Index

In this index, tables, figures, and boxes are indicated in bold type

A activated partial thromboplastin test refusal of treatment 57, 458 ABCD, resuscitation 403, 405 (APTT) 380 sexual abuse 395 abdomen acute abdomen 84, 197, 210 sexual activity 70, 456, 460, 466 distension 82, 207, 207, 444 acute chest syndrome 376 sleep patterns 23, 23 examination 82, 82–84, 83, 84, 186, 194 acute illnesses 28 smoking 161, 170, 460 neonates 432 see also emergency paediatrics syncope 221, 227, 248 location of signs/symptoms 84, 84 acute kidney injury (AKI) 333, 334–335 tasks of 457, 457 masses, palpation 83 acute lymphoblastic leukaemia 53, 110, unsafe sex 460 rebound tenderness 197 379, 379 vomiting 186 trauma 324 Adie‐Holmes pupil 96 vulnerable 457, 457 abdominal migraine 196 adipose tissue, growth 15 adrenaline 421 abdominal pain adolescence/adolescent 13, 455–467 aggressive behaviour 387 acute 196–197, 198, 210 accidents 460 AIDS 156, 156–157, 400 causes 196, 333 acne 462 air enema 211, 211 diagnosis, clues 198 changes occurring in 455, 456–457 airway 163 investigations 197, 197 physical 456, 458–459 neonates 429–430, 449 periumbilical 193, 210 psychological 456, 461 thermal injury 424 recurrent 192–195 social 457 airway obstruction causes 192, 193, 193 see also puberty acute upper tract 165, 166, 182, 405, diagnosis, clues 195–196 communication with 62, 68 407, 408 idiopathic (functional) 195, 209, 209 about chronic illness 47 at a glance 408 investigations 194, 194–195 consent 42, 64, 458 management 407, 408 management 195, 195 consultations 62, 68, 458 in neonates 449 non‐organic 193, 193, 195, 195, contraception see contraceptives, for signs 165, 166, 407 209, 387 adolescents functional, in neonates 449 organic vs. non‐organic 193, 193 diabetes mellitus 303 partial 163 psychogenic 195, 209 dieting and body shape 461, 462, 463 stridor and 165 abdominal reflexes 88 drug abuse/misuse 419, 459–460, 460 wheezing and 163 abducens nerve, examination 90 epilepsy 242 alcohol 130, 459 ABO incompatibility 448 growth in 14, 459 alkaline phosphatase (ALP) 111 abortion 466 gynaecological problems 465–467 alkalosis 112, 112 abscess health care for 457 metabolic 112, 113, 203, 417 peritonsillar 144 approach to adolescents 47, 69, 458 respiratory 112, 112, 113, 424 sub‐periosteal 314 facilities/clinics 457, 457 all‐immune thrombocytopenia 110 absence seizures 232, 237, 239, 243, 261 guidelines for relating to 458, 458 allergens 163, 170, 351, 421 abuse, child see child abuse HEADSS approach 458 allergic disorders, post‐streptococcal 144 Abusive Head Trauma (AHT) 246 seeing doctor alone 47, 458 allergic reactions acanthosis nigricans 288, 292, 305 health‐destructive behaviour 419, 456, rash 352 accessory nerve, examination 90 COPYRIGHTED459–461, 460 MATERIALsevere 421, 422 accidents 31, 460 health issues facing 456, 457–458 urticaria 352, 360, 360 see also trauma independence, needed in disability 52 allergy accommodation disorders 96–97 intellectual development, disorder 269 history taking 68 acetone 114, 298 nocturnal enuresis 329 milk 164 acid–base balance 111–113 nutrition 22 testing 168 normal ranges 111 nutritional obesity management 293 allopurinol 54 acidosis 112, 112 palliative care 57 ambiguous genitalia 343 metabolic 112, 112–113, 167, 424 physical activity levels 22, 23 amblyopia 234, 250, 250 respiratory 112, 112 pregnancy in 465, 466, 467 amenorrhoea 465, 465 acne 462 psychological problems 462–465 Ametop® 108 acrocyanosis 221, 438 depression and suicide 464, ammoniacal dermatitis (nappy rash) 355, act of omission vs. commission 41 464–465 355, 356, 362, 362 activated charcoal 420 eating disorders 461, 462–464, 463 amoxicillin, otitis media 145

Essential Paediatrics and Child Health, Fourth Edition. Mary Rudolf, Anthony Luder and Kerry Jeavons. © 2020 John Wiley & Sons Ltd. Published 2020 by John Wiley & Sons Ltd. Companion website: www.wiley.com/go/rudolf/paediatrics

0004765449.INDD 495 6/18/2020 8:16:23 PM 496 / Index

anaemia 54, 108, 372 antidiarrhoeal agents 188, 192 respiratory failure 405 breathing difficulty 167 antiemetics 187, 188 triggers 163, 168, 170 causes 372 antiepileptic drugs see anticonvulsants astigmatism 249 blood loss 109, 109, 109–110, antihistamines 356, 358, 360, 421 asymmetrical tonic neck reflex (ATNR) 372, 373 antimuscarinics 169, 330 92, 93 haemolysis 109, 109–110, 200 antipyretics 136, 142 ataxia 87, 89 chronic haemolytic 376 antistreptolysin O (ASO) titre 325, 331 athlete’s foot (tinea pedis) 357, 365, investigations 373 anxiety 62, 388 365–366, 366 flow diagram 109, 372 communication about procedures 63, 108 atopic dermatitis 352, 354, 354, 358–359 iron deficiency see iron deficiency anaemia aorta, overriding, Fallot tetralogy 226, 226 advice 358 microcytic 109, 109, 373, 374 aortic flow murmur 222 clinical features 353, 358, 358 hypochromic 108–109, 109, 374 aortic stenosis 78, 220, 223–224, 225 at a glance 359 observation for 76 aortic valve 77, 78 management 358–359, 359 with reticulocytosis 109, 109–110 apex beat 77, 77, 80 atopy 161, 168, 354 sickle cell see sickle cell anaemia Apgar score 429, 430 atrial septal defect (ASD) 78, 220, 222, 222 anal atresia 444 apnoea 164, 231, 404, 441 attachment 11 anal examination 199, 200, 322 central 441 attention deficit disorder (ADD) 261, 386, neonates 432 neonates 429, 441, 441, 449–450 388, 389–390 anal fissure 199, 200, 212, 213 obstructive 441, 449–450 attention deficit hyperactivity disorder anal sphincters 198 primary, or secondary 429 (ADHD) 261, 386, 388, 389, 390 anaphylactic reaction 421, 422 apnoea of prematurity 436, 441 auditory nerve, examination 90 androgens 458, 458 appendicitis, acute 186, 196, 198, 210, 210 aura, migraine 244 precocious puberty 461, 461 at a glance 210 auscultation 70, 77–78 anencephaly 451 Argyll‐Robertson pupil 96–97 abdomen 82, 84 anger, punitive 383, 387 arms, assessment 94 cardiovascular system 76, 77–78 angioneurotic oedema 360 arousal system 11, 12 respiratory system 79, 81, 161 animal contacts, febrile child 135, 137, 141 arthritis authoritarian parenting style 12, 12 anion gap 113 juvenile chronic (JCA) 141, 310 authoritative parenting style 12, 12 anismus 198 juvenile idiopathic see juvenile idiopathic autism 49, 256, 261 ankle clonus 262, 265 arthritis (JIA) automatisms 237 ankle jerk 88, 88, 91 reactive 310–311 AVPU score 411 ankle oedema 77 septic see septic arthritis awareness, focal seizures 237 anorectal examination ascites 83–84 axillae, examination 85 chronic diarrhoea 190 asexuals 456 recurrent abdominal pain 194 Asperger syndrome 261 B anorexia nervosa 462, 463, 463, 465 asphyxia, neonates 430 babies see infants anterior fontanelle, bulging 90, 235, 245 aspiration Babinski response 88, 262, 265 anthropometric measures 281 foreign bodies see foreign bodies ‘baby‐bottle tooth decay’ 202, 202 anti‐infective agents, in breast milk 17 in gastro‐oesophageal reflux 202 Baby Friendly Initiative 15 anti‐reflux formulas 186 aspirin 136 back, examination, neonatal 432 anti‐tissue transglutaminase (TTG) 207 asthma 46, 112, 163, 168–174 bacterial infection 110 antibiotics clinical features 168, 174 acute gastroenteritis 189, 205–206, 206 adverse effects 124 cough 160, 162, 162, 168 meningitis see meningitis infective endocarditis 226–227 wheezing 160, 161, 163, 164, pyrexia of unknown origin 141, 141 meningitis in neonates 447 165, 168 see also specific bacteria meningococcal septicaemia 155, 351 diagnosis 168 bad news, breaking 62 neonatal infections 447 diary 171, 172, 173 bag and mask ventilation 429–430, 430, 441 osteomyelitis 313 follow‐up, checklist 171, 171–172, 173 ‘ballottement’ 83 otitis media 145 at a glance 174 bariatric surgery 293, 305 prophylactic, VUR/recurrent UTIs investigations 81, 162 barium swallow 203 326, 328 issues for family/at school 173 Barlow test 33, 432, 453, 453–454 pyrexia of unknown origin and 142 management 168, 168–171, 169, barrel chest 79–80, 80, 173, 175 sepsis 421 173, 174 basal ganglia, damage 262 septic arthritis 315 of acute attack 170 baths, tepid 136 urinary tract infection 326 medication 168–169, 169 BCG (Bacille Calmette–Guérin), anticholinergics 169, 330 ‘relievers’ and ‘preventers’ 169 vaccine 37, 39 anticonvulsants 239, 239–240, 422 monitoring 171, 171 bedtime problems 385 generalised seizures 413, 414, 415 peak expiratory flow rate 119, 162, bedtime routine, and struggles at 23 neonates 440 171, 171 bedwetting, night see nocturnal side effects 240, 242 prognosis 173 enuresis (NE)

0004765449.INDD 496 6/18/2020 8:16:23 PM Index / 497

behaviour blood chemistry investigations 110–111 brain aggressive 387 normal ranges 111 CT scan 120, 411 health‐destructive, adolescence 419, 456, pathology, examples 113 development 10 459–461, 460 blood culture, infective endocarditis 227 abnormal, after neglect in early years high‐risk, in adolescents 456, 457 blood gases 111–113 11, 11 behavioural problems in dehydration 113, 417 growth 15, 397, 435 advice and support 31, 383, 384 in diabetic ketoacidosis 113 injury, in shock 409 attention deficit disorder 261, 386, 388, interpretation 112, 112–113, 113 MRI scan 119, 120, 121, 238 389–390 in neonatal respiratory distress 437 tumours 53 autism 256, 261 normal ranges 111 brain death 412 in chronic illnesses 46 pathology, examples 113 brainstem, herniation 235 headache due to 233 in respiratory failure 406, 406 brainstem death 412 indicative of serious disturbance 382, 382 blood glucose see glucose, blood breaking news intellectual development, disorder 269 blood loss 372 bad news 62 management 383–384, 384 anaemia due to 109, 109–110, of disability diagnosis 50, 51 in obesity 286 372, 373 breast see also emotional/behavioural problems see also bleeding budding 459, 459 benefits, financial 52 blood pH 111, 112, 113 development 458, 459, 459 benign paroxysmal vertigo 231, 247–248 blood pressure 78–79 in boys 462 benzodiazepines 240, 413, 414, 422 haematuria and 324 premature 461, 462 beta‐agonists 169, 169 measurement 78 breast‐feeding 15, 15–17 beta cells, failure 298 raised 79 advantages 15, 16–17, 17, 373 bicarbonate 111, 112, 113, 417 in shock 408 contraindications 17, 157 bifidus factor, in breast milk 17 systolic, upper limit of normal 79 dehydration and 113, 417, 418 biliary atresia 215, 442, 449 blood tests, samples 108 difficulties 16 bilirubin 200, 443 blood transfusion 409, 442 prescribing for mothers 129–130 conjugated/unconjugated 200, 200, blood urea 11, 111 support for 15 442, 443 blood–brain barrier (BBB) 124 technique 16 kernicterus 442 body constitution 124, 416 ways to encourage 15, 17 metabolism 200, 200, 443 body fluids 416 WHO recommendation 15 urine 115 body image 461, 462 breast milk 15 Bilirubin‐Induced Neurologic Damage body mass index (BMI) 73, 74, 287 anti‐infective agents in 17 (BIND) 442 boys, charts 75 benefits 15, 16–17, 17, 373 binge drinking 459 calculation 73 drugs in 17, 130 binge eating 463, 464, 464 nutritional obesity 293 pump 16 birthmarks 368, 369 body size, calculation 124–125 transitional 16 bites, child abuse 393, 393 body surface area (BSA) 124 volume and flow 16 bladder bonding, maternal 12, 18 breast‐milk jaundice 449 control, lack of 321, 321–322, 322 bone breast pump 16 emptying problems 322 non‐accidental injuries 393, 394 breath‐holding spells 221, 231, expected capacity 322, 323 pain 379 246–247, 247 neurogenic 321, 322, 323 scans 313 cyanotic 247, 247 outlet obstruction 322, 450 bone age 281 pallid 247, 247 overactive 198, 321, 322, 330 bone marrow suppression 54 breath sounds 81 bladder neck obstruction 322, 450 bone marrow transplantation 54 breathing blast cells 379, 379 Bordetella pertussis 37 difficulty 167 bleach baths 358, 359 bottle(s), sterilization 18, 18 neonates 429–430, 445 bleeding bottle feeding 17–18, 18 noisy 81, 163 with constipation 199, 200 optimal, ways to promote 18, 18 breathlessness 406 haemophilia 380 overfeeding, vomiting and 18, 186 acute/severe, signs 401 idiopathic thrombocytopenic purpura see also formulae, infant heart failure 219 110, 351, 378 botulinum injections 264 bricks, building, motor development intracranial see intracranial bleeding bow legs 312 102, 103 into joints 310 bowel movements 198, 213, 213 brief, resolved, unexplained episode (BRUE) see also blood loss; specific haemorrhage bowel obstruction 198, 199 230, 231, 425–426 types neonates 432, 444, 444 British National Formulary for Children® 124 blindness 274–276 bowel sounds 84, 186 brittle bone disease 395 blood brachial pulse 76 bronchial breathing 81 in stool 187, 188, 196, 199, 199–200, 212 bradycardia 410 bronchial narrowing 81 in urine see haematuria Braille 274, 276 bronchiectasis 175, 176, 181

0004765449.INDD 497 6/18/2020 8:16:24 PM 498 / Index

bronchiolitis 160, 179, 179, 180, 406 Candida infection cerebrospinal fluid (CSF) 114 at a glance 180 dysuria 320 analysis 114, 114 wheezing 164, 165, 179 nappy rash 355, 356, 363, 363 in meningitis 114, 114, 235 bronchitis 160 oral 363, 363 normal ranges 114 bronchodilators 168, 170, 421 vaginal discharge 465, 465 cervical adenitis 147 bronchopneumonia 149 candidal dermatitis 355, 356, 363, 363 cervical cancer 40 bronchopulmonary dysplasia 446 cannabis 130, 460 cervical lymph nodes 85, 85, 139 bronchospasm 164 capillary blood sampling 108 see also lymphadenopathy, cervical Brudzinski sign 235 capillary refill time 77, 408, 417 CGH array (comparative genomic bruises/bruising 378, 393 carbamazepine 239, 240 hybridisation) 121 birth trauma 439 carbohydrate counting 299 chemotherapy 54, 55 child abuse 393, 393 carbon dioxide, partial pressure 111, chest idiopathic thrombocytopenic purpura 112, 406 asymmetry 80 110, 350, 378, 378 cardiac arrest 404, 404–406, 405, 425 barrel 79–80, 80, 173, 175 multiple 110, 378 cardiac catheterization 220 describing location of signs 81, 81 ‘bulge sign’ 93 cardiac conditions 222–227 examination 79–80, 161 bulimia 186, 463, 463–464 see also specific conditions (as listed neonates 432 bullae 348 page 217) expansion, assessment 80, 81 bullying 69–70, 286, 291, 388 cardiac failure see heart failure funnel (pectus excavatum) 80, 80 burns 424 cardiac massage 404 pain 167, 167 child abuse 393, 393 cardiac output, drugs improving 409 pigeon (pectus carinatum) 76, 80, 80 grading 424 cardiac symptoms/signs 218–221 recession, respiratory distress 79, 79, management 424, 425 fainting/syncope 221, 221 437, 445 strategies for reducing 31 see also cyanosis; heart murmurs shape 79–80, 80, 173, 297 surface area, estimation 425 cardiogenic shock 408 signs, wheezing and 164 buttocks, wasted 82 cardiomegaly 117 chest wall, deformity 79–80, 80, 173, 175 cardiopulmonary resuscitation 407 chest X‐ray 116–118 C cardiorespiratory arrest 404–406 abnormal features 117 C’s, three (in measles) 137, 149 causes 404 anterior–posterior (AP) 116 café‐au‐lait spots 368, 369 management 404–405, 405 heart murmur investigation 220 caffeine 130 cardiovascular system, examination 76, lateral 116, 116, 117, 118 callus 394 76–79, 77, 78, 79 normal 116, 116 Campylobacter, acute diarrhoea 189 Carer’s Allowance 52 posterior–anterior (PA) film 116, cancer, child with 46, 52–55 case reports, written 3 116, 117 aetiology and pathophysiology 52–53 cataracts 33, 250, 259, 274, 431 reading, method 116–117, 117 cancer types 52, 53 catch‐up growth 14, 253, 397 specific conditions 118 diagnosis, support for family/child 52, 53 cellulitis, scrotal 338, 339 aspirated foreign bodies 180, 181 at a glance 56 central venous pressure (CVP) 409 asthma 168, 170 histology 52–53 cephalhaematoma 431 bronchiolitis 179 issues at school 55, 56 cerebellar disease 89 cystic fibrosis 175, 176 issues for family 54, 55 cerebellar signs 86, 89 lobar collapse/consolidation 117, 118 leg pain, or limp 309, 315 cerebellum, damage 262 pleural effusion 118 management 52, 56 cerebral lesions 233, 262 pneumonia 178, 179 of acute problems 54 cerebral oedema 411, 417 respiratory distress syndrome 437, chemotherapy 54 cerebral palsy 86, 87, 259, 262–266 445, 445 goals 53, 53 aetiology/pathology 262, 262, 265, 448 chicken pox 153, 153–154, 154 late consequences 55, 55 associated problems 263 diagnostic patterns 138 palliative care 54, 55 ataxic 262 at a glance 154 radiotherapy 53–54 delayed walking 257, 258, 262, 263 in immunosuppressed patients 54, 153 supportive treatment 54, 56 dystonic (athetoid) 262 rash 153, 153, 351, 352 surgery 53 gait 262, 262, 312 vaccine 153 of symptoms 54 at a glance 265 child abuse 64, 392–398 monitoring 54, 56 holding a child with 263, 264 clinical evaluation 392 presentation 52, 56 issues at school/for family 266 emotional 40, 64, 259, 268, 397 prevalence 52, 56 management 263–264, 264, 265 fabricated or induced illness 397 prognosis 54–55, 55–56, 56 muscle tone examination 87, 263 forms/types of 392, 396–398 relapses, management 54 presentation and diagnosis 263, 265 global developmental delay 259, 260 second cancers 55 spastic 262, 264 investigations 394–395, 394 staging 52 clinical features 262, 262–263, long‐term outcomes 25 see also leukaemia 263, 265 management 395, 396

0004765449.INDD 498 6/18/2020 8:16:24 PM Index / 499

medical neglect 397–398 cleft lip 255, 451, 451 ‘solution‐focused’ approach 65 non‐organic failure to thrive 283, 291, cleft palate 432, 451, 451 support for families over time 64, 64–65 292, 397 clinical skills 3 community paediatricians 30 by parent, court case 42 clinics, for adolescents 457, 457 community therapists 50 physical 246, 392, 392, 396–397 ‘drop‐in’ 457 complement (C3, C4) 325, 331 clinical features 393, 393–394 clonazepam 240 compliance, drugs 129 at a glance 396 clonus 88 computed tomography (CT) scan 119, physical examination 393, 393–394 closed questions 65, 68 120, 175 prognosis 394, 397 Clostridium tetani 36 cystic fibrosis 175, 176 Red Flags 392 clubbing, finger 75, 75, 76, 161, 164, 173 of head, abuse investigation 394 sexual 40, 64, 397 clumsiness 257, 390 head injury 423 signs 393–394, 397, 465 cluster headaches 233, 234 computer, ‘fourth party’ in consultations 64 see also neglect coarctation of aorta 220, 225, 225, 432 concentration, difficulties 388, 389 child care 23–24 heart murmurs 220 conduct disorder 387 child development see development, child cocaine 460 conduct problems, early, outcomes 25 child development team 49, 49, 50, 50, 65, coeliac antibodies 190, 207 condylomata acuminata 366, 366 254, 264, 269 coeliac disease 190, 192, 198, 207, confidentiality, for adolescents 457, 458 child health promotion see health 207, 208 congenital adrenal hyperplasia 343, promotion, child at a glance 208 432, 462 child health service see health care services weight faltering 207, 284, 285 congenital anomalies of the kidney and child‐minders 23 cognitive function urinary tract (CAKUT) 334 Child Protection Officers 395 adolescents 456 congenital dislocation, hips see Child Protection Plan 40 development 10, 10 developmental dislocation of the childhood absence epilepsy (CAE) 238 cold sores 356, 357, 367, 367 hips (DDH) childhood epilepsy with central‐temporal colic 204–205, 205 congenital heart disease 164, 222–223, 224 spikes 238 collagen vascular diseases 308 cyanotic 221, 226, 438, 438 children at risk, identification 35, 393 collapsing pulse 76 neonates 438, 438 Children Centres 31 colleges 24 family history 219 Children’s Glasgow Coma Scale 411 colostrum 16 at a glance 224 chlamydial infection 460 colour, observation of child 75 see also specific conditions chloride, in sweat 120 coma 410–412 congenital hypothyroidism 32, 139, 258, choanal atresia 449 causes 410 260, 294, 295 choking 164, 202, 407, 425 at a glance 412 congestive heart failure 223 management 407, 407 investigations 411, 411 coning 235, 411 strategies for reducing 31 comedones 462 consanguinity 69 cholestatic jaundice 82, 200, 201 commission vs. omission 41 conscience, development 13 choreoathetosis 86–87 communication 61–66, 255 consciousness changes, severe/acute chromosomal disorders 267, 268 with adolescents 62, 68, 458 401, 410 chronic disease/illnesses 28, 46–48 with children 62–64, 68 consent 42, 64 conditions included 46 during examination 70 child/adolescent 42, 64, 458 effects on children 46, 46, 48, 48 for procedures 63, 108 parental 42, 64, 108, 458, 467 effects on family 46–47, 48 in chronic illness 47 constipation 186, 198–199, 323 evaluation, key points 47, 47 computers and medical information 64 bleeding with 199, 200 factors affecting adjustment to 46 consent and 42, 64 causes 186, 198 at a glance, summary 48 in consultations 62, 68 chronic 212–213, 214 growth faltering 283 diversity in 63 functional 192, 212–213, 214 identification, growth monitoring 35 ethical conflicts and 42–43 at a glance 214 management, principles 47, 47–48, 48 in hearing loss 273 management/prognosis 213, 213 paediatric care 47 need to understand and respond 62 recurrent abdominal pain 195 prevalence 46, 48 non‐verbal, difficulties 256 soiling from 190, 198, 199, 212 progress, monitoring 65 with other professionals 65–66 constitutional delay 280, 281, 282, 285, respiratory system signs 79–80 in palliative care 56 291, 461 school and 46, 48, 48 parent‐led, goals 65 consultations 68–70 short stature due to 280, 282 with parents see parent(s) with adolescents 62, 68, 458 chronic kidney disease (CKD) 334–335, 372 patient requirements from doctor 62, 62 child‐friendly environment 62 chronic lung disease 446 ‘problem‐focused’ approach 65 communication and 62, 68 chronology of problem 69 problems/poor 62 ‘fourth party’ (computer) 64 cigarette burns 393, 393 professional qualities/skills 62, 63 with parent, without child present cirrhosis, hepatic 201, 201, 215 setting/atmosphere for 62 62, 68 classroom assistant 51 skills, and importance of 62 ‘triadic’ 62

0004765449.INDD 499 6/18/2020 8:16:24 PM 500 / Index

contact dermatitis 353, 354, 354, cranial radiation 55 death 359–360, 360 craniosynostosis 290 of child 57 continuous positive airway pressure crawling, infants 101, 103 omission vs. commission 41 (CPAP) 437, 441, 445 creatine kinase 266 decision making contraceptives, for adolescents 42, 64, creatinine, serum 11, 111 consent by child, age and 42, 64, 458 241–242, 456, 458, 466–467 creatinine clearance 11, 54 medical ethics 42–43 methods, advantages/disadvantages 466 cremasteric reflex 88, 338, 339 deep tendon reflexes contractures, minimization 263, 264 crepitations 81 assessment 88, 91, 92 ‘controlled crying’ 23 cretinism 294 cerebral palsy 262, 265 convulsions critically ill children 400, 401, 403 defaecation, avoiding 198, 199, 386 bacterial meningitis 235 see also emergency paediatrics dehydration 111, 125, 186, 187, 416–418 neonatal 439, 439–440, 440 Crohn disease 190, 208, 310 in acute diarrhoea 187, 416 syncope vs. 221 croup 165, 166, 166, 181–182, 182 causes 416, 416 see also seizures at a glance 182 clinical signs 186, 416 Coombs’ test 442 crusts, skin lesions 348 electrolytes and blood gases 113, 417 coordination, examination 88, 89 crying 247 at a glance 419 coordination of care, chronic illnesses 48 breathlessness on 219, 223 history and examination 416–417 cord clamping, delayed 429 colic 204, 205 hypernatraemic 113, 417, 417 corneal light reflex 96 cyanosis 221 hyponatraemic 113, 416, 417 corticosteroids cyanotic breath‐holding spell 231, 247 investigations 417 in anaphylactic reaction 421 excessive, pain in febrile child 135 isonatraemic (isotonic) 113, 416, 417 in asthma 169, 170 hoarseness, in croup 181 management 187, 417–418, 418 in croup 181 response association 13 mild/moderate/severe 416, 417, 417 excess, Cushing syndrome 296 cryptorchidism 339, 340, 342 severity, assessment 416, 417 inhaled, in wheezing 164 cultural customs, communication and 62 type, determining 417 in juvenile idiopathic arthritis 317 culture in vomiting 186, 187 in nephrotic syndrome 332 blood 227 delayed motor maturation 257, 258 surfactant production and 435, 445 CSF 114, 114 dental care 31, 202 topical 354, 358 urine 115, 116, 325, 326 dental caries 202, 202 Corynebacterium diphtheriae 36 Cushing disease/syndrome 280, 296 dental development 14, 15 coryza 144, 165 Cushing triad 233, 245, 410 depression, in adolescents 464, 464–465 costochondral junction, pain 167 cyanosis 76, 220, 221, 224 dermatitis 352, 354 costophrenic angle 117, 118 central 76, 219, 221, 431, 438 ammoniacal (nappy rash) 355, 355, 356, cough 79, 160–162 in neonates 437, 437–438, 438 362, 362 causes, by age 160 at a glance 439 atopic see atopic dermatitis characteristics 161, 161, 162 peripheral 219, 221, 438 candidal 355, 356, 363, 363 chronic 160, 161 persistent 221 contact 353, 354, 354, 359–360, 360 differential diagnosis 162 cyanotic breath‐holding spell 247, 247 seborrhoeic see seborrhoeic dermatitis foreign bodies causing 160, 161, 162, 180 cyanotic congenital heart disease 221, 226, ‘sneaker’/‘trainer’ 360 investigations 161, 162 438, 438 dermatological conditions 345, 358–369 management 162 cystic fibrosis 175–176, 177 see also specific conditions (listed page 345) nocturnal 161, 161, 405 clinical features 175, 189–190, 192 dermatological symptoms/signs 345, persistent, or recurrent 161 at a glance 177 346–357 productive/non‐productive 161, 162 infections in 175 acute/chronic rashes see rash(es) psychogenic 162 investigations 119, 175, 176 infectious skin lesions 356, 356, 357 recording 79 management/prognosis 175–176, 177 itching 356, 356 upper respiratory tract infection 144, 160 prevalence, pathophysiology 175, 177 lesion types see skin lesions vomiting associated 186 screening test 32, 175 nappy rash see nappy rash counselling 47 sweat test 119, 161, 175 desferrioxamine 374 genetic 50, 266, 269 weight/growth faltering 286 desquamation 157, 157, 348 Court of Protection 458 cystitis 326 DESSCRIBE 237, 238 cover test 97, 97 cytochrome P450 system 125 development, child 3 cow’s milk cytomegalovirus (CMV) 258, 268, abnormal 100, 102, 105, 253, 254 protein intolerance 192, 198, 199, 208 434, 435 assessment see developmental assessment toddlers and preschool years 20 delays see developmental concerns/problems Coxsackie virus 154 D early years 10, 10–11, 12–13 crackles 81 day nurseries 24 history taking 68, 69 cradle cap 360, 361 daydreaming 243, 261, 389 child abuse history 392 cranial nerves 86 daytime wetting 321, 321–322, 322 failure to thrive 283 examination 89, 90 deafness see hearing loss fits, faints and funny turns 231

0004765449.INDD 500 6/18/2020 8:16:24 PM Index / 501

monitoring, health promotion 34–35, 36 developmental dislocation of the hips investigations 190, 191 physical growth see growth (DDH) 312, 453, 453–454, 454 management 190, 192 psychomotor 12–13 examination for 32, 432, 453, 453 non‐infective causes 187 quality and quantity aspects 102, 253 factors increasing risk 453 spurious 199 school age 13 at a glance 454 toddler 206 social interactions 12–13 developmental learning disorder 389 diary developmental assessment 36, 99–105, dyslexia 255, 389 asthma 171, 172, 173 253, 254 see also learning disability diabetic 301, 303 carrying out, tools for 100, 100 developmental paediatrics, skills headaches 233 cooperation lacking 253 required 253 symptom 190 fine motor skills 100, 102, 103 developmental screening 36 diastolic murmurs 78 in global developmental delay 259 dextrocardia 80 diet gross motor skills 100, 100, 101, diabetes insipidus 323, 324 in ADHD 390 102–103, 257 diabetes mellitus 46, 298–305 balanced 20, 21 key components 100, 100 acute problems, management 302–303 chronic kidney disease 335 major milestones 100, 100, 105, 252 see also diabetic ketoacidosis (DKA) Crohn disease 208 failure to meet 268 aetiology/pathophysiology 298 cystic fibrosis 176 social skills 13, 100, 104, 104–105 brittle 302 diabetes, management 300 special senses 105 clinical features 298, 298, 304, 323 gluten‐free 207 speech/language skills 100, 103, complications 298, 304, 305 low in fibre 198, 199 103–104, 255, 256 diagnosis 298, 304 obesity and 286 warning signs 102, 105, 105 diary 301, 303 school age children 20, 21, 22 developmental concerns/problems 100, at a glance 304 see also food(s) 105, 252–259 honeymoon period 303 dietary supplements, cystic fibrosis 176 abnormal development 100, 102, 105, initial presentation 298 dieting, in adolescence 461, 462, 463, 465 253, 254 management 299–302, 304 diphtheria 36, 144 aetiological factors 253, 253 goals 299 vaccine 36, 37 delay(s) 100, 102, 252, 254, 259 medical 299, 299–300 diplegia 262, 262–263 global see global developmental delay nutritional obesity and 293 spastic 87, 87, 262 referral for 36 prognosis and long‐term issues 304, 305 dipstick testing, urine 114–115, 115 delay/difficulty in talking 102, 255, routine follow‐up, checklist 303, disability, child with 46, 49–51 255–256, 256, 389 303, 304 assessment 49, 52 delay in gross motor skills 257, 258 type 1 (juvenile) 298–305 causes, school children 49 delay in motor maturation 257, type 2 (adult‐onset) 298, 305 education and schools 50–51, 52 258, 263 diabetes nurse specialist 305 at a glance, summary 52 delay in walking 102, 257, 257, 258, Diabetes UK 305 issues for family/at school 52, 53 262, 263 diabetic ketoacidosis (DKA) 113, 167, 298, learning see learning disability detection 30, 49, 253 302, 304 management, principles 50, 50–51, 51 see also developmental assessment blood gases and pH 113 mild, impact on child 46 general issues (at a glance) 254 electrolyte abnormalities 111, 113, 302 neural tube defects 451 global problems 255, 256, 257 management 299, 302 physical, and multiple 49 history and examination 253 metabolic cycle leading to 298, 298 presentation 49 management 253–254 signs 167, 298, 410 prevalence 49, 51 maturational delay 255, 256 diabetic team 299 see also developmental conditions/ skills gained, then lost 253, 259 diagnosis, ‘fishing for’ 108 disabilities understanding vs. performance 100 diagnosis list 71 Disability Living Allowance 52 warning signs 102, 105, 252 diaphragm, chest X‐ray 117 discharge letters 65 developmental conditions/disabilities diaphragmatic hernia 436, 437, 450 discipline, lack of 388 261–276 diarrhoea 187 disease modifying drugs 318 attention deficit disorder 261, 386, 388, acute 187–188 diseases (childhood), new morbidities 389–390 causes 187, 205, 207 28, 28 autism 49, 256, 261 differential diagnosis 189 dislocation of hips see developmental blind/partially sighted child history, examination 187–188, 416 dislocation of the hips (DDH) 274–276, 275 investigations 188, 188 disorders of sex development (DSD) 339, cerebral palsy see cerebral palsy management 188, 418 341, 343 Duchenne muscular dystrophy 266, 267 bloody 199, 333 disseminated intravascular coagulation hearing impairment see hearing loss chronic, recurrent 189–192 (DIC) 110 intellectual development see intellectual causes 189, 191 distraction, strategy 88, 108 developmental, disorders of differential diagnosis 189, 192 DMSA scan 326, 328, 334 pervasive 104, 261 history, examination 190 doctors, health care services for children 28

0004765449.INDD 501 6/18/2020 8:16:24 PM 502 / Index

‘double bubble’ sign 444, 444 dystrophin 266, 267 brief, resolved, unexplained episode Down syndrome 270–271, 271, 272 dysuria 320, 320–321 (BRUE) 230, 425–426 genetic tests 121 advice 321, 465 burns and scalds 424, 425 at a glance 271 drowning 425 global developmental delay 258, 260 E febrile seizures see febrile seizures intellectual development disorder 267 ear, examination 94–95, 95, 145 head injury 423–424 small head 289 ear, nose and throat, examination 94–96, 95 paracetamol poisoning 424 drawing skills, development 102, 103 ear drum 94, 95, 95 salicylate poisoning 424 “dream doctors” 63 eating difficulties 283, 291, 385–386 sepsis 421 dressing, by child 104, 105 parental guidelines 386, 386 stroke 424 drinking, patterns, polyuria and 323 eating disorders 22, 461, 462–464, 463 SUDIC 425–426, 426 drowning 31, 425 growth monitoring 35 emergency treatment 401, 403, 404 drowsiness, bacterial meningitis 235 eating habits seizures 413, 415 drug(s) preschool children 20 factors predisposing 401 accidental poisoning 419 school age children 22 history and examination 403 administration routes 125, 126–127, 129 Eatwell Guide 20, 21, 22 immediate assessment 401, 403, 404 adverse effects 124, 129 ecchymosis 347 management before history/examination in breast milk 17, 130 echocardiography 220, 224 401, 403, 404 compliance 129 ectopic testes 339, 340, 342 presentations 400–401, 400–420 contraindicated in breast‐feeding 130 eczema 352, 353, 354 by age 400 formulations 126–128 acute/chronic 352 cardiorespiratory arrest see gastrointestinal function effect 125 see also dermatitis cardiorespiratory arrest history taking 68 education choking 407, 407 mechanism of action 124 adolescents, on drug misuse 460 coma see coma metabolism and clearance 125 children 23–24 dehydration see dehydration overdosing 126–127 with asthma 173 infants 400, 403 deliberate 419 with diabetes 299, 305 Paediatric Early Warning Scores 403 protein binding 125, 130 with disability 50–51 poisoning 419–420, 420 skin permeability 125 with epilepsies 241–242 Red Flags, signs 403 spacing of doses 128 with hearing impairment 273 shock see shock unlicensed use 129 with intellectual development upper airway obstruction see airway see also prescribing for children; specific disorder 269 obstruction drugs and diseases of family, about chronic illnesses 47 speed of deterioration 400, 401 drugs of abuse health 30–31 EMLA® 108 in adolescence 459–460, 460 parents, in diabetes 299 emotional abuse 40, 64, 259, 268, 397 signs of taking 460 school involvement, in chronic illness 48 emotional/behavioural problems 381–390 in pregnancy/breast‐feeding 130 sex 466–467 abused children 397 dry‐powder inhaler (DPI) 169 see also school(s) in adolescence 456 Duchenne muscular dystrophy 266, 267 Education and Health Care Plan in cancer, for child and family 55 ductus arteriosus 225, 225, 226, 226, 438, (EHCP) 51, 269 in chronic illnesses 46 449, 449 educational problems 381–390 common problems 382 closure 449 in chronic illnesses 46 difficult/disobedient behaviour 387, patent 220, 225, 449, 449 educational services, for child with 387–388 duodenal atresia 444, 444 disability 50 eating difficulties see eating difficulties dying child 57 egocentric infants 13 factors contributing to 383, 383 palliative care see palliative care Eisenmenger syndrome 222, 223 factors protecting from 383, 383 support, in cancer 54 elbow, pulled (‘nursemaid’s) 313, 313 headache due to 233 dysarthria, jerking 89 electrocardiography (ECG) 118, 118–119, history 383 dysdiadochokinesis 89 220, 239 management 383–384, 384 dysentery 137, 199, 200 interpretation 118, 118–119 nightmares and night terrors 231, dyslexia 255, 389 electroencephalography (EEG) 238, 413 247, 385 dysmenorrhoea 196, 465 electrolytes 416 in obesity 286 dysmorphic signs/features 75, 86, 259, 439 in dehydration 113, 417 parental guidelines 384, 385, 386, 387 neonate examination 431 in diabetic ketoacidosis 111, 113, 302 psychosomatic symptoms 387 dysmorphic syndromes 258, 260 in pyloric stenosis 113, 203 recurrent abdominal pain and 193 neonate examination 431 emergency care orders 395 Red Flags 382, 382 obesity in 288 emergency paediatrics 399–426 sleeping difficulties 385 small head 289 assessment and management 401, 403 unwanted habits 386–387 dyspraxia 390 conditions causing 400, 401, 421–426 see also behavioural problems dystonia 87, 124 anaphylactic reaction 421, 422 emotional changes in adolescence 456

0004765449.INDD 502 6/18/2020 8:16:24 PM Index / 503

emotional deprivation 257 Escherichia coli 205, 326, 401 movements, assessment 96, 96 emotional stress 385 acute diarrhoea 189 strain 232 emotional support, in cancer 54 neonatal infections 447 eye contact 13, 104, 104, 275 empathy 62, 65 Shiga‐toxin (STEC) 333, 334 emphysema 81, 180 Escherichia coli O157:H7 333 F encephalitis ethical dilemmas 42–43 fabricated or induced illness (FII) 397 post‐measles 149 ethical issues 41–43 facial nerve, examination 90 subacute sclerosing (SSPE) 149 ethics 41 factitious fever 134, 142 encephalopathy 211, 410 conflicts 42–43 factor VIII deficiency 380 encopresis 198, 199, 212–213, 321, medical, principles 41 faecal impaction 213, 322 386–387 ethnic minorities, as health determinant 25 faecal retention 198–199, 212, 386–387 management 213, 213 ethosuximide 239, 240 failure to thrive (FTT) 202, 280, 283–285, 285 non‐retentive 198 eustachian tube, dysfunction 145 cardiac failure 219 endocarditis, infective 226–227 Ewing’s sarcoma 53 chronic diarrhoea 190, 192 endocrine disorders 291–305 examination of children 5, 70–97 chronic liver disease 201, 215 identification, growth monitoring 35 abdominal 82, 82–84, 83, 84 cirrhosis and 215 obesity due to 287 approach to 72–97 coeliac disease 207, 208, 284, 285 short stature due to 280, 282 cardiovascular 76, 76–79, 77, 78, 79 cystic fibrosis 177, 286 see also specific disorders developmental see developmental differential diagnosis, clues 285–286 endometriosis 343 assessment examination 284 enterobiasis (threadworms) 215, 215, 320, diagnosis list 71 gastro‐oesophageal reflux 202, 203, 321, 368 ear, nose and throat 94–96, 95 283, 286 enuresis see nocturnal enuresis (NE) flexibility in routine 70 growth, faltering 283–285, 285, 397 enuresis alarm 330, 330 genitalia 85–86 history 283–284 environmental factors growth 72, 72–74, 73, 74 HIV infection 156, 156 control, in asthma 170–171 hospital notes 71 investigations 285, 285 delay in walking 257, 258 musculoskeletal 93–94, 94 management 285, 285 emotional/behavioural problems 383 neurological see neurological examination neglect 284, 286, 291, 397 failure to thrive 283, 291, 292 notes, problem lists and action plan non‐organic (environmental) 283, health determinant 24, 24 70–71 291, 292, 397 ephedrine 144 observation (general) 68, 70, 75 organic vs. non‐organic 283 epididymo‐orchitis 338, 339 see also observation psychosocial causes 283, 284, 285 epiglottitis, acute 165, 166, 166, 182 principles 70 see also weight, faltering epilepsies 46, 231 rectal 84, 197, 199, 200, 210 fainting 221, 221, 227, 248 diagnosis 237–238, 238, 243 respiratory system 79, 79–81, 80, 81 see also fits, faints and funny turns gene panels, tests 121 reticuloendothelial system 84, Fallot tetralogy 226, 226, 438 at a glance 243 84–85, 85 falls, strategies for reducing 31 issues at school 242, 243 review of systems 68, 70, 70 familial cold urticaria (FCU) 143 issues for family 241–242 from right side 70 familial Mediterranean fever (FMF) 143 low risk after febrile seizures 422 systematic 70 family management 238–241, 239, 243 young children 70 chronic illness effect on 46–47, 48 acute seizures 240 see also specific conditions/disorders education about chronic illness 47 general issues 240, 242 examination of neonates 430–432, 431 emotional/behavioural problems due to medical 239, 239–240 examinations, student 383, 383 surgery 240, 240 OSCE 3, 4, 4–5 internet and medical information access 64 monitoring and follow‐up 241, 242 practice 4 issues for, child with prevalence 237, 243 preparation 3–4, 4–5 asthma 173 prognosis 242 technique and tips for 4, 4 cancer 52, 53, 55 syndromes 237, 238 written 3 cerebral palsy 266 terminology 237 exanthemata 137, 351 epilepsy 241 see also seizures differential diagnosis 137 hearing impairment 273, 274 epileptic seizures 237 exanthematous diseases 137 intellectual development disorder 269 see also seizures exchange transfusion 442 visual impairment 276 epileptic spasms (West syndrome) 231, 237, excoriation 348 problems, recurrent abdominal pain 238, 239, 243 expiratory noise see wheezes/wheezing and 193 Epstein–Barr virus (EBV) 147 extended matching questions (EMQs) 3, 4 reaction to diagnosis of child with erosion, skin 348 extradural haematoma 120 disability 51 erythema infectiosum see fifth disease eye(s) relationships, in cancer 55 erythrocyte sedimentation rate (ESR) 108 examination 96, 96, 105 structure, as health determinant 25 erythropoietin (EPO), supplement 335 neonates 431 support for

0004765449.INDD 503 6/18/2020 8:16:24 PM 504 / Index

family (cont’d) feeding prescribing for children 125, 127 in cancer 53, 54, 55 infants, eye contact during 13 replacement/administration 416 in cerebral palsy 266 self‐feeding by infants 104, 105 calculations 418, 418 child with disability 51 small infants 435–436 in diarrhoea 188 child’s death 57 see also bottle feeding; breast‐feeding for febrile child 136 in chronic illness 48 feet, flat 312 in vomiting 187 in emergency 403 female genital disorders 343 see also intravenous fluids in juvenile idiopathic arthritis 318 femoral anteversion 312, 312 focal motor seizures 232 over time 64, 64–65 femoral epiphyses, slipped capital 309, foetal alcohol syndrome 258, 260, in palliative care for child 57 315, 316 267–268, 268 see also parent(s) femoral head, avascular necrosis 315, 315 follicle‐stimulating hormone (FSH) family history 68, 69, 69 femoral pulses, in neonates 432 458, 458 child abuse and 392 femur, chronic osteomyelitis 314 fontanelle(s) chronic skin rashes 354 ferritin 109, 373 anterior, bulging 90, 235, 245 failure to thrive 284 fever 135 closing 288 fits, faints and funny turns 231 acute 135–136, 136, 351 examination 431 global developmental delay 259 causes 134 food(s) headaches 233 differential diagnosis 136–137 asthma associated 171 late walking 257 investigations 135, 136 atopic dermatitis and 358 obesity 286 management 136, 136 to avoid in babies/toddlers 19, 20 family tree, history taking 69, 69 factitious 134, 142 to avoid in migraine 244 Fanconi syndrome 323 hyperthermia 134 groups, balanced diet 20, 21 fat (body), pharmacology and 124 infections causing 134, 135 child health/growth, effect on 22 fatty liver disease 215 meningococcal septicaemia 154, 155 portion numbers 21, 22 fears, in consultations, eliciting 68 non‐infectious causes 134 ‘pickiness’ 20 febrile child 133–158 periodic 143, 143 see also diet breathing difficulty 167 prolonged 141 Food Standards Agency 20 cervical adenitis 147 with a rash 137, 137–138, 138, foreign bodies chicken pox 153, 153–154, 154 139, 351 aspiration 180, 180–181, 181, 407 fever as symptom/sign 134 meningococcal septicaemia 154, 155, airway narrowing 163 fifth disease (erythema infectiosum) 236, 352 cough and 160, 161, 162, 180 153, 153 stridor in 165 stridor 165, 166 flu‐like viral infections 146 with swelling in neck 139, 139–140, 140 wheezing 163, 165, 180 hand, foot and mouth disease 154 as symptom and sign 134 chest X‐ray 180, 181 HIV infection and AIDS 156, 156–157 temperatures in 135 vaginal 320 infectious mononucleosis 147, 147 of unknown origin 141, 141–142, 142 foreign travel, febrile child 135, 137, 141 Kawasaki disease 157, 157, 158 see also febrile child formulae, infant 15, 17–18 key points, acute fever 136 fifth disease (erythema infectiosum) 153, complementary, to breast‐feeding 16 mastoiditis 149 153, 351 composition 17 measles 149, 149, 150 diagnostic patterns 138 cow’s milk protein intolerance 208 meningitis see meningitis rash 137, 153, 349, 351, 352 in lactose intolerance 207 meningococcal septicaemia 154–155, 155 Filatov–Dukes disease 153 preparation of feeds 17–18, 18 mumps 148, 148 fine motor skills, assessment 100, 100, 102 soya milk 207, 208 otitis media 145, 145–146, 146 finger clubbing 75, 75, 76, 161, 164, 173 formulary 124 parotitis 148 finger feeding, by infant 102, 103 formulations, drug 126–128 periodic fevers 143, 143 finger foods 19 forward parachute reflex 91, 93 pneumonia see pneumonia FISH (fluorescence in situ fractures roseola 151 hybridization) 121 of growth plate 313 rubella 150, 150, 151 fissures 348 non‐accidental 393, 394, 395, 396 scarlet fever 151–152, 152 anal 199, 200, 212, 213 spiral 394, 395 tonsillitis 144, 144–145, 145 fits, faints and funny turns 230–231 fragile X syndrome 258, 260, 267 upper respiratory tract infections 144 by age 230 Fraser (Gillick) competence 42, 458 UTI see urinary tract infection (UTI) differential diagnosis 231, 232 frog position, hypotonic infant 91, 91 see also fever flat feet 312 ‘frozen watchful’ expression 393 febrile seizures 136, 412, 415, 422 floppy baby 90–91 full blood count (FBC) 108–110, atypical 422 flu‐like viral infections 146 394, 395 at a glance 423 fluid(s) fundoscopy 97 feedback body compartments 416 fungal infections 54 from clinicians/course teachers 3 losses 416 funnel chest 80, 80 finger, by infant 102, 103 calculation 418 funny turns see fits, faints and funny turns

0004765449.INDD 504 6/18/2020 8:16:24 PM Index / 505

G germ cell tumours 53 grommets 273 gait German measles see rubella gross motor development 100, 100, 101, abnormal/unusual 87, 312, 312 gestational age 433 102–103 assessment 94 respiratory distress syndrome and 445 growing pains 309, 313 observation 87, 89, 94 Giardia lamblia and giardiasis 190, 192, 215 growth 13–14, 14, 15, 35, 252 spastic cerebral palsy 262, 262, 312 Gilles de la Tourette syndrome 248 abnormal/problems 14, 35–36, 36, 74, 161 waddling 87, 87, 266 Gillick (Fraser) competence 42, 458 in child abuse/neglect 35, 393 gastritis, Helicobacter pylori 195, 210 glandular fever (infectious mononucleosis) global developmental delay 259 gastro‐oesophageal reflux 195, 202, 203, 110, 147, 147 assessment/examination 72, 72–74, 73, 74 283, 425 Glasgow Coma Scale (GCS) 410, 411, 423 in chronic diarrhoea 190 at a glance 203 glioma, optic 121 in diabetes mellitus 303 weight/growth faltering 283, 286 global developmental delay 257, 258–259, 260 in microcephaly 290 gastroenteritis, acute 186 causes 258, 258, 270 in obesity 287, 287 bacterial 189, 205–206, 206 diagnosis, clues 260 in recurrent abdominal pain 194 dehydration due to 187, 416 global intellectual developmental disorders catch‐up 14, 253, 397 at a glance 206 255, 256, 258, 258, 259 charts and centiles see growth charts viral 189, 205, 206 glomerular filtration rate (GFR) 111, constitutional delay 280, 281, 282, 285, gastrointestinal disorders 202–215 125, 334 291, 461 in Down syndrome 270 glomerulonephritis, acute 324, 325, 331, 331 endocrine and metabolic disorders see also specific disorders (as listed page 183) at a glance 331 277–306 gastrointestinal function, drug action haematuria 324, 325, 331 factors affecting 14, 14, 35 and 125 management 331, 331 failure 164 gastrointestinal infections 205–206, 206 glossopharyngeal nerve, examination 90 fall‐off 35, 194, 259, 280, 281, 282, bottle feeding and 15, 18 glucagon 302 287, 303 gastrointestinal symptoms/signs 185–201 glucose causes 282 abdominal pain see abdominal pain blood 230 faltering 283–285, 285, 397 blood in stool 187, 188, 196, 199, continuous monitoring 301, 301 see also failure to thrive (FTT) 199–200, 212 insulin levels and meals/ guidelines for concern 36, 36 constipation and encopresis see injections 299–300, 300 infancy 14, 73, 73, 74, 280 constipation; encopresis monitoring 300–301, 301 monitoring, health promotion 34–36, 36 diarrhoea see diarrhoea monitoring in small infants 435 recommendations 29, 35 jaundice see jaundice raised 167, 298 normal 34, 35, 280 vomiting see vomiting CSF 114, 114 of organs 14, 15 Gaucher disease 308, 310 metabolism 298 patterns, interpretation 74, 281 gaze, positions 96, 96 in oral rehydration solutions 125 in obesity 287, 287 gene panels 121 urine 115 plateauing see growth, fall‐off general practitioners (GPs) 30 glucose‐6‐phohsphate dehydrogenase plotting by age 36, 73–74, 74, 284 generalized tonic–clonic seizures 237, 239, deficiency (G6PDD) 125 proportional failure 283 240, 243 glue ear 94–95, 95, 146, 272 Red Flags for concern 280 genetic counselling 50, 266, 269 gluten, intolerance 207 retardation, intrauterine see intrauterine genetic syndromes, short stature due to 282 glycosuria 324 growth retardation (IUGR)

genetic testing 121 glycosylated haemoglobin (HbA1c) 302, 303 spurt, adolescents 14, 459 genetics ‘going off their feet’ 401 standards 35, 35, 72–73, 73 cystic fibrosis 175 goitre 139, 140, 294, 295 through life course 14 diabetes mellitus 305 ‘golden hour’ 409 growth, endocrine and metabolic disorders Duchenne muscular dystrophy 266, 267 gonadal development 15 291–305 growth influenced by 14 gonadal dysgenesis (Turner syndrome) 280, see also specific disorders (as listed page 277) issues in chronic illnesses 48 297, 297, 461 growth charts 34, 72–73, 73, 280 genitalia 337–343 gonadal tumours 53 crossing of centiles 74, 280, 280, 283, 290 ambiguous 343, 432, 462 gonadotrophin‐releasing hormone (GnRH) infants 73, 284, 284 conditions affecting 341–343 458, 458 intrauterine growth retardation 284, see also specific conditions gonorrhoea 460 434, 434 daytime wetting and 322 Gower sign 87, 266, 266 interpretation 74 development, puberty 458, 459, 459 grasping, infants 102, 103 nutritional obesity 293 examination 85–86 Graves disease 294 growth hormone, deficiency 296 neonates 432 grey baby syndrome 124 grunting, expiratory 79, 161, 178 symptoms 338–340 grief, parental 55, 56 guidelines groin, swellings 85, 339, 339 groins NICE see NICE guidelines impalpable testes 339, 339 examination 85 Royal College of Paediatrics and Child scrotal swellings 338, 338, 339 swelling 85, 86, 339, 340 Health 42–43

0004765449.INDD 505 6/18/2020 8:16:24 PM 506 / Index

Guillain‐Barre syndrome 167 Hashimoto (autoimmune) thyroiditis 294 safeguarding children 40–41 gynaecological problems 465–467 head in school 31 gynaecomastia 462 circumference 14, 288 screening tests 32–34, 32, 33 measurement (occipitofrontal) health records, child 30, 63–64, 64 H 72, 72, 431 hospital notes 71 habits, unwanted in children 386–387 normal increase, vs. hydrocephalus 289 health visitors 30, 31, 40, 50, 384 haemangioma, superficial 368, 369 control, infants 91, 101, 102 Healthy Child Programme 28–30, 29, haemarthrosis 310 CT scan 394, 423 30–31 haematocrit 108, 109 examination, in neonates 431 healthy eating 21, 22, 22 haematological disorders 308, 373–380 growth 245, 288, 289 hearing see also specific disorders (as listed page 371) intrauterine growth retardation development 10, 10 haematological indices/tests 108–111 434, 435 for language development 255, 256 normal ranges 108 poor 289–290 test/examination 255 haematological symptoms/signs 372–373 injury 246, 247, 423 infants 93, 105 haematoma CT scan, indications 423 neonates 32 inguinal 339 non‐accidental 394, 395, 397 school age children 34 subdural 246, 397 large 288, 288–289, 289 hearing aids 273, 273 haematuria 114, 115, 324–325 small (microcephaly) 259, 289, 289–290 hearing loss 49, 272–273, 273, 274 benign familial 324 head lag 91, 101, 102, 266 causes 272, 274 causes 324, 331 head lice 367–368, 368 children at risk for 272 diagnosis, clues to 325 headache(s) 232–234, 234 conductive 255, 272, 272 investigations 114, 115, 115, acute serious 232 management 273 324–325, 325 causes 232, 245, 387 delay/difficulty in talking 255, 256, macroscopic/microscopic 324 cluster 233, 234 256, 272 urinalysis 114, 115, 115, 324–325 diagnosis, clues 234 fluctuating, secretory otitis media 273 haemodialysis 335 diary 233 at a glance 274 haemoglobin 108, 108 history and examination 232 issues for family/school 273, 274

glycosylated (HbA1c) 302, 303 management 233 management 273, 273 normal levels 108, 108, 372 recurrent 232 mumps complication 148 sickle cell (HbS) 376 Red Flags 232, 233 neurosensory 255, 272, 273 haemoglobinopathies 372 ‘thunderclap’ 234, 250, 424 sensorineural 34, 236, 272, 435 screening test 32 see also migraine; tension headaches management 273 see also sickle cell anaemia; thalassaemia, HEADSS approach 458 heart beta health chest X‐ray 117 haemolysis 372 adverse factors and long‐term outcomes 25 disease see cardiac conditions ABO incompatibility 448 in childhood, implications for adults 2, 54 heart failure 224, 227 anaemia due to 109, 109–110, 200 determinants 24, 24–25, 25 congestive 223 in fetus and neonates 448 guidance, in The Health Child symptoms/signs 219, 220, 227 jaundice due to 200, 200, 201 Programme 28, 29 wheezing 164, 165 prehepatic jaundice in neonates 442 poor, long‐term outcomes 25 heart murmurs 78, 78, 167, 218–221, 224 raised potassium, artefact 111 health care 27–43 aortic flow 222 haemolytic disease of the newborn for adolescents 457 causes 218 448–449 health care services 28 characteristics 220 haemolytic uraemic syndrome (HUS) for adolescents 457, 457 continuous 220 333–334 for child with disability 50 history and examination 219–220 haemophilia 308, 310, 380 professionals and agencies involved 28, 28 innocent (functional) 218, 219, 220, Haemophilus (spp.) 175 as pyramid of care 28, 28 222, 432 Haemophilus influenzae 145, 177, 182, 313 safeguarding children 40, 41 sites 222, 222 Haemophilus influenzae type B 38, 165, 182 health‐destructive behaviour, adolescents investigations 220 vaccine 37, 38, 182 419, 456, 459–461, 460 management 221 haemorrhage see bleeding; specific health education 30–31 neonates 432 haemorrhages health promotion, adolescence 457 pathological 218, 219, 220 haemosiderosis 374, 375 health promotion, child 27–43 diagnosis, clues 220, 432 hand(s) growth/development monitoring pulmonary flow 222 dominance 103 34–36, 36 heart rate observation of child 75 Healthy Child Programme and 30–31, 31 neonates 430, 430 hand, foot and mouth disease 154 medical/developmental problems normal, by age 76, 76 ‘happy wheezers’ 164 detection 30 heart sounds 77–78 Harrison’s sulcus 80, 80, 173 professionals involved 28, 30 heart valve, palpation, areas 77

0004765449.INDD 506 6/18/2020 8:16:24 PM Index / 507

heel prick 32, 33, 108 homelessness 24, 25 hypoglycaemic agents, oral 305 heel‐toe walking 89 homosexuals 456 hypokalaemia 111 heel–shin test 89, 89 hormones, growth influenced by 14 hyponatraemia 111, 111, 113 height 14 hospice care 56–57 hyponatraemic dehydration 113, 416, 417 discrepancy with parental height hospital notes 71 hypopituitarism 342 280, 280 hospitalization 28 hypospadias 342, 342–343, 343 final, prediction 14, 280 household agents, poisoning by 419 neonates 432 measurement 72, 72, 280 housing, as health determinant 24, 25 hyposplenism 378 target 74 human papillomavirus (HPV) 40, 460 hypotension weight discrepancies 14, 280 vaccine 37, 40 postural 221 see also short stature human parvovirus B19 153 shock 408 Heimlich manoeuvre 407, 407 ‘humanhood’ 41 hypothalamic–pituitary axis 461, 461, 462 Helicobacter pylori gastritis 195, 210 hyaline membrane disease see respiratory hypothermia, small infants 435 hemiplegia 87, 87, 262, 262, 263 distress syndrome (RDS) hypothyroidism 280, 287, 294, 295, spastic 91, 262, 262 hydration, assessment 188 295, 296 Henoch–Schönlein purpura 363, 364 hydrocephalus 245–246, 246, 288, 289, 447 acquired, at a glance 296 clinical features 198, 363, 364 after intracranial haemorrhage, neonates congenital 32, 139, 258, 260, 294, 295 rash 200, 350, 351, 352, 364 245, 448 hypotonia 87, 257, 259 swollen joints 198, 310 hydrocoele 86, 338, 339, 341 infants 91, 432 at a glance 364 anatomical development 342 hypoventilation 112 hepatitis hydronephrosis, ultrasound 119 hypoxia 404, 405, 406 infectious, jaundice 201, 442 hygiene, poor, dysuria or vaginal discharge neonates 429 neonatal 442, 449 due to 320, 465 viral 214, 214 hyper IgD syndrome (HIDS) 143 I hepatitis A 214, 214 hyper‐resonance 81, 83, 164, 170 idiopathic thrombocytopenia purpura (ITP) hepatitis B 214, 214, 449 hyperactivity 261, 269, 388 110, 350, 351, 378, 378 hepatitis C 214, 214 ADHD 261, 386, 388, 389, 390 at a glance 379 hepatosplenomegaly 83, 85, 201, 259, 432 hyperbilirubinaemia 200, 200 rash, petechiae 110, 350, 352, 378 neonatal convulsions 439 conjugated 442 IgA nephropathy 331 hernia neonatal 442, 449 illness diaphragmatic 436, 437, 450 unconjugated 442 growth influenced by 14 inguinal see inguinal hernia hypercapnia 405 homelessness and 25 umbilical 82 hyperglycaemia 167, 298 long‐term outcomes 25 herpes simplex virus (HSV) 235, 357 hyperinflation, lungs 175, 176, 179, 179 poverty and poor housing and 25 cold sore 356, 357, 367, 367 hyperkalaemia 111 immigrants, health determinant 25 hip(s) hypermetropia 248, 249 immune response, impairment 400, 401 developmental dislocation see hypermobility of joints 309 small infants 436, 447 developmental dislocation of the hypernatraemia 111, 111, 113 immunizations 36–40 hips (DDH) hypernatraemic dehydration 113, 417, 417 guidelines 36 dislocatable, detecting in neonate 453, hyperoxia test 438, 438 high uptake level, importance 36 453–454 hypersplenism 110 history taking 68, 69 dislocation, in cerebral palsy 264 hypertension 232, 292, 305, 335 in immunosuppressed patients 54 septic arthritis 315 hyperthermia 134 routine, schedule in UK 36, 37 ultrasound, transient synovitis 314 hyperthyroidism 294, 295 uptake level reduced 36 Hirschsprung disease 198, 199, 444, hypertonia 87 see also vaccines 450, 450 clasp‐knife 262, 265 immunodeficiency 400 histamine 163 delayed walking 258 HIV infection 156 history taking 65, 67, 68–70 infants 91, 432 vaccination guidelines 36 method 68, 68–70 hyperventilation 112, 113, 221, 232, 248 immunoglobulins notes, writing 70–71 absence seizures, EEG 239 in breast milk 17 sensitivity over fears 68 hypoalbuminaemia 332 maternal IgG 447 see also specific conditions/disorders hypoglossal nerve, examination 90 immunosuppression, cancer therapy causing HIV infection 156, 156–157, 460 hypoglycaemia 54, 380 breast‐feeding contraindication 17, 157 coma due to 411 impetigo 356, 357, 364–365 at a glance 156 in diabetes 302–303 inborn errors of metabolism 258, 260, hives (urticaria) 352, 360, 360 management 299, 302–303 268, 269 hoarseness 181 nocturnal 301, 303 incest 397 Hodgkin’s disease 53 small for gestational age infants 435 incontinence, urinary see urinary incontinence holistic approach 2, 47 symptomatic, in small infants 435 indulgent parenting style 12, 12

0004765449.INDD 507 6/18/2020 8:16:25 PM 508 / Index

inequality, as health determinant 24, 24 weight measurement 72 issues for family/school 269 infant formulae see formulae, infant wheezing 164, 168, 179 management 268–269, 269, 270 infantile spasm 231, 237, 238, 239, 243 infections profound 267 infants acute, shock 409 routine reviews 269, 270 0‐2 months old 12–13 acute pyrexia due to 134, 135 severe 267, 268, 269 5‐8 months old 13 coma due to 410, 411 vision deficits 274 8‐18 months old 13 emergency presentations 400, 401 intensive care, ethical issues and withdrawal 18 months old and over 13 in neonates with respiratory distress 437 41–42 analgesia 108 prenatal 435 intention tremor 89 atopic dermatitis 358 pyrexia of unknown origin 141, 141 interferon, in breast milk 17 attachment 11 recurrent 143, 143 interpreters 63 body composition 416 sepsis 378, 401, 403, 421 intestinal obstruction 186 bonding 12, 18 small infants 436 congenital 444, 444 breast‐feeding see breast‐feeding see also fever; specific infections intestinal tract, in cystic fibrosis 175 care, advice for parents 30 infectious diseases, childhood 138, 138, intoeing 312, 312 cerebral lesions 262, 263 349, 352 intracranial bleeding 114, 245, 378 colic 204–205, 205 infectious mononucleosis 110, 147, 147 in neonates 448 cough 160 infectious skin lesions 356, 356, 357, intracranial pressure, raised 114, 233, dehydration 113, 417 364–368 245, 289 development 10 infective endocarditis 226–227 headaches 233, 234, 245, 379 assessment see developmental inflammatory bowel disease 190, 208–209 idiopathic 114, 245 assessment abdominal pain 195, 208 large head 288 influences on 10–11, 35 chronic diarrhoea 190, 192, 208 signs 114, 410, 411 mobility 13 inflammatory markers 190 intrauterine growth retardation (IUGR) psychomotor 12–13 influenza 138 282, 283, 284, 286, 434–435 ECG 118, 118–119 vaccination 146 asymmetrical 434, 435, 435 emergency presentation 400 infratentorial tumour 233, 245 catch‐up growth 14, 292 fits, faints and funny turns 230, 230, inguinal haematoma 339 causes 292, 434, 435 231 inguinal hernia 86, 338, 339, 341, 342 at a glance 436 foods to avoid 19, 20 bilateral 341 growth/weight faltering 283, 284, growth 14, 35, 73, 73, 74, 280 development, anatomy 341, 342 286, 292 normal 34, 35 at a glance 341 neonatal convulsions 439 growth charts 73 management 341 problems found 433 hand use/movement 102, 103 inguinal lymph node, enlarged 339 short stature 282 The Health Child Programme 29 inhalers 169, 170, 173 symmetrical 434, 434, 435 heart rate 76 injections, by children/families 127 see also small for gestational age (SGA) immunization programme (UK) , 37 injuries, strategies for reducing 31, 31 infants large for gestational age 284 inspiratory noise see stridor intrauterine infections 258, 260, 267, 268 length measurement 72, 72, 280 insulin intravenous fluids 125, 127 mortality rates 428 deficiency 298 in dehydration 125, 418, 418 neurological examination 90–93, 91, levels, blood glucose relationship calculations 418, 418 92, 93 300, 300 in shock 409, 409 nutrition 10, 15 pens, injecting 300, 300 intravenous medications 127 physical activity 23 preparations, short‐/long‐acting 299, 300 intraventricular haemorrhage 120, 448 posture 12, 101, 102 pumps 127, 300, 300 intussusception 200, 211, 211–212, relationships 10, 11 regimens, basal–bolus 299 212, 334 respiratory failure 406 resistance 288, 305 abdominal pain 196, 198, 200 rooting at nipple 16 therapy 299, 299–300 diarrhoea 187 seizures 237, 238 blood glucose monitoring and at a glance 212 sepsis 401, 403, 421 300–301, 301 recurrence 212 sleep patterns (by age) 23 in diabetic ketoacidosis 302 vomiting 187 sleep problems 385 intellectual developmental, disorders of 100, investigations 107–121 sleep training 23 256, 267–269 painful, consent for 63, 108 small 433–436, 435 aetiology/pathophysiology 267–268, performing tests in children/infants 108 see also prematurity/premature infants; 270, 270 see also specific investigations and diseases small for gestational age (SGA) autism 49, 256, 261 iodine, deficiency 139 infants clinical features and severity 267, 268, 270 iridocyclitis, chronic 319 social interactions 12–13 diagnosis of cause 269 iron urinary tract infection 326, 328 at a glance 270 deficiency 109, 372, 373 vision, assessment 91, 96 global 255, 256, 258, 258, 259 dietary requirements 373 vocalization 13 idiopathic 260 overload 375

0004765449.INDD 508 6/18/2020 8:16:25 PM Index / 509

iron chelating agents 375 ketosis 298 Legg–Calvé–Perthe disease 309, 315, 315 iron deficiency anaemia 20, 109, 109, 207, kidneys length 372, 373 congenital anomalies 324, 325 intrauterine growth retardation 434, 435 clinical features and investigations 109, drug excretion 125 measurement 72, 72 109, 373 enlargement, neonate 432, 450–451 let‐down reflex 16 at a glance 374 horse‐shoe 334 leucocytes management, prevention 373 palpation 83 in CSF 114 irritability, infants/neonates 90, 431 ultrasound 119 in urine 115 irritable bowel syndrome 195, 209–210 Kingella kingae 313, 315 leucocytosis 110 isolation, in chronic illness 47 knee, effusion 93 left shift 110, 142, 147, 162, 178, itching, conditions causing 356, 356 knock‐knees 292, 312 311, 313 of anus 215, 320, 368 Koplik spots 137, 149, 149 leucopenia 110 of scalp 367 Kussmaul breathing 113, 167, 410 leukaemia 110, 310, 315, 372, 379–380 see also pruritus acute lymphoblastic 53, 110, 379, 379 itch–scratch–itch cycle 358 L at a glance 380 labial adhesions 343 leukotriene receptor antagonist (LTRA) 169 J laboratory tests 108 levetiracetam 239, 240 jargon development 104 lactation, physiology 16, 16 liaison 65 jaundice 82, 200–201 lactic acidosis 429, 430 in chronic illnesses 48 breast‐milk 449 lactoferrin 17, 373 professional 65–66 causes 200, 200 lactose intolerance 192, 206–207 lichenification 352 cholestatic 82, 200, 201 lamotrigine 239, 240 life‐sustaining treatment, forgoing/refusal 57 differential diagnosis 201 language 255 lifestyles history and examination 200, 200–201 assessment 103–105, 255–256 healthy 292 investigations 201 delay/difficulty 102, 104, 255, unhealthy 22 neonatal 431, 442, 443, 444 255–256, 256 light‐accommodation discordance 96–97 causes 442 diagnosis, clues 256 light touch, sensory assessment 90 at a glance 443 development 10, 100, 103, 103–105, 255 limbs, examination, in neonate 432 of prematurity 448 word number 103, 104, 255 limp 308–309 prolonged, investigations 442, 443 disorders 49, 255, 256, 256 causes 308, 314 obstructive 200 understanding of, assessment 104 listening 62, 65, 383 jejunal atresia 444 language barriers 63 liver jejunal biopsy 207, 207 laryngomalacia 165, 166 chronic disease 201, 215 jerking movements 87, 237 laryngotracheobronchitis, acute see croup drug metabolism 125 jitteriness, in neonates 431 larynx, floppy 165 palpation 77, 82–83, 83 joints ‘late developers’ 291 transplantation 215 effusion 93, 313 lateral ventricles, MRI scan 120 see also hepatitis large, examination 93 laxatives 213, 213 lobar collapse 117, 118 stiffness 311 ‘lazy eye’ 250, 250 local anaesthetic creams 108 swollen 310–311, 311 lead poisoning 109, 196, 374 logbooks, student 3

causes 310, 313, 315 learning long‐acting β2‐agonist (LABA) 169 trauma 313, 313 additional needs 46 long QT syndrome 119 juvenile absence epilepsy (JAE) 238 paediatrics 2, 3 long‐term medical conditions see chronic juvenile chronic arthritis (JCA) 141, 310 learning disability 46, 49, 267, 270, 389 disease/illnesses juvenile idiopathic arthritis (JIA) 308, 316, obesity and 286 ‘loop’ wiring system 273 316–318, 317 see also intellectual developmental, low birthweight infant 429, 433 at a glance 317 disorders of lower motor neurone lesion 87, 88 management 318, 317 left to right shunt, defects causing 222, lower respiratory tract disease 160, 405 pauciarticular 316, 316–317, 317 222–223, 223 lubricants 358 polyarticular 316, 316, 317 left ventricular hypertrophy 223 lumbar puncture 110, 114, 235, 411 systemic 316, 316, 317 leg contraindications 235 juvenile myoclonic epilepsy (JME) 238 bow 312 lung inspection 94, 309 chest X‐ray 116, 117, 117, 118, 179 K trauma 308 collapse, aspirated foreign body 180 karyotype 121 leg pain 308–309, 309, 310 consolidation 81, 118, 179 Kawasaki disease 141, 157, 157–158 causes 308, 308–309, 315 CT scan (high‐resolution) 120 kernicterus 442 differential diagnosis, clues to 310 fetal 445 Kernig’s sign 235, 236 growing pains 309, 313 hyperinflation 175, 176, 179, 179 ketoacidosis see diabetic ketoacidosis (DKA) investigations 309, 309 hypoplasia 334 ketone bodies 114, 115 organic vs. non‐organic 309, 310 lobar collapse 117, 118 ketones 114, 298, 301 legal records 71 luteinizing hormone (LH) 458, 458

0004765449.INDD 509 6/18/2020 8:16:25 PM 510 / Index

lymph nodes meningismus 235 midazolam, buccal 240, 240, 241, 422 cervical 85, 85, 139 meningitis 90, 235–236 migraine 233, 234, 244 enlargement see lymphadenopathy bacterial 235, 235, 236, 351 abdominal 196 inguinal 339 CSF analysis 114, 114, 235 at a glance 244 occipital, enlargement 85 management 236, 236 milk 15 ‘shotty’ 84, 85, 339 causes 235, 236 allergy 164 lymphadenopathy 84, 85 clinical features 235, 236 consumption by infants 19, 19 cervical 85, 139, 139, 140 headache 232, 234 see also breast milk; formulae, infant cervical adenitis 147 complications, prognosis 236 consumption by toddlers 20 tonsillitis 144 diagnosis 114, 235 see also cow’s milk inguinal 339 differential diagnosis 137, 236 mitral valve 77 lymphocytes, in breast milk 17 at a glance 236 MMR vaccine 37, 39, 137, 150, 153, 349, lymphocytosis 110, 147 management 235–236, 236, 351 351, 352 lymphoid tissue, growth 15 meningococcal 137, 235, 236 mobility lymphoma 339 neonates 447 development in infants 13, 101, 103 non‐Hodgkin’s 53 viral 114, 235, 235, 236 training, in visually impaired 275 lysozyme, in breast milk 17 meningococcaemia see meningococcal molluscum contagiosum 356, 357, 366, septicaemia 366–367 M meningococcal septicaemia 154–155, 155, Mongolian spots 368, 369 macrogol 3350 213 235, 236, 351 morals 41 macules 347 differential diagnosis 137 morbidities, new, in child health 28, 28 magnetic resonance imaging (MRI) at a glance 155 Moro reflex 92, 93, 432 scan 119, 120, 121, 238 investigations 138 mother and toddler groups 24 make‐believe play 13 management 138, 154–155, 155 motor examination 87–88 malabsorption 190, 215, 283 rash 135, 137, 154, 236, 350, 352 motor maturation, delayed 257 in cystic fibrosis 175, 176 meningococcal vaccine 37, 39, 155 motor skills sugar 190 meningococci (N. meningitidis) 39, 154, fine, assessment 100, 100 male genital disorders 341–343 236, 421 gross, assessment 100, 100, 101 malnutrition, growth influenced by 14 meningocoele 452, 452 see also walking manipulation, infants 102 meningoencephalitis 148, 235, 236, mouth Mantoux testing 39 411, 413 examination 82 Marcus‐Gunn pupil 96 menstrual problems, adolescents neonates 432 mastitis 17 465, 465 in Kawasaki disease 157, 157 mastoid process, swelling 139, 140, 149 mental capacity 42, 64, 458 movements mastoiditis 140, 149 mental health problems/disorders 28 abnormal 86–87 masturbation 386 early, long‐term outcomes 25 range, assessment 93 maternal bonding 12, 18 mental retardation 258, 267 spontaneous, in infants 90, 431 maturational delay 255, 256 see also intellectual developmental, Muckle Wells syndrome (MWS) 143 mealtime, family 22, 386 disorders of mucocutaneous lymph node syndrome mean cell haemoglobin (MCH) 108, 109 mesenteric adenitis 198, 211 (Kawasaki disease) 141, 157, mean cell volume (MCV) 108, metabolic acidosis 112, 112–113, 157–158 108–109, 372 167, 424 mucus, oversecretion 163 measles 137, 149, 149, 150, 351 metabolic alkalosis 112, 113, 203, 417 multi‐source feedback (MSF) 3 diagnostic patterns 138 metabolic disorders 291–305 multidisciplinary team at a glance 150 fits, faints and funny turns 230 in cerebral palsy 264 rash 137, 149, 149, 349, 351, 352 screening tests 32 child development team 49, 49, 50, 50, recurrence, MMR uptake reduction 36 see also specific disorders 254, 264, 269 vaccine (MMR) 36, 37, 39, 137, 150, 351 metabolism in chronic illnesses 48 meconium, failure to pass 444 drugs 125 communication in 65–66 meconium ileus 175, 444 effects of cancer and therapy 54 diabetic team 299, 305 mediastinal deviation 80 metatarsus adductus 312, 312 palliative care 56 medical clowns 63, 63 metered‐dose inhaler (MDI) 127, 169 multiple‐choice questions (MCQs) 3, 4 medical neglect 397–398 metoclopramide 124 mumps 139, 148, 148 medical problems, detection 31 microcephaly (small head) 259, 289, diagnostic patterns 138 medication overuse headache 233 289–290 at a glance 148 medium‐chain acyl‐CoA dehydrogenase microcytosis 373 vaccine 37, 39 deficiency (MCADD) 32 micrognathia 449 murmurs, heart see heart murmurs megacolon 212 microthrombi 333 muscle power, examination 88 melaena 200 micturating cystourethrogram (MCUG) muscle tone, examination 87, 88 menarche 459 326–327, 327, 328, 334 in babies 90–91 delayed 459, 461, 461, 465 micturition see urination muscle wasting, examination 87

0004765449.INDD 510 6/18/2020 8:16:25 PM Index / 511

muscular dystrophy 257, 258 neglectful parenting style 12, 12 nephropathy, diabetic 298 musculoskeletal disorders 307, 313–318 Neisseria meningitidis 39, 154, 236, 421 nephrotic syndrome 116, 325, 332, see also specific disorders (as listed page 307) neonatal onset multi‐system inflammatory 332, 333 musculoskeletal pain, chest 167 disease (NOMID) 143 minimal change 332 musculoskeletal system neonates 427–454 neural tube 451, 452 examination 93–94, 94, 311 asphyxia 430 neural tube defects 432, 451–452, 452 problems in obesity 286 breast engorgement 462 neuroblastoma 53 symptoms/signs 308–312 breathing 429–430, 445 neurocutaneous syndromes 259, 260, 271 Mycobacterium tuberculosis 17, 39 conditions 428, 445–454 neurodegenerative conditions 258, 260, Mycoplasma pneumoniae 177, 178 acute kidney injury 335 268, 290 myelocoele 451 biliary atresia 449 neurological behaviour, abnormal in myelomeningocele 451, 452 breast‐milk jaundice 449 neonates 432 myoclonic seizures 232, 237, 239, 243 cleft palate and lip 432, 451, 451 neurological disorders 229, 235–250 myoclonus 237 DDH see developmental dislocation of see also specific disorders (as listed page 229) myopia 34, 248, 249 the hips (DDH) neurological examination 253 diaphragmatic hernia 450 in babies 90–93, 91, 92, 93 N haemolytic disease of newborn of children 86, 86–90, 87 naevi 448–449 cerebellar signs 89 pigmented 368, 369 hepatitis 449 cranial nerves 89, 90 spider 82, 347 Hirschsprung disease 450, 450 gait 87, 87 strawberry 368, 369 hydronephrosis 450–451 motor 87–88, 88 naevus flammeus 368, 369 infections 400, 436, 447, 447 sensation 89 nail bed angle 75, 75 intracranial haemorrhage 448 in global developmental delay 259 nail‐biting 386 jaundice of prematurity 448 large head 289 nappy rash 354, 355, 356 meningitis 235, 236, 447 neurological symptoms/signs 230–234 ammoniacal 355, 355, 356, 362, 362 necrotizing enterocolitis 448 fits, faints and funny turns 230, Candida 355, 356, 363, 363 neural tube defects 451–452, 452 230–231, 231, 232 at a glance 362 obstructive apnoea 449–450 headaches see headache(s) psoriatic 355, 356, 361, 362 patent ductus arteriosus 449, 449 squint (strabismus) 234, 234 seborrhoeic dermatitis 355, 355, pneumonia 447 neuromuscular disease 266, 267 356, 360 respiratory distress see respiratory neuronal circuits, development 10, 10 nasal obstruction 144 distress syndrome (RDS) neutropenia 110 National Child Measurement Programme retinopathy of prematurity 454 febrile 54, 110 (NCMP) 35 septic arthritis 315 ‘new morbidities of childhood’ 382 National Institute for Health and Care cranial ultrasound 120 newborn infants see neonates Excellence (NICE) see NICE examination 428, 430–432, 431 NICE nature and nurture 9–25 for developmental dislocation of hips traffic light system, serious illness see also development, child 33, 432, 453, 453 400–401, 402 nebulizers 169–170, 170 The Health Child Programme 29 TV/screen time recommendation 22 neck heart rate 430, 430 NICE guidelines anterior/posterior triangles 84–85 hypoxia 429 asthma 168, 173 asymmetrical tonic reflex 92, 93 maturity, assessment 433 atopic dermatitis 359 examination 219 measurement 431 attention deficit disorder 262 examination of lymph nodes 84–85 mortality rates 428, 429 autism spectrum disorder 261 stiffness, meningitis 235 resuscitation 428, 429, 429–430, bedwetting 331 swelling in, fever with 139, 430 child maltreatment 395 139–140, 140 screening tests 32, 32–34, 33, 34, 175 constipation 199, 214 webbing 297, 297 signs and problems 433–444 diabetes mellitus 305 necrotizing enterocolitis 448 apnoea 441, 441 diarrhoea and vomiting 189 neglect 40, 259, 392, 397 bowel obstruction 444, 444 epilepsies 242 abnormal brain development after convulsions 439, 439–440, 440 feverish illness in children under 5 years 11, 11 cyanosis 437, 437–438, 438, 439 400–401, 402, 421 child, long‐term outcomes 25 jaundice see jaundice head injury 423 examination 393 respiratory distress 433, 435, 436, meningitis 237 failure to thrive 284, 286, 291, 397 436–437, 437 UTI diagnosis/management 115, 328 global developmental delay 259, small infants 433, 433–436, 434, night terrors 231, 247, 385 260, 268 435, 436 nightmares 385 investigations 394–395 see also intrauterine growth retardation nipples, development, and trauma 16 medical 397–398 (IUGR); prematurity Nissen fundoplication 202 weight/growth faltering 286 neoplastic disease see cancer, child with nitrites 115 see also child abuse nephromegaly 450, 451 nitrogen wash‐out test 438, 438

0004765449.INDD 511 6/18/2020 8:16:25 PM 512 / Index

nits (head lice eggs) 367–368, 368 growth patterns 287, 287 at a glance 146 ‘no tears’ approach 23 history 286 secretory 95, 146, 272, 273 nocturnal enuresis (NE) 321, 322, identification, growth monitoring 35 oto‐acoustic emission testing 34 329–330, 386 investigations 288, 288 otoscopic examination 94–95, 95, 145 causes 322, 329, 386 management 288, 288, 292–293 ovarian cancer 343 daytime wetting with 321, 321, 329, 330 nutritional 287, 292–293, 293, 294 ovarian cysts 343 definition 321, 329 prevention 293 ovarian torsion 343 encopresis with 198, 321 prognosis 293 overfeeding, avoidance 18, 19, 186 at a glance 330 secondary 287 overnutrition, growth influenced by 14 management 329–330 type 2 diabetes mellitus 305 ovulation 465 see also wetting Objective Structured Clinical Examination oxybutynin 330 nodules, skin 347 (OSCE) 3, 4 oxygen, partial pressure 111, 112, 406 non‐accidental injuries 40, 64, 392, 393, practice for 5 oxygen therapy 164, 406, 445 393, 396–397 preparing for 4–5 oxygenation, emergency 404 see also child abuse observation 68, 70, 75 oxytocin 16 non‐Hodgkin’s lymphoma 53 abdomen 82, 82 non‐steroidal anti‐inflammatory drugs cardiovascular system 76, 76 P (NSAIDs) 335 in emergency presentation 403 P wave 118, 118 normal ranges, investigations 108 genitalia 85 Paediatric Early Warning Scores 403 acid–base and blood gases 111 musculoskeletal system 93 paediatric Gait, Arms, Legs and Spine blood chemistry 111 nervous system 86, 86 (pGALS) assessment 93, 311 CSF 114, 114 in infants 90, 91 paediatric rotation 2 haematological indices 108 respiratory system 79, 79–80 getting the most out of 2–3 normoglycaemia 298 urinalysis 114 paediatric services 28 nose, examination 95 occupational therapist 50, 264, 318, 390 paediatricians nose–finger test 89 oculomotor nerve, examination 90 communication skills 62 nosocomial infections, neonates 447 oedema community 30 notes 70–71 ankle 77 developmental 50 hospital 71 generalized 325, 332 paediatrics 2–5 writing‐up 71 haematuria and 324 assessment methods 3 nursemaid’s elbow 313, 313 observation for 82 tips to performing well 4 nurseries, day 24 sacral 167 see also examinations, student nursery school 24 oesophageal atresia 444 ethical issues in 41–43 nurses oesophagitis 202, 283 preparation for examinations 3–4, 4–5 health care services for children 28, 30 oestrogen progress and changes of approach 2 school 30 in mother 16 skills needed 3 nutrition 15 secretion, precocious puberty 461, 461 pain adolescence 22 off‐label prescribing 129–130 abdominal see abdominal pain breast‐feeding see breast‐feeding olfactory nerve, examination 90 acute/severe, signs 401 in cancer 54 oligohydramnios 334 assessment 88 in cerebral palsy 266 oliguria 408 febrile child 135 early years 10, 15–19, 19, 20, 31 omission vs. commission 41 growing 309, 313 formula feeds see formulae, infant open questions 65, 68 leg see leg pain growth influenced by 14 ophthalmoscopy, red reflex 32–33, 33, 97, menstrual cramps 465 health promotion and 31 105, 274, 431 on micturition (dysuria) 320, 320–321 infant, principles 19 opiates, abuse 460 withdrawal of intensive care, ethical iron deficiency 372, 373, 374 opisthotonos 91, 91, 202 issue 41 poor, long‐term outcomes 25 optic glioma 121 pain relief preschool years 20 optic nerve, examination 90 for investigations/tests 108 school age children 20, 21, 22, 22 oral rehydration solutions (ORS) 125, in palliative care 57 weaning 19, 19, 20 417–418 palivizumab 179 nutritional history 68, 69, 283 orchitis 148 palliative care 54, 55–57 nutritional obesity 287, 292–293, 293, 294 organ growth 14, 15 child with cancer 54, 55 nystagmus 89 organomegaly, neonates 432, 450–451 communication, principles 56 orthopaedic surgery, in cerebral palsy 264 organization 56–57 O Ortolani test 33, 432, 453, 453 principles 55–56 obesity 22, 286–288 osteogenesis imperfecta 395 symptom control 57, 57 assessment 74, 75, 293 osteomyelitis 308, 313, 314 palliative care plan 57 causes 286 osteosarcoma 53 palliative care team 56, 57 genetic/hypothalamic 287 otitis media 94, 95, 145, 145–146, 146, 149 pallid spells 247, 247 examination 287, 287–288 differential diagnosis 136 pallor 196, 372, 373

0004765449.INDD 512 6/18/2020 8:16:25 PM Index / 513

palmar erythema 82 response to cancer in child 54, 55 peripatetic teacher 273, 275, 276 palmar grasp reflex 92, 93 rights of 42 peripheral neural disease, signs 87 palpation 70 sleep deprivation 23 peristalsis, visible 444 abdomen 82, 82, 197 support, over time 64, 64–65 peritoneal dialysis 335 cardiovascular system 76, 76–77 see also family peritoneal irritation (peritonism) 197 chest/respiratory system 79, 80 parent‐held child health records 30, 63–64 peritonitis 210 genitalia 85 parent–child relationship 11–12, 13 peritonsillar abscess (quinsy) 144 musculoskeletal system 93 parenteral therapy, at home 127 periventricular haemorrhagic infarction 448 neurological examination of infants 90 parenting 11–12 periventricular leucomalacia (PVL) 448 pancreatic insufficiency, exocrine 175, 176, factors influencing 12 ‘permanence of objects’ 104–105 189–190 single parents 25 Personal Child Health Record (PCHR) 30, pancreatic supplements 176 skills, lack of 30 63–64, 64 pancytopenia 54 styles and influences 11–12, 12 pertussis (whooping cough) 38–39, 38 pansystolic murmurs 78, 220, 223 parotid gland, swelling 139, 140, 148, 148 diagnostic patterns 138 papilloedema 411 parotitis 148 at a glance 38 papules 347 partial sight 274–276, 275 vaccine 37, 38 paracetamol 124, 125, 136 passive smoking 31, 160, 161 petechial rash 137, 138, 154, 235, 347, poisoning 424 past medical history 68, 69 350, 351, 352 parachute reflex 91, 93 in emergency presentations 403 Peyer’s patch 211 parainfluenza virus 181 rash in febrile child 137, 351 pGALS assessment 93, 311 parasitic infections 190, 196, 215 patches, skin 347 pH parasternal heave 76, 77 ‘patellar tap’ sign 93 arterial 111, 112, 113 parasuicide attempt 420 patent ductus arteriosus 225, 449, 449 urine 115 parenchymal haemorrhage 448 heart murmurs 220, 449 pharmacodynamics 124 parent(s) patient notes 70 pharmacogenetics 124 ability to cope 65 peak expiratory flow rate (PEFR) 119, pharmacokinetics 124 advice on baby care 31 162, 171 pharmacology 124–125 advice on cleft palate/lip 451 chart, asthma monitoring 171, 171 pharyngitis, acute 144 advice on febrile seizures 422 peak flow see peak expiratory flow rate (PEFR) phenylketonuria 32, 268 breaking news of child’s disability to peanuts, aspiration 180 phenytoin 241 50, 51 pectus carinatum 76, 80, 80 phimosis 343 child abuse by 396 pectus excavatum 80, 80 phototherapy 361, 442, 448 child health promotion involvement 30 pediculosis capitis 367–368, 368 physical activity 22–23 child’s growth, discussions 35 ‘peek‐a‐boo’ 13, 104, 105 by age, recommended levels 23 chronic illness effect on 47 pelvic inflammatory disease 196 epilepsies and 240–241, 242 communication with 62–64 pelvic masses 322 nutritional obesity management 292, 293 about chronic illness 47 pelviureteric junction (PUJ) physiotherapist 50 approach to support 65 obstruction 450 cerebral palsy, role 263, 264, 266 at examination of child 72 pencil skills, development 102, 103 pica 109, 373, 374 exploring concerns 64, 65 penicillin, prophylactic 376, 378 pigeon chest (pectus carinatum) 76, 80, 80 goal identification/achievement 65 penis, curved 342, 432 pilocarpine iontophoresis 119 plan of action, development 65 peptic ulceration 198, 210 pincer grip 102, 103 progress review 65 percussion 70 pinworms (threadworms) 215, 215, 320, questioning, helping to talk 64, 65 abdomen 82, 83–84 321, 368 without child present 62, 68 chest 79, 80–81 plan of action 71 concerns over adolescents 458 dullness and stony dullness 81 plantar reflex 88, 93 concerns over behavioural problems 383 hyper‐resonance 81, 83, 164, 170 plaques 347, 361 consent 42, 64, 108, 458, 467 shifting dullness 83 plasticity, brain 11 education about chronic illness 47 perinatal history 68, 69 platelets education about diabetes 299 perinatal mortality rates 428, 429 normal range 108 failure to act in child’s best interests 42, 64 perinatal statistics 428, 429 reduced count see thrombocytopenia feelings/response to child’s chronic periodic fever, aphthous stomatitis, playgroups 24 illness 47 pharyngitis, adenitis (PFAPA) 143 playing grief 55, 56 periodic fevers 143, 143 active 22–23 guidelines for managing periodic review 65 lack of safe areas for 25 behavioural problems 383, 384, 384 periods (menstrual) make‐believe 13 eating difficulties 386 absence 465, 466 observation, delay/difficulty in talking sleeping problems 385, 385 heavy 465 255, 256 temper tantrums 387 painful 465 with other young children 13 hostility and defensiveness 65 starting see menarche school age children 13 reassurance, in seizure 413 periosteal bleeds 394 with toys 13

0004765449.INDD 513 6/18/2020 8:16:25 PM 514 / Index

pleural effusion 118 at a glance 434 intolerance 190, 192, 198 pneumococcal disease 376 infections 447, 447 in urine 115 pneumococcal vaccine 37, 39 intracranial haemorrhage 448 proteinuria 116, 332 pneumonia 81, 177–178 jaundice of 448 persistent 327 causative organisms 177, 178 patent ductus arteriosus 449 pruritus 82, 351 chest X‐ray 178, 179 problems for infants 435–436 atopic dermatitis 358 cough in 162 respiratory distress syndrome see cirrhosis 215 differential diagnosis 136, 178 respiratory distress syndrome (RDS) jaundice 201 at a glance 178 retinopathy 454 scabies 367 management and prognosis 178, 178 prenatal infections 435 see also itching, conditions causing in neonates 447 prepuce, irretractable 343 pseudo‐paralysis 315 viral 177, 179 preschool children pseudo‐tumour cerebri 114, 245 poikilocytes 374, 376, 378 atopic dermatitis 358 Pseudomonas aeruginosa 175 poisoning cough 160 pseudoseizures (psychogenic non‐epileptic at a glance 420 fits, faints and funny turns 230, 231 seizures) 221, 232, 248 poisons 419 growth 14 pseudosquint 249, 249 strategies for reducing 31 The Health Child Programme 29 psoriasis 310, 353, 354, 354, 361, 361 Poisons Reference Unit 419 immunization programme (UK) , 37 guttate 361 polio, vaccine 37, 38 nutrition, and milk consumption 20 nappy rash 355, 356, 361, 362 poliomyelitis virus 38 physical activity levels 22, 23 psychiatric problems, adolescence 456 polycystic ovarian syndrome (PCOS) psychomotor development 12–13 psychogenic non‐epileptic seizures 232, 248 305, 343 sleep patterns 23, 23 psychological changes in adolescence 456 polycythaemia 109 social interactions 12–13 psychologist 50 polydipsia 298, 298, 305, 323 wheezing 163, 164 psychomotor development 12–13, 252 psychogenic 324 see also toddlers psychosocial factors/issues polymerase chain reaction (PCR) 114, 235 prescribing for children 123–130 asthma 173 polyuria 298, 298, 305, 323, 323–324 abbreviations used 128, 129 chronic illness, impact 46, 47 popliteal angle, assessment 91, 92 dose writing guidelines 126–127, 127 epilepsy 242 port‐wine stain 368, 369 errors 124 failure to thrive 283, 284, 285 Portage system 269 of fluids 125 growth affected by 14, 280, 282 posseting 186, 202, 283 importance 124 suicide attempt in adolescents 464–465 postural hypotension 221 off‐label 129–130 psychosomatic symptoms 387 posture personalized 125 puberty 458 examination 87 pharmacology and physiology 124–125 boys/girls 459, 459 infants 12, 101, 102 safe, guidelines 129 delayed 459, 461, 461 potassium 416 see also drug(s) constitutional 291, 461 normal/abnormal levels 111, 111 prescriptions, writing 126, 126–128, growth 280 Potter syndrome/sequence 334 127, 128 hormonal changes 458, 458 poverty 11 abbreviations used 128, 129 key ages 458–459, 459 as health determinant in children 24, PRN (as needed) 127, 129 parental onset 280 24–25 presenting complaint, history of 68, 69 physical changes at 456–457, 458–459 long‐term outcome 25, 25 preterm infants 428, 429, 433 precocious 459, 461, 461–462 Prader‐Willi syndrome 121 see also prematurity/premature infants ‘true’ 461, 461, 462 praecordium, examination 76–77, 219 primitive reflexes 91, 92, 93, 263 problems of 461, 461–462 pregnancy pro‐drugs 125 pubic hair, development 458, 459, 459 in adolescents 465, 466, 467 probiotics 188, 205 precocious 461, 462 breast changes 16 problem list, in examination 70–71 public health issues, growth monitoring 35 in diabetes mellitus 305 processus vaginalis 341, 341, 342, 342 pull to sit 101, 102 infections during 258, 260, 269 professional qualities/skills, pulmonary flow murmur 222 perinatal history, taking 68, 69 communication 62 pulmonary hypertension 222, 223 prescribing in 129–130 professionals pulmonary valve 77, 78 rubella in 150 ethical conflicts, withdrawal of care 42–43 stenosis 220, 225–226, 225 teratogenicity 130 health care services for children 28, 30 pulse 76, 76 pregnancy test 394, 394 prognosis, withdrawal of intensive care 41 cardiorespiratory arrest 404 prematurity/premature infants 428, prolactin 16, 16 character 76 429, 433 prolactin‐inhibiting factor 16 in coarctation of aorta 225 airway obstruction 449 proprioception, assessment 89 in dehydration 417 apnoea of 436, 441 protein femoral, in neonates 432 developmental delays 253, 259 binding to drugs 125, 130 rate and rhythm 76 disorders of 433, 433, 434 CSF 114 volume 76

0004765449.INDD 514 6/18/2020 8:16:25 PM Index / 515

pulse oximetry 445 papular 352 renal transplantation 335 pulse rate 76 petechial 137, 138, 154, 235, 347, 350, renal tubular acidosis 323 punishment 383 351, 352 renal tubular disorders 323 punitive anger 383, 387 polymorphic 137, 138, 158 renal tumours 324, 325 pupil purpuric 137, 137, 138, 154, 349, 350, renal/urinary tract disorders 320, 326–335, unilateral dilated 411 351, 352 332–335 white 33, 97, 105, 274 ‘slapped cheek’ 137, 153, 153, 349, acute glomerulonephritis see pupillary reflex 96–97, 105, 411 351, 352 glomerulonephritis purpura 347 vesicular 137, 138, 153, 153, 349, 352 acute kidney injury 333, 334–335 pustules 348 reaching, by infants 102, 103 chronic kidney disease 334–335, 372 pyelonephritis 326, 327 reactive arthritis 310–311 congenital 334 pyloric stenosis 113, 186, 203, 204, 416 reciprocations, concept 13 haemolytic uraemic syndrome 333–334 blood chemistry 113, 203 records nephrotic syndrome 116, 325, 332, at a glance 204 parent‐held child health 30, 63–64 332, 333 pylorus, hypertrophy 203 professionals, of child 30 see also urinary tract disorders pyramid of care 28, 28 see also health records, child resources, scarce 42, 43 pyrexia see fever recovery position 413 respect 62 pyrexia of unknown origin (PUO) 141, rectal examination 84, 197, 199, 200, 210 respiration, failure, in neonates 429, 430 141–142, 142 rectal hyposensitivity 199, 212, 213 respiratory acidosis 112, 112 ‘red book’ 63–64, 64 respiratory alkalosis 112, 112, 113, 424 Q Red Flags respiratory depression 413 Q wave 118, 118 chronic lower respiratory tract respiratory disorders 168–182 QRS complex 118, 118 disease 160 in neonates, cyanosis 438 QT interval 118 developmental warning signs 252 see also specific disorders (as listed page 159) calculated (QTc) 119 growth concerns 280 respiratory distress 79, 112 quality of life 41, 42 headaches 232, 233 in bronchiolitis 179 quinsy (peritonsillar abscess) 144 indicative of serious disturbance 382, 382 in neonates 435, 436, 436–437, 437 neonatal infections 447 causes, cyanosis and 438 R neonatal resuscitation 429 management 437 R wave 118, 118 non‐accidental injury 392 observation for 79, 79 radiofemoral delay 76, 78 signs of severe illness 403 severe, signs 164, 406 radiotherapy 53–54 vomiting 186 signs 161, 164, 437 late consequences 55, 55 red reflex 32–33, 33, 97, 105, 274, 431 wheezing and 164 Ramstedt procedure 203 redcurrant jelly stools 187, 196, 200, 211 respiratory distress syndrome (RDS) 438, rash(es) reflex anoxic seizures 247, 247 445–446 acute 349–351 reflex anoxic spells 231 chest X‐ray 437 causes 349 reflexes complications 446 generalized, diagnostic clues 352 examination 88 at a glance 446 management 351, 351 in infants 91, 92 management/prognosis 445–446 centrifugal 351 primitive 91, 92, 93, 263 preterm infants 433, 435, 436, 437 centripetal 351 see also specific reflexes respiratory failure 405–406 in childhood infectious diseases 138, refractive errors 248, 248–249 causes 405, 405 349, 351, 352 refusal of treatment 57, 458 at a glance 406 see also specific infections registers, special 30 investigations, management 406, 406 chronic 352–354 regurgitation 186 respiratory rate 79 causes 352 rehydration 416–417, 417 neonates 430, 431 diagnosis, clues to 354 in dehydration 416–417, 417 normal, by age 80 description 346, 351, 352 in diabetic ketoacidosis 302 respiratory support, in neonatal respiratory examination and characteristics 137 protocol 417 distress 437 in febrile child 137, 137–138, 138, 139, see also fluid(s) respiratory symptoms/signs 160–168 351 relationships breathing difficulty 167 itchiness 351 early years 10, 11 chest pain 167, 167 macular 137, 138, 150, 347, 349, 352 parent–child 11–12, 13 see also cough; stridor; wheezes/wheezing maculopapular 137, 138, 150, 152, renal biopsy 331, 332 respiratory syncytial virus (RSV) 163, 165, 347, 349, 351, 352 renal function tests 111 168, 179 measles 137, 138, 149, 347, 349, renal mass 324 respiratory system 351, 352 renal replacement therapy (RRT) 335 in Duchenne muscular dystrophy 266 meningococcaemia 135, 137, 154, 236, renal scarring 327, 328, 334 examination 79, 79–81, 80, 81 350, 352 renal stones 324, 325 respite care 52 nappy see nappy rash renal symptoms/signs 320–321 responsive feeding, principle 19, 20

0004765449.INDD 515 6/18/2020 8:16:25 PM 516 / Index

resuscitation 403, 404, 404 scabies 354, 367, 367 visual acuity testing 34 ABCD 403, 405 scalds 393 wheezing 163, 164 cardiopulmonary 407 child abuse 393, 393 school nurses 30 in drowning 425 management 424 scissoring, lower limbs 91, 92 neonates 428, 429, 429–430, 430 scales, skin 348 scoliosis 94, 94 reticulocytes 108 scarlet fever 137, 151–152, 152 screen time 22, 451–452, 452 reticulocytosis, anaemia with 109, 109–110 diagnostic patterns 138 screening 32–34, 451 reticuloendothelial system 84 at a glance 152 developmental 36 examination 84, 84–85, 85 rash 151–152, 152, 349, 352 Healthy Child Programme 29 retina, normal focusing 248 school(s) questions, musculoskeletal system 93–94 retinal haemorrhage 393, 394 adolescents at 457, 464 timeline 32 retinoblastoma 53 aggressive behaviour and 387, 388 screening tests 32–34, 32, 33 retinopathy, diabetic 298 asthma and 173 scrotal swellings 338, 338, 339, 341 retinopathy of prematurity 454 attention deficit disorder and 261, seborrhoeic dermatitis 353, 354, 354, review of systems 68, 70, 70 388, 389 360, 361 Reye syndrome 136 cancer and 55 nappy area 355, 355, 356, 360 rhabdomyosarcoma 53 cerebral palsy and 266 seizures 237 rhesus incompatibility 448 chronic illnesses and 46, 48, 48 absence 232, 237, 239, 243, 261 rhonchi 81, 163 concerns/difficulties of children in 46, 69 causes 412 see also wheezes/wheezing developmental disorder and 261 classification and terminology 237 ribs diabetes and 299, 305 coma and 410, 411 callus around 394 disability management 50–51 febrile see febrile seizures missing, on chest X‐ray 117 medical 50 focal 237, 239, 243 right ventricular hypertrophy 76, 118–119 emotional/behavioural problems and focal motor 232, 237 Fallot tetralogy 226, 226 388–390 generalized 237, 412–415 rigors 135 emotional/behavioural problems due to at a glance 415 ringworm (tinea corporis) 356, 357, 383, 383 history, examination 413 365, 365 epilepsy and 242, 243 investigations 413, 413 road traffic accidents, prevention 31 failure at 389, 389 management 413–415, 414, 415 rolandic epilepsy 238 health promotion in 31 tonic–clonic 237, 239, 240, 243 Romberg’s sign 89, 90 hearing impairment and 273, 274 see also status epilepticus roseola 151, 351 intellectual development disorder and 269 management 239, 238–239, 240, diagnostic patterns 138 involvement, in chronic illness 48 413–415, 414, 415 rash 137, 151, 352 mainstream, child with disability 51 myoclonic 232, 237, 239, 243 rotavirus 188, 189, 205 non‐attendance 388, 388–389, 464 in neonates 439, 439–440, 440 vaccine 37 phobia 388–389 psychogenic non‐epileptic 232, 248 Royal College of Paediatrics and Child primary/secondary 24 reflex anoxic 247, 247 Health, guidelines, withdrawal of problems based 388–390 sensory 237 treatment 42 refusal 388–389 solitary 412 rubella 137, 138, 150, 150, 151, 268, 351 special, child with disability 51 temporal lobe 232, 243 diagnostic patterns 85, 137, 138 visual impairment and 275, 276 visual 237 at a glance 151 see also education see also convulsions; epilepsies rash 138, 150, 150, 151, 349, 352 school age children self‐confidence 11 vaccine (MMR) 37, 38, 137, 150, 153, aggressive behaviour 388 self‐esteem, low 389, 466 349, 351, 352 atopic dermatitis 358 self‐feeding by infants 104, 105 rumination 186 cough 161 self‐help groups 48 running, gait 87, 87 development 13 self‐respect 11 education 24, 51 sensation, testing in children 89 S see also education; school(s) sensory loss 89 S wave 118, 118 emergency presentations 400, 401, 401 sepsis 378, 421 safeguarding children 40–41, 395, 395 fits, faints and funny turns 230, infants 401, 403, 421 child health service, role 40, 41 230–231, 232 management 421 salbutamol 126 growth 14 septic arthritis 308, 310, 315 salicylate poisoning 424 The Health Child Programme 29 differential diagnosis 137 salmon patch (naevus flammeus) 368, 369 hearing screening 34 septicaemia Salmonella, acute diarrhoea 189 immunization programme (UK) 37 meningococcal see meningococcal Salter‐Harris fracture 313 nutrition 20, 21, 22, 22 septicaemia sanctity of life 41 physical activity 22–23, 23 temperature chart in 155 satellite lesions, impetigo 357, 365 seizures 237, 238 ‘setting sun’ sign 245 savants 261 sleep patterns 23, 23 sex education 466–467

0004765449.INDD 516 6/18/2020 8:16:25 PM Index / 517

sex hormones 14, 458 skin turgor 417, 417 social skills, development, assessment 100, sexual abuse see child abuse, sexual skull, growth 290 104, 104–105 sexual activity, in adolescents 456, 460, 466 ‘slapped cheek’ rash see fifth disease social workers 48, 50, 395 unsafe sex 460 (erythema infectiosum) socialization, school age children 13 sexual characteristics, secondary 458, sleep 23 socioeconomic factors 14 458–459, 461 deprivation (parents) 23 health determinant 24, 24 sexuality difficulties, habits 23, 385, 385 language delay 255 awareness, in adolescence 456 patterns, by age 23, 23 sodium 416 variance, medical issues 456 training 23 excess intake 111 sexually transmitted disease 460, 465 sleep and wake cycles, infants 12 loss 111, 416, 417 ‘shaken baby syndrome’ 186, 393, 394 sleep apnoea 144, 167, 286 normal/abnormal levels 111, 111 shapes, recognizing 13 slipped capital femoral epiphyses 309, sodium valproate 239, 240 shifting dullness 83 315, 316 soiling 190, 198, 199, 212, 386–387 Shigella, acute diarrhoea 189 small for gestational age (SGA) infants 280, solvent misuse, in adolescence shock 401, 408–409 283, 429, 434 459–460, 460 cardiogenic 408 asymmetrically small 434, 435 sounds, observation of child 75, 103 causes 408 at a glance 436 spacer device 169, 169 in dehydration 417 management, outcome 435 spastic diplegia 87, 87, 262 at a glance 410 problems for 435–436 spastic hemiplegia 91, 262, 262 hypotensive 408, 408, 409 respiratory distress syndrome risk reduced spasticity 87, 262, 263, 264 hypovolaemic 408 435, 445 special educational needs and disabilities investigations 409, 409 symmetrically small 434, 434 (SEND) 50–51 management 409, 409 see also intrauterine growth retardation special needs, children with 50, 51, 269 poor skin perfusion 77, 408 smile special needs teacher 50 short stature 279–281, 280, 281, 287 failure to, age 104 speech 255 adolescents 461 first 13, 104, 104 assessment 255–256 causes 280, 296, 297, 435, 461 smoke inhalation 424 baby response to 105 concerns 280, 280, 461 smoking 130 carer’s, for infants 13 diagnosis, clues to 282 adolescents 460 cerebellar lesion 89 examination, investigations 281, 281 asthma and 170, 173 development 100, 103, 103–105, 255 familial (constitutional) 281, 282, cough and 160, 161, 162 delay 102, 255, 255–256, 256 283, 291 passive 31, 160, 161 disorder 256 management 281 ‘sneaker’ dermatitis 360 therapy 255, 264 siblings Snellen chart 34, 34, 96 speech and language therapist 50 chronic illness effect on 47 snoring 167, 286 spider naevi 82, 347 issues in cancer 55 “SOAP” method, case information 65, 71 spina bifida 451–452, 452 sickle cell anaemia 308, 310, 372, 376–378 social aspects spina bifida occulta (SBO) 321, 322, 432, at a glance 377 changes in adolescence 457 452, 452 investigations 376, 378 chronic illness and school 46 spinal irradiation 55 screening test 32, 376 health‐destructive behaviour in spine, examination 90, 94 sickle cell trait 376 adolescents 459, 460 in neonate 432 sickled cells 376, 378 school involvement, in chronic illness 48 spleen, enlarged 83, 83 sign language 273 Social Care 40 splenectomy 378 sinus arrhythmia 78, 118 in child abuse 395 splenic infarction 376, 378 sitting, infants 101, 102 for child with disability 50 splenomegaly 201 sixth form college 24 social development 13 sponging, febrile child 136 skeletal dysplasia 282 assessment 100, 104, 104–105 sputum 161 skeletal growth 15 social disadvantage, as health determinant ‘squatting’ 226 skeletal maturity 281 24, 24, 25 squint see strabismus (squint) skeletal survey 394, 395 social history 68, 69–70, 392 stairs, climbing 103 skin conditions see dermatological social interactions stammering 255, 256 conditions autism and 261 standing 101 skin lesions child development 12–13 staphylococcal infection, impetigo 364 abdominal, observation 82 social media Staphylococcus aureus 175, 313 description 346 abuse/shaming 70, 388 star charts 329, 384, 384 desquamation 157, 157, 348 adolescents and 457 ‘statement’ of needs of child 46, 389 infectious 356, 356, 357, 364–368 social paediatrics 391–398 status epilepticus 237, 240–241, 410, non‐accidental injury 393, 393 see also child abuse; neglect 412–413, 422 permeability, to drugs 125 social pragmatic communication investigations 413, 413 types 346, 347–348 disorder 261 management 413, 414

0004765449.INDD 517 6/18/2020 8:16:26 PM 518 / Index

steatorrhoea 201, 207 sucrose drops 108 palpation 85–86 stem questions 3 sudden unexplained death in infancy and puberty, changes 459, 459 stepping reflex 93 childhood (SUDIC) 15, 130, retracted 85 sterility, infant formulae preparation 18 425–426, 426 retractile 339, 342 sternal recession 437, 445 risk factors 425 undescended 339, 340, 342, 432 stethoscope, child’s concern 70 suffering, withdrawal of intensive care, testicular descent 341, 342 sticky‐tape test 215, 215 ethics 42 palpation for 32, 34, 340 stiffness, abnormal gait 87 sugar malabsorption 190 testicular torsion 338, 339, 342 Still disease 141, 316, 316 suicide, adolescents 464, 464–465 testicular tumour 339, 342 stitch (pain) 167 suicide attempt 420, 464, 464–465 tetanus 37 stool softeners 213, 213 sumatriptan 244 vaccine 36, 37 stools support groups 48 thalassaemia, beta 372, 374–375, 375 blood in 187, 188, 196, 199, 199–200, supratentorial tumours 245 homozygous, at a glance 376 212, 333 surfactant 435, 445 screening test 32 changing, in neonates 444 administration 446 thalassaemia trait 109, 374 investigations in diarrhoea 188 deficiency 445 thelarche 461 normal patterns 189 surgery, cancer 53 premature 462 ‘stork mark’ (naevus flammeus) 368, 369 sweat, collection and analysis 119–120 theophylline 125 strabismus (squint) 234, 234, 249, 249–250 sweat test 119–120, 161, 175 therapeutic relationship 62 convergent squint 249 Sweep audiometry tests 34 thermal injuries 424 cover test for 97, 97 swollen joints see joints, swollen Thin Basement Membrane Disease examination check list 97 synapses 10, 10 (TBMD) 324 false 249, 249 syncope 221, 221, 227, 232, 248 thirst 323 management 250 see also fits, faints and funny turns threadworms (enterobiasis) 215, 215, 320, non‐paralytic 249, 249 synovitis, transient 308, 314, 314–315 321, 368 paralytic 249 systems, review of 68, 70, 70 thrills 77, 77, 78 stranger anxiety 104, 104–105 systolic ejection murmurs 78, 220, fluid, abdomen 83–84 strawberry naevus 368, 369 222, 223 throat streptococcal infections systolic murmurs 78, 220, 222, 225 examination 95, 95–96 acute glomerulonephritis 324, 325, 331 systolic pressure, abnormal 79, 79 sore 144 group A haemolytic, impetigo 364 thrombocytopenia 54, 110, 378, 379 tonsillitis 144 T all‐immune 110 Streptococcus, group B 401, 421, 447 T wave 118, 118 thrush, oral 363, 363 Streptococcus pneumoniae 145, 177, 315 tachycardia 220, 227, 408, 421 thumb‐sucking 386 Streptococcus pyogenes 313 tachypnoea 161, 431 ‘thunderclap’ headache 234, 250 stress tactile vocal fremitus 81 thymus gland 116 in adolescents 464 talking, delay/difficulty 255, 255–256, thyroid gland diabetes management 303 256, 389 palpation 295 effects in early years 11 see also language; speech swelling 139, 140, 295 positive 11 tall children 280 thyroiditis 140, 294–295, 295 tension headaches and 244, 245 Tanner stages 459, 459 tibial torsion, medial 312, 312 tolerable 11 teasing 388 tics 232, 248 toxic 11 telangiectasis 347 time out, strategy 384, 387 stress response, over‐sensitive 11 television, time 22 tinea capitis 357, 365, 365 stridor 81, 163, 165–166, 407 temper tantrums 387, 387 tinea corporis 356, 357, 365, 365 causes 165, 181 temperature tinea pedis (athlete’s foot) 357, 358, 365, differential diagnosis 166 body 365–366 management 166 normal 135 TNF‐receptor associated periodic fever stroke 250, 424 in septicaemia 155 (TRAPS) 143 Strycar rolling ball 96 taking 135, 135 toddlers students see examinations, student; paediatrics chart, pyrexia of unknown origin 141 abdomen 82 stupor 410 sensory assessment 89 aspirated foreign bodies 180, 407 Sturge–Weber syndrome 368 temporal lobe seizures 232, 243 diabetes mellitus 303 stuttering 255 tendon reflexes see deep tendon reflexes diarrhoea 192, 206 subacute sclerosing encephalitis (SSPE) 149 tension headaches 232, 233, 234, 244–245 foods to avoid 19, 20 subdural haematoma 246, 397 at a glance 245 The Health Child Programme 29 subglottic stenosis 165, 166 testes immunization programme (UK) 37 substance abuse, in adolescents ectopic 339, 340, 342 nutrition 20 459–460, 460 examination in neonates 432 poisoning 419 suckling, infant 16, 435 impalpable 339, 339 see also preschool children

0004765449.INDD 518 6/18/2020 8:16:26 PM Index / 519

toewalking 312 U wetting and 321, 322, 323 toilet training 104, 105, 321 UK Child Growth Standards (1990) 73, 74 see also specific disorders (as listed page 319) tongue, strawberry 157 ulcerative colitis 190, 208–209, 310 urinary tract symptoms/signs 320–321 tonsil(s) ulcers 348 see also specific signs (as listed page 319) enlargement 144 ultrasound 119, 119 urination examination 95–96 cranial, neonate 120 ‘avoidance manoeuvres’ 321, 322 tonsillectomy 144 hips, transient synovitis 314 daytime wetting see wetting tonsillitis 144, 144–145, 147 kidney 119 pain (dysuria) 320, 320–321, 465 differential diagnosis 136 pyloric stenosis 203, 204 pattern 323 at a glance 145 umbilical hernia 82 whilst sleeping see nocturnal enuresis (NE) tooth decay 202, 202 underachievers 46 urine avoidance, bottle feeding 18 undernutrition, in cerebral palsy 266 blood in see haematuria topical calcineurin inhibitors (TCIs) 359 understanding of language, delay in colour and odour 114, 324 topiramate 239, 240 talking 255 culture 115, 116, 325, 326 TORCH infection 435, 439 undressing child, for examination 70 dark‐coloured (‘coca‐cola’) 200, 201, total body impairment 262, 263 UNICEF, breast‐feeding support 15 324, 331 toxicity, acute/severe, signs 401 unintentional injury 31 reflux see vesicoureteric reflux (VUR) toxoplasmosis 268 unsafe sex 460 specific gravity 115 trachea, position, examination 80, 80 upper motor neurone lesion 87, 88 specimen collection 114, 326 ‘trainer’ dermatitis 360 signs 86 urobilinogen 115, 200, 443 transcutaneous bilirubinometry 442 upper respiratory tract infection (URTI) 144 urticaria (hives) 352, 360, 360 transexuals 456 acute pyrexia 134 transgender 456 cough in 160, 162 V transient synovitis 308, 314, 314–315 enlarged glands in neck 139, 139 vaccines transillumination 86, 338 urea 11, 111 BCG 37, 39 transitional milk 16 ureter, ectopic 334 chicken pox 153 transplantation urethra, abnormal siting 342, 342–343 diphtheria 37, 37 bone marrow 54 urethral valves, posterior 334, 450 DTaP 37, 37 liver 215 uric acid 54 Haemophilus influenzae type B (HiB) 37, renal 335 urinalysis 114–116 39, 182 transposition of great vessels 226, 226, in dehydration 417 hepatitis B 39 438, 438 dipstick testing 114–115, 115 HPV 37, 40 trauma haematuria 114, 115, 115, 324–325 influenza 146 abdomen 324 pathology, examples 115–116, 332 IPV (inactivated polio vaccine) 37, 38 head 246, 247 urinary frequency 298, 298, 305, 323–324 live attenuated 36 joint pain/swelling 313, 313 urinary incontinence meningococcal 37, 39, 155 leg 308 ‘avoidance manoeuvres’ 321, 322 MMR 36, 37, 39, 137, 150, 351 loin/flank 324 congenital anomalies causing 334 pertussis (whooping cough) 37, 38 traumatic tap 114 daytime 321, 321–322, 322 pneumococcal 37, 39 tremor, examination for 89 urge 321, 321 polio 37, 38 tricuspid valve 77 see also wetting rotavirus 37 tricyclic antidepressants 330 urinary tract disorders 326–330 rubella 37, 39, 150 trigeminal nerve, examination 90 congenital 323, 326, 334 schedule 37 trisomy 18 121 obstruction, in neonates 450–451 tetanus 37, 37 trisomy 21 see Down syndrome see also specific disorders (as listed page 319) see also immunizations trochlear nerve, examination 90 urinary tract infection (UTI) 326–327 vaginal discharge 465, 465 troponins, cardiac 409 atypical 326, 328 vagus nerve, examination 90 truancy 389 causes 326, 327 varicella see chicken pox trust, building 65, 68 clinical features 320, 326 vaso‐vagal syncopal attacks 221, 248 tuberculin sensitivity 39 abdominal pain 196, 198 vasopressin 330 tuberculosis 39–40 haematuria 324, 325 venous hum 222 at a glance 40 diagnosis 115, 116, 326 ventilation, in neonates 437, 441, 445–456 vaccine 37, 38 differential diagnosis 137 ventricular hypertrophy tuberous sclerosis 238 at a glance 327 left 224 tumour lysis 54 investigations 326–327, 327, 328 right see right ventricular hypertrophy Turner syndrome 280, 297, 297, 461 urinalysis results 115, 116, 326 ventricular septal defect (VSD) 78, tympanic membrane management 326, 326, 327 222–223, 223, 224 bulging, otitis media 95, 145, 145 NICE guidance 115, 328 Fallot tetralogy 226, 226 examination 94, 95 prognosis 327 at a glance 219 perforation 145 recurrent 326, 327, 328, 334 heart murmurs 220, 223

0004765449.INDD 519 6/18/2020 8:16:26 PM 520 / Index

ventriculoperitoneal shunt 246 vomiting 185, 185–187, 186, 283 in anorexia nervosa 463 verruca (plantar warts) 357, 366 after taking medication 126–127 in diabetes mellitus 298, 298 vertigo, benign paroxysmal 231, 247–248 bile‐stained 186, 186, 432, 444 in nutritional obesity 292 very low birthweight infants 429, 433 blood‐stained 186, 186, 203 pharmacology and 124 vesicles 347 causes 185, 186, 202 West syndrome (epileptic spasms) 231, 237, vesicoureteric reflux (VUR) 326, 327, 328, dehydration 416, 417 238, 239, 243 329, 334 examination 186, 187 wetting 321, 321–322, 322 severity, grading 328 inducing, in poisoning 420 diagnosis, clues to 323 vigabatrin 239, 240 projectile 186, 203, 416 at night see nocturnal enuresis (NE) Vincent’s curtsey 321, 322 Red Flags 186 psychogenic 323 viral infection Von‐Willebrand disease 380 wheals 348, 349, 352 asthma triggered by 163 urticaria 352, 360, 360 febrile child 146 W wheezes/wheezing 81, 163–164, 164 febrile child with rash 138, 351 waddling gait 87, 87 causes 163, 163 hepatitis 214, 214 waist, circumference, boys 75 differential diagnosis 165 leucocytosis 110 waking in night 385 foreign bodies 163, 165, 180 meningitis 114, 235, 235, 236 walking, infants 101, 103, 257 infants 164, 168, 179 pneumonia 177, 179 delay 102, 257, 257, 258, 262, 263 multi‐trigger 163, 164 pyrexia of unknown origin 141, 141 ward of court, child as 42, 64, 395 recurrent, asthma 160, 161, 164, 168 tonsillitis 144, 144–145 warts respiratory failure, history 405 wheezing 163, 164, 165 common 356, 357, 366, 366 viral 163, 164, 165 vision/visual system plantar 357, 366 whey 17 development 10, 10, 13 venereal (condylomata acuminata) white cell count 108 examination 96, 96 366, 366 increased 110, 379 infants 91, 96, 105 water, body 416 reduced 110 visual acuity 250 excess 111 whole exome sequencing 121 subnormal (amblyopia) 234, 250, 250 intra‐/extracellular compartments 124 whole genome sequencing 121 testing 34, 35, 96 loss 113 whooping cough see pertussis (whooping visual defect/deficits waterhammer pulse 76 cough) amblyopia 234 Waterhouse–Friderichsen syndrome 154 ‘wiggly finger’ test 96, 96 blindness 274–276, 275 weaning 19, 19, 20 Wilm’s tumour 53, 324, 324 at a glance 275 weight withdrawal of treatment management 275, 275–276 assessment 72 ethical issues 42 partial sight 274–276, 275 control, type 2 diabetes 305 of intensive care, ethics 41–42 refractive errors 248, 248–249 dehydration assessment 416, 417, 417 professionals’ ethical conflicts 42–43 visual evoked response (VER) testing 275 in diarrhoea 188, 190 workplace‐based assessments (WPBA) 3 visual fields, assessment 96, 96 failure to gain 283 World Health Organization (WHO) 15, 19 visual reflexes, assessment 96–97, 105 faltering 283, 284, 285, 291, 397 growth charts 73, 73 vital signs, neonates 431, 437 differential diagnosis, clues 285–286 written case reports 3 vitamin management 285, 285 written examinations 3 deficiency, in cirrhosis 215 fluid requirements based on 418, 418 supplements, infants 19 gain, excessive X vocal fremitus, tactile 81 avoidance, in bottle feeding 18 X‐ray, chest see chest X‐ray vocal resonance 81 identification, growth monitoring 35 xanthine derivatives 436, 441 vocalization, development 13, 103, height discrepancies 280 103–105 intrauterine growth retardation Z voluntary organizations 48, 50, 51 434, 435 zidovudine 157 volvulus 444 loss zinc deficiency 111

0004765449.INDD 520 6/18/2020 8:16:26 PM 0004765449.INDD 521 6/18/2020 8:16:26 PM 0004765449.INDD 522 6/18/2020 8:16:26 PM