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Gastroenterology and hepatology

After reading this chapter you should be able to assess, diagnose and manage: conditions presenting with the common symptoms of abdominal disease conditions resulting in malabsorption diseases and disorders of the pancreas diseases and disorders of the liver congenital malformations and surgical disorders of the gastrointestinal tract and liver Gastrointestinal conditions commonly present with the following symptoms: abdominal pain changes in stool consistency and frequency vomiting…

Hearing and ENT

After reading this chapter you should be able to assess, diagnose and manage hearing impairment conditions affecting the ears, nose and throat including epistaxis Hearing Impairment Paediatric hearing impairment impacts negatively on the speech, language, social, emotional and educational development of a child and should be considered as a cause in any child with speech, learning or behavioural difficulties. Prevention, timely diagnosis and early intervention of…

Respiratory

After reading this chapter you should be able to assess, diagnose and manage: chronic cough wheezing illnesses lower respiratory tract infection cystic fibrosis presentation sleep disordered breathing life-threatening events including sudden unexpected death in infancy and select and interpret appropriate respiratory investigations understand the indications for long-term ventilation and respiratory support Respiratory investigations Blood gases Values for carbon dioxide and pH do not differ markedly between…

Cardiology

After reading this chapter you should: understand investigation of cardiac diseases, e.g. ECG, echocardiograms, cardiac catheterisation and their appropriate selection in diagnosis and management know the various presentations of congenital heart problems and to be able to assess, diagnose and manage be able to assess, diagnose and manage murmurs, chest pain, palpitations, cardiac arrhythmias and syncope be able to assess, diagnose and manage heart failure, myocarditis,…

Immunology

After reading this chapter you should: primary and secondary immunodeficiency understand the presentation and management of autoimmune disorders The impact of an infection depends on many factors including those of the host, those of the infecting organism and those of the environment including access to medical care. Recurrent infection is seen frequently in paediatric practice and there is often a need to assess whether this is…

Allergy

After reading this chapter you should be able to: to assess, diagnose and manage allergies Allergic conditions can present in a wide variety of ways from mild episodic rashes through to dramatic, rapid-onset, life-threatening illness. Many symptoms are common to those seen in other conditions and consequently the true aetiology can be missed and inappropriate diagnoses and management plans provided. Similarly, an incorrect allocation of an…

Infection control

After reading this chapter you should: be able to follow the UK national guidelines on notification of communicable diseases know the principles of infection control be able to advise on immunisation in children with certain medical conditions know about the appropriate use of antimicrobials know the current infection control strategies for local, epidemic and pandemic infections Notification of communicable diseases Public health services in the UK…

Infectious diseases

After reading this chapter you should: be able to assess, diagnose and manage infections acquired in the UK and overseas Infections acquired in the UK Infections present at all ages, in any organs and can cause mild or life-threatening illness. They can present with symptoms that are nonspecific, particularly in younger infants, where it can be difficult to distinguish between viral and bacterial infection. Clinical presentation…

Safeguarding

After reading this chapter you should be able to: recognise the different presentations of abuse assess and manage abuse and fabricated illness know the emotional and behavioural consequence of abuse and neglect Safeguarding children is the responsibility of everyone Parents, wider family members, carers, teachers, health professionals, law enforcement agencies and society at large must have a role in protecting children and young people from physical…

Fluids and electrolyte management

After reading this chapter you should: be able to assess, diagnose and manage fluid and electrolyte disturbances be able to assess, diagnose and manage disorders of acid-base balance (included elsewhere) An understanding of fluid and electrolyte requirements in children and young people is of major clinical importance. Patients who are well may need little intervention with their fluid requirements, but an assessment should always be made…

Unintentional injuries and poisoning

After reading this chapter you should be able to assess, diagnose and manage: unintentional injuries including trauma and drowning life-threatening haemorrhage head and spinal injuries burns and scalds life- or limb-threatening injuries injuries that can be managed less urgently and their x-ray appearances poisoning Unintentional injuries Children and young people can present to the emergency department with significant and life-threatening injuries. Their emergency care and management…

Emergency medicine

After reading this chapter you should be able to assess diagnose and manage: cardiac arrest shock anaphylaxis and acute upper airways obstruction acute seizures acute neurological emergencies Children and young people frequently present to emergency departments with overwhelming and life-threatening acute conditions. Prompt assessment and management is crucial and requires the coordinated effort of skilled paediatric practitioners. Basic life support When any vulnerable children (premature infants…

Behavioural medicine and mental health

After reading this chapter you should: be able to assess, diagnose and manage common emotional and behavioural problems know about the effects of physical diseases on behaviour and vice versa know and understand the presentation of conduct disorders and antisocial behaviour understand the role of Child and Adolescent Mental Health Services (CAMHS) be able to assess and diagnose important mental health problems be able to identify…

Nutrition

After reading this chapter you should be able to assess, diagnose and manage: problems arising during the establishment of infant feeding regimes malnutrition, obesity and their complications specific vitamin, mineral and micronutrient deficiencies The assessment of nutrition in paediatric practice requires an understanding of the requirements through the periods of growth and development along with an appreciation of the actual intake and content of fluids and…

Genetics and dysmorphology

After reading this chapter you should: be able to explain and provide advice regarding patterns of inheritance be able to diagnose and manage common genetic and dysmorphological conditions be able to discuss the role of pre- and postnatal genetic investigations understand the effects of environmental factors affecting the fetus Patterns of inheritance Chromosomal abnormality and mutations There are many conditions seen in paediatric practice that are…

Growth and puberty

After reading this chapter you should: know the causes of problems relating to growth and puberty be able to assess, diagnose and manage problems relating to growth and puberty Disorders of growth Growth is an excellent clinical tool to help distinguish between health and disease in any child in any setting and can be affected by genetics, nutrition and pathology in any system. It is a…

Adolescent medicine

After reading this chapter you should be able to: manage transition of adolescents with chronic health needs to adult services assess and diagnose risk-taking behaviours including non-adherence, self-harm, alcohol and substance misuse and make appropriate referral to specialist services to assess, diagnose and manage eating disorders and know the risks and complications of treatment to assess, diagnose and manage problems relating to sexual health including contraception,…

Neonatology

After reading this chapter you should be able to diagnose and manage: birth injury short and long-term consequence of preterm birth common medical conditions common surgical conditions congenital anomaly common postnatal problems and know the effect of prenatal and perinatal events on neonates Antenatal assessment of fetal growth Antenatal assessment of the mother and fetus requires a comprehensive history and examination, investigations for potential congenital infections…

Preparing for the AKP exam

After reading this chapter you should understand: the structure and format of the AKP examination the range of topics covered by the syllabus the style of questions presented in the examination how each question is produced and reviewed advice on some aspects of examination preparation The Applied Knowledge in Practice (AKP) examination is one of the three theory exams that must be passed before a candidate…

Necrotizing enterocolitis

Introduction Infants in the neonatal intensive care unit (NICU) are faced with several debilitating diseases that significantly increase the rates of morbidity and mortality. Many of these illnesses are not greatly understood, and many theories have been postulated in terms of pathogenesis and diagnostic and treatment approaches. One of these diseases is necrotizing enterocolitis (NEC), which largely affects premature infants by causing intestinal gut necrosis. There…