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The Short Textbook of Pediatrics
Suraj Gupte
SECTION 1: INTRODUCTION TO PEDIATRICS
1:
Pediatrics: Contemporary Trends
NATIONAL HEALTH MISSION
National Rural Health Mission
Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH + A) Strategy
National Urban Health Mission
INDIA NEWBORN ACTION PLAN
CHILD HEALTH IN INDIA'S 12TH FIVE YEAR PLAN
INDIA'S NEW NATIONAL HEALTH POLICY
CHILD RIGHTS UNDER UNITED NATIONS
CHILD RIGHTS IN INDIA
CHILD RIGHTS ADVOCACY AND THE PEDIATRICIANS
NUTRITIONAL DEFICIENCY STATES
Infectious Diseases
Diarrheal Diseases
The Camel-back Concept
Emerging Issues
HIGH MORBIDITY AND MORTALITY: CAUSE AND SOLUTION
SECTION 2: CORE PEDIATRICS
2:
Pediatric History-taking and Physical (Clinical) Examination
INFORMANT
ENVIRONMENT
APPROACH
RECORD
BASIC INFORMATION
PRESENTING COMPLAINTS
HISTORY OF PRESENT ILLNESS
HISTORY OF PAST ILLNESSES
BIRTH HISTORY
Antenatal
Natal
Postnatal
DEVELOPMENTAL MILESTONES
IMMUNIZATION STATUS
DIETARY HISTORY
PERSONAL HISTORY
FAMILY HISTORY
SOCIOECONOMIC STATUS
SYSTEM REVIEW
PRE-EXAMINATION PREPARATION
GENERAL EXAMINATION
OVERALL APPEARANCE
VITAL SIGNS
ANTHROPOMETRY
SKIN, APPENDAGES AND MUCOSA
LIMBS AND FEET
LYMPH NODES
HEAD
Occipitofrontal Circumference
Shape
Cephalic Index (Cranial Index)
Sutures and Fontanels
FACE
EYES
NOSE
MOUTH AND THROAT
EARS
NECK
CHEST
HEART
Auscultation
Heart Sounds
Murmurs
Systolic Nurmurs
Diastolic Murmurs
Continuous Murmur (Machinery Murmur)
ABDOMEN
GENITALIA
PERIANAL AND RECTAL EXAMINATION
SPINE AND BACK
SALIENT DEVELOPMENTAL MILESTONES
IMMUNIZATION STATUS
GENERAL PHYSICAL EXAMINATION*
MUSCLE STATUS: GENERALIZED OR SELECTIVE WASTING
SYSTEMIC EXAMINATION
SUMMARY OF THE CASE
3:
Normal Growth
DEFINITIONS
VARIOUS STAGES (PERIODS) OF GROWTH
Prenatal Stage
Postnatal Stage
TYPES OF GROWTH STUDIES
VARIOUS FACTORS INFLUENCING GROWTH
Genetic Factors
Intrauterine Factors
Fetal Factors
Placental Factors
Maternal Factors
Postnatal Factors
Nutritional Factors
Socioeconomic Factors
Environmental Factors
Chronic Diseases
Growth Potentials
Emotional Factors
Hormonal Factors
POOR FETAL AND EARLY CHILDHOOD GROWTH AND ADULT DISEASE
PRINCIPLES OF GROWTH (LAWS OF GROWTH)
Order of Growth
Postnatal Growth Patterns
General (Somatic) Type
Genital (Gonadal) Type
Neural Type
Lymphoid Type
Variations in Body Proportions
Types of Body Build (Somatotypes)
Somatic Growth
Growth Spurts
IMPORTANT CRITERIA /INDICES FOR ASSESSMENT OF GROWTH
Weight
Length/Height
Weight for Height
Growth Velocity
Body Ratios/Proportions
Head Circumference
CHEST CIRCUMFERENCE
Head/Chest Circumference Ratio
Mid Upper-arm Circumference
Skin-fold Thicknes
Body Mass Index
Bone Age
Dentition
Delayed Eruption
Physiological and Structural Growth
GROWTH CHART
(Road to Health Chart)
Goal
Types
Applications (Uses)
GROWTH MONITORING
Definition
Features
Criticism
Schedule
LINEAR CATCH-UP GROWTH
Definition
Influencing Factors
Types
Operative Factors
Modus Operandi
GROWTH (REFERENCE) STANDARDS: LOCAL OR INTERNATIONAL?
4:
Growth Disorders
DEFINITION
ETIOLOGY
CLINICAL FEATURES
DIAGNOSIS
Clinical Work-up
INVESTIGATIONS
TREATMENT
FOLLOW-UP
LONG-TERM CONSEQUENCES (SEQUELAE)
DEFINITION
CLASSIFICATIONS
SALIENT FEATURES OF IMPORTANT TYPES
Constitutional Short Stature
Primordial Dwarfism
Nutritional Stunting
Emotional Deprivation
Chronic Systemic/Visceral Diseases
Endocrinopathies
Skeletal Disorders
Chromosomal Disorders
Genetic Disorders
Idiopathic Short Stature
DIAGNOSTIC APPROACH
History and Physical Examination
Anthropometry
Sexual Maturity Rating (Pubertal Staging)
Investigations
Level I
Level II: Specific Investigations
Level III: Sophisticated Tests
MANAGEMENT
GROWTH HORMONE THERAPY
SURGICAL INTERVENTIONS
ETIOLOGY
APPROACH
History
Physical Examination
Investigations
DEFINITION
EPIDEMIOLOGY/PREVALENCE
ETIOPATHOGENESIS
Exogenous (Constitutional) Obesity
Endogenous Obesity
Physiological Obesity
CLINICAL FEATURES
Exogenous Obesity
Endogenous Obesity
Somatic Types
DIAGNOSIS
COMORBIDITIES/COMPLICATIONS
MANAGEMENT
Dietetic Restriction
Greater Physical Activity
Supportive Therapy
Surgery
PREVENTION
DEFINITION
ETIOPATHOLOGY
CLASSIFICATION
Scaphocephaly (Dolichocephaly)
Brachycephaly
Oxycephaly (Acrocephaly, Turricephaly, Tower Head/Skull)
Plagiocephaly
Trigonocephaly
CLINICAL FEATURES
DIAGNOSIS
COMORBIDITIES/COMPLICATIONS
TREATMENT
DEFINITION
TYPES
Primary Microcephaly
Secondary Microcephaly
ETIOLOGY
CLINICAL FEATURES
DIAGNOSTIC EVALUATION
TREATMENT
PROGNOSIS
DEFINITION
ETIOLOGY
CLINICAL FEATURES
DIAGNOSTIC EVALUATION
TREATMENT
5:
Development
DEFINITION
DOMAINS OF DEVELOPMENT
NORMAL DEVELOPMENTAL MILESTONES
PRINCIPLES OF DEVELOPMENT
VARIOUS FACTORS INFLUENCING DEVELOPMENT
Adverse Factors
Prenatal Factors
Neonatal Risk Factors
Postneonatal Factors
Psychosocial Factors
Protective Factors
Breastfeeding
Well Informed Educated Parents
Parental Positive Attitudes
ASSESSMENT OF DEVELOPMENT
Developmental Screening
Types
Guidelines
Various Tests Employed
Denver Developmental Screening Test
Baroda Developmental Screening Test
Trivandrum Developmental Screening Test
Goodenough Draw-a-Man Test
Definitive Development Assessment Tests
Intelligence Quotient (IQ)
PROMOTION OF DEVELOPMENT
Sensible Parenting
Early and Timely Stimulation
Balanced Television-Exposure
Soft Neurological Signs and Development
6:
Developmental, Behavioral and Psychiatric Disorders
DEFINITION
ETIOLOGY
DIAGNOSIS
MANAGEMENT
DEFINITION
PREVALENCE
ETIOLOGY
PATHOPHYSIOLOGY
CLASSIFICATION
CLINICAL FEATURES
DIAGNOSIS
COMORBIDITIES
MANAGEMENT
Multidisciplinary Approach
Special Considerations
CLASSIFICATION
ETIOLOGY
DIAGNOSIS
MANAGEMENT
Tutoring
Pharmacotherapy
PROGNOSIS
EPIDEMIOLOGY
ETIOLOGY
PATHOPHYSIOLOGY
CLINICAL FEATURES
COMORBIDITIES
DIAGNOSIS
MANAGEMENT
Non-pharmacological/General Measures
Pharmacotherapy
Prognosis
ASD AS A COMMUNITY CHALLENGE
SOCIAL COMMUNICATIVE DISORDER
CEREBRAL PALSY
GENERAL CONSIDERATIONS
CATEGORIZATION
GENESIS
PRINCIPLES OF COUNSELING
RUMINATION DISORDER
PICA
ANOREXIA NERVOSA
BINGE EATING
BULIMIA NERVOSA
FOOD FUSSINESS
ENURESIS
Types
Clinical Features
Etiology
Diagnosis
Treatment
ENCOPRESIS
ETIOLOGY
CLINICAL FEATURES
DIAGNOSIS
DIFFERENTIAL DIAGNOSIS
TREATMENT
PROGNOSIS
THUMB SUCKING
NAIL BITING
TEETH GRINDING (BRUXISM)
STUTTERING
TICS (HABIT SPASM)
TEMPER TANTRUMS
OPPOSITIONAL DEFIANT DISORDER
CONDUCT DISORDER
JUVENILE DELINQUENCY
Etiology
Prevention
Management
WHY DRUGS?
HYSTERIA
Common Presentations
Management
ETIOLOGY
CLINICAL FEATURES
Physical Abuse
Sexual Abuse
Non-organic failure to thrive
DIAGNOSIS
Physical Abuse
Sexual Abuse
Non-organic Failure to Thrive
TREATMENT
PROGNOSIS
PREVENTION
MUNCHAUSEN SYNDROME BY PROXY
Clinical Features
Etiology
Diagnosis
Management
ROLE OF PEDIATRICIAN IN BEHAVIORAL, DEVELOPMENTAL AND PSYCHIATRIC DISORDERS
7:
Adolescent Medicine
SPECIAL FEATURES OF THREE PHASES OF ADOLESCENCE
PUBERTY CHANGES
Morphological Changes
Order of Morphological Changes in Girls
Order of Morphological Changes in Boys
TANNER'S SEXUAL MATURITY RATING
Puberty Spurt
Psychological Changes
FACTORS INFLUENCING ADOLESCENT HEALTH AND DEVELOPMENT
Modifiable (External) Factors
Protective Factors
Social, Cultural and Political Factors
Gender-related Factors
Non-modifiable (Internal) Factors
ADOLESCENT PSYCHOLOGY
Self-esteem (Self-concept)
Formation of the Identity
Psychological Problems
ADOLESCENT SEXUALITY
Sexual Concerns
Self-gratification
Homosexuality
Promiscuous Sex
ADOLESCENT NUTRITION
SPECIAL HEALTH, MEDICAL AND PSYCHOSOCIAL PROBLEMS OF THE ADOLESCENTS
Infections
Eating Disorders
Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder
Malnutrition
Iron Deficiency Anemia (IDA)
Obesity
Puberty Goiter
Depression
Suicide
Substance Abuse
Juvenile Delinquency
Adolescent Violence and Aggression
Teenage Pregnancy
Sexually Transmitted Diseases and HIV/AIDS
Menstrual Problems
BREAST DISORDERS/PROBLEMS
Breast Asymmetry
Breast Hypoplasia
Congenital Anomalies
Breast Mass
Gynecomastia
Nipple Discharge
PENILE PROBLEMS
Congenital Anomalies
Skin Lesions
Balanitis and Balanoposthitis
SCROTAL PROBLEMS
Undescended Testes
Hydrocele
UROLOGIC PROBLEMS
DERMATOLOGICAL PROBLEMS
Acne
Hirsutism
Others
SLEEP DISORDERS
Narcolepsy
Insomnia
ORTHOPEDIC PROBLEMS
PROMOTION OF ADOLESCENT HEALTH
Health Education
Life Skills Education (LSE)/Skills-based Education (SBE)
Family Life Education (FLE)
Counseling for Managing Stress and Emotions
Nutritional Care and Counselling
Immunization of the Adolescent
Early Diagnosis and Management of Medical and Behavioral Conditions
Legislation
INDIA'S LEAP FOR ADOLESCENT WElFARE:MISSION KISHORE UDAY
8:
Pediatric-related Biostatistics
DEFINITION
THE CONCEPT OF NORMAL
DATA, INFORMATION AND INTELLIGENCE
TYPES OF STUDIES
STATISTICAL AVERAGES
Arithmetic Mean (Mean)
The Median
The Mode
MEASURES OF VARIATION (DISPERSION)
The Range
The Mean Deviation
The Standard Deviation
Z Score
Normal Distribution (Normal Curve)
SAMPLING
CHI-SQUARE TEST
PERCENTILE
SIGNIFICANT (P) VALUE
ROLE OF STATISTICS IN GROWTH AND DEVELOPMENT
9:
Community Pediatrics
DEFINITION
COMMUNITY PEDIATRICS AS A COMMITMENT
BASIC PRINCIPLES
ADVANTAGES
FACTORS INFLUENCING FAMILY HEALTH
FAMILY HEALTH PROGRAM
MATERNAL AND CHILD HEALTH SERVICES
Objectives
Delivery
NATIONAL HEALTH MISSION
INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS) SCHEME
Objectives
Package of Services
Beneficiaries of Services
Delivery of Services
Community Participation
MAGNITUDE OF THE PROBLEM
MAJOR PATTERNS OF CHILD LABOR (FIGS 9.5A AND B, FIG. 9.6)
BACKGROUND FACTORS
HEALTH HAZARDS
THE WAY-OUT
ETIOLOGIC CLASSIFICATION
REHABILITATION
AVAILABLE WELFARE SERVICES IN INDIA
ISSUES AND PROBLEMS
Female Feticide/Infanticide
Nutritional Status
Morbidity and Mortality
Educational Status
Girl Child Abuse and Neglect
Girl Child Laborer
Girl Street Child
THE SOLUTION/PRACTICAL ACTION PLAN
MAGNITUDE OF THE PROBLEM
MAJOR TYPES
PREVENTIVE MEASURES
EDUCATION
STRICT IMPLEMENTATION OF RULES
ELIMINATION OF CAUSATIVE FACTORS
MEDICAL CARE OF THE VICTIM
SURVEY AND RESEARCH
REPRODUCTIVE AND CHILD HEALTH (RCH PROGRAM
For the Children
For the Mother
For the Eligible Couples
For Reproductive Tract Infection (RTI)/Sexually Transmitted Diseases (STDs)
INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS (IMCI)
Major Components
INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESS (IMNCI)
Major Components
Types of IMNCI
Principles of IMNCI Guidelines
Steps of Management
BABY-FRIENDLY HOSPITAL INITIATIVE
PRIORITY HEALTH PROBLEMS
AIMS AND OBJECTIVES
SALIENT COMPONENTS/FEATURES
A BOON
AGE-WISE TV VIEWING
ADVERSE EFFECTS
THE WAY-OUT
BACKGROUND
WHY SUCH AN EXCLUSIVELY PREFERENTIAL STRESS ON THE UNDER-FIVES?
SERVICES RENDERED
OPERATIONAL MODALITIES
DISPOSAL OF HOSPITAL WASTE
10:
Immunization
VACCINATION
Vaccine Efficacy
Vaccine Effectiveness
IMMUNIZATION
DEFINITION
THREE PILLARS
EQUIPMENT
CATEGORIES
AEFI IN RELATION TO INDIVIDUAL VACCINES
PREVENTION
SURVEILLANCE AND REPORTING
VACCINE VIAL MONITOR
ROUTE OF VACCINE ADMINISTRATION
SAFE INJECTION PRACTICES
IMPORTANT GUIDELINES ON IMMUNIZATION
RECOMMENDED IMMUNIZATION SCHEDULES IN INDIA
National Schedule
Indian Academy of Pediatrics Schedule
IMMUNIZATION OF ADOLESCENTS
IMMUNIZATION OF THE IMMUNOCOMPROMISED
IMMUNIZATION OF PRETERM/LOW BIRTH WEIGHT (LBW) INFANTS
LAPSED IMMUNIZATION
UNKNOWN IMMUNIZATION STATUS
AT WHAT AGE(S) TO VACCINATE?
SITE
METHOD
NORMAL REACTIONS FOLLOWING VACCINATION (IMMUNOGENICITY)
CONTRAINDICATIONS
AEFI AND THEIR MANAGEMENT
PROTECTIVE EFFICACY
ORAL POLIO VACCINE (OPV)
Availability
Dosage Schedule
Administration
How OPV Behaves in the Body?
Contraindications
AEFI
Vaccine Vial Monitoring
INACTIVATED POLIO VACCINE (SALK VACCINE)
INDICATIONS
DOSE
DOSAGE SCHEDULE
AEFI
CONTRAINDICATION
STORAGE
DOSAGE SCHEDULE
ADMINISTRATION
AEFI
CONTRAINDICATIONS
STORAGE
INDICATIONS
DOSE
DOSAGE SCHEDULE
AEFI
CONTRAINDICATION
STORAGE
AVAILABILITY
DOSE
DOSAGE SCHEDULE
AEFI
CONTRAINDICATION
STORAGE
INDICATIONS
DOSE
DOSAGE SCHEDULE
AEFI
INDICATIONS
DOSE
DOSAGE SCHEDULE
AEFI
CONTRAINDICATIONS
PRECAUTIONS
STORAGE
DOSE
DOSAGE SCHEDULE
AEFI
CONTRAINDICATIONS
PRECAUTION
STORAGE
INDICATIONS
DOSE
CONTRAINDICATION
AEFI
INDICATION
DOSE
DOSAGE SCHEDULE
AEFI
INDICATION
DOSE
DOSAGE SCHEDULE
AEFI
CONTRAINDICATIONS
PROTECTION
INDICATION
DOSE
DOSAGE SCHEDULE
AEFI
STORAGE
TYPHOID Vi POLYSACCHARIDE VACCINE
Dose/Schedule
AEFI
Contraindication
Storage
Vi POLYSACCHARIDE CONJUGATE TYPHOID VACCINE
Dose/Schedule
AEFI
Contraindication
Storage
ORAL TYPHOID VACCINE: TY21
Dose
AEFI
Contraindications
Caution
Storage
INDICATIONS
DOSE
DOSAGE SCHEDULE
AEFI
CONTRAINDICATIONS
PRECAUTION
STORAGE
INDICATIONS
DOSE/SCHEDULE
AEFI
CONTRAINDICATION
STORAGE
INDICATIONS
DOSE/SCHEDULE
AEFI
CONTRAINDICATION
STORAGE
INDICATION
DOSE/SCHEDULE
Live Attenuated Culture-Derived SA-14-14-2
Inactivated Cell Culture-derived SA-14-14-2 (JEEV by BE India)
Inactivated Vero cell culture-derived Kolar strain, 821564XY, JE vaccine (JENVAC by Bharat Biotech)
AEFI
CONTRAINDICATION
INDICATIONS
DOSE/SCHEDULE
AEFI
STORAGE
INDICATION
DOSE/SCHEDULE
AEFI
CONTRAINDICATIONS
PRECAUTIONS
STORAGE
SEROPROPHYLAXIS
PRE-EXPOSURE PROPHYLAXIS
BACKGROUND
DEFINITION
BENEFITS
CONSUMER-RELATED BENEFITS
HEALTH DEPARTMENT/FACILITY-RELATED BENEFITS
ADVERSE EFFECTS
BENEFITS VIS-À-VIS ADVERSE EFFECTS
RECOMMENDED COMBINATION VACCINES
11:
Nutritional Requirements
DEFINITION
FIBER-CONTAINING FOODS
TYPES
ADVANTAGES
DISADVANTAGE
DAILY REQUIREMENT
DEFINITION
ADVANTAGES OF LOW GLYCEMIC INDEX FOOD ITEMS
IRON
ZINC
FREE RADICALS CAUSING TISSUE DAMAGE
ANTIOXIDANTS
DEFINITION
COMMONLY-EMPLOYED IMMUNONUTRIENTS
ROLE
ADMINISTRATION
INDICATIONS
FUTURE PROSPECTS
12:
Infant and Young Child Feeding
OVERVIEW
IMPORTANT DEFINITIONS
ANATOMICAL ASPECTS OF LACTATION
PHYSIOLOGY OF LACTATION
In Relation to Mother
In Relation to the Infant
BREASTFEEDING/HUMAN MILK: THE SUPREME GIFT
Composition
Advantages/Benefits of Human Milk
For the Infant
For the Mother
For the Community
Breastfeeding Schedule
Breastfeeding Technique
Proper Positioning
Proper Attachment
Basic Principles of Breastfeeding
Contraindications
Common Breastfeeding Problems
Inverted or Retracted Nipples
Sore Nipple
Breast Engorgement
Breast Abscess
Not Enough Milk
World Health Organization (WHO)'s 10 Point Strategy for Successful Breastfeeding
LACTATION FAILURE
Definition
Etiology
Prevention
Treatment
Relactation in Partial Lactation Failure
Relactation in Complete Lactation Failure
Evidence of Successful Relactation
EXPRESSED BREAST MILK (EBM)
Indications
Prerequisites
Steps of Milk Expression
Storage
Feeding of Low Birth Weight Infants
Feeding of HIV-Positive Mothers' Infants
HUMAN MILK BANKING
COMPLEMENTARY FEEDING
Definition
Recommended Age
Prerequisites/Attributes of an Ideal Complimentary Food
Types of Complementary Foods
Complementary Feeding Regimen
ARTIFICIAL (FORMULA) FEEDING
COMMON FEEDING PROBLEMS
Regurgitation
Vomiting
Suckling and Swallowing Difficulties
Dehydration and Fever
Excessive Crying
Colic
Change in Bowel Habit
Underfeeding
Bottle Addiction
Overfeeding
Inexperienced Mothers
13:
Malnutrition
OVERVIEW
CERTAIN DEFINITIONS
PREVALENCE
ECOLOGY OF MALNUTRITION
Bad Economy
Ignorance
Faulty Food Habits and Feeding
Medical Reasons
Large Families
Closely-spaced Families
Working Mother
Bad Start
Secondary Malnutrition
PATHOPHYSIOLOGY
ASSESSMENT OF NUTRITIONAL STATUS
Dietary History
Clinical Signs
Anthropometry
Age-dependent Indices
Age-independent Indices
Investigations
Assessment for Associated Disorders
Vital Health Statistics
Ecologic Factors
EVOLUTION OF PEM
Dietary Hypothesis
Adaptation Hypothesis
Aflatoxin Contamination Hypothesis
Golden's Hypothesis of Free Radicals
Jellife's Hypothesis of Interactions and Sequelae
PEM AND DISTURBANCES OF METABOLISM
Water, Electrolytes and Minerals
Protein and Amino Acids
Lipids
Carbohydrates and Energy
PEM AND INFECTION
PEM AND DIARRHEA
PEM AND FAMILY PLANNING
PEM AND ENDOCRINE STATUS
Cortisol
Somatomedins
Insulin
Growth Hormone
Glucagon
Thyroxin
PEM AND CARDIAC FUNCTION
PEM AND RENAL FUNCTION
PEM AND DRUG DISPOSITION
VARIOUS CLASSIFICATIONS OF PEM
Based on Clinical Features
Syndromal Classification
Based on Weight for Age
Gomez Classification
Wellcome or International Classification
Indian Academy of Pediatrics (IAP) Classification
Jelliffe Classification
Based on Weight for Height
Waterlow Classification
MacLaren Classification
Based on Height for Age
Waterlow Classification
Based on Weight for Height and Height for Age
Waterlow Classification
WHO Classification
Based on MUAC
Arnold Classification
Based on Skinfold Thickness
Based on BMI (kg/m2)
SPECIAL FEATURES OF CLINICAL SYNDROMES
Kwashiorkor
Clinical Features (Figs 13.7 to 13.9)
Biochemical Changes
Diagnosis
Marasmus
Clinical Features (Figs 13.16 to 13.18)
Biochemical Changes
Diagnosis
Marasmic Kwashiorkor
Prekwashiorkor
Nutritional Stunting
COMPLICATIONS OF PEM
PRINCIPLES OF MANAGEMENT OF PEM
Domiciliary (Home) Management
Mild Moderate Malnutrition
Uncomplicated Severe Acute Malnutrition (SAM)
Management in Nutrition Rehabilitation Center (NRC)
Hospital Management
Severe Acute Malnutrition
Uncomplicate SAM
Complicated SAM
Treatment Outcome
Prevention
Community Based Therapeutic Care (CTC)
READY TO USE THERAPEUTIC FOOD (RUTF)
Background
RUTF as Medical Nutrition Therapy
PHENOMENA ENCOUNTERED DURING NUTRITIONAL REHABILITATION
Favorable
Unfavorable
Refeeding Edema
Pseudotumor Cerebri
Nutritional Recovery Syndrome (Gomez Syndrome)
Encephalitis-like Syndrome
Refeeding Syndrome
Rickets
Anemia/Micronutrient Deficiency
PROGNOSIS IN PEM
LONG-TERM SEQUELAE OF PEM
Growth Retardation
Mental Impairment
Malnutrition and Liver
PREVENTION OF MALNUTRITION
At Family Level
At Community Level
At National Level
At World Level
NATIONAL NUTRITION PROGRAMS
Applied Nutrition Program
Special Nutrition Program (SNP)
Midday Meal Program
Nutritional Anemia Prophylaxis Program
Supplementary Nutrition in ICDS
Balwadi Nutrition Program
Anemia Control Program
Nutritional Blindness Prevention Program
Iodine Deficiency Control Program
ICDS Scheme
NATIONAL NUTRITION POLICY
Aims and Objectives
National Plan of Action on Nutrition (NPAN)
OVERWEIGHT AND OBESITY
14:
Vitamins
INTRODUCTION
CLASSIFICATION
THIAMINE
Deficiency
Differential Diagnosis
Diagnosis
Treatment
Prognosis
Prevention
RIBOFLAVIN
Deficiency
Diagnosis
Treatment
Prevention
NICOTINIC ACID
Deficiency
Diagnosis
Differential Diagnosis
Treatment
Prevention
PANTOTHENIC ACID
Deficiency
Treatment
PYRIDOXINE
Deficiency
Diagnosis
Treatment
Excess/Toxicity
BIOTIN
Deficiency
Treatment
Prevention
VITAMIN B12
Deficiency
Diagnosis
Treatment
FOLIC ACID
Deficiency
Diagnosis
Treatment
Prevention
VITAMIN C
Deficiency
Scurvy
Etiopathogenesis
Clinical Features
Differential Diagnosis
Diagnosis
Treatment
Prevention
VITAMIN A
Deficiency
Excess/Toxicity (Hypervitaminosis A)
Vitamin A Deficiency (VAD)
Etiology
Prevalence
Clinical Features
Diagnosis
Treatment
Prevention
VITAMIN D
Functions
Sources
Daily Requirement
Deficiency
Excess/Toxicity (Hypervitaminosis D)
Vitamin D Deficiency Rickets
Certain Terms and Semantics
Etiology
Prevalence
Clinical Features
Differential Diagnosis
Diagnosis
Treatment
Prognosis
Prevention
Long-term Complications (Sequelae)
Other Types of Rickets
Rickets of Prematurity
Malabsorptive Rickets
Drug-induced Rickets
Hepatic Rickets
Hereditary Vitamin D-dependent Rickets
Refractory Rickets
Renal Rickets
Familial Hypophosphatemic Rickets
Oncogenous Rickets
Magnesium-dependent Resistant Rickets
Rickets: Broad Canvas
VITAMIN E
Deficiency
Treatment
Excess/Toxicity
VITAMIN K
Deficiency
Etiology
Clinical Features
Prophylaxis
Treatment
Excess/Toxicity
15:
Micronutrients/Trace Elements/Minerals
CERTAIN DEFINITIONS
Micronutrients
Trace Elements
Minerals
CLASSIFICATION
IRON
Deficiency
Excess
IODINE
Deficiency
Excess
ZINC
Deficiency
Diagnosis
Treatment
Prophylaxis
Excess
COPPER
Deficiency
Excess
COBALT
Excess
SELENIUM
Deficiency
Excess
CHROMIUM
Deficiency
Excess
MANGANESE
Deficiency
Excess
FLUORINE
Deficiency
Excess
MOLYBDENUM
Deficiency
Excess
NICKEL
Deficiency
Excess
VANADIUM
SILICON
ARSENIC
CALCIUM
Deficiency
Toxicity/Excess
MAGNESIUM
Deficiency
Toxicity/Excess
SODIUM
Deficiency
Excess
POTASSIUM
Deficiency
Excess
IMPLICATIONS OF MICRONUTRIENTS INTERACTIONS
16:
Fluids, Electrolytes and Acid-base Balance and Disturbances
TOTAL BODY WATER
SODIUM
POTASSIUM
DEHYDRATION
HYPONATREMIA
Etiology
Clinical Features
Early
Late
Treatment
HYPERNATREMIA
Etiology
Clinical Features
Treatment
HYPOKALEMIA
Etiology
Clinical Features
Diagnosis
Treatment
HYPERKALEMIA
Etiology
Clinical Features
Treatment
METABOLIC ACIDOSIS/ACIDEMIA
Etiology
Clinical Features
Treatment
METABOLIC ALKALOSIS/ALKALEMIA
Etiology
Clinical Features
Treatment
RESPIRATORY ACIDOSIS/ACIDEMIA
Etiology
Clinical Features
Treatment
RESPIRATORY ALKALOSIS/ALKALEMIA
Etiology
Clinical Features
Treatment
MIXED ACID-BASE DISTURBANCES
PRINCIPLES OF FLUID AND ELECTROLYTE THERAPY
Deficit Therapy
Maintenance Therapy
Replacement of Ongoing Losses
FLUID THERAPY IN SPECIAL SITUATIONS
Diarrheal Dehydration
Malnutrition
Acute Kidney Injury (AKI)
Heart Failure
Pyloric Stenosis
Intestinal Obstruction
Burns
SECTION 3: NEONATOLOGY
17:
Neonatology
INTRODUCTION
NOMENCLATURE/DEFINITIONS RELATED TO PERINATAL/NEONATAL PERIOD
IMPORTANCE OF NEONATAL CARE
NEONATAL MORTALITY AND MORBIDITY PATTERN: OVERVIEW
NEONATAL RESUSCITATION PROGRAM (NRP)
High-risk Situation
The Golden Minute Concept
Initial Rapid Assessment: Whether Resuscitation Needed or Not?
Resuscitation Equipment
Adequate Preparation for Resuscitation
TABC of Resuscitation: Initial Steps in Stabilization
Opening the Airway
Initiating Breathing
Maintaining Circulation
Pulse Oximetry
Supplementary Oxygen
Major Changes in 2010 NRP Guidelines by AHA/AAP
Do not in Neonatal Resuscitation
Salient Features of 2015 NRP Guidelines
Apgar Score
THE FULLTERM NEWBORN (BOX 17.9)
Physical Characteristics
Physiological Characteristics
Neurodevelopment
Psychosocial Development
PRIMITIVE NEONATAL REFLEXES
Moro Reflex
Startle Response
McCarthy Reflex
Rooting and Suckling Reflexes
Glabellar Reflex/Tap
Grasp Reflex
Crossed Extension Reflex
Tonic Neck Reflex
Traction Reflex
Plantar (Babinski) Reflex
Chvostek Sign
SOME MINOR PROBLEMS OF THE NEWBORN THAT MAY CAUSE PARENTAL ANXIETY
Physiological Jaundice
Vomiting
Transitional Stools
Constipation
Toxic Erythema (Erythema Toxicum)
Milia
Mongolian Spots
Salmon Patches (Macular Hemangioma, Nevus Simplex, Stork Bites)
Benign Neonatal Hemangiomatosis (BNH)
Harlequin Color Change
Epstein Pearls
Sucking Callosities
Physiological Mastitis
Vaginal Bleeding
Subconjunctival Hemorrhage
Natal (Congenital) Teeth
Cephalhematoma
Caput Succedaneum
Hiccup (Hiccough)
Nasolacrimal Duct Blockade
Umbilical Hernia (Fig. 17.37)
Hydrocele
Nonretractable Prepuce (Physiological Phimosis)
Hymenal Tags
THE PRETERM INFANT
Predisposing Causes
Characteristic Features
CLASSIFICATION OF INTRAUTERINE GROWTH RETARDATION (IUGR)
Etiology
LOW BIRTH WEIGHT (LBW) INFANTS
Handicaps/Risks of LBW
LBW from IUGR/SFD/SGA
LBW from Prematurity
Management
Prognosis
Prevention
ESSENTIAL NEWBORN CARE
Basic Principles
Immediate Care at the Time of Delivery
Care in First Few Hours
Care Beyond First Few Hours
Discharge and Follow-up
Follow-up
DETERMINATION OF GESTATIONAL AGE AT BIRTH
DANGER SIGNS IN A NEWBORN
NEONATAL THERMAL DISORDERS
NEONATAL HYPOTHERMIA
Definition
Etiology
Clinical Features
Treatment
Prognosis
Prevention
SCLEREMA
Definition
Etiopathology
Clinical Features
Treatment
Prognosis
KANGAROO MOTHER CARE (KMC)
Definition
Benefits
Prerequisites
Method of Administration
Termination of Administration
INCUBATOR CARE
RADIANT WARMER (OPEN CARE SYSTEM)
NEONATAL HYPERTHERMIA
Clinical Features
Treatment
Prevention
BREASTFEEDING
Composition
Benefits
Reflexes with Breastfeeding
Technique of Breastfeeding
Ten Steps of Successful Breastfeeding
FEEDING THE LBW INFANT
Feeding Problems of the LBW Infant
Nutritional Needs of the LBW Infant
Method of Feeding/Providing Nutrition
Breastfeeding
Alternative Methods of Milk Feeding
Intermittent Feeding
Continuous Feeding (Intragastric Drip)
Palady/Katori-spoon Feeding
Expressed Breast Milk
Nutritional Supplements
Intravenous (Central) Feeding
Parenteral Nutrition
Non-nutritive Suckling
HYPOXIC-ISCHEMIC ENCEPHALOPATHY (HIE)
Definition
Etiopathogenesis
Clinical Features
Differential Diagnosis
Diagnosis
Treatment
Prevention
Prognosis
Long-term Sequelae
RESPIRATORY DISTRESS
Definition
Assessment
Etiology
Diagnostic Approach
Management
RESPIRATORY DISTRESS SYNDROME
Etiopathogenesis
Clinical Features
Diagnosis
Prevention
Differential Diagnosis
Treatment
Prevention
Complications
Prognosis
MECONIUM ASPIRATION SYNDROME
Pathophysiology
Clinical Features
Complications
Diagnosis
Differential Diagnosis
Treatment
Prevention
Prognosis
PERSISTENT PULMONARY HYPERTENSION OF THE NEWBORN (PPHN)
Etiology
Clinical Features
Diagnosis
Treatment
Prognosis
TRANSIENT TACHYPNEA OF THE NEWBORN (TTN)
Etiology
Clinical Features
Diagnosis
Differential Diagnosis
Treatment
Prognosis
BRONCHOPULMONARY DYSPLASIA (BPD)
Pathophysiology
Clinical Features
Diagnosis
Differential Diagnosis
Treatment
Complications
Prognosis
NEONATAL PNEUMONIA
Etiology
Clinical Features
Diagnosis
Treatment
Prognosis
PNEUMOTHORAX
RECURRENT NEONATAL APNEA
Etiopathogenesis
Diagnosis
Treatment
Prognosis
STRIDOR
NEONATAL SHOCK
Etiopathogenesis
Classifications
Clinical Features
Complications
Diagnosis
Treatment
Prognosis
INFECTIONS IN THE NEWBORN
Superficial Infections
Neonatal Conjunctivitis
Pyoderma
Oral Thrush (Moniliasis, Candidiasis)
Noma Neonatorum
Septic Umbilicus (Omphalitis)
Systemic Infections
Neonatal Sepsis (Nns)
NECROTIZING ENTEROCOLITIS (NEC)
Etiology
Clinical Features
Investigations
Treatment
Prognosis
Sequelae
NEONATAL MALARIA
Etiology
Clinical Features
Diagnosis
Treatment
Prophylaxis
TETANUS NEONATORUM
HEMORRHAGIC DISEASE OF THE NEWBORN
NEONATAL JAUNDICE
Etiologic Considerations
Frequently Encountered Types of Jaundice
Physiological Jaundice (Fig. 17.51)
Exaggerated Physiological Hyperbilirubinemia
Pathological Jaundice
Breastfeeding Jaundice
Breast Milk Jaundice
Diagnostic Approach
History
Clinical Examination
Laboratory Investigations
Principles of Management
Phototherapy
Indications
Fiberoptic Phototherapy (Bili Blankets)
Exchange Blood Transfusion
Pharmacotherapy and Other Therapeutic Modalities
NEONATAL CHOLESTASIS SYNDROME
G6PD DEFICIENCY
NEONATAL HEPATITIS SYNDROME
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Prognosis
HEMOLYTIC DISEASE OF THE NEWBORN
Rhesus Hemolytic Disease
Clinical Features
Diagnosis
Treatment
Prevention
ABO-Hemolytic Disease
KERNICTERUS
Definition
Pathophysiology
Etiology
Clinical Features
Investigations
Treatment
Prognosis
NEONATAL SEIZURES
Etiology
Clinical Features
Investigations
Treatment
Prognosis
METABOLIC DISORDERS OF THE NEWBORN
Neonatal Hypoglycemia
Definition
Etiology/Predisposing Factors
Clinical Features
Treatment
Prevention
Prognosis
NEONATAL HYPOCALCEMIA
Etiology
Clinical Features
Investigations
Treatment
NEONATAL HYPOMAGNESEMIA
INFANTS OF DIABETIC MOTHERS
Clinical Features
Treatment
Prognosis
TRANSPORT OF THE SICK NEONATES
Types
Indications
Major Principles
MATERNAL MEDICATION AND ADVERSE EFFECTS ON THE FETUS
MATERNAL MEDICATION AND ADVERSE EFFECTS ON BREASTFED INFANT
FOOD AND ENVIRONMENTAL AGENTS AND ADVERSE EFFECTS ON THE INFANT
MATERNAL DISEASE AND THE GROWING FETUS AND THE NEWBORN
Maternal HIV/AIDS
Maternal Hepatitis B Infection
Maternal Tuberculosis
Maternal Syphilis
Maternal Hypothyroidism
Maternal Diabetes
HIGH-RISK NEONATES (HRN)
Definition
Etiology
Identification
Care/Therapeutic Considerations
Follow-up Program
Goals
Staff in the Neonatal Follow-up Clinic
Indications
Components of Follow-up Checkup
NEWBORN SCREENING
Definition
Diseases Needing Screening
Metabolic Screening
Screening Tests
Critical Congenital Heart Disease
Hearing
Vision
NEONATAL HYPERBILIRUBINEMIA
Malformations
Developmental Dysplasia
Developmental Screening
COMMUNITY CARE OF THE NEWBORN
Objectives
Key Activities
Role of ASHA
SECTION 4: PEDIATRIC INFECTIONS
18:
Viral Infections
SMALLPOX
MONKEYPOX: A NEW CHALLENGE
POLIOMYELITIS
Etiological Considerations
Transmission and Spread
Clinical Features
Diagnosis
Differential Diagnosis (Table 18.1)
Treatment
Prophylaxis
POST-POLIO SYNDROME
Definition
Etiopathogenesis
Diagnostic Criteria
Management
GUILLAIN-BARRÉ SYNDROME
ACUTE FLACCID PARALYSIS SURVEILLANCE
Definition
Etiology
AFP Surveillance
Special Features
Indicators of Quality
Role
VARICELLA (CHICKENPOX)
Etiopathogenesis
Epidemiology
Clinical Features
Diagnosis
Complications
Treatment
Prophylaxis
Prognosis
MEASLES
Etiopathogenesis
Epidemiology
Clinical Features
Diagnosis
Differential Diagnosis
Complications
Treatment
Prophylaxis
RUBELLA
Etiopathogenesis
Clinical Features
Congenital Rubella Syndrome
Diagnosis
Treatment
Prophylaxis
MUMPS
Etiology
Epidemiology
Clinical Features
Differential Diagnosis
Diagnosis
Clinical
Investigative
Complications
Treatment
Prophylaxis
Prognosis
ERYTHEMA INFECTIOSUM
Clinical Features
Diagnosis
Management
ROSEOLA INFANTUM
Etiology
Clinical Features
Diagnosis
Differential Diagnosis
Complications
Treatment
HAND-FOOT-MOUTH DISEASE
Etiology
Clinical Features
Diagnosis
Differential Diagnosis
Complications
Treatment
Prevention
Prognosis
INFECTIOUS MONONUCLEOSIS
Etiopathogenesis
Epidemiology
Clinical Features
Complications
Diagnosis
Differential Diagnosis
Treatment
Prognosis
DENGUE
Etiopathogenesis
Epidemiology
WHO's Current Classification
Clinical Features
Febrile Phase
Critical Phase
Recovery Phase
Dengue Hemorrhagic Fever (DHF)/Dengue Shock Syndrome (DSS)
Diagnosis
Differential Diagnosis
Complications
Treatment
Monitoring
Discharge Criteria
Prognosis
Prevention
CHIKUNGUNYA
Definition
Etiology
Epidemiology
Clinical Features
Diagnosis
Treatment
Prevention and Control
JAPANESE ENCEPHALITIS
Etiology
Clinical Features
Management
Prognosis
Prevention/Control
RABIES
Etiology
Pathogenesis
Epidemiology
Clinical Features
Diagnosis
Differential Diagnosis
Treatment
Prevention
Post-exposure Prophylaxis
Pre-exposure Prophylaxis
PEDIATRIC ACQUIRED IMMUNE DEFICIENCY SYNDROME
Etiological Virus
Epidemiology
Pathogenesis
Clinical Features
Diagnosis
Management
Prognosis
Special Issues in Pediatric HIV/AIDS
Prevention of Vertical Transmission to Baby
Breastfeeding
Immunization
HIV/AIDS and Tuberculosis
RESPIRATORY SYNCYTIAL VIRUS INFECTION
Epidemiology
Risk Factors
Diagnosis
Treatment
Prophylaxis
INFLUENZA
Etiopathogenesis
Transmission and Spread
Clinical Features
Complications
Diagnosis
Treatment
Prophylaxis
BIRD (AVIAN) FLU
VIRAL HEPATITIS
SLOW VIRUS INFECTION
EMERGING VIRUS INFECTIONS
SEVERE ACUTE RESPIRATORY SYNDROME (SARS)
19:
Bacterial Infections
STAPHYLOCOCCAL INFECTIONS
Microbiological Aspect
Epidemiology
Pathogenesis
Clinical Features
Treatment
HEMOPHILUS INFLUENZAE INFECTIONS
Microbiological Aspects
Epidemiology
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Prevention
STREPTOCOCCAL INFECTIONS
Microbiological Aspects
PNEUMOCOCCAL INFECTIONS
Microbiological Aspects
Epidemiology
Clinical Features
Diagnosis
Treatment
MENINGOCOCCAL INFECTIONS
Etiology
Pathogenesis
Clinical Features
Diagnosis
Treatment
Prognosis
Prevention
Chemoprophylaxis
Vaccination
DIPHTHERIA
Etiopathogenesis
Epidemiology
Clinical Features
Faucial Diphtheria
Laryngeal Diphtheria
Nasal Diphtheria
Cutaneous and other Rare Diphtheria
Diagnosis
Complications
Treatment
Prophylaxis
Prognosis
PERTUSSIS
Etiopathogenesis
Clinical Features
Diagnosis
Clinical
Investigative
Complications
Treatment
General Measures
Pharmacotherapy
Prophylaxis
Prognosis
TETANUS
Etiopathogenesis
Clinical Features
Diagnosis
Complications
Treatment
Anti-tetanus Serum (ATS)
Prophylaxis
Prognosis
TYPHOID FEVER
Etiopathogenesis
Epidemiology
Clinical Features
Differential Diagnosis
Diagnosis
Clinical
Investigations
Complications
Treatment
Specific
General Measures
Prophylaxis
Prognosis
BRUCELLOSIS
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Prognosis
TUBERCULOSIS
SYPHILIS
LEPTOSPIROSIS
Definition
Etiopathogenesis
Clinical Features
Differential Diagnosis
Diagnosis
Treatment
Prevention
LEPROSY
HELICOBACTER PYLORI (H. PYLORI) INFECTION
RICKETTSIAL INFECTIONS
Classification
Transmission
Pathophysiology
Clinical Features
Diagnosis
Differential Diagnosis
Complications
Treatment
Prophylaxis
Prognosis
20:
Fungal Infections
INTRODUCTION
INVASIVE CANDIDIASIS
Etiological Fungus
Risk Factors
Clinical Features
Diagnosis
Treatment
Prevention
CRYPTOCOCCOSIS
Etiology
Risk Factors
Clinical Features
Diagnosis
Treatment
ASPERGILLUS SPECIES INFECTION
Etiological Fungus
Risk Factors
Clinical Features
Diagnosis
Treatment
Prognosis
MUCORMYCOSIS
Etiology
Diagnosis
Management
HISTOPLASMOSIS
Etiological Fungus
Clinical Features
Diagnosis
Treatment
21:
Protozoal Infections and Infestations
MALARIA
Etiology
Life Cycle
Epidemiology
Host Response
Pathogenesis
Clinical Features
Complications
Cerebral Malaria
Hypoglycemia
Noncardiogenic Pulmonary Edema
Renal Impairment
Coagulation Abnormalities
Black Water Fever
Algid Malaria
Quartan Malarial/Nephropathy
Tropical Splenomegaly
Differential Diagnosis
Diagnosis
Peripheral Blood Film
Bone Marrow
Quantitative Buffy Coat Test
Fluorescent Antibody Technique
Rapid Diagnostic Test
Polymerase Chain Reaction (PCR)
Treatment
Uncomplicated Vivax Malaria
Uncomplicated Falciparum Malaria
Uncomplicated Mixed Malaria
Complicated (Severe) Malaria
Prognosis
Prophylaxis and Control
TROPICAL SPLENOMEGALY
Definition
Etiopathogenesis
Pathology
Clinical Features
Diagnosis
Complications
Treatment
Prophylaxis
LEISHMANIASIS
KALA-AZAR (BLACK-SICKNESS*, VISCERAL LEISHMANIASIS)
Etiopathogenesis
Epidemiology
Clinical Features
Complications
Differential Diagnosis
Diagnosis
Treatment
Monitoring of Therapy
Prophylaxis
Prognosis
GIARDIASIS
Etiopathogenesis
Clinical Features
Diagnosis
Pharmacotherapy
Resistant/Repeated Giardiasis
AMEBIASIS
Etiopathogenesis
Clinical Features
Diagnosis
Pharmacotherapy
Amebic Colitis
Amebic Liver Abscess
FREE LIVING AMOEBAE
Diagnosis
Treatment
TOXOPLASMOSIS
CRYPTOSPORIDIOSIS
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
22:
Helminthic Infections and Infestations
CLASSIFICATION
ASCARIASIS
Etiopathogenesis
Clinical Features
Diagnosis
Pharmacotherapy
OXYURIASIS
Etiopathogenesis
Diagnosis
Clinical Features
Treatment
ANCYLOSTOMIASIS
Etiopathogenesis
Diagnosis
Clinical Features
Treatment
STRONGYLOIDIASIS
Etiopathogenesis
Diagnosis
Clinical Features
Treatment
TRICHURIASIS
Etiopathogenesis
Diagnosis
Clinical Features
Treatment
TAPEWORMS
Clinical Features
Taenia Solium (Pork Tapeworm)
Taenia Saginata (Beef Tapeworm)
Hymenolepis Nana (Dwarf Tapeworm)
Chemotherapy
NEUROCYSTICERCOSIS (NCC)
HYDATID DISEASE
Etiology
Clinical Features
Diagnosis
Treatment
VISCERAL LARVA MIGRANS
Clinical Features
Diagnosis
Treatment
FILARIASIS
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Prognosis
Prevention
TROPICAL EOSINOPHILIA
Etiopathogenesis
Clinical Features
Differential Diagnosis
Diagnosis
Treatment
Prognosis
23:
Intrauterine Infections
OVERVIEW
CONGENITAL TOXOPLASMOSIS
Clinical Features
Diagnosis
Treatment
Prevention
CONGENITAL RUBELLA
Clinical Features
Diagnosis
Prevention
CYTOMEGALOVIRUS (CMV) DISEASE
Diagnosis
Treatment
Prevention
HERPES SIMPLEX VIRUS
Clinical Features
Diagnosis
Treatment
Prevention
Prognosis
CONGENITAL SYPHILIS
Clinical Features
Diagnosis
Treatment
PERINATAL HIV/AIDS
Clinical Features
Diagnosis
Management
VARICELLA ZOSTER VIRUS INFECTION
Mode of Infection
Clinical Features
Diagnosis
Treatment
24:
Nosocomial Anaerobic and Opportunistic Infections
NOSOCOMIAL INFECTIONS
Definition
Types and Frequency
Risk Factors
Etiologic Considerations
Mode of Transmission
Common Nosocomial Infections
Investigations
Preventive and Control Measures
Specific
General
ANAEROBIC INFECTIONS
Etiopathogenesis
Pathology
Clinical Features
Diagnosis
Treatment
Prognosis
OPPORTUNISTIC INFECTIONS
In Normal Host
In Susceptible Host
Host Compromised by Changes in the Skin or Mucous Membranes, or by Anatomic Defect
Host Compromized by Inherited/Acquired Defects Affecting Defense
25:
Fever Spectrum
OVERVIEW
TYPES OF FEVER
FEVER WITHOUT LOCALIZING SIGNS
Fever without Localizing Signs in Neonates
Fever without Localizing Signs in Infants Aged 1–3 Months
Fever without Localizing Signs in Infants Aged 3 Months–3 Years
FEVER OF UNKNOWN ORIGIN
Definition
Etiology (Table 25.2)
Diagnostic Approach
FEVER WITH RASH
Etiology
Diagnostic Approach
Laboratory Tests
Management
INVESTIGATIONS
MANAGEMENT
PROGNOSIS
SECTION 5: PEDIATRIC SUBSPECIALTIES
26:
Pediatrics Pulmonology
INTRODUCTION
CLINICAL EVALUATION OF A RESPIRATORY CASE
SPECIAL DIAGNOSTIC PROCEDURES
Radiology/Imaging
Serology
MICROBIOLOGIC EXAMINATION OF BODY SECRETIONS
Skin Tests
PILOCARPINE IONTOPHORESIS FOR SWEAT CHLORIDE
Pulmonary Function Tests
Arterial Blood Gas Analysis
Transillumination
DIRECT LARYNGOSCOPY
Bronchoscopy
Thoracoscopy
Thoracocentesis
Lung Tap
Lung Biopsy
Polygraphic Monitoring
RESPIRATORY MANIFESTATIONS OF SYSTEMIC DISEASE
COMMON MANIFESTATIONS OF RESPIRATORY DISEASE
Cough
Definition
Etiology
Diagnostic Evaluation
Treatment
Wheezing
Definition
Etiopathogenesis
Differential Diagnosis
Treatment
Stridor
Definition
Etiology
Treatment
Dyspnea
Epistaxis
Etiology
Treatment
Hemoptysis
UPPER RESPIRATORY TRACT INFECTION
Definition
Etiology
Clinical Features
Complications
Treatment
SINUSITIS
Clinical Features
Treatment
Chronic Sinusitis
ACUTE PHARYNGITIS
Etiology
Clinical Features
Diagnosis
Differential Diagnosis
Complications
Treatment
CHRONIC TONSILLITIS
ADENOIDS
Clinical Features
Diagnosis
Treatment
CROUP SYNDROME
EPIGLOTTITIS
LARYNGOTRACHEOBRONCHITIS
Spasmodic Croup
FOREIGN BODY IN LOWER RESPIRATORY TRACT
Clinical Features
Diagnosis
Management
ACUTE BRONCHITIS
BRONCHIOLITIS
Etiopathogenesis
Epidemiology
Clinical Features
Differential Diagnosis
CONGESTIVE CARDIAC FAILURE
Diagnosis
Complications
Treatment
Prophylaxis
Prognosis
PNEUMONIAS
Classifications
Important Definitions
Clinical Features
Complications
Diagnosis
Treatment
Antibiotics in Community-acquired Pneumonia
Antibiotics In Hospital-acquired Pneumonia
General Measures
Treatment of Complications
Prognosis
BRONCHIECTASIS
Definition
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Prognosis
DRY PLEURISY
Etiology
Clinical Features
Diagnosis
Treatment
PLEURAL EFFUSION
Etiology
Clinical Features
Diagnosis
Treatment
EMPYEMA THORACIS
Definition
Etiology
Clinical Features
Complications
Diagnosis
Treatment
Prognosis
LUNG ABSCESS
Etiology
Clinical Features
Diagnosis
Treatment
BRONCHIAL ASTHMA
Definition
Etiopathogenesis
Triggers/Excitatory Factors
Predisposing Factors
Pathophysiology
Pathology
Clinical Features
Diagnosis
Differential Diagnosis
Complications
Management of Acute Exacerbation of Asthma
Specific Measures
Additional Measures
Management of Status Asthmaticus
Management of Persistent Asthma
Education of Asthma Child's Parents
TUBERCULOSIS
Etiopathogenesis
Clinical Types
Primary Focus
Hilar Lymphadenitis
Segmental Lesions
Pleural Effusion
Miliary Tuberculosis
Central Nervous System Tuberculosis
Superficial Tuberculous Lymphadenitis
Abdominal Tuberculosis
Skeletal Tuberculosis
Renal Tuberculosis
Skin Tuberculosis
Chronic Pulmonary Tuberculosis
Other Forms of Tuberculosis
Diagnosis
Mantoux Test
Interpretation
Antituberculous Treatment
Indications for Antituberculous Therapy
Categorization of Antituberculous Drugs
Currently Recommended Antituberculous Regimens
Intermittent Versus Daily Regimen
Newer Case Definitions
Treatment Regimens
Tuberculosis Preventive Therapy
Problem of Drug Resistant Tuberculous Strains
RECURRENT RESPIRATORY INFECTION
Definition
Etiology
Diagnosis
Clinical
Investigative
Treatment/Prevention
CYSTIC FIBROSIS
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
DROWNING AND NEAR DROWNING
Definition
Etiopathogenesis
Clinical Features
Treatment
Sequelae
ACUTE RESPIRATORY DISTRESS SYNDROME
Definition
Etiopathogenesis
Clinical Manifestations
Laboratory Diagnosis
Treatment
Complications
Prognosis
CHILDHOOD INTERSTITIAL LUNG DISEASE
Definition
Classification
Etiopathogenesis
Clinical Features
Diagnosis
Prognosis
ACUTE RESPIRATORY FAILURE
Definition
Classification
Clinical Features
Complications
Investigations
Broad Line of Treatment
Prognosis
SEVERE ACUTE RESPIRATORY SYNDROME
MIDDLE EAST RESPIRATORY SYNDROME
27:
Pediatric Cardiology
EVALUATION OF A CARDIOVASCULAR CASE
Clinical Work-up
Investigative Work-up
FETAL CIRCULATION
CIRCULATORY CHANGES AT BIRTH AND NEONATAL BLOOD CIRCULATION
HEART FAILURE (CONGESTIVE CARDIAC FAILURE)
Etiology*
Clinical Features
Investigations
Management
Goals
Measures for Reducing Cardiac Work
Measures for Increasing Cardiac Contractility by Inotropic Agents
Measures for Reducing Cardiac Size to Improve its Performance
Measures for Correction of the Underlying Cause
CONGENITAL HEART DISEASE
Incidence
Etiology
Maternal Infections
Maternal Medication
Heredity
Genetic Factors
Environmental Factors
Associated Conditions
Classification
Diagnosis
Characteristic Features of Three Groups of CHD
Spontaneous Closure/Corrections
Treatment
Complications
Prevention
Counseling
VENTRICULAR SEPTAL DEFECT
Classification
Hemodynamics/Pathophysiology
Clinical Features
Diagnosis
Natural History/Course
Complications
Treatment
ATRIAL SEPTAL DEFECT*
Hemodynamics/Pathophysiology
Clinical Features
Diagnosis
Complications
Treatment
PATENT DUCTUS ARTERIOSUS
Hemodynamics/Pathophysiology
Clinical Features
Complications
Diagnosis
Treatment
TETRALOGY OF FALLOT*
Hemodynamics/Pathophysiology
Clinical Features
Diagnosis
Complications
Associated Cardiovascular Anomalies
Treatment
Surgery
Palliative Surgery
Total Correction (Definitive Surgery)
FALLOT'S PHYSIOLOGY
TRICUSPID ATRESIA
Hemodynamics/Pathophysiology
Clinical Features
Diagnosis
Treatment
EBSTEIN ANOMALY
Hemodynamics/Pathophysiology
Clinical Features
Diagnosis
Treatment
Prognosis
EISENMENGER SYNDROME
Clinical Features
Diagnosis
Treatment
Prognosis
Prevention
TRANSPOSITION OF THE GREAT ARTERIES
Hemodynamics
Clinical Features
Diagnosis
Treatment
TOTAL ANOMALOUS PULMONARY VENOUS RETURN
Hemodynamics/Pathophysiology
Clinical Features
Diagnosis
Treatment
Prognosis
HYPOPLASTIC LEFT HEART SYNDROME
Hemodynamics
Clinical Features
Diagnosis
Treatment and Prognosis
AORTIC STENOSIS
Hemodynamics
Clinical Features
Diagnosis
Treatment
COARCTATION OF AORTA SYNDROME
Hemodynamics
Clinical Features
Diagnosis
Treatment
Prognosis
PULMONARY STENOSIS
Hemodynamics
Clinical Features
Diagnosis
Treatment
CONGENITAL HEART DISEASE AND NEUROLOGIC COMPLICATIONS
RHEUMATIC FEVER/RHEUMATIC HEART DISEASE
Epidemiology
Etiopathogenesis
Clinical Features
Major Criteria
Carditis
Polyarthritis
Rheumatic (Sydenham's) Chorea
Subcutaneous Nodules
Erythema Marginatum
Minor Criteria
Fever
Polyarthralgia
Laboratory Manifestations
Essential Criteria
Other Investigations
New Diagnostic Modalities
Differential Diagnosis
Complications
Treatment
Rheumatic Prophylaxis
Prognosis
RHEUMATIC HEART DISEASE
Mitral Regurgitation
Pathophysiology
Clinical Features
Diagnosis
Differential Diagnosis
Treatment
Complications
Mitral Stenosis
Pathophysiology and Hemodynamics
Clinical Features
Diagnosis
Management
Aortic Regurgitation
Pathophysiology and Hemodynamics
Clinical Features
Diagnosis
Treatment
Prognosis
Tricuspid Regurgitation
Hemodynamics
Clinical Features
Diagnosis
Treatment
ENDOMYOCARDIAL DISEASES
Endocardial Fibroelastosis
Endomyocardial Fibrosis
CARDIOMYOPATHY
Definition
Clinical Categories of Primary Cardiomyopathy
Dilated (Congestive) Cardiomyopathy
Restrictive Cardiomyopathy
Hypertrophic Cardiomyopathy
INFECTIVE ENDOCARDITIS
Etiology
Pathogenesis and Pathology
Clinical Features
Investigation
Complications
Diagnosis
Treatment
Prognosis
Prophylaxis and Prevention
PERICARDITIS
Definition
Etiology
Clinical Features
Diagnosis
Treatment
DEXTROCARDIA
Dextrocardia with Situs Inversus (Fig. 27.30)
Isolated Dextrocardia (Without Situs Inversus)
Levocardia with Situs Inversus
MYOCARDITIS
Etiology
Clinical Features
Diagnosis
Treatment
CARDIAC ARRHYTHMIAS
Etiology
Types
Supraventricular Tachycardia
Etiology
Clinical Features
Diagnosis
Treatment
Sick Sinus Syndrome
Clinical Features
Treatment
Long QT Syndrome
SYSTEMIC HYPERTENSION
Blood Pressure Measurement in Children
Etiology
Clinical Features
Diagnosis
Management
Pharmacological Therapy
Course and Prognosis
Prevention
INTERVENTIONAL CARDIAC PROCEDURES
28:
Pediatric Neurology
INTRODUCTION
DEVELOPMENTAL ASPECTS
NEUROLOGICAL EVALUATION
Clinical Work-up
Soft Neurological Signs
Investigative Work-up
Cerebrospinal Fluid
Neuroimaging
Electroencephalography
Evoked Potential Response
Biopsy
Psychometric Tests
Electroretinography
Electromyography
Nerve Conduction Studies
NEURAL TUBE DEFECTS
Etiopathogenesis
Types
Prenatal Diagnosis
Prevention
PSEUDOTUMOR CEREBRI
Definition
Clinical Features
Etiopathogenesis
Treatment
ACUTE STROKE SYNDROMES
Definition
Types
Differential Diagnosis
Treatment
Prophylaxis
Prognosis
BELL PALSY
Definition
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Prognosis and Outcome
ACUTE FLACCID PARALYSIS
GUILLAIN-BARRÉ SYNDROME
Definition
Etiopathogenesis
Clinical Features
Diagnosis
Differential Diagnosis
Treatment
Prognosis
PARAPLEGIA
Definition
Etiopathogenesis
Clinical Features
Diagnosis
Management
Specific
Supportive
RHEUMATIC CHOREA
ATAXIA
Definition
Types
Etiology
ACUTE CEREBELLAR ATAXIA
SPASMUS NUTANS
MENTAL RETARDATION
Definition
Classification
Epidemiology
Etiology
Clinical Features
Diagnosis
Assessment of Mental Age
Investigations
Differential Diagnosis
Management
Prevention
DOWN SYNDROME
Types
Clinical Features
Diagnosis
Clinical
Radiologic Findings
Dermatologic Findings
Management
AUTISM SPECTRUM DISORDER
CEREBRAL PALSY (LITTLE DISEASE)*
Definition
Etiology
Pathology
Clinical Features
Handicaps/Comorbidity
Diagnosis
Treatment
Pharmacotherapy
Physiotherapy
Occupational Therapy
Surgical/Orthopedic Therapy
Prevention
MENINGITIS
BACTERIAL MENINGITIS
Clinical Features
Diagnosis
Treatment
Antibiotic Therapy
Corticosteroids
Controlling Seizures
Controlling Raised Intracranial Pressure
Controlling Blood Pressure
Supportive Measures
Complications
Prognosis
Sequelae
NEUROTUBERCULOSIS
Epidemiology
Etiopathogenesis
Clinical Features
First or Prodromal Stage
Second or Transitional Stage
Third or Terminal Stage
Diagnosis
Differential Diagnosis
Treatment
Anti-tuberculosis Treatment
Corticosteroids
Reduction of Cerebral Edema
Controlling Seizures
Supportive Measures
Prognosis
Sequelae
TUBERCULOUS ENCEPHALOPATHY
Definition
Clinical Features
Pathology
Diagnosis
Treatment
TUBERCULOMA
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
ENCEPHALITIS (MENINGOENCEPHALITIS)
Definition
Encephalitis vis-à-vis Encephalopathy
Etiologic Considerations
Clinical Features
Diagnosis
Treatment
Prognosis
ACUTE DISSEMINATED ENCEPHALOMYELITIS
Definition
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
REYE SYNDROME
HYDROCEPHALUS
Definition
Circulation of Cerebrospinal Fluid
Etiology
Clinical Features
Diagnosis
Treatment
Prognosis
INTRACRANIAL SPACE-OCCUPYING LESIONS (ICSOL)
BRAIN ABSCESS
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
SUBDURAL EFFUSION
Subdural Hematoma
NEUROCYSTICERCOSIS
Etiopathogenesis
Clinical Features
Diagnostic Investigations
Treatment
Medical Therapy
Surgical Therapy
Prevention
INTRACRANIAL TUMORS
CAVERNOUS SINUS THROMBOSIS
Clinical Features
Diagnosis
Treatment
OVERVIEW AND GENERAL CONSIDERATIONS
Definition
Epidemiology
Etiology
Diagnosis
Treatment
FEBRILE SEIZURES
Definition
Incidence
Special Features
Treatment
Prophylaxis (Long-term Treatment)
Prognosis
EPILEPSY
Definition
Classification
Brief Description of Major Types
Tonic-Clonic Seizures
Absence Seizures
Partial Seizures
Syndrome of Benign Childhood Epilepsy with Centrotemporal Spikes
Myoclonic Epilepsies
Infantile Myoclonic Epilepsy
Lannox-Gastout Syndrome
Neonatal Seizures
STATUS EPILEPTICUS
Drug Therapy of an Acute Convulsive Episode
DRUG THERAPY OF STATUS EPILEPTICUS
Out of Hospital Treatment
Hospital Treatment
LONG-TERM ANTIEPILEPTIC DRUG THERAPY
Tonic-clonic Seizures
Absence Seizures
Complex Partial Seizures
Myoclonic Seizures
Duration of AED Therapy
INTRACTABLE SEIZURES
Definition
Epilepsies Vulnerable to Intractability
Diagnostic Evaluation
Treatment
Pharmacotherapy
Ketogenic Diet
Role of Surgery in Epilepsy
INFANTILE TREMOR SYNDROME
COMA
Stages
MODIFIED GLASGOW COMA SCALE
Etiopathogenesis
Emergency Measures
Diagnosis
History
Physical Examination
Investigations
Management
NEURODEGENERATIVE DISORDERS
Definition
Classification
Clinical Features
Salient Features of Specific Neurodegenerative Disorders
Subacute Sclerosing Panencephalitis
Rett Syndrome
Kinky Hair (Menkes) Disease
Metachromatic Leukodystrophy
Demyelinating Diseases
Friedreich Ataxia
Hepatolenticular Degeneration (Wilson Disease)
NEUROCUTANEOUS SYNDROMES (PHAKOMATOSES)
Neurofibromatosis
Tuberous Sclerosis (Bourneville Disease)
Sturge-Weber Disease
Ataxia Telangiectasia
von-Hippel-Landau Disease
Linear Nevus Syndrome
Incontinentia Pigmenti (Bloch-Sulzberger Disease)
29:
Pediatric Gastroenterology
BASICS OF GASTROINTESTINAL TRACT
DIAGNOSTIC WORK-UP FOR GASTROINTESTINAL DISORDERS
Clinical Work-up
Special Investigative Work-up
DIARRHEAL DISEASES: AN OVERVIEW
ACUTE DIARRHEA
Etiology
Viral Diarrhea
Bacterial Diarrhea
Parasitic Diarrhea
Pathogenesis
Diarrhea: Modus Operandi of Development
Secretory and Osmotic Diarrhea
Diarrheal Dehydration: Modus operandi
Clinical Features
Clinical Assessment of Diarrheal Dehydration
Management
Conventional Rehydration Therapy
World Health Organization (WHO) Guidelines on the Management of Diarrheal Dehydration
Antibiotics
Pharmacotherapy for Symptomatic Control
Nutrition (Diet)
Ancillary Measures
Prognosis
Prevention
Complications/Sequelae
CHOLERA
Etiology
Epidemiology
Clinical Features
Diagnosis
Complications
Management
Prophylaxis
ACUTE BACILLARY DYSENTERY
Definition
Etiopathogenesis
Epidemiology
Clinical Features
Differential Diagnosis
Diagnosis
Treatment
Specific
General Measures
Prognosis
Prevention
ANTIBIOTIC-ASSOCIATED DIARRHEA
Definition
Etiopathogenesis
Clinical Features
Diagnosis
Differential Diagnosis
Treatment
Prognosis
Prevention
ORAL REHYDRATION THERAPY
Indications
Standard Formulation
Low Osmolarity ORS
ReSoMal (ORS in severely malnourished children)
Home-made Preparations of ORS
Administration
Limitations
PERSISTENT DIARRHEA
Definition
Etiology
Clinical Features
Diagnosis
Treatment
Diet
Vitamins and Micronutrients
Probiotics
Antimicrobial Therapy
Wormicidals
Response to Therapy
Diet During Convalescence
Prevention
Prognosis
CHRONIC DIARRHEA
Definition
Evaluation Protocol
Pathophysiologic Mechanisms
Etiologic Considerations
Chronic Diarrhea/Malabsorption: A Practical Approach
CELIAC DISEASE
Etiopathogenesis
Clinical Features
Diagnosis
Conventional Approach
Treatment
Prognosis
CYSTIC FIBROSIS
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Complications
ENDEMIC TROPICAL SPRUE
PROTEIN-LOSING ENTEROPATHY
Etiology
Clinical Features
Diagnosis
Treatment
CARBOHYDRATE MALABSORPTION
Disaccharide Malabsorption
Clinical Features
Diagnosis
Treatment
Monosaccharide Malabsorption
COW MILK PROTEIN INTOLERANCE
Clinical Features
Etiology
Treatment
ACRODERMATITIS ENTEROPATHICA
Etiology
Clinical Features
Differential Diagnosis
Diagnosis
Treatment
INFLAMMATORY BOWEL DISEASE
Definition
Ulcerative Colitis
Etiology
Clinical Features
Investigations
Differential Diagnosis
Treatment
Complications
Crohn's Disease
Clinical Features
Diagnostic Investigations
Treatment
Prognosis
Crohn's Disease Versus Ulcerative Colitis
FUNCTIONAL GASTROINTESTINAL DISORDERS
CHRONIC ABDOMINAL PAIN
Definition
Classification/Types
Diagnosis
Clinical Work-up
Investigative Work-up
Treatment
CONSTIPATION
Definition
Etiology
Diagnostic Evaluation
Clinical Work-up
Investigative Work-up
Treatment
VOMITING
Definition
Types
Etiology
Clinical Features
Diagnostic Evaluation
Clinical
Investigative
Complications
Treatment
RECURRENT APHTHOUS STOMATITIS
Etiology
Clinical Features
Diagnosis
Differential Diagnosis
Treatment
THRUSH (ORAL MONILIASIS)
Clinical Features
Diagnosis
Treatment
GEOGRAPHICAL TONGUE
STRESS ULCER DISEASE
Clinical Features
Etiopathogenesis
Treatment
GASTROESOPHAGEAL REFLUX DISEASE
Definition
Risk Factors
Clinical Features
Complications
Diagnosis
Differential Diagnosis
Management
Conservative Measures
Pharmacotherapy
Surgery
Prognosis
DYSPHAGIA
Definition
Etiology
GASTROINTESTINAL BLEEDING
Etiology
Upper Gastrointestinal Bleeding
Lower Gastrointestinal Tract Bleeding
Diagnosis
History and Physical Examination
Investigations
Management
Upper Gastrointestinal Bleeding
Lower Gastrointestinal Bleeding
Prognosis
HELICOBACTER PYLORI INFECTIONS
Epidemiology
Pathogenesis
Clinical Features
Diagnosis
Differential Diagnosis
Treatment
FOOD ALLERGY
Causative Foods
Operational Mechanisms
Clinical Features
Diagnosis
Treatment
BEZOARS
ABDOMINAL TUBERCULOSIS
Clinical Features
Diagnosis
Treatment
INTESTINAL FAILURE
Definition
Etiology
Complications
Treatment
SURGICAL GASTROINTESTINAL PROBLEMS
30:
Pediatric Hepatology and Pancreatology
FUNCTIONS OF LIVER
MANIFESTATIONS OF LIVER DISEASE
HEPATIC MANIFESTATIONS OF SYSTEMIC DISEASES
DIAGNOSTIC WORK-UP FOR SUSPECTED LIVER DISORDER
Clinical Evaluation
Investigative Evaluation
ACUTE VIRAL HEPATITIS
Etiologic Viruses
Mode of Infectivity
Clinical Features
Differential Diagnosis
Diagnosis
Complications
Treatment
Hepatitis A
Hepatitis B
Hepatitis C (Chronic)
Hepatitis E
Prevention
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Hepatitis E
Prognosis
ACUTE LIVER FAILURE
Definition
Etiopathogenesis
Clinical Grading
Investigations
Management
General Measures
Specific Measures
Prognosis
CHRONIC LIVER DISEASE (CLD)
Definition
CHRONIC HEPATITIS
Definition
Etiopathogenesis
Staging and Grading
Clinical Features
Diagnosis
Investigations
Management
Prognosis
METABOLIC LIVER DISEASE
Definition
Etiology
Clinical Features
Diagnosis
Clinical Clues
Investigations
Treatment
WILSON DISEASE
Definition
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
GLYCOGEN STORAGE DISEASES (GSD)
GALACTOSEMIA
AUTOIMMUNE LIVER DISEASE
Definition
Types
Characteristic Features
Clinical Features
Diagnosis
Treatment
NONALCOHOLIC FATTY LIVER DISEASE/STEATOSIS
Definition
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Prevention
PORTAL HYPERTENSION
Intrahepatic Portal Hypertension (IHPH)
Etiology
Clinical Features
Diagnosis
Treatment
Prognosis
Extrahepatic Portal Hypertension
Etiology
Clinical Features
Diagnosis
Treatment
NEONATAL CHOLESTASIS SYNDROME (NCS)
Etiology
Clinical Features
Diagnosis
Management
Prognosis
EXTRAHEPATIC BILIARY ATRESIA
CHOLEDOCHAL CYST
CHOLECYSTITIS
Cholecystitis with Cholelithiasis
Acute Acalculous Cholecystitis
DRUG-INDUCED LIVER INJURY
Types
Diagnosis
Management
HEPATOMEGALY
Etiology
Approach to Evaluation
History and Physical Examination
Investigations
Treatment
LIVER ABSCESS
PYOGENIC LIVER ABSCESS
Etiology
Clinical Features
Diagnosis
Management
Prognosis
Complications
AMEBIC LIVER ABSCESS
THE CHILD WITH ASCITES
Definition
Etiology
Diagnostic Approach
Clinical Work-up
Special Investigations
Management
INDIAN CHILDHOOD CIRRHOSIS
Etiologic Considerations
Pathology
Clinical Features
Diagnosis
Treatment
Prognosis
Prevention (Table 30.9)
REYE SYNDROME
Definition
Epidemiology
Etiopathogenesis
Pathology
Clinical Features
Complications
Differential Diagnosis
Laboratory Diagnosis
Treatment
Specific Measures
Diet
Surgery
Prognosis
LIVER TRANSPLANTATION
Indications
Contraindications
Procedure
Complications
Immunosuppression to Prevent “Rejection”
Results
PANCREAS: BASICS IN A NUTSHELL
ACUTE PANCREATITIS
Etiology
Clinical Features
Complications
Pathophysiology
Diagnosis
Clinical
Investigations
Hematological and Serum Markers for Predicting Severity?
Treatment
Prognosis
31:
Pediatric Nephrology
CLINICAL EVALUATION
INVESTIGATIVE EVALUATION
RENAL AGENESIS
HORSE-SHOE KIDNEYS
POLYCYSTIC DISEASE OF KIDNEYS
DUPLEX RENAL SYSTEM
PELVIURETERIC JUNCTION (PUJ) STENOSIS
POSTERIOR URETHRAL VALVES
MEATAL STENOSIS
PHIMOSIS AND PARAPHIMOSIS
ANTENATAL DIAGNOSIS OF DEVELOPMENTAL ANOMALIES
NEUROGENIC BLADDER
OBSTRUCTIVE UROPATHY
Predisposing Factors
Manifestations
Diagnosis
Treatment
PROTEINURIA
Definition
Measurement
Types
Benign Proteinuria
Organic Proteinuria
HEMATURIA
Definition
Types
Etiology
Diagnosis
History and Clinical Examination
Investigations
Treatment
URINARY TRACT INFECTION
Etiological Considerations
Clinical Features
Diagnosis
Treatment
Specific Treatment
Recurrence
Supportive Measures
ACUTE GLOMERULONEPHRITIS
Etiology
Diagnosis
Treatment
ACUTE POSTSTREPTOCOCCAL GLOMERULONEPHRITIS
Definition
Etiopathogenesis
Clinical Features
Diagnosis
Differential Diagnosis
Complications
Treatment
Treatment of Complications
Prognosis
RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS
Definition
Types
Diagnosis
Treatment
HENOCH-SCHONLEIN PURPURA (HSP)
IMMUNOGLOBULIN A NEPHROPATHY
SLE-RELATED NEPHRITIS
RENAL TUBULAR DISORDERS
Renal Tubular Acidosis (RTA)
Type I (Distal RTA)
Type II (Proximal RTA)
Type III (Combined proximal and distal RTA)
Type IV (Hyperkalemic)
NEPHROGENIC DIABETES INSIPIDUS (NDI)
Definition
Types
Treatment
BARTTER SYNDROME
Definition
Clinical Features
Treatment
GITELMAN SYNDROME
ACUTE KIDNEY INJURY
Definition
Etiology
Evaluation
Clinical
Investigative
Management
General Measures
Maintenance of Fluid and Electrolyte Balance
Attention to Complication
Dialysis
Nutrition
Prognosis
CHRONIC KIDNEY DISEASE
Definition
Staging
Etiology
Clinical Features
Diagnosis
Treatment
Diet
Attention to Complications/Comorbidities
Renal Transplantation
HEMOLYTIC-UREMIC SYNDROME
Definition
Etiology
Pathogenesis
Pathology
Clinical Features
Diagnosis
Complications
Treatment
NEPHROTIC SYNDROME
Definition
Etiopathogenesis
Relative Incidence of Types of NS
STEROID-SENSITIVE/RESPONSIVE NEPHROTIC SYNDROME
Pathology
Clinical Features
Diagnosis
Treatment
First Attack
Relapse
STEROID-RESISTANT NEPHROTIC SYNDROME
Complications
Prognosis
RENAL OSTEODYSTROPHY
Definition
Clinical Features
Diagnosis
Treatment
END-STAGE RENAL DISEASE (ESRD)
Etiology
Modalities of Treatment
ENURESIS
32:
Pediatric Hematology
ANEMIAS
Definition
Grading
Classification of Anemias
NUTRITIONAL ANEMIAS
IRON DEFICIENCY ANEMIA (IDA)
Clinical Features
Diagnosis
Differential Diagnosis
Treatment
Specific Treatment
Control Measures
ANEMIA OF PROTEIN ENERGY MALNUTRITION (PEM)
PHYSIOLOGICAL ANEMIA OF PREMATURITY
Definition
Etiology
Treatment
HYPOCHROMIC ANEMIAS REFRACTORY TO IRON
Pyridoxine (Vitamin B6) Dependency Anemia
Sideroblastic Anemia
Anemia of Infection
Anemia of Lead Poisoning
Anemia of Thalassemia
MEGALOBLASTIC ANEMIA
Definition
Etiology
Deficiency of B12
Folate Deficiency
Clinical Features
Diagnosis
Treatment
HEMOLYTIC ANEMIAS
Characteristics of Hemolysis
Classification
HEREDITARY SPHEROCYTOSIS
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
THALASSEMIA*
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Prognosis
Prevention and Counseling
SICKLE CELL ANEMIA
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Preventive Measures
Prognosis
GLUCOSE 6 PHOSPHATE DEHYDROGENASE (G6PD) DEFICIENCY
Clinical Features
Diagnosis
Treatment
Prevention
PYRUVATE KINASE DEFICIENCY
Clinical Features
Treatment
AUTOIMMUNE HEMOLYTIC ANEMIA
AIHA Associated with Warm Autoantibodies
Clinical Features
Laboratory Findings
Treatment
Prognosis
AIHA Associated with Cold Autoantibodies
Clinical Features
Treatment
Prognosis
METHEMOGLOBINEMIA
APLASTIC ANEMIA
Definition
Etiopathogenesis
Clinical Features/Types
Investigations
Treatment
MECHANISM OF COAGULATION
APPROACH TO A CHILD WITH BLEEDING/HEMOSTATIC DISORDER
History and Physical Examination
Investigations
DISSEMINATED INTRAVASCULAR COAGULATION
Definition
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Prognosis
VITAMIN K DEFICIENCY BLEEDING
HEMOPHILIA
Classification
Clinical Features
Diagnosis
Clinical Evaluation
Investigative Evaluation
Antenatal Diagnosis
Treatment
Preventive Care
Prognosis
VON WILLEBRAND DISEASE (VWD)
IMMUNE THROMBOCYTOPENIC PURPURA
Definition
Etiopathogenesis
Clinical Features
Acute Type
Chronic Type
Diagnosis
Differential Diagnosis
Treatment
Acute ITP
Chronic ITP
Refractory ITP
Prognosis
NEONATAL ALLOIMMUNE THROMBOCYTOPENIA
Definition
Clinical Features
Diagnosis
Treatment
Prevention
WISKOTT-ALDRICH SYNDROME (WAS)
DRUG-INDUCED THROMBOCYTOPENIA
HENOCH–SCHÖNLEIN PURPURA
Definition
Etiology
Clinical Features
Diagnosis
Complications
Treatment
Prognosis
PURPURA FULMINANS
LEUKOCYTE DYSFUNCTION
NEUTROPENIA
Etiology
Febrile Neutropenia
Clinical Features
Diagnosis
Management
Prevention
THROMBOTIC DISORDERS
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Prognosis
POLYCYTHEMIA
Primary Polycythemia
Secondary Polycythemia
BLOOD COMPONENT THERAPY
Classification
Unmodified Components
Packed RBCs
Platelets
Granulocytes
Fresh Frozen Plasma (FFP)
Indications
Dose
Cryoprecipitate
Modified Components
Gamma-irradiated Blood Products
Saline Washed RBCs
Saline Washed Platelets
BONE MARROW TRANSPLANTATION
Types
Indications
Procedure
Complications
Outcome
33:
Pediatric Oncology
INTRODUCTION
LEUKEMIA
ACUTE LYMPHOBLASTIC LEUKEMIA
Clinical Features
Diagnosis
Treatment
Prognosis
ACUTE NON LYMPHOBLASTIC LEUKEMIA (ANLL)
Clinical Features
Diagnosis
Treatment
Prognosis
CHRONIC MYELOID LEUKEMIA (CML)
Clinical Features
Treatment
Prognosis
CONGENITAL LEUKEMIA
HODGKIN LYMPHOMA (HL)
Etiopathology
Histological Types
Clinical Features
Diagnosis
Mandatory
Optional
Treatment
Prognosis
NON-HODGKIN LYMPHOMA (NHL)
Etiopathology
Clinical Features
Diagnosis
Treatment
Prognosis
WILMS' TUMOR
Clinical Features
Diagnosis
Treatment
Prognosis
NEUROBLASTOMA
Clinical Features
Diagnosis
Treatment
Prognosis
TUMORS OF LIVER
Hepatoblastoma
Clinical Features
Investigations
Treatment
Prognosis
BRAIN TUMORS
Overview
Manifestations
Investigations
INFRATENTORIAL BRAIN TUMORS
Cerebellar Tumors
Brainstem Tumors
Fourth Ventricle Tumor
SUPRATENTORIAL BRAIN TUMORS
BONE TUMORS
OSTEOSARCOMA
Predisposing Factors
Clinical Features
Diagnosis
Treatment
EWING SARCOMA
Clinical Features
Diagnosis
Treatment
SOFT TISSUE SARCOMAS
Rhabdomyosarcoma
Clinical Features
Diagnosis
Treatment
RETINOBLASTOMA
Predisposing Factors
Clinical Features
Diagnosis
Treatment
THYMOMA
Clinical Features
Treatment
TERATOMAS
ONCOLOGICAL EMERGENCIES
Definition
Treatment
FEBRILE NEUTROPENIA
Definition
Etiology
Clinical Features
Treatment
TUMOR LYSIS SYNDROME
Definition
Etiology
Clinical Features
Treatment
RAISED INTRACRANIAL PRESSURE
Etiology
Clinical Features
Treatment
SUPERIOR VENA CAVA/MEDIASTINAL SYNDROME
Etiology
Clinical Features
Diagnosis
Treatment
HYPERLEUKOCYTOSIS
Definition
Clinical Features
Treatment
SPINAL CORD COMPRESSION SYNDROME
Etiology
Clinical Features
Treatment
BONE MARROW TRANSPLANTATION
Indications
Procedure
Complications
Outcome
34:
Pediatric Immunology
IMMUNOLOGICAL SYSTEM: FUNDAMENTALS
Cellular Components
Complement System
IMMUNOGLOBULINS
IMMUNODEFICIENCY STATES
PRIMARY IMMUNODEFICIENCY STATES
B CELL DEFECTS
T CELL DEFECTS
COMBINED B AND T CELL DEFECTS
NEUTROPHILS DEFECTS
COMPLEMENT DEFECTS
RED FLAG SIGNS FOR PRIMARY IMMUNODEFICIENCY
SECONDARY IMMUNODEFICIENCY
DIAGNOSTIC APPROACH IN IMMUNODEFICIENCY
Clinical Clues
Investigations
Treatment
IMMUNOLOGIC BASIS OF AUTOIMMUNE DISEASES
Types of Autoimmune Diseases
Mechanism of Development
IMMUNOLOGIC BASIS OF ALLERGY (ATOPY)
IMMUNOLOGIC ASPECTS OF MALIGNANCY
IMMUNODEFICIENCY AND SPECIAL RISKS
INTRAVENOUS IMMUNOGLOBULINS
Composition
Essential Prerequisites/Requirements
Indications
Abuse
Contraindications
Advantages of Intravenous over Intramuscular Immunoglobulin
Hazards
Precautions
BONE MARROW TRANSPLANTATION
35:
Pediatric Rheumatology
INTRODUCTION
COMMON CHARACTERISTICS OF RHEUMATOLOGIC DISORDERS
RHEUMATIC FEVER
TRANSIENT SYNOVITIS
REACTIVE ARTHRITIS
SEPTIC ARTHRITIS
TUBERCULOUS ARTHRITIS
PERTHES DISEASE
JUVENILE IDIOPATHIC ARTHRITIS
Definition
Etiopathogenesis
Clinical Features
Diagnosis
Differential Diagnosis
Treatment
Drug Therapy
General Measures
Complications
Prognosis
SYSTEMIC LUPUS ERYTHEMATOSUS
Pathology
Clinical Features
Diagnosis
Laboratory Work-up
Diagnostic Criteria
Treatment
Prognosis
DERMATOMYOSITIS
POLYARTERITIS NODOSA
SCLERODERMA
Clinical Features
Differential Diagnosis
Treatment
MIXED CONNECTIVE TISSUE DISEASE
GOODPASTURE SYNDROME
FASCITIS
BENIGN RHEUMATOID NODULES
VASCULITIS SYNDROMES
KAWASAKI DISEASE
Definition
Etiology
Clinical Features (Figs 35.5A to F)
Diagnosis
Differential Diagnosis
Treatment
Prognosis
HENOCH-SCHONLEIN PURPURA
POLYARTERITIS NODOSA
BEHCET DISEASE
TAKAYASU ARTERITIS
GRANULOMATOSIS WITH POLYANGITIS
Definition
Diagnosis
Differential Diagnosis
Treatment
MARFAN SYNDROME
EHLER-DANLOS SYNDROME
36:
Pediatric Dermatology
INTRODUCTION
MORPHOLOGY OF SKIN LESIONS
ATOPIC DERMATITIS
Clinical Features
Diagnosis
Treatment
INSECT BITE HYPERSENSITIVITY
DRUG ERUPTION
SCABIES
Clinical Features
Diagnosis
Treatment
PEDICULOSIS
RINGWORM INFECTIONS
MONILIASIS
DIAPER RASH
Clinical Features
Treatment
PRICKLY HEAT
SEBORRHEA
Clinical Features
Treatment
URTICARIA
PYODERMAS
Classification
Treatment
ERYSIPELAS
SCALDED SKIN SYNDROME (SSS)
ICHTHYOSIS*
CAFE AU LAIT SPOTS
ALBINISM
VITILIGO
LEPROSY
Etiopathogenesis
Clinical Classification/Features
Lepromatous Leprosy
Tuberculoid Leprosy
Borderline Leprosy
Diagnosis
Treatment
Prevention
HEMANGIOMA
TELANGIECTATIC ANGIOMA
EPIDERMOLYSIS BULLOSA (EB)
ERYTHEMA MULTIFORME
PEMPHIGUS
EHLER-DANLOS SYNDROME
MOLLUSCUM CONTAGIOSUM
WARTS
ERYTHEMA NODOSUM
SKIN TUBERCULOSIS
ECTODERMAL DYSPLASIAS
ACNE
PSORIASIS
Clinical Features
Diagnosis
Treatment
37:
Accidental Poisoning
APPROACH
LABORATORY EVALUATION
GASTROINTESTINAL DECONTAMINATION
Gastric Lavage
Activated Charcoal
Whole Bowel Irrigation (WBI)
TOXIN ELIMINATION (ENHANCEMENT OF EXCRETION)
Administration of Antidotes
Prevention
HYDROCARBON POISONING
KEROSENE OIL POISONING (FIGS 37.1A and B)
Clinical Features
Diagnosis
Complications
Treatment
Prognosis
ORGANIC PHOSPHATE POISONING
Clinical Features
Diagnosis
Treatment
DDT POISONING
Clinical Features
Treatment
BARBITURATE POISONING
Clinical Features
Treatment
PARACETAMOL (ACETAMINOPHEN) TOXICITY
Modus Operandi
Clinical Features
Treatment
Prognosis
IBUPROFEN TOXICITY
Clinical Features
Treatment
ASPIRIN POISONING
Clinical Features
Treatment
PHENOTHIAZINE TOXICITY
Clinical Features
Treatment
CHLOROQUINE-INDUCED PSYCHOSIS
CYPROHEPTADINE POISONING
IRON (IRON SALTS) POISONING
Clinical Features
Diagnosis
Treatment
MORPHINE AND OTHER OPIATES POISONING
Clinical Features
Treatment
DHATURA POISONING
Clinical Features
Treatment
LEAD POISONING
Clinical Features
Diagnosis
Treatment
MERCURY POISONING
Acute Mercury Poisoning
Clinical Features
Treatment
Chronic Mercury Poisoning
Acrodynia
Minamata Disease
LATHYRISM
38:
Envenomation
SNAKE BITE
Clinical Features
Local Manifestations
Constitutional Manifestations
Laboratory Investigations
Grading of Envenomation
Treatment
Immediate Measures
Specific Measures
Desensitization
Supportive Measures
Prevention
Complications
SCORPION STING
Clinical Features
Benign Stings
Potentially Dangerous Sting
Fatal Sting
Treatment
Mortality
39:
Pediatric Endocrinology
HYPOTHALAMUS AND ITS DISORDERS
DIABETES INSIPIDUS
Central Diabetes Insipidus
Etiology
Investigations
Differential Diagnosis
Treatment
Nephrogenic Diabetes Insipidus
Diencephalic Syndrome
PITUITARY AND ITS DISORDERS
Pituitary Hormones
Regulation and Metabolism of Hormones
GROWTH HORMONE DEFICIENCY
Etiology
Clinical Features
Diagnosis
Differential Diagnosis
Treatment
GROWTH HORMONE EXCESS
Differential Diagnosis
Treatment
SHORT STATURE
THYROID AND ITS DISORDERS
HYPOTHYROIDISM
CONGENITAL HYPOTHYROIDISM
Etiology
Clinical Features
Investigations
Supportive
Differential Diagnosis
Treatment
Prognosis
ACQUIRED HYPOTHYROIDISM
Etiology
Clinical Features
Diagnosis
Treatment
HYPERTHYROIDISM
Etiology
Clinical Features
Diagnosis
Treatment
GOITER
Etiology
Diagnosis
Treatment
PARATHYROID AND ITS DISORDERS
HYPOCALCEMIA
Definition
Etiology
Clinical Features
Diagnosis
Treatment
HYPERCALCEMIA
Etiology
Clinical Features
Investigations
Treatment
ADRENAL AND ITS DISORDERS
Fundamentals
ADRENAL INSUFFICIENCY
ADDISON DISEASE
Clinical Features
Diagnosis
Treatment
CONGENITAL ADRENAL HYPERPLASIA (CAH)
Definition
Pathophysiology
Classification
Clinical Features
Prenatal Diagnosis
Neonatal Screening
Treatment
Diagnosis
Clinical
Radiological
Laboratory
Treatment
ADRENAL HYPERFUNCTION
Cushing's Syndrome*
Definition
Etiology
Clinical Features
Diagnosis
Treatment
Hyperaldosteronism
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Pheochromocytoma
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
GONADS AND THEIR DEFICIENCY
UNDESCENDED TESTES
Etiology
Types
Pseudocryptorchidism
True Cryptorchidism
Complications
Treatment
MICROPENIS
Definition
Etiology
Investigations
Treatment
Precocious Puberty
Definition
Types
Diagnosis
Treatment
DELAYED PUBERTY
Definition
Etiology
Diagnosis
Management
Hormonal Therapy in Girls
Hormonal Therapy in Boys
DISORDERS OF SEXUAL DIFFERENTIATION
Types of Hermaphroditism
DIABETES MELLITUS
Childhood Diabetes vs Adult Diabetes
Current Classification
Etiopathogenesis
Clinical Features
Diagnosis
Management
Routine Diabetes
Diabetic Ketoacidosis (DKA)
Complications
Prognosis
THE OBESE CHILD
40:
Genetics in Health and Disease
THE HUMAN GENOME PROJECT (HGP)
GENETICS IN HUMAN WELLBEING
HUMAN CELL DIVISION
THE GENES
Types of Inheritance and Single Gene Disorders
Variations in Expression of Genetic Traits
CONSANGUINITY
TYPES OF GENETIC DISORDERS
PEDIGREE CHART
Symbols
THE CHROMOSOMES
Number
Size, Shape and Structure
Types
Denver Classification (Modified)
Sex Chromatin
Chromosomal Studies
CHROMOSOMAL DISORDERS
HIGH-RISK GENETIC DISORDERS AND CANCER
APPROACH TO A CHILD WITH A GENETIC DISORDER
THERAPEUTICS IN GENETIC DISORDERS
GENE THERAPY
Definition
Prerequisites
Gene Therapy Trials
The Technique
Prerequisite
Adverse Effects
PREVENTION OF GENETIC DISORDERS
Avoidance Spectrum
Molecular Detection of Carrier State (Carrier Screening)
Newborn Screening
Periconceptional Folic Acid
Prenatal Diagnosis
Genetic Counseling
GENETIC COUNSELING
Definition
Indications
Prerequisites
DERMATOGLYPHICS
Definition
Normal Dermatoglyphic Pattern
Deramtoglyphics in Disease
41:
Inborn Errors of Metabolism
DEFINITION
Etiopathogenesis
Pathophysiological Classification
Clinical Presentation
Acute Presentation
Chronic/Progressive Presentation
PHENYLKETONURIA (PKU)
Clinical Features
Diagnosis
Treatment
ALKAPTONURIA
Etiology
Clinical Features
Diagnosis
Treatment
HOMOCYSTINURIA
Etiology
Clinical Features
Diagnosis
Treatment
MAPLE SYRUP *URINE DISEASE
Etiology
Clinical Features
Diagnosis
Treatment
HARTNUP DISEASE
Etiology
Clinical Features
Diagnosis
Treatment
TYROSINEMIA TYPE I
Etiology
Clinical Features
Diagnosis
Treatment
UREA CYCLE DEFECTS
Clinical Features
Diagnosis
Treatment
ORGANIC ACIDURIAS (OAs)
Clinical Features
Diagnosis
Treatment
Prognosis
GALACTOSEMIA
Clinical Features
Diagnosis
Treatment
GLYCOGEN STORAGE DISEASE TYPE IA
Clinical Features
Diagnosis
Complication
Treatment
GAUCHER DISEASE
Etiology
Clinical Features
Diagnosis
Treatment
NIEMANN-PICK DISEASE
Etiology
Clinical Features
Diagnosis
Treatment
MUCOPOLYSACCHARIDOSES (MPS)
WARNING SIGNS
ACUTE ONSET IEM GROUP
Investigative Work-up
Treatment
CHRONIC/PROGRESSIVE IEM GROUP
Investigative Work-up
Treatment
42:
Neuromuscular Disorders
MOTOR NEURON DISORDERS
SPINAL MUSCULAR ATROPHIES
Classification
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
PERIPHERAL NEUROPATHIES
General Characteristics
GUILLAIN-BARRÉ SYNDROME
Chronic Inflammatory Demyelinating Polyradiculoneuropathy
HEREDITARY NEUROPATHIES
HEREDITARY MOTOR-SENSORY NEUROPATHIES (HMSN)
ACUTE FLACCID PARALYSIS (AFP)
BELL'S PALSY
NEUROMUSCULAR JUNCTION DISORDERS
Myasthenia Gravis
Transient Neonatal Myasthenia
Persistent Neonatal Myasthenia Gravis
Juvenile Myasthenia Gravis
CONGENITAL MYOPATHIES
MYOTUBULAR MYOPATHY
BENIGN CONGENITAL HYPOTONIA
Clinical Features
Diagnosis
Complications
Prognosis
MUSCULAR DYSTROPHIES
DUCHENNE MUSCULAR DYSTROPHY
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Prognosis
Prevention
BECKER MUSCULAR DYSTROPHY
SCAPULOPERONEAL OR SCAPULOHUMERAL MUSCULAR DYSTROPHY
MYOTONIC MUSCULAR DYSTROPHY
Etiology
Clinical Features
Differential Diagnosis
Treatment
LIMB-GIRDLE MUSCULAR DYSTROPHY
FACIOSCAPULOHUMERAL MUSCULAR DYSTROPHY
CONGENITAL MUSCULAR DYSTROPHY
STEROID-INDUCED MYOPATHY
THYROID MYOPATHY
Hyperthyroidism (Thyrotoxicosis)
Hypothyroidism
PARATHYROID MYOPATHY
METABOLIC MYOPATHIES
INFLAMMATORY MYOPATHIES
TOXIC/DRUG-INDUCED MYOPATHIES
AUTONOMIC NEUROPATHIES
FLOPPY INFANT SYNDROME
Definition
Etiology
Clinical Features
Comorbidities
NEUROMUSCULAR DISORDER:
A PRACTICAL APPROACH
Evaluation
Clinical Evaluation
Investigative Evaluation
SECTION 6: ALLIED SPECIALTIES
43:
Pediatric Ophthalmology
DEVELOPMENTAL ASPECTS
ORBITAL DISEASES
Hypertelorism
Hypotelorism
Exophthalmos (Proptosis)
Enophthalmos
Microphthalmia
Orbital Cellulitis
Periorbital (Preseptal) Cellulitis
Tumors
DISEASES OF THE EYELIDS
Ptosis
Lagophthalmos
Eyelid Retraction
Entropion
Ectropion
Blepharospasm
Blepharitis
Hordeolum
Chalazion
Coloboma
Tumors
DISEASES OF THE LACRIMAL SYSTEM
Congenital Nasolacrimal Duct Obstruction
Dacryostenosis
Dacryocystitis
Alacrima (Dry Eye)
CONJUNCTIVAL DISEASES
Conjunctivitis
Subconjunctival Hemorrhage
Chemosis
Pingueculum
Pterygium
Dermoid Cyst/Dermolipoma
Conjunctival Nevus
Symblepharon
CORNEAL DISEASES
Megalocornea
Microcornea (Anterior Microphthalmia)
Keratoconus
Sclerocornea
Dendritic Keratitis
Interstitial Keratitis
Phlyctenules
Corneal Ulcers
Peters Anomaly
PUPILLARY AND IRIS ABNORMALITIES
DISEASE OF LENS
Cataracts
Ectopia Lentis
DISEASE OF THE UVEAL TRACT
EYE MOVEMENT AND ALIGNMENT DISEASES
Strabismus (Squint)
Clinical Types
Diagnostic Tests
Treatment
REFRACTIVE ERRORS
Hypermetropia (Hyperopia)
Myopia
Astigmatism
Anisometropia
Impairment/Paralysis of Accommodation
VISUAL DISORDERS
DISEASES OF THE RETINA AND VITREOUS
Retinopathy of Prematurity (Retrolental Fibroplasia)
Etiopathogenesis
Classification
Treatment
Prevention
RETINOBLASTOMA
Retinitis Pigmentosa
Retinal Detachment
Hypertensive Retinopathy
Diabetic Retinopathy
OPTIC NERVE DISEASES (FIGS 43.5 TO 43.9)
Papilledema (Choked Disk)
Optic Neuritis
Optic Atrophy
SYSTEMIC MEDICATION AND OCULAR DAMAGE
OCULAR TRAUMA
44:
Pediatric Ear, Nose and Throat (ENT) Problems
INTRODUCTION
THE EAR DISORDERS
Foreign Bodies in the Ear
Acute Otitis Media (AOM)
Etiology
Clinical Features
Treatment
Prognosis
Complications
Deafness (Hearing Impairment)
Types
Etiology
Clinical Effects
Evaluation
Assessment of Hearing through Special Techniques
Treatment
THE NOSE DISORDERS
Foreign Body in Nose
Epistaxis
Sinusitis
Nasal Polyps
THE THROAT DISORDERS
Diphtheria
INTUBATION AND TRACHEOSTOMY
45:
Pediatric Dental Problems
NORMAL DENTITION
DENTAL MALOCCLUSION
DENTAL CARIES
Etiopathogenesis
Clinical Features
Treatment
Prevention
FLUOROSIS
GUIDELINES FOR PREVENTION OF DENTAL DISEASE
Dental or Oral Hygiene
Diet
Fluoride and Fluoridation
Regular Dental Check-ups
CLEFT LIP AND PALATE
46:
Pediatric Surgery
GASTROINTESTINAL PROBLEMS
Congenital Hypertrophic Pyloric Stenosis
Clinical Features
Diagnosis
Treatment
Hiatal Hernia
Esophageal Atresia and Tracheoesophageal Fistula
Clinical Features
Diagnosis
Treatment
Congenital Diaphragmatic Hernia
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Duodenal and Other Intestinal Atresias
Intestinal Malrotation
Intussusception
Etiologic Considerations
Clinical Features
Diagnosis
Treatment
Prognosis
Hirschsprung's Disease
Clinical Features
Investigations
Treatment
Prognosis
Meconium Plug Syndrome
Meconium Ileus
Meckel's Diverticulum
Clinical Features
Diagnosis
Treatment
Necrotizing Enterocolitis
Appendicitis
ANORECTAL PROBLEMS
Imperforate Anus and Other Anorectal Malformations
Anal Fissure
Perianal Abscess and Fistula
Pilonidal Sinus and Abscess
ANOMALIES RELATED TO THE UMBILICUS
Vitellointestinal Fistul\a
Umbilical Polyp
Umbilical Hernia
Exomphalos (Omphalocele) and Gastroschisis
ANOMALIES OF THE HEPATOBILIARY SYSTEM
Extrahepatic Biliary Atresia (EHBA)
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Prognosis
Choledochal Cysts
Varieties
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Cholecystitis (Calculus Type)
GENITOURINARY PROBLEMS
Obstructive Uropathy
Congenital Ureteropelvic Junction Obstruction
Posterior Urethral Valve
Renal Stone
Etiology
Clinical Features
Diagnosis
Treatment
Primary Bladder Stone Disease
Etiology
Clinical Features
Treatment
Priapism
Etiology
Treatment
Tight External Urethral Meatus
Phimosis and Paraphimosis
Hypospadias and Epispadias
Ambiguous Genitalia
INGUINOSCROTAL PROBLEMS
Inguinal Hernia
Hydrocele
Undescended Testes
Epididymo-Orchitis
Acute Scrotum
HEAD AND NECK PROBLEMS
Cleft Lip and Cleft Palate
Cystic Hygroma
Thyroglossal Cyst
Brachial Cyst
Brachial Sinus and Fistula
Sternomastoid Tumor
MISCELLANEOUS PROBLEMS
Abscess
47:
Pediatric Orthopedics
CONGENITAL DEFICIENCY OF LONG BONES
CLUBFOOT
FLATFOOT
RADIAL CLUB HAND
TRIGGER THUMB
POLYDACTYLY
SYNDACTYLY
CONGENITAL CONSTRICTION BANDS/RINGS
CONGENITAL PSEUDARTHROSIS OF THE TIBIA
DISLOCATION OF PATELLA
KNOCK-KNEE (GENU VALGUM)
BOW LEG (GENU VARUM)
CLEIDOCRANIAL DYSOSTOSIS
HEMIHYPERTROPHY
SLIPPED CAPITAL FEMORAL EPIPHYSIS
DEVELOPMENTAL DYSPLASIA OF THE HIP
Etiology
Clinical Features
Diagnosis
Treatment
Prognosis
SCOLIOSIS
KYPHOSIS
GENETIC SKELETAL DYSPLASIAS
Osteogenesis Imperfecta
Marfan Syndrome
Arthrogryposis Multiplex Congenita
Achondroplasia
PSEUDOACHONDROPLASIA
Osteopetrosis (Marble Bone Disease)
Definition
Etiopathology
Types
Clinical Features
Differential Diagnosis
Treatment
Infantile Cortical Hyperostosis
Definition
Clinical features
Diagnosis
Treatment
Prognosis
Osteochondritis
Limb Length Discrepancy
Etiology
Evaluation
Treatment
CHILD ABUSE AND NEGLECT
INFECTIONS/INFLAMMATIONS OF BONES AND JOINTS
Acute Septic (Pyogenic) Arthritis
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Osteomyelitis
Etiopathogenesis
Clinical Features
Diagnosis
Differential Diagnosis
Treatment
TUBERCULOSIS OF BONES AND JOINTS
TRANSIENT SYNOVITIS OF THE HIP
RHEUMATOID ARTHRITIS
BONE TUMORS
PEDIATRIC SPORTS MEDICINE
Indications for Restriction
Categorization of Sports
Areas of Concern
Disqualifications and Limitations
Pediatric Evaluation
The Pediatric Sports Medicine Program and the Pediatrician's Responsibilities
PEDIATRIC FRACTURES
Special Features
Patterns
Management Highlights
SECTION 7: MISCELLANEOUS AND UNCLASSIFIED ISSUES
48:
Miscellaneous and Unclassified Pediatric Issues
CHILD ADOPTION
Why Adoption?
Source of Adoption: A Relative or an Agency?
Adoption Laws
Adoption and the Pediatrician
INFANTILE TREMOR SYNDROME
Epidemiologic Considerations
Etiology
Clinical Features
Course
Diagnosis
Treatment
Prognosis
SUDDEN INFANT DEATH SYNDROME
Etiopathogenesis
Diagnosis
Treatment
PROGERIA
CHRONIC FATIGUE SYNDROME
Etiopathogenesis
Clinical Features
Diagnosis
Treatment
Prognosis
GROWING PAINS
HISTIOCYTOSIS
SARCOIDOSIS
Etiopathogenesis
Clinical Features
Diagnosis
Differential Diagnosis
Treatment
Prognosis
SOME MINOR PROBLEMS OF THE NEWBORN, THE INFANT AND THE YOUNG CHILD
Neonatal Period
Later Infancy and Childhood
Tongue-tie (Ankyloglossia)
Delayed Speech
Eating Problem
Bedwetting
Umbilical Hernia
Protuberant Abdomen
Irregular/Asymmetrical Skull
Bowlegs (Genu Varum)/Knock-knees (Genu Valgum)
Flat Feet (Pes Planovalgus)
HEAT INJURY
SHOCK
Types
Clinical Features
Diagnosis
Treatment
EMERGING AND RE-EMERGING INFECTIONS
Definitions
Classification
Noteworthy Emerging and Re-emerging Infections
Contributing Factors
Control Measures
EVIDENCE-BASED MEDICINE
NEED FOR THE EVIDENCE-BASED MEDICINE
Essential Steps in Evidence-based Medicine
Sources of Evidence-based Medicine
Limitations of Evidence-based Medicine
SECTION 8: PEDIATRIC PROCEDURES
49:
Pediatric Practical Procedures
INTRODUCTION
GENERAL RULES/PRECAUTIONS
RESTRAINT AND POSITIONING
INTRAMUSCULAR INJECTION
Usual Sites
Method
Special Note
INTRADERMAL INJECTION
Method
Special Note
VENIPUNCTURE
INTRAVENOUS(IV)INFUSION
Scalp Vein Infusion
Venesection (Cutdown or Cutopen)
Umbilical Vein Catheterization
CENTRAL VENOUS ACCESS
ARTERIAL PUNCTURE
INTRAOSSEOUS INFUSION
SUBCUTANEOUS INFUSION
INTRAPERITONEAL INFUSION
RECTAL INFUSION
BONE MARROW ASPIRATION
BONE MARROW TREPHINE
LUMBAR PUNCTURE
SUBDURAL PUNCTURE OR TAP
VENTRICULAR TAP
THORACENTESIS
PERICARDIAL PUNCTURE
ABDOMINAL PARACENTESIS
SUPRAPUBIC BLADDER ASPIRATION
Method
HEEL PUNCTURE
Method
Special Note
LIVER BIOPSY
KIDNEY BIOPSY
INTUBATION
ENDOTRACHEAL INTUBATION
PHOTOTHERAPY
EXCHANGE TRANSFUSION
Why the Procedure is Performed?
Risks
LYMPH NODE BIOPSY
FINE NEEDLE ASPIRATION
Requirements
Method
Special Role
Caution
GASTRIC LAVAGE
Method
Special Note
MANUAL REMOVAL OF FOREIGN BODY FROM AIRWAY
Removal in an Infant
Back Blow Chest Thrust
Removal in a Child Older than 1 Year
Subdiaphragmatic Abdominal Thrusts (Heimlich's Maneuver)
CARDIAC RESUSCITATION
ASSISTED VENTILATION
Bag and Mask Ventilation
Continuous Positive Airway Pressure
Mechanical Ventilation
50:
Pediatric Laboratory Procedures
BACKGROUND
BLOOD EXAMINATION
Total Leukocyte Count (TLC)
Collection
Hemoglobin
Hematocrit
Red Cell Count
Peripheral Blood Film
Differential Leukocyte Count (DLC)
Erythrocyte Sedimentation Rate
Reticulocyte Count
Platelet Count
URINE EXAMINATION
Collection
Physical Examination
Chemical Examination
Urine Microscopy
STOOL EXAMINATION
Collection
Microscopy
Direct
Occult Blood
Fat Globules
Reducing Substances
Stool pH
CEREBROSPINAL FLUID EXAMINATION
Collection
Examination
SECTION 9: PEDIATRIC SYNDROMES
51:
Pediatric Syndromes
SECTION 10: PEDIATRIC DRUG DOSAGES
52:
Pediatric Drug Dosages
APPENDICES
INDEX
TOC
Index
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