Page 581 Bleeding due to coagulation disorders......Page 582 Severity......Page 584 Haemophilia centres......Page 585 Anaphylactoid purpura (Henoch–Schönlein purpura)......Page 586 Physiology of anticoagulation......Page 587 Approach to management of a patient with suspected malignancy......Page 589 Acute leukaemia......Page 590 Treatment......Page 591 Classification and prognostic factors......Page 592 Brain and central nervous system tumours......Page 593 Treatment......Page 594 Treatment......Page 595 Neuroblastoma......Page 596 Wilms' tumour (nephroblastoma)......Page 597 Osteosarcoma......Page 598 Rhabdomyosarcoma and soft tissue sarcoma......Page 599 Late effects of cancer therapy......Page 600 Palliative care......Page 601 Part 17: Seizure disorders and disorders of the nervous system......Page 602 Febrile seizures......Page 603 Treatment......Page 604 Treatment......Page 605 Treatment......Page 606 Benign focal epilepsies of childhood......Page 607 Treatment......Page 608 Epilepsies with focal seizures due to structural brain abnormalities......Page 609 Breath-holding attacks......Page 610 Assessment of children with seizures......Page 611 General principles of treatment of seizures in children......Page 612 What are the prenatal causes?......Page 614 Why are premature and low-birth-weight infants at risk of cerebral palsy?......Page 615 Ataxic cerebral palsy (less than 5%)......Page 616 Associated disabilities......Page 617 Consequences of the motor disorder......Page 618 Developmental assessment and referral to appropriate services for the child and family......Page 619 Is there evidence of regression or lack of progress in any area of development?......Page 620 One functional system or group of systems......Page 621 Are any other, less evident, diagnoses suggested by a systematic review of known mechanisms of disease?......Page 622 Are there any treatable disorders among the diagnoses being considered in this child?......Page 623 Diagnosis of neuromuscular disease based on anatomical, electrophysiological, biochemical, histopathological or DNA identif .........Page 624 Spinal muscular atrophy type I (Werdnig–Hoffmann disease)......Page 625 Guillain–Barré syndrome......Page 626 Charcot–Marie–Tooth disease (hereditary motor and sensory neuropathy)......Page 627 Congenital myasthenic syndromes......Page 628 Muscular dystrophies......Page 629 Duchenne muscular dystrophy......Page 630 Congenital type......Page 632 Acknowledgements......Page 633 Embryology and pathogenesis......Page 634 Clinical features......Page 635 Management of myelomeningocele......Page 636 Management of physical disability and mobility......Page 637 Arnold–Chiari malformation......Page 638 Prevention of neural tube defects......Page 639 Large heads (macrocephaly)......Page 640 Hydrocephalus......Page 641 Approach to clinical diagnosis......Page 642 Investigations......Page 643 Ventriculoperitoneal shunt......Page 644 Complications of ventricular shunts......Page 645 Clinical manifestations......Page 646 Types of migraine......Page 647 Aetiology......Page 648 Treatment......Page 649 Tension-type headache......Page 650 Chronic daily headache......Page 651 Idiopathic intracranial hypertension (previously known as benign intracranial hypertension)......Page 653 Extracranial causes......Page 654 Investigations......Page 655 Part 18: Urinary tract disorders andhypertension......Page 658 Urinalysis and microscopy......Page 659 Initial treatment......Page 660 Investigations......Page 661 Urinary tract infection and normal renal ultrasound findings......Page 663 Vesicoureteric reflux......Page 665 Duplication......Page 666 Management......Page 667 Cystic renal disease......Page 668 Post-streptococcal glomerulonephritis......Page 669 Lupus erythematosus......Page 670 Minimal change nephrotic syndrome......Page 671 Congenital nephrotic syndrome......Page 672 Chronic kidney disease......Page 673 Hypertension......Page 674 Part 19: Endocrine disorders......Page 678 Growth hormone–insulin-like growth factor I axis......Page 679 Childhood growth......Page 680 Mid-parental height......Page 681 Short stature......Page 683 Chromosomal abnormalities and syndromes......Page 684 Issues to determine......Page 685 Management......Page 686 Investigations......Page 687 Psychological support and counselling......Page 688 Approach to diagnosis and treatment......Page 689 Treatment......Page 690 Premature thelarche......Page 691 Asymmetrical breast development......Page 692 Aetiology and genetics......Page 693 Acquired......Page 694 Aetiology......Page 695 Aetiology......Page 696 Management......Page 697 Management......Page 698 Prognosis......Page 699 Summary......Page 700 Internal genitalia......Page 701 External genitalia......Page 702 History......Page 703 Diagnostic categories for disorders of sexual development......Page 704 Undervirilized XY......Page 705 Congenital adrenal hyperplasia......Page 706 Long-term management......Page 707 Clinical presentation......Page 708 Stabilization of newly diagnosed type 1 diabetes......Page 709 Insulin......Page 710 Long-term microvascular and macrovascular complications......Page 711 Hypoglycaemia......Page 713 Adherence......Page 714 Type 2 diabetes......Page 715 Hypocalcaemia......Page 717 Rickets......Page 720 Renal osteodystrophy......Page 721 Hypercalcaemia......Page 722 Osteoporosis......Page 723 Magnesium disorders......Page 724 Part 20: Gastrointestinal tract and hepatic disorders......Page 726 Intussusception......Page 727 Acute appendicitis......Page 728 Differential diagnosis......Page 730 Recurrent abdominal pain in children......Page 731 Malrotation with volvulus......Page 732 Pyloric stenosis......Page 733 Migraine......Page 734 Cyclical vomiting syndrome......Page 735 Bacterial and parasitic gastroenteritis......Page 736 Clinical features......Page 737 Electrolyte loss......Page 738 Severe dehydration ( ≥ 10%)......Page 739 Sugar malabsorption......Page 740 Ulcerative colitis......Page 741 Exclusive enteral nutrition......Page 742 Cancer risk......Page 743 Clinical assessment......Page 745 Stool examination......Page 746 Fatty diarrhoea (steatorrhoea)......Page 747 Fat malabsorption......Page 748 Chronic pancreatitis......Page 749 Impaired lymphatic drainage......Page 750 Carbohydrate malabsorption......Page 751 Congenital......Page 752 Vitamin B 12......Page 753 Amino acids......Page 754 Summary of the diagnostic approach to suspected malabsorption......Page 755 Clinical manifestations......Page 756 Diagnostic tests......Page 757 24-hour intra-oesophageal pH monitoring......Page 758 Oesophageal manometry and multi-channel intraluminal impedance......Page 759 Acid suppression......Page 760 Epidemiology......Page 761 Gastric adenocarcinoma......Page 762 Diagnostic tests ( Box 20.4.9)......Page 763 Treatment......Page 764 Laboratory patterns of liver dysfunction......Page 765 Clinical signs of liver dysfunction......Page 767 Liver disease in the neonate and infant......Page 769 The acutely unwell neonate and infant with liver disease......Page 770 Chronic liver disease in the infant......Page 771 Liver disease in the older child......Page 772 The older child with chronic liver dysfunction......Page 773 Liver failure......Page 774 Part 21: Skin disorders......Page 776 Infections......Page 777 Red, scaly rashes in the neonate or young infant......Page 778 Congenital melanocytic naevi (CMN)......Page 779 Epidermal naevi......Page 780 Complications of haemangiomas......Page 781 Moles (acquired melanocytic naevi)......Page 782 Specific patterns......Page 783 Clinical features......Page 784 Neonatal herpes simplex......Page 785 Indolent ulceration in the immunosuppressed patient......Page 786 Staphylococcal scalded skin syndrome......Page 787 Streptococcal perianal disease......Page 788 Tinea versicolor......Page 789 Clinical features and diagnosis......Page 790 Papular urticaria......Page 791 Explanation and education......Page 792 Discoid eczema......Page 793 Allergic contact dermatitis......Page 794 Other causes......Page 795 Photosensitivity in children......Page 796 Hair loss in children......Page 797 Management......Page 798 Recurrent mouth ulcers......Page 799 Part 22: ENT, eye and dental disorders......Page 800 The nose......Page 801 Otitis media......Page 802 Diagnosis and management of otitis media......Page 803 Management......Page 805 Acute sore throat......Page 806 Obstructive sleep apnoea......Page 808 Aetiology in older children......Page 809 Assessment......Page 810 Examination......Page 811 Misalignment of the eyes......Page 812 Accommodative esotropia......Page 813 Trauma......Page 814 Conjunctivitis......Page 815 Visual handicap......Page 816 Glaucoma......Page 817 Diabetes mellitus......Page 818 Summary......Page 819 Teething......Page 820 Developmental defects of enamel......Page 821 Dental caries......Page 822 Fluoride......Page 823 Fluorosis......Page 824 Trauma......Page 825 Permanent dentition......Page 826 Bleeding gums......Page 827 Infections......Page 828 Treatment......Page 829 Congenital heart disease......Page 830 A ......Page 832 B ......Page 833 C ......Page 834 D ......Page 836 E ......Page 837 F ......Page 838 H ......Page 839 I ......Page 840 M ......Page 842 N ......Page 843 O ......Page 844 P ......Page 845 R ......Page 846 S ......Page 847 U ......Page 849 W ......Page 850 Z ......Page 851

This is the seventh edition of a highly regarded, major textbook of paediatrics.

Key features

• Empahasis on differential diagnosis from a presenting-problem point of view..
• Covers the social and preventative aspects of child health
• Covers the common diseases of childhood and their treatment with a presenting-problem approach
• Contextualises the disease in description of social, genetic and epidemiological factors.
• Clinical example boxes throughout
• Key learning points in Practical Points boxes throughout
• Clearly sign-posted text

Plus

Free online access to the whole book through www.studentconsult.com, where you will also find:

• Over 500 interactive self-assessment questions
• Further reading suggetions
• Links to other helpful online resources
• Additional illustrations

• Empahasis on differential diagnosis from a presenting-problem point of view..
• Covers the social and preventative aspects of child health
• Covers the common diseases of childhood and their treatment with a presenting-problem approach
• Contextualises the disease in description of social, genetic and epidemiological factors.
• Clinical example boxes throughout
• Key learning points in Practical Points boxes throughout
• Clearly sign-posted text

Plus

Free online access to the whole book through www.studentconsult.com, where you will also find:

• Nearly 400 interactive self-assessment questions
• Further reading suggetions
• Links to other helpful online resources
• Additional illustrations

• 51 new chapter authors
• New chapter on sleep problems
• New chapter on refugee health
• All chapters updated, with several major re-writes

Plus

Free online access to the whole book through www.studentconsult.com, where you will also find:

• Nearly 400 interactive self-assessment questions
• Further reading suggestions
• Helpful references
• Additional illustration

This is the seventh edition of a highly regarded, major textbook of paediatrics. Key features Covers the social and preventative aspects of child health Covers the common diseases of childhood and their treatment with a presenting-problem approach Clinical examples throughout Key learning points in Practical Points boxes throughout Clearly sign-posted text New to this edition: 51 new chapter authors All chapters brought up to date with major re-writes of several chapters New chapter on Sleep Problems New chapter on Refugee Health Plus Free online access to the whole book through www.studentconsult.com, where you will also find: Over 500 interactive self-assessment questions Further reading Links to other helpful online resources Additional illustrations care. Empahasis on differential diagnosis from a presenting-problem point of view. Covers the social and preventative aspects of child healthCovers the common diseases of childhood and their treatment with a presenting-problem approachContextualises the disease in description of social, genetic and epidemiological factors. Clinical example boxes throughoutKey learning points in Practical Points boxes throughoutClearly sign-posted text Plus Free online access to the whole book through www.studentconsult.com, where you will also find: Nearly 400 interactive self-assessment questions Further reading suggetions Links to other helpful online resources Additional illustrations