Rapid Paediatrics and Child Health
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Rapid Paediatrics and Child Health Rapid Paediatrics and Child Health Helen A. Brough Clinical Lecturer in Paediatric Allergy and SpR Paediatrics and Child Health Ram Nataraja SpR Paediatric Surgery Second Edition This edition first published 2010, Ó 2010 by Helen A. Brough and Ram Nataraja. Previous edition: 2004. Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Blackwells publishing program has been merged with Wileys global Scientific, Technical and Medical business to form Wiley-Blackwell. Registered office: John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 111 River Street, Hoboken, NJ 07030-5774, USA For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell The right of the author to be identified as the author of this work has been asserted in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. Library of Congress Cataloging-in-Publication Data Brough, Helen. Rapid paediatrics and child health / Helen Brough, Ram Nataraja. – 2nd ed. p. ; cm. – (Rapid series) Rev. ed. of: Rapid paediatrics and child health / Helen Brough ... [et al.]. 2004. ISBN 978-1-4051-9330-6 (pbk. : alk. paper) 1. Pediatrics–Handbooks, manuals, etc. I. Nataraja, Ram. II. Title. III. Series: Rapid series. [DNLM: 1. Pediatrics–Handbooks. WS 39 B875r 2010] RJ48.R375 2010 618.92–dc22 2009051053 ISBN: 9781405193306 A catalogue record for this book is available from the British Library. Set in 7.5/9.5pt Frutiger-Light by Thomson Digital, Noida, India Printed and bound in Malaysia Impression 2010 v Contents Preface, ix List of abbreviations, xi Acne vulgaris, 1 Allergic rhinitis (AR), 3 Anaemia, aplastic, 4 Anaemia, haemolytic, 6 Anaemia, iron deficiency, 8 Anaemia of prematurity, 10 Anorectal malformations (ARM), 11 Appendicitis, acute, 12 Asthma, 14 Atopic eczema, 17 Atrial & Atrioventricular septal defects (ASD & AVSD), 18 Attention deficit hyperactivity disorder (ADHD), 19 Autistic spectrum disorder, 20 Breath-holding attacks, 21 Bronchiolitis, acute, 23 Cerebral haemorrhage, 25 Cerebral palsy, 27 Chronic lung disease (CLD) of prematurity, 29 Cleft lip (CL) and palate (CLP), 30 Coarctation of the aorta (COA), 31 Coeliac disease, 32 Conduct disorder, 33 Congenital adrenal hyperplasia, 34 Congenital hypothyroidism, 36 Congenital infections, 38 Constipation, 40 Cow’s milk protein allergy, 42 Croup (acute laryngotracheobronchitis), 44 Cryptorchidism, 46 Cystic fibrosis (CF), 47 Delayed puberty, 49 Depression, 51 Developmental dysplasia of the hip (DDH), 53 Diabetes mellitus (type I) (DM), 54 Down syndrome (trisomy 21), 56 Duchenne/Becker muscular dystrophy, 57 Encephalitis, 59 Epiglottitis, acute, 61 vi Contents Epilepsy in childhood, 62 Exomphalos and gastroschisis, 64 Faecal soiling (encopresis), 66 Failure to thrive, 67 Febrile seizures, 68 Food allergy, 70 Fractures, 72 Functional abdominal pain (FAP), 74 Fungal skin infections, 76 Gastroenteritis, 78 Gastro-oesophageal reflux disease (GORD), 80 Genetic skeletal dysplasias, 81 Global developmental delay, 83 Glomerulonephritis, acute, 85 Group B streptococcal (GBS) infection, 87 Head lice (pediculosis), 89 Hearing impairment, 91 Heart failure, 93 Hernia, congenital diaphragmatic (CDH), 95 Hernias, inguinal, 96 Hirschsprung disease, 97 Human immunodeficiency virus (HIV), 99 Hydrocephalus, 101 Hyperthyroidism, 103 Hypoglycaemia in neonates, 105 Hypospadias, 107 Hypoxic-ischaemic encephalopathy (HIE), 108 Impetigo, 110 Inadvertent poisoning, 111 Inborn errors of amino acid metabolism, 113 Inborn errors of carbohydrate metabolism, 115 Inflammatory bowel disease, 117 Intraventricular haemorrhage (IVH), 119 Intussusception, 120 Juvenile idiopathic arthritis (JIA), 121 Kawasaki disease, 123 Klinefelter syndrome, 124 Lactose intolerance, 126 Legg-Calve-Perthes disease, 127 Leukaemia, acute lymphoblastic (ALL), 129 Leukaemia, acute myeloid (AML), 131 Limping child, 133 Liver disease, chronic, 135 Contents vii Liver failure, acute, 137 Lymphoma, Hodgkin, 138 Lymphoma, non-Hodgkin (NHL), 140 Malrotation of the intestine, 142 Marfan syndrome, 143 Measles, mumps, rubella (MMR), 144 Meckels diverticulum (MD), 146 Meconium aspiration syndrome, 147 Meningitis, 149 Mesenteric adenitis, 151 Myotonic dystrophy, 152 Near-drowning, 154 Necrotising enterocolitis (NEC), 156 Neonatal jaundice, 157 Nephrotic syndrome, 159 Neurocutaneous syndromes, 161 Nocturnal enuresis, 163 Obesity in children, 165 Oesophageal atresia and tracheo-oesophageal fistula, 167 Osgood-Schlatter syndrome, 169 Otitis media, acute and chronic, 170 Patent ductus arteriosus (PDA), 172 Persistent pulmonary hypertension (PPH), 173 Phimosis and foreskin disorders, 174 Pneumonia, 175 Pneumothorax, 177 Precocious puberty (complete), 178 Precocious puberty (partial), 180 Primary immune deficiency, 181 Pulmonary valve stenosis, 183 Pyloric stenosis, 184 Renal failure, acute (ARF), 185 Renal failure, chronic (CRF), 187 Respiratory distress syndrome (RDS), 189 Retinopathy of prematurity (ROP), 191 Rheumatic fever, 192 Safeguarding children, 194 Scabies, 196 School refusal, 197 Septicaemia, 199 Short stature, 201 Sickle cell anaemia, 203 Sleep-related disorders, 204 viii Contents Small bowel atresia, 205 Sticky eye/conjunctivitis, 206 Sudden infant death syndrome (SIDS), 208 Supraventricular tachycardia (SVT), 210 Testicular torsion, 212 Tetralogy of Fallot, 213 Thalassaemia, 215 Tics, 217 Transient tachypnoea of the newborn (TTN), 219 Transposition of the great arteries, 220 Turner syndrome, 221 Upper respiratory tract infection (URTI), 222 Urinary tract anomalies, 224 Urinary tract infection, 226 Varicella (chickenpox), 228 Venous access, 230 Ventricular septal defect (VSD), 231 Visual impairment, 232 Vitamin D deficiency, 234 Whooping cough (pertussis), 235 Appendices Appendix 1 Taking a History in Paediatrics, 237 Appendix 2 Neonatal Resuscitation, 239 Appendix 3 Formal Assessment of the Neonate at Birth, 240 Appendix 4 Examination of the Newborn, 241 Appendix 5 Breastfeeding Versus Bottlefeeding, 244 Appendix 6 Infant Feeding, 246 Appendix 7 Paediatric Resuscitation, 248 Appendix 8 Developmental Stages in Children, 249 Appendix 9 Immunisation Schedule, 252 Appendix 10 Child Health Promotion Programme, 253 Appendix 11 Status Epilepticus, 254 Further Reading, 255 ix Preface Rapid Paediatrics and Child Health is part of a series of books for medical students that are designed to facilitate learning about core topics in a structured format. Each page is divided into our own ‘‘surgical sieve’’: Definition, Aetiology, Associated/Related, Epidemiology, History, Examination, Pathophysiology, Investigations, Management, Complications and Prognosis. In the second edition we have included over 150 common conditions that cover the major topics in all paediatric medical, surgical and neonatal specialities. All of the topics have been updated with the current paediatric medical and surgical guidelines including NICE. There is also a new section called Further Reading where suggested papers for each chapter are listed in line with evidence based practice. Core knowledge, important investigative techniques and treatment modalities are all included in each chapter. The investigations suggested are for guidance and are not always necessary for a child with the condition. This book has been designed to be easy to carry around and also to allow rapid access to information whether in the outpatient department, the ward or theatre, so you can consolidate theory with practice. The authorship team consisting of both a paediatric and a paediatric surgical SpR means that we have brought different experiences in paediatrics to the book to create a truly unique resource. We hope you enjoy reading this book as much as we have enjoyed writing it! xi List of Abbreviations F female ATN acute tubular necrosis M male ATP adenosine triphosphate 1 primary AUSS abdominal ultrasound 2 secondary AV atrioventricular " increase(d) AVPU alert, verbal response, painful # decrease(d) response, unresponsive ! to/lead(s) to AVSD atrioventricular septal defect > greater than AXR abdominal X-ray < less than BD twice a day approximately BCG bacille