Case-based Reviews in Pediatric Emergencies Suraj Gupte, Novy Gupte
INDEX
ABCDEFGHIJKLMNOPQRSTUVWXYZ
Page numbers followed by b refer to box, f refer to figure, fc refer to flowchart, and t refer to table.
A
Acidosis 48, 169, 216
Acquired
bleeding disorders 281
coagulation factor deficiencies 281
hypopituitarism 40
Acquired immune deficiency syndrome 262
Activated partial thromboplastin time 280, 282
Acyclovir 86
Addison's disease 56
Adenotonsillar hypertrophy 309
Adenoviruses 154, 161
Adipsic diabetes insipidus 42
Adrenal
crisis 46, 48–50
acute 46
suspect 48
hyperplasia, congenital 43, 56
insufficiency 47, 50
causes of primary 48
secondary 48
diagnosis of 49
secondary 48
types of 47
Aedes aegypti 199
Aerosolized therapies 172t
Airborne transmission 219
Airway 71, 86fc
management of 54
pressure, continuous positive 311
pressure-release ventilation 149, 150
secretions 162
Akinetic seizure 78
Alanine transaminase 201, 203
Albuterol 157
Aldosteronism, primary 187
Allopurinol 288
Alveolar diseases 142
Ambulatory blood pressure monitoring 186
Amikacin 137
Aminoacidogram 133
Amnesia 55
Amoxicillin 161, 217
Amoxicillin-clavulanic acid 144
Amphetamines 178
Ampicillin 24
Amrinone 195
Analgesics, role of 72
Anaphylactic
reactions 238
shock 2
Anaphylaxis 1–3, 5, 6, 288
causes for 3
diagnosis of 4
episodes of 6
mimics of 4
refractory 6
signs of 3f
symptoms of 3f
Anatomic defects, congenital 39
Androctonus australis 230
Anemia, severe 271
Anesthetics, role of 72
Anesthetizing drugs 96, 97t, 98
Angiotensin
converting enzyme 196
inhibitors 3, 11, 12
receptor blockers 11
Annular pancreas, embryology of 65
Anorexia 155, 271
Antibiotic therapy 137, 157
duration of 275
Anticipated intraoperative complications 62
Antidiarrheal agents 243
Antidiuretic
effect 38
hormone 37, 39, 295
Antiemetics 224
Antiepileptic drug 81, 83, 86, 98
therapy 85
Antihypertensive drug 189t
treatment 184
Antimalarial
chemotherapy 211
drugs 211
Antineutrophilic cytoplasmic antibodies 22
Anti-seizure prophylaxis, role of 72
Anti-snake venom 238
treatment, stop 238
Antistreptolysin O 21
antibodies 30
Antitumor necrosis factor 306
Antiviral
agents 222, 222t
drug 223
therapy 223
therapy 157
Anxiety 55
Aortic arch sidedness 195
Apert syndrome 309
Aphasic seizure 78
Apnea hypopnea index 312
Appetite test 271, 272t
Aquaporin 39
Arboviral encephalitis 112
Arboviruses 112
Arginine vasopressin 37
Arginosuccinic acid 133
Artemisinin 211
Artemisinin-based combination therapy 116
Arterial blood
gas 131, 195
analysis 130
oxygen saturation 143
pressure 104
Arterial pressure, mean 69
Artesunate 212
Arthralgia 264
Arthritis 29, 264
Ascorbic acid 27
Aspartate aminotransferase 201
Aspartate transaminase 262
Aspiration pneumonia 165
Astatic seizure 78
Asthma 3, 155, 168, 174
acute severe 168
pathophysiology of 169
severe 173t, 174
severity, classification of 170t
Astrovirus 241
Ataxia 55
Atonic seizure 78
Atrial septal defect 142, 193
Atrioventricular valve regurgitation 194
Atropine sulphate 237
Autoimmune
adrenal insufficiency 48
anemia 264
disorders 302
encephalitis 117
syndrome 118t
hepatitis 255, 264
Autonomic nervous system 55
Avian influenza viruses 219
Azithromycin 144
Azotemia, prerenal 10
B
Bacterial meningitis 135, 138, 139fc
antibiotics in acute 137b
Bacterial pneumonias 162
Barbiturate coma, role of 73
Barbiturate, high-dose 73
Barium meal 65f
Battle's sign 71
B-cell lymphoma 286
Beckwith-Wiedemann syndrome 56, 309
Benzodiazepines 72, 84, 87, 93, 94, 215
Bernard-Soulier syndrome 283
Beta-blockers 55
Bezold-Jarisch reflex 2
Bickerstaff encephalitis 127
Bilious emesis 65
Bilirubin load, increased 263
Biphasic anaphylaxis 4
Bleeding
local 235f
severe 208b
Bleomycin 15
Blindness, cortical 216
Blood 12
counts, routine 142
glucose 32, 131
pressure 62, 135, 182, 186, 207, 236
controlling 138
management of 183
measurement 185
monitoring 186
products, transfusion of 208
sugar 83, 86
test 227, 232
transfusion 208
urea 30
nitrogen 290
vessels, large 302
Blood-brain barrier 108
Body mass index 52
Body temperature management 107
Botulism 122, 125
Bradypnea 141
Brain
abscess 76
herniation
infections 93
injury
primary 68
secondary 68
tissue oxygen 72
Brainstem reflexes 119
Breakbone fever 199, 262
Breastfeeding 240
Breath-holding spells 78
Breathing 54, 71, 86fc, 242
increased work of 155
Broken neck sign 235, 236f
Bronchial mucosa 169
Bronchiolitis 145, 154, 155
acute 153
diagnosis of 155
obliterans 158
severe 153, 157, 158
Bronchitis
epidemiology of 154
etiology of 154
severe 158
Bronchodilators 157, 158
Bronchopneumonia 155, 161
Buccal mucosa 295
Budd-Chiari syndrome 255
Bungarus caeruleus 234f
Burkitt's lymphoma 285
C
Cairo-Bishop scoring 287, 287t
Calcineurin inhibitors 178
Calcium channel blockers 62
Calicivirus 241
Campylobacter jejuni 127, 241
Capillary blood glucose 52, 54
Capillary refill 242, 295
time 207
Captopril 196
Carbon dioxide, end-tidal 99
Cardiac arrhythmias 84
Cardiogenic syncope 78
Cardiomegaly 194
Cardiomyopathy 62
Cardiopulmonary disease 153
Cardiotoxin 225
Cardiovascular
disease 3, 305
system 178, 185
Carnitine palmitoyl synthase 133
Carvedilol 196
Causative organisms 249
Cefotaxime 116, 146
Ceftazidime 137
Ceftriaxone 110
injection 86
Cefuroxime 144
Central airway obstruction 142
Central diabetes insipidus 37, 41
causes of 39b
Central nervous system 84, 100, 130, 142, 178, 185, 201, 303, 312
infection, cause of 136
signs 226
symptoms of 293
Cerebral
autoregulation curve 104f
blood
flow 72, 100
volume 70, 106
edema 35
signs of 35
glucopenia 55
malaria 112, 210, 211, 214, 213–216
monitoring
multimodal 104
palsy 79, 309
perfusion pressure 67, 69, 99, 105
Cerebrospinal fluid 70, 88, 91, 110, 117, 123, 135, 136, 139
Cervical lymph nodes 220
Charcot's triad 263
Chediak-Higashi syndrome 281
Chest
discomfort 221
retraction 140, 141
wall retractions 145
Chiari malformation 309
Child's immune status 145
Childhood
obstructive sleep apnea 309b
vasculitis 301
Chlamydia 161
Chloramphenicol, combination of 137
Chlorpheniramine maleate, injection of 224
Cholestatic liver disease 255
Churg-Strauss
arteritis 302
vasculitis 303
Churg-Strauss syndrome 306
Ciprofloxacin 24
Cisplatin 15
Clevidipine butyrate 180
Clonic seizure 78
Clonidine 189
Clopidogrel 15
Clostridium difficile 241
Clot formation time 270
Cloxacillin 144
Coagulation cascade 282fc
Coarctation of aorta 178, 187
Cocaine 178
Common cobra 233f
Common cold 221t
differ 221
Community acquired pneumonia 161
antibiotics in 163
Complete blood
count 131
picture 285
Congenital heart defects, repair of 197
Congestive heart failure 192–195, 197t
causes of 193
pathophysiology of 194
treatment of 197
Conn's classification 258
Convulsive status epilepticus 83, 88
Coral snakes 233
Corpus callosotomy 97
Corticosteroids 137, 187
Cough 72, 192, 221
Counterregulatory hormone 55, 55t
deficiency of 56
Cranial nerve 135
signs 226
C-reactive protein 302
Crescentic glomerulonephritis 22
disorders with 22b
Crouzon syndrome 309
Cryptosporidium 241, 244, 263
Cushing's disease 178
Cushing's reflex 261
Cushing's syndrome 187
Cushing's triad 72
Cutaneous vasculitis 303
Cyanosis 155
Cyclic adenosine monophosphate 39
Cyclosporine 15
Cystic fibrosis 217
Cytoadherence 213
Cytokine releasers 225
Cytomegalovirus 126, 261
D
Daboia russelii 234f
Deafness 39
Decompensation, management of acute 197
Deep vein thrombosis 37
Deficit therapy 294
Dehydration 48, 242, 273, 276, 295, 295t
degree of 242t
grade 241
in gastroenteritis, management of 246fc
mild 241
mild-to-moderate 242
moderate 243, 291
severe 40, 242, 243, 271
treatment of 241
Dengue 200, 204, 208
diagnosis of 204
disease 199
fever 200, 203
control in 203
derangements in 202
stages of 202
hemorrhagic fever 200
infection 203, 204f
severe 199, 200, 208
risk factors 202f
shock syndrome 200, 201
virus 199
Dengue-related hepatic involvement 203
Dexamethasone 137, 173
Diabetes 217
insipidus 37, 39, 42
diagnosis of 40
types of 39
mellitus 39, 53
Diabetic ketoacidosis 31, 33, 34, 36
classified 33
complications of 35
resolution of 35
Dialeptic seizures 78
Diarrhea 49, 241
acute 245, 246b
causes of acute 241
complications of acute 241
episode of 248
negative 16
positive 16
role of
antibiotics in 244
prebiotics in 245
therapy of acute 245
Diarrheal
dehydration, grading of 242t
diseases 240
Diastolic blood pressure 177, 182
Diazepam 88, 94, 228
Digoxin 196
Diphenhydramine 1
Diphtheria 122
Disopyramide 55
Disseminated encephalomyelitis, acute 112, 116
Disseminated intravascular coagulation 225, 267, 282
Diuretic therapy, adverse effects of 196
Dizziness 55, 59
Dobutamine 195
injection 224
Dopamine 195
infusion 2
Dorsal root ganglia 122
Down's syndrome 309
Dravet syndrome 79
Drugs
first line 85f
second line 85, 94
third line 85
Duodenoduodenostomy 66
Duodenojejunostomy 66
Duodenum, surgical bypass of 66
Dysarthria 55
Dysentery 249, 249f
acute 248, 250
complications of 249
Dysphagia 227
Dysplastic kidneys 178
Dyspnea 154
Dystonia 133
Dysuria 29
E
Ebstein's anomaly 193
Echis carinatus 234f
Elapidae 233
Electrographic seizures 96
Electrolyte imbalance 84, 290
correct 274
Emergency room, stabilization in 71t
Enalapril 196
Encephalitis 112
syndrome, acute 110, 112, 113
Encephalopathy 221
Endocrine 178
disorders 187
disturbances 60
Endogenous toxins 11
End-organ damage 184
Endoscopic
sclerotherapy 256, 257, 258t
variceal ligation 256, 258t
Endotracheal intubation, role of 174
Entamoeba histolytica 249
Enteric adenovirus 241
Enteroviral illness including polio 124
Enterovirus 112, 116, 154
Envenomation 224
degree of 236, 236t
local 237
mild 227
moderate 227
signs of 234
site of 225
Enzymes 54
Epilepsy, history of 83
Epileptic
encephalopathy 79
seizure 78
Epithelial cells 154
Epstein-Barr virus 126, 261
Erythromycin 144
Escherichia coli 14, 135, 136, 161, 249
infection 135
vaccines 245
Esmolol 189
Esophageal
atresia 64
balloons 257f
Extensive superficial infection 271
Extracorporeal carbon dioxide removal 152
Extracorporeal membrane oxygenation 150, 151
role of 151
Extrahepatic portal venous obstruction 254
Extremities 207
Eye 178, 220, 242
movement, nonrapid 79
opening 119
Eyelid
myoclonia 78
swelling of 4
F
Facial dysmorphism 52, 79
Falciparum malaria, severe 211
Familial dysautonomia 187
Fang marks 234f
Fat necrosis 267
Fatty acid oxidation disorder 133
Febrile
encephalopathy, acute 110, 112, 113, 115, 117
phase 202
seizures 93
status epilepticus 93
Feeding in gastroenteritis, management of 246fc
Fenoldopam 180
Fever 220, 221, 271, 288
mild 223
Fibrinolysis inhibitors 283
Flaccid paralysis, acute 121, 122, 122t, 123, 126, 127
Fluid 290
redistribution of 11
status, management of 16
Food
allergy 43
and drug administration 288
Foreign body in airway 155
Fosphenytoin 89, 94
Four-lumen minnesota tube 257f
Free fatty acids 57, 225
Fresh frozen plasma 278
Functional residual capacity 141
Furosemide 24, 180, 196
injection of 224
G
Gallop rhythm 194
Gas
chromatography mass spectrometry 114
exchange goals 28, 149
Gastric
hyperdistention 227
leiomyosarcoma 60
varices 258
Gastroenteritis 245
acute 240, 244, 291, 293
Gastroesophageal
reflux 43, 155
varices 258
Gastrointestinal
bleeding 267, 278
causes of 251, 254t
mid 254
signs 227
tract 296
Gaucher's disease 254
Gelastic seizure 78
Genetic
defects 39
epilepsy 79
testing 283
Genitourinary signs 227
Gentamicin 137
G-glutamyl transpeptidase 260
Giardia lamblia 241
Gingival sulci, bleeding from 235f
Glanzmann thrombasthenia 283
Glasgow Coma Scale 99, 114, 119, 210, 260
modified 101t
Glomerular
abnormalities 20
filtration rate 10, 299
Glomerulonephritis
acute 11, 18, 19, 178
poststreptococcal 19
chronic 187
primary 19
Gluconeogenic enzymes 55
Glucose 57
homeostasis 52
insulin infusion 44
Glucose-6-phosphate dehydrogenase 262
deficiency 288
Glutamic acid decarboxylase 114
Glycogenolytic enzymes, activating 55
Glycoprotein 219
Glycosaminoglycans 225
Gram-negative
bacilli 165
orgainisms 136, 164
Gray hepatization 166
Growth
failure 195
hormone 57
deficiency 56
Grunting 155
Guillain-Barré syndrome 122, 124, 126, 127, 127t, 187
management of 127
pathogenesis of 127
subtypes of 126
H
H1N1-influenza 151
Haemophilus influenzae 126, 135–138, 146, 154, 160, 161, 164
meningitis 137
vaccine 135
Haemophilus pertussis 154, 158
Hallermann-Streiff syndrome 309
Head injury 72
management of severe 105
severity of 68, 69t
Headache 55, 220, 221, 288
children experience 59
Heart
failure 187
acute decompensation of 193
category of 194
treatment of acute 195
rate 62, 192, 207, 242
Helium-oxygen mixture 174
Hemagglutinin 218
Hematological signs 227
Hematuria 26–28
diagnosis of 30fc
glomerular 29t
management of 30fc
nonglomerular 29t
pathophysiology of 27
Hemiparesis 216
Hemiscorpius lepturus 224
Hemodynamic monitoring 207t
Hemoglobin 135, 199, 270, 285, 290
Hemogram 188
Hemolysis 288
Hemolytic toxin 225
Hemolytic uremic syndrome 11, 14–16, 178, 304
atypical 15, 16t
typical 16t
Hemophagocytic lymphohistiocytosis, primary 262
Hemophilia 279
Hemorrhage 187
Hemostasis
defects in primary 283
primary 279, 280f
secondary 279
Hemostatic disorders 280
Henoch-Schönlein purpura 11, 301, 303, 304
Hepatic
dysfunction 263
failure 290
venous pressure gradient 251
Hepatitis
A viruses 203
acute 260, 261b, 264, 265
B 126
viruses 203
C viruses 203
causes of acute 263
setting of acute 263
Hepatorenal syndrome 252
Hermansky-Pudlak syndrome 281
Herniation 103
syndromes 102t
Herpes simplex
encephalitis, treatment of 116, 116t
virus
encephalitis 116
polymerase chain reaction 110
Herpesvirus 154
Hirschsprung disease 64
Histamine 225
Holliday-Segar method 294, 294t
Hormonal tests, essential 44
Horn cell, anterior 122
Hospital acquired pneumonia 161, 164
antibiotics in 165
antimicrobials in 164b
Human immunodeficiency virus 19, 126
Hyaluronidases 225
Hydralazine 180, 189
Hydrochlorothiazide 195
Hydronephrosis 187
Hydrophiidae 233
Hyperaldosteronism 178
Hyperammonemia 132, 133fc
cutoff value for 132
management of 132
Hyperekplexia 79
Hyperglycemia 73, 225, 267
correlation of 73
Hyperinflated lungs 153
Hyperinflation 153
Hyperinsulinemia 53, 57
Hyperinsulinism 56
Hyperkalemia 12, 48, 50, 225, 294
causes of 299, 299fc
management of 289
Hyperlucent lung syndrome 158
Hypernatremia 77, 187, 297
managed 41
treatment of 297
Hypernatremic dehydration 243
Hyperosmolar therapy 70
Hyperphosphatemia, management of 288
Hypersensitivity vasculitis 303
Hypertension 29, 59, 62, 177, 178, 184, 185, 187, 188b
acute severe 184
causes of 186
chronic 187b
malignant 177, 178b
portal 252, 253f, 254t
transient 187b
diagnosis of severe 185
essential 187
malignant 176, 177, 179b
pharmacotherapy for malignant 180t
severe 184, 185, 187, 189, 189t
stages of 177t
treat 62
treatment in severe 189
Hypertensive
crisis 179b
emergency 176, 177, 185, 185b
manifestations of 178t
encephalopathy 21
retinopathy 187
urgency 177
Hyperthermia 84
Hyperthyroidism 178
Hypertonic saline 70
nebulization, role of 158
Hyperventilation
role of 72
severe 72
Hypervolemic hypernatremia 297
Hypocalcemia 75, 77, 267
Hypocarbia 73
Hypoglycemia
acute episode of 57b
drugs causing 55
pathological 56, 57
prevent 272
Hypoglycemia 48, 50, 52, 54, 55, 55b, 55t, 56, 57, 62, 75, 84, 215, 235, 271, 276
in emergency room, pathological 56fc
to maintain sugars 54b
Hypokalemia 123
causes of 298, 298b
evaluation of 298fc
management of 298
mild 298
moderate 298
severe 298
treatment of 298
Hypokalemic periodic paralysis 125
Hyponatremia 48, 75, 77, 291, 294–296, 296fc
with edema 295
Hypotension 1, 48, 62, 73
manage 73
Hypotensive shock 209
Hypothermia 98, 271, 276
prevent 272
Hypothyroidism 309
Hypotonic hyponatremia 295
Hypovolemia 62, 215
Hypovolemic hypernatremia 297
Hypoxemia 73
in children 73
Hypoxia 73, 169
sign of severe 141
Hypoxic ischemic insult 75
I
Immunodeficiency 162
Immunoglobulin 23
Immunomodulatory therapies 97, 98
Impending herniation 101
Infection
related causes 93
serious secondary 223
treatment of 274
Infectious
diseases 153, 199
gastrointestinal disorder 248
Infective pathologies 115t
Inflammatory bowel disease 264
Inflammatory demyelinating polyneuropathy, acute 121
Influenza 112, 126, 136, 161, 217, 219–221, 221t
diagnostic test 221
prognosis in 222
uncomplicated 220b
vaccine 217, 222b
virus 154, 218, 219
replication 218f
survival of 219
types of 218
Inherited bleeding disorder 281t
Inspiratory pressure, maximum 150
Insulin 52, 57, 300
dependent diabetes 264
infusion therapy 33
secretion 225
Insulin-like growth factor binding protein-1 57
Intensive care unit 127
Interstitial nephritis, acute 11, 24
Intestinal
obstruction 43, 267
perforation 267
Intracranial
hypertension 69, 71
mass 187
pressure 69, 99, 110, 215
acute surges in 107t
controlling raised 138
increased 187
monitoring 71, 104, 105f
volume curve 103f
temperature 139
Intravascular volume depletion 11
Intravenous
acyclovir 110, 116
calcium gluconate 294
fluids 144
immunoglobulin 88
infusion 238
rehydration 273
Ipratropium 173
bromide 172
Irritability 155
Ischemic infarct 75
Isolated gastric varices 258
Isovolemic hypernatremia 297
Isradipine 180
J
Japanese B encephalitis 116
Jugular venous distention 195
K
Kawasaki disease 301, 302, 305
classification for 305b
Kayser-Fleischer ring 255
Ketamine 96, 97
role of 174
Ketogenic diet 97, 98
Ketones 57
Ketotic hypoglycemia 56
Kidney 178
disease
acute 9
chronic 15, 178
injury
acute 9, 10, 11b, 12b, 12t, 13, 14, 252
causes of acute 10
intrinsic acute 11, 11t
network, acute 10
prerenal acute 11, 11t
treatment of acute 12
malformations of 187
King cobra 233f
Klebsiella 161, 164, 165
Klippel-Feil syndrome 309
Krait 233, 234f, 236f
Kussmaul's breathing 215
L
Labetalol 179, 180, 189
Lacosamide 94, 95
Lactic acidosis 133
Leiurus quinquestriatus 230
Lennox-Gastaut syndrome 78
Leptospirosis 112
Leukemia 285
Leukocyte, differential 135
Levetiracetam 89, 94
Life-threatening emergency 1
Listeria meningitis 137
Listeria monocytogenes 136
Live attenuated influenza vaccine 223
Liver
cell failure 56
disease, chronic 256, 264
dysfunction 203
failure
acute 261b, 263, 265
chronic 203
function test 227
in sepsis, causes of 263b
involvement, etiology of 263
transplantation 203
Lobar pneumonia, stages of 166
Loeffler pneumonia 165
Loeffler syndrome 165
Lorazepam 88, 90, 93, 94, 215
Losartan 196
Lower gastrointestinal bleeding 254
Lower osmolarity oral rehydration salts 244
Lower
pontine 102
respiratory tract 153
Lumbar puncture 113
second 137
Lung injury 147
acute 151
Lupus anticoagulant 282
Lupus nephritis 178
Lyme's disease 112, 126
Lyme's serology 126
Lymphangitis 235f
Lymphoblastic leukemia, acute 285, 286, 287
Lymphocytes 91
M
Macrolides 144
Magnesium sulfate 174
Malaria 210
complicated 211
detection of 214
development of severe 213
manifestations of severe 210
negative rapid 111
severe 211, 211b, 212t
tests for 214
Malnutrition, severe acute 112, 270, 271, 272, 275, 276
Mannitol 70
Maple syrup urine disease 130, 133
Marfan's syndrome 309
Massive cell damage 148
Measles 112
infection 112
Medullary carcinoma thyroid 60
Meningism 214
Meningitis 136, 138
Meningococcal meningitis 136, 137
Meningoencephalitis 76
Mental
confusion 55
status 242
Metabolic
acidosis 31, 84, 133, 210
cause 131
crisis 129, 132
disorders 133t
classification of 132
disturbances, acute 93
signs 227
Metastatic spread 163
Methemoglobinemia 288
Methicillin 24
Methicillin-resistant staphylococcus 144
Methylprednisolone 173
Metoclopramide 217
Metroprolol 196
Microcytic hypochromic cells 270
Micronutrient supplementation 245, 274
Microvascular blood flow 213
Midazolam 82, 88, 94, 93, 96, 97, 215
infusion 91, 92, 110
Midbrain 102
Miller fisher variant 127
Milrinone 195
Minoxidil 189
Mitochondrial disorders 60
Mitomycin 15
Monro-Kellie doctrine 103
Morbid obesity 309
Motor response 101
Mouth 242
Mucocutaneous bleeding 279
Mucosal neuromas 60
Mucous membranes 220
Multicystic kidney 187
Multiple organ dysfunction syndrome 204
Mumps 112
Myalgia 220
Myasthenia gravis 117
Mycobacterium tuberculosis 161
Mycoplasma 158
Mycoplasma pneumoniae 116, 126, 154, 161, 165
Myelogenous leukemia, chronic 286
Myeloid leukemia, acute 286, 287, 287
Myocardial
depression 267
function 2
Myocarditis 221
Myoclonic 78
absence 78
atonic 78
jerks 78
seizures 78
Myoclonus, negative 78
Myositis 122, 221
N
N-acetyl cysteine, infusion of 203
Nasal
congestion 223
obstruction, chronic 309
National Anti-malaria Program 211, 212t
National polio surveillance project 123
Nausea 55, 136, 227, 288
Nebulizer solution 172
Neck rigidity 135
Neisseria meningitides 136
Neonatal pneumonia 164, 166
Nephritic, disorders with acute 24
Nephritis
acute 19
etiology 19b
Nephritogenic streptococci 19
Nephrotic syndrome 264, 290, 293
Nephrotoxin 225
Nerve conduction study 121
Netilmicin 137
Neuraminidase 218
inhibitors 223
Neuroblastoma 178, 187
Neurocutaneous syndromes 79
Neurocysticercosis 75, 76, 115
Neurological
emergency 100, 110
sequelae 216
signs 226
Neurologically injured child 104
Neurometabolic disorders 79, 129
Neuromuscular junction 122
Neuroprotective measures 103
Neurotoxic snakebite 237
Neurotoxin, concentrations of 225
Neutropenia 288
Nicardipine 179, 180, 189
Nifedipine 189
Nitazoxanide 244
Nitric oxide, inhaled 146
Nitroblue tetrazolium test 137
Nitroglycerine 189
N-methyl-D-aspartate 114
Nonallergic anaphylaxis 2
Nonbilious emesis 65
Nonconvulsive status epilepticus 84, 88, 95
Nonglomerular hematuria 28
Non-Hodgkin lymphoma 286, 287
Noninvasive
positive pressure ventilation 174
ventilation 174
role of 168
Nonketotic hyperglycinemia 133
Non-neurological systemic signs 226
Nonpoisonous snake 233
Nonradiopaque foreign bodies 163
Nonrespiratory causes 142
Nonsteroidal anti-inflammatory drugs 4, 11, 12, 24, 203, 269
Nonstructural protein 218
Normoglycemia, restoration of 215
Normovolemia 104
Norwalk virus 241
Nucleoprotein 218
Nutrition 73, 126
role of 151
Nutritional edema 271
classification of 271t
O
Obstructive sleep apnea 308, 310
causes of 309
complications of 311
signs of 309
treatment of 311
Obstructive uropathy 178
Ophiophagus hannah 233, 233f
Optic atrophy 39
Oral
fludrocortisones 50
hydrocortisone replacement 50
hypoglycemic agent 54
medications, dosage of 196t
nifedipine 180
rehydration 273
salt 243, 244
solution 240, 242, 244t, 273t
therapy 241, 243, 294
Organic
acidemia 133
diagnosis of 133
treatment of suspected 133
personality changes 55
Ornithine transcarbamylase deficiency 133
Oropharyngeal papillomatosis 309
Oscillatory ventilation, high frequency 146, 149, 150
Oseltamivir 217, 222
Osmolarity 70
Osmotic agent 107
Osteopetrosis 309
Oxygen 157, 197
prongs 144
role of 171
saturation 150, 171
maintain 149
supplementation 145
levels of 144
P
Pain
management 126
severe abdominal 249
Palmar pallor, severe 271
Palpitation 55, 59
Pancreas
annular 64, 66
embryology of 65
Pancreatic infection 269
Pancreatitis
acute 266
causes of 267
complications of acute 267b
management of severe 268
severe acute 266, 267
Pandemic influenza 217
Papilledema, bilateral 176
Paracetamol 203
Paragangliomas 59
Parainfectious myelitis 122
Parainfluenza 158
viruses 154, 161
Parasitemia, levels of 216
Parasympathetic signs 226
Parathyroid hyperplasia 60
Parental hydrocortisone 50
Parenteral antibiotics 144
Paresthesias 55
Paroxysms 59
Parvovirus 241
Patch test 5f
Patent ductus arteriosus 142
Pathogen antimicrobial 164
Pediatric
acute hypertension 183
acute liver 263b
failure 260, 263
hypertension, pharmacotherapy in 191f
hypoglycemia 57
intensive care unit 100, 146, 168, 170, 228
team 67
status epilepticus, drugs in 94t
Penicillin hypersensitivity 164
Penicillinase-resistant penicillin 164
Pericardial effusion 267
Pericarditis 221
Perinorm 217
Peripheral
airway obstruction 142
edema 195
nerves 122
pulse 207
Persistent
hypoglycemia, causes for 56b
pneumonia 161
vomiting 271
Perspiration 55
Pertussis 161
Phenobarbital 89
Phenobarbitone 84, 94, 97
Phentolamine 62, 180, 189
Phenytoin 24, 88, 94
sodium 84, 85
Pheochromocytoma 58–61, 178, 187
diagnosis of 60
management of 61
surgery in 62t
symptom triad of 59f
treatment of 61fc
Phosphodiesterase inhibitors 195
Phospholipases 225
Phosphor diesterases 225
Pierre Robin anomaly 309
Piperacillin 137
Pit viper 233
Plasma
ammonia 131
renin activity 188
Plasminogen activator inhibitor 282
Plasmodium falciparum 210, 213
asexual parasitemia 211
Platelet function
analyzer 283
defects 281
disorders 278
treatment for 283
Pleural effusion 267
complication of 166
Pneumococcal
meningitis 136, 137
pneumonia 164
vaccine 160
Pneumococcus 136, 138, 154, 161
Pneumocystis carinii 161, 165
Pneumocystis jiroveci 161
Pneumonia 144, 160–162
chronic 162b, 164
classification of 161
complications of 163
congenital 161
diagnosis of 163, 166
primary atypical 165
recurrent 161
severe 271
signs of 165
symptoms of 165
thrush 165
type of 163
Poisonous snakes 233
Poliomyelitis 187
Polyarteritis nodosa 301, 305
Polycystic kidney disease 255
Polymerase chain reaction 214, 250
Polymorphonuclear neutrophils 135
Poor feeding 155
Porphyria 126
Portal
circulation, anatomy of 253f
hypertension 251, 255b
vein thrombosis 254
Positive end-respiratory pressure 150
Postcoarctation repair 187
Postdiphtheritic polyneuropathy 124
Postencephalitic sequelae 79
Potassium metabolism 297
Prader Willi syndrome 309
Prazosin 228
Prednisolone 116
Prodrug 89
Prophylactic hyperthermia 70
Prophylaxis 217
role of secondary 258
Propofol 72, 97
Prostaglandin 299
Protein 204
Prothrombin time 280, 282
Pseudohyperkalemia 299
Pseudohypoaldosteronism 44
Pseudomonas aeruginosa 164, 165
Pseudomonas meningitis 137
Pseudomonas pneumonia 165
Ptosis 235f
Pulmonary
candidiasis 165
chondroma 60
congestion
signs of 195
symptoms of 195
diseases, chronic 162
edema 62, 197, 215, 225
management of 193
venous connection 193
Pulse 135
oximeter 143
estimate 143
quality of 242
rate 295
Pyelonephritis, chronic 187
Pyloric stenosis 43
Pyogenic meningitis, age-wise etiology of 136b
Pyruvate dehydrogenase deficiency 133
Q
Quinine 55, 211, 212t
salt 212
R
Rabies 112, 124
Raccoon eyes 71
Raised intracranial pressure 99, 178
Ranitidine 224
Rapid sequence intubation 114
Rasburicase 288
Rash 29, 288
Red blood cell 11, 26, 29, 30, 213, 256
Red cell deformability influence severity 214
Red hepatization 166
Reflex anoxic seizure 79
Refractory status epilepticus 91, 92, 93, 97t
causes of 93
Rehabilitation phase 274
Rehydration therapy 294
Renal
arteritis
with aortitis 187
without aortitis 187
artery 178
stenosis 187
biopsy 12
indications of 12
cell carcinoma 60
disorders 187
failure 216
acute 8, 9, 21, 296
chronic 296
function test 188
abnormal 227
histology 24
injury, acute 8, 12
tubular acidosis 296, 298
tumors 187
ultrasonography 188
vasculitis 302
vein thrombosis 187
Renovascular disorders 187
Respiration 135
Respiratory
acidosis 84
causes 142
distress 140–145, 288
assessment instrument 156t
causes of 142, 142b
development of severe 153
diagnose 142
management of 193
signs of 141t, 171
symptoms of 141t, 171
syndrome, acute 28, 142, 146, 147f, 148, 152, 267
treatment of 145
emergency 145
failure 141, 174
malformations, congenital 162
rate 1, 140, 153, 207, 236, 270
age-related 140t
signs 227
status 143
syncytial virus 141, 154, 161
system 224
Retinal angiomas 60
Reye's syndrome 56, 221, 264
Rhabdomyolysis 84
Rheumatology 301
Rhinorrhea 192, 223
Rickettsial 161
Rifampicin 24
Ringer's lactate 240
Roseola 112
Rotavirus 241, 245
Russell's viper 233, 234f
injects 238
S
Saccharomyces boulardii 245
Safe food 244
Salbutamol 1, 2, 157, 173
nebulization 145
Salicylates 55
Salmonella 241, 249
Salmonella typhi 245
Salt craving 49
Sanitation 244
Sarin's classification 258
Saw-scaled viper 233, 234f
Scorpion
antivenom 230
role of 229
envenomation, pathophysiology of 225
manifestations, system of 226
sting 224, 227, 230
cause of death in 230
envenomation, signs of 226b
Sea snake 233, 233f
Seasonal influenza 222t, 223
vaccines 222
Segmental hypoplasia 187
Seizure
acute 75, 79
causes of acute 76
classification of acute 77
controlling 138
Sengstaken-Blakemore tube 256, 257f
Sensorium 207
Sepsis 43, 263
Septic shock 275, 276
treatment of 273
Serotonin 225
Serum
antiganglioside antibodies 127t
creatinine 30, 123, 290
electrolytes 30, 188
glutamic
oxaloacetic transaminase 199
pyruvic transaminase 199
N-methyl D-aspartate 111
osmolality 40, 42
potassium 290
sickness reactions 239
sodium 290, 291, 293
Shiga toxin 249
Shigella 241, 248
dysenteriae species 249, 250
organisms 245
Shock 205fc, 215, 235, 267
decompensated 205, 206fc
Sialyl-galactosyl moieties 219
Sickle cell diseases 309
Skeletal muscle breakdown 235
Skin 220
allergy testing 5f
fold 242
rashes 264
reactions 4
turgor 295
Small-vessel vasculitic diseases 302
Snakebite 232, 233
complications of 239
effects of 239
first aid for 236f
symptoms with 233
Sodium
bicarbonate 294
morrhuate 257
nitroprusside 179, 180, 189
succinate 173
tetradecyl sulfate 257
valproate 94, 95
Sodium-water balance maintained 38
Somatic signs 226
Somatosensory 77
Sore throat 221, 223
Spinal cord 122
hemangioblastomas 60
Spironolactone 195, 196
Splanchnic arteriovenous fistula 254
Splenic
infarct 267
vein thrombosis 254
Spurious hypokalemia 298
Staphylococcal
meningitis 137
pneumonia 163, 163b, 164
Staphylococcus aureus 164
pneumonia 164
Status epilepticus 83, 84, 86–88, 92, 93, 93t, 98, 215
management of 86, 86fc, 96f
pathophysiology of 85
stages of 85
Steroids 157, 158, 173, 178
course of 137
Storage disorders 254
Streptococcus hemolyticus 136
Streptococcus pneumoniae 15, 138, 160, 161, 164
Stuffy nose 221
Sturge-Weber syndrome 79
Subcutaneous
emphysema 163
insulin therapy 35
Subfalcine 102f
Sublingual nifedipine 180
Sulfonylureas 55
Super-refractory
epilepsy, management of 90
status epilepticus 88fc, 90, 92, 95, 97t
management of 86
Surfactant replacement therapy 146
Swyer-James syndrome 158
Sympathetic signs 226
Synacthen doses 49t
Syncope 49
Systemic
envenomation 237
glucocorticoids 6
hypotension 73
illness 56
vasculitis 19
venous congestion
signs of 195
symptoms of 195
Systemic lupus erythematosus 11, 299
Systolic blood pressure 177, 182
T
Tachycardia 1, 55, 194
Tachypnea 1, 141, 153, 195
Tacrolimus 15
Takayasu arteritis 306
Tandem mass spectrometry 114, 130
Tap sign 226
Temporal arteritis 303
Tendon reflexes 135
Therapeutic hypothermia 98
Thiazide diuretics 41
Thiopentone 96, 97
Thoracic chest wall defects 142
Thrombin time 282
Thrombocytopenia 281
Thrombotic thrombocyt 11
Thyroid stimulating hormone 57
Thyroiditis 264
Thyroxine 57
Ticarcillin 137
Tick bite 112
paralysis 125
Tick-borne encephalitis 112
Ticlopidine 15
Tonic-clonic seizures 78
Topiramate 94, 95
Toxic
encephalopathy 142
fumes, inhalation of 158
metabolites, formation of 129
Transient
hypoglycemia, causes for 55b
pseudohypoaldosteronism 43
Transjugular intrahepatic portosystemic shunt 256, 259
Transverse myelitis 221
acute 124
Traumatic brain injury 67, 70–73
management of severe 67
severe 73, 100
Treacher Collins syndrome 309
Tremulousness 55
Tricuspid regurgitation 193
Trivalent influenza vaccine 222
Tryptophan 225
Tuberculoma 75, 76, 115
Tuberculous pneumonia 165
Tubular necrosis, acute 11, 267, 298
Tumor 115
lysis syndrome 285, 286, 286t, 287, 288fc, 289
necrosis factor-α 203
Typhoid hepatitis 262
Typical hemolytic uremic syndrome 15
U
Umbilical artery catheterization 187
Upper gastrointestinal
bleeding 254
endoscopy 256
Upper pontine 102
herniation syndromes 101
Urea cycle
defect 133, 133fc
disorder 130
diagnosis of 129
Urethral valves, posterior 178
Uric acid 57
Urinary
catecholamines 188
electrolyte 188
tract infection 29, 44
severe 45
Urine 12
analysis 188
culture 188
output 242, 295
test 227
V
Valproate 89
Vancomycin 144
Variceal bleed 251
acute 254, 256fc, 258, 259
control 257
Variceal hemorrhage 251
Varicella zoster 112
encephalitis 116
Varices
endoscopic grading of 258b
endoscopic management of 258t
Vascular
aneurysms 267
endothelium 213
Vasculitic
diseases, types of 303
disorders 302
medium-vessel 302
Vasculitis 302
category 303
diagnosis of 304
diseases, causes of 302
manifestations of 303b
symptoms of 303
syndrome 301
types of 302, 304
unclassified forms of 307
Vasopressin synthesis 39
Vein thrombosis 178
Ventilation 169, 174
Ventricular septal defect 142, 192
Verbal response 101
Versive seizure 78
Vesicoureteral reflux nephropathy 187
Vibrio cholerae 245
Viperidae 233
Viral 161
infections 136
myositis 125
pneumonia 165
respiratory infection 264
shedding 219
Virologic tests 157
Visual disturbances 55
Vitamin
B12 123
deficiency 126
K antagonists 282
Vitiligo 49, 264
Voltage gated potassium channel 114
Vomiting 48, 59, 136, 155, 227, 288
von Hippel-Lindau syndrome 60
von Willebrand
disease 278, 282
factor antigen 278
W
Waterhouse-Friderichsen syndrome 136
Wegener's granulomatosis 303
Weight loss 49
Wheezing 155
White blood cell 11, 206, 285, 287
White-coat hypertension 185
Wilson's disease 255, 262, 263
Wiskott-Aldrich syndrome 281
X
Xanthine oxidase 288
Y
Yersinia enterocolitica 241
Z
Zanamivir 217, 222
×
Chapter Notes

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FM1Case-based Reviews in PEDIATRIC EMERGENCIESFM2
FM3Case-based Reviews in PEDIATRIC EMERGENCIES
Academic Editor Suraj Gupte MD FIAP FSAMS (Sweden) FRSTMH (London) Professor and Head Postgraduate Department of Pediatrics Mamata Medical College and General and Super Specialty Hospitals Khammam, Telangana, India
E-mail: drsurajgupte@gmail.com
Website: www.drsurajgupte.com
Editor: The Short Textbook of Pediatrics, Recent Advances in Pediatrics (Series), Textbook of Pediatric Emergencies, Neonatal Emergencies, Pediatric Nutrition, and Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Infectious Diseases, Influenza: Complete Spectrum, Clinical Problem Solving in Neonatal Emergences and Intensive Care, etc.
Author: Differential Diagnosis in Pediatrics, Instructive Case Studies in Pediatrics, Pediatric Drug Directory, Influenza, Perspectives in Influenza, Nutrition in Neonatal ICU, Speaking of Child Care, etc.
Chief Editor (Gastroenterology Section): International Journal of Gastroenterology, Hepatology, Transplant and Nutrition.
Co-editor: Asian Journal of Maternity and Child Health (Manila, Philippines).
Section and Guest Editor: Pediatric Today (New Delhi).
Editorial Advisor: Asian Journal of Pediatric Practice (New Delhi).
Editorial Advisory Board Member/Reviewer: Indian Journal of Pediatrics (New Delhi), Indian Pediatrics (New Delhi), Indian J Child Health (Gwalior), Synopsis (Detroit, USA), Maternal and Child Nutrition (Preston, UK), Journal of Infectious Diseases (Turkey), EC Pediatrics (London), Journal of Clinical Pediatrics, etc.
Examiner: Several Universities, including National Board of Examinations (NBE) for DNB, New Delhi; All India Institute of Medical Sciences (AIIMS), New Delhi; Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh; Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar; Indira Gandhi Open University (IGNOU), New Delhi.
Pediatric Faculty Selection Expert: All India Institute of Medical Sciences (AIIMS), Punjab Public Service Commission, Jammu and Kashmir Public Service Commission, Union Public Service Commission.
Executive Editor Novy Gupte MD Foreword Elizabeth Smith MRCP FRCP PhD
FM4
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Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
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Case-based Reviews in Pediatric Emergencies / Suraj Gupte
First Edition: 2017
9789386322500
FM5Dedicated to
All those associated with achievement of excellence in management of pediatric emergencies
FM7Contributors FM11Foreword
Notwithstanding huge advancement in the West in Emergency pediatrics, it still remains an emerging field in the South-East Asia. Mercifully, in India, it has begun to receive increasing attention. Nevertheless, in spite of the World Health Organization having repeatedly drawn attention to the excellence of case-based teaching and learning, there remains a paucity of such literature in dealing with emergencies and intensive care in pediatrics.
It is in this context that the Case-based Reviews in Pediatric Emergencies by Dr Suraj Gupte, an icon in pediatrics at national and international level, assumes a special significance.
Empowered by over 50 experts as contributors, the book stands out as a unique and innovative treatise dealing with a wide spectrum of pediatric emergencies. These have been dealt with in a comprehensive, lucid, and easy-to-follow manner.
As a norm, each case scenario is followed by a “Critical Case Review in a Nutshell”. The subsequent “Interactive Topic Review” in the form of questions and answers is very pertinent, providing clarity of the subject. The contents, presentation, format, and language are simple, to-the-point, and profusely illustrated using tables, boxes, clinical photographs and other figures, including flowcharts/algorithms. At the end of each chapter, “Key Learning Points” are given to drive home the take-home messages. Each and every chapter is a testimony to the clear and precise thought process of the authors and the editors.
All in all, Dr Suraj Gupte's excellent book, Case-based Reviews in Pediatric Emergencies, in my opinion, is a strongly recommended treatise for all pediatricians, more so for those actively involved in emergency and intensive care pediatrics.
Elizabeth Smith MRCP FRCP PhD
Chief of Emergency Pediatrics
Hong Kong Medical Center
Hong Kong
FM13Preface
The new book, Case-based Reviews in Pediatric Emergencies, draws its inspiration from the philosophy that enhancing emphasis on clinical scenarios is crucial to the learning of management of pediatric emergencies. The errors committed and the strong positives attained become a stepping stone in improved clinical delivery of optimal care.
Each of the 45 chapters authored by 53 experts in the field kickstarts with one or more case scenarios, focusing on presentation, diagnosis, and management of the problem. It is followed by a short critical review of the case and developments in its management. The error, if any, and important therapeutic points are particularly brought to light. Finally, there appears an extensive interactive discussion in the form of frequently asked questions (FAQs) on the topic as such. In this discussion, such important points that remain elusive in the textbooks receive special attention.
Clinical orientation and practical applicability receive a central stage in each and every chapter. Contents are rationally listed in various sections. In order to enhance the impact of the narration, a large number of illustrations (including algorithms), tables and boxes stand incorporated. In addition to the core matter, “Key Learning Points” are given at the end. “Suggested Reading” have also been incorporated providing some key references for more probing readers. A comprehensive index is also provided to facilitate easy access to requisite issues.
The Case-based Reviews in Pediatric Emergencies should turn out to be a welcome and significant educational tool for the target readers, especially the postgraduates, residents and upcoming intensivists, and emergency pediatricians.
Suraj Gupte
Novy Gupte
FM15Acknowledgments
We would like to acknowledge: