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Nutrition

Learning objectives By the end of this chapter the reader should: Understand the principles of body composition in children and its assessment Understand the scientific basis of nutrition Understand the physiological basis of normal enteral nutrition and its variation throughout childhood Know the constituents of a healthy diet at all ages, including breastfeeding and formula feeding in infancy Know the constitution of infant feeds commonly used…

Growth and puberty

Learning objectives By the end of this chapter the reader should: Understand the basic principles underpinning normal growth Understand growth measurement and charts and their interpretation Be able to identify abnormal growth patterns Know about the genetic and environmental factors that influence growth Know the common causes and assessment and investigation of short stature Know the common causes of tall stature Understand the causes and how…

Neonatal medicine

Learning objectives By the end of this chapter the reader should: Understand the scientific basis of diseases and conditions affecting the newborn, including the consequences of prematurity Know about the acquired infections in newborn infants Know about the physiology and principles of treatment of jaundice in the neonatal period Understand the causes and mechanism and sequelae of brain injury in term infants Know about the pathophysiology…

Perinatal medicine

Learning objectives By the end of this chapter the reader should: Know the definitions used in perinatal medicine and their uses and limitations Know about pre-pregnancy and prenatal conditions which may affect the fetus Understand the difference and importance of small for gestational age and intrauterine growth restriction Understand how multiple births may affect the fetus Be aware of the embryology of the human fetus and…

Genetics

Learning objectives After reading this chapter the reader should: Understand the scientific basis of genetic disorders and the patterns of inheritance they show Know how to use this knowledge to frame the important clinical aspects of the disorders commonly encountered in paediatric practice Understand the principles underpinning malformation disorders Understand the scientific basis and clinical use of chromosome and molecular genetic tests including karyotype, fluorescence in…

Child protection

Learning objectives By the end of this chapter the reader should: Be aware of the epidemiology of child abuse Appreciate why recognition and response is important Know why recognition and response to child maltreatment is difficult Have a framework for assessment and management of a child with suspicion or allegation of maltreatment, including physical abuse, sexual abuse, neglect, emotional abuse and fabricated illness Child abuse exists…

Accidents and poisoning

Learning objectives By the end of this chapter the reader should: Understand the epidemiology and psychosocial links of accidents in children Understand the physiological and metabolic mechanisms and consequences of accidents, including trauma, drowning, inhalation Understand the concept of SIDS (sudden infant death syndrome) and its prevention Understand the mode of action, physiological and metabolic mechanisms and consequences of poisoning in children Accidents Traumatic injury is…

Paediatric emergencies and critical care

Learning objectives By the end of this chapter the reader should: Understand the scientific basis for the recognition and management of the seriously ill or injured child Understand the science underpinning basic and advanced life support Know how to interpret blood gas abnormalities Understand the pathophysiology of respiratory failure Understand the scientific basis of respiratory support including mechanical ventilation in children Know about the basis for…

Developmental problems and the child with special needs

Learning objectives By the end of this chapter the reader should: Be aware of the epidemiology of neurodisability Know about the aetiology, different clinical patterns and management of cerebral palsy Know about the causes of impaired development and regression Know about attention deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASD) and developmental coordination disorder (DCD) Question 5.1 The epidemiology of disability Which of the following statements…

Normal child development

Learning objectives By the end of this chapter the reader should: Have an understanding of normal child development Understand the scientific basis of normal development Be aware of the theory and tools available for assessment Understand the concept of ‘red flags’ and limit ages for developmental milestones Understand the importance of repeated developmental assessment over time Understand the basis of the Healthy Child Programme Introduction One…

History and examination

Learning objectives By the end of this chapter the reader should: Understand the importance of history and examination in securing a diagnosis Know where and how history has its limitations Understand how the history usually gives important clues to diagnosis Know how elements of the history may be used to more effectively target your physical examination Understand the value of the clinical examination and the science…

Epidemiology and public health

Learning objectives By the end of this chapter the reader should: Understand how disease and health is measured in populations or groups and be able to use measures of disease incidence and prevalence Understand and be able to use measures of effect (e.g. relative risk, absolute risk and number needed to treat) Know the main indices of population child health and their significance Know the strengths…

The role of science and research in paediatrics

Learning objectives By the end of this chapter the reader should know: Why science and research are relevant to all paediatricians, not just scientists and academics Why children's biomedical research is essential The relevance of synthesizing existing evidence and identifying gaps How children's research has evolved Why contributing to research to reduce uncertainties in care is a clinical obligation How to acquire research skills How and…

Rheumatology

Clinical issues 1 What is an antinuclear antibody (ANA)? ANA is made up of circulating γ-globulins directed against several known and unknown nuclear proteins. Unfortunately, the classic immunofluorescence technique is being replaced by a still nonvalidated enzyme-linked immunosorbent assay (ELISA) technique to save costs. When it is measured by an immunofluorescent technique, it is also called fluorescent antinuclear antibody (FANA). It is expressed as a titer,…

Pulmonology

Acknowledgment The editor gratefully acknowledges contributions by Drs. Robert W. Wilmott, Bradley A. Becker, Ellen R. Kaplan, Carlos R. Perez, William D. Hardie, Barbara A. Chini, and Cori L. Daines that were retained from previous editions of Pediatric Secrets . Allergic rhinitis 1 How common is allergic rhinitis? Very common . Ten percent to 30% of children and adults in the developed world experience allergic rhinitis,…

Orthopedics

Acknowledgment The editors gratefully acknowledge contributions by Drs. Francis Y. Lee, John P. Dormans, Richard S. Davidson, Mark Magnusson, David P. Roye, and Joshua E. Hyman that were retained from earlier editions of Pediatric Secrets . Clinical issues 1 If a newborn infant is not moving one arm spontaneously, what could be the problem? You need to determine whether the baby is not moving because he…

Oncology

Acknowledgments The editors gratefully acknowledge contributions by Drs. Peter Adamson, Richard Aplenc, Emily Lipsitz, and Kerice Pinkney, as well as from all of the previous authors, that were retained from prior editions of Pediatric Secrets . Chemotherapy and radiation therapy 1 What are the most common cytotoxic chemotherapeutic drug classes, and in which cell cycle phase are they the most active? Chemotherapeutic drugs are usually classified…

Neurology

Acknowledgment The editors and the author gratefully acknowledge contributions by Drs. Kent R. Kelly, Douglas R. Nordli Jr., Peter Bingham, and Robert R. Clancy that were retained from earlier editions of Pediatric Secrets . Antiepileptic drugs 1 Should treatment with antiepileptic drugs (AEDs) be started after the first afebrile seizure in a child? Children with an isolated, uncomplicated seizure usually do not require AED therapy. Epidemiologic…

Nephrology

Acknowledgment The editors gratefully acknowledge contributions by Drs. Michael Norman, Thomas Kennedy, James Prebis, and Stephen J. Wassner that were retained from the first editions of Pediatric Secrets . Acid–base, fluids, and electrolytes 1 How do you assess a child with hyponatremia? The serum sodium concentration, even in states of volume depletion, reflects the extracellular water or volume status. In children presenting with hyponatremia, the volume…

Neonatology

Acknowledgment The editors gratefully acknowledge contributions by Drs. Philip Roth, Mary Catherine Harris, Carlos Vega-Rich, and Peter Marro that were retained from the previous editions of Pediatric Secrets . Delivery room issues 1 When should the umbilical cord be clamped after birth? Obstetric and midwifery practice has varied in the timing of umbilical cord clamping over the last 50 years from immediately clamping the cord after…