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…
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…
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…
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…
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…
Acknowledgment The editors gratefully acknowledge contributions by Drs. Jennifer Duchon, Alexis M. Elward, David A. Hunstad, Lisa Saiman, and Joseph W. St. Geme III that were retained from previous editions of Pediatric Secrets. Anti-infective therapy Key Points: Anti-Infective Therapy 1. Formal allergy testing is frequently negative in patients who report a penicillin allergy. 2. Rashes seen with viral or bacterial illnesses may confound a history of…
Acknowledgment The editors gratefully acknowledge contributions by Dr. Anne F. Reilly, Dr. Greg A. Holländer, and Dr. Anders Fasth that were retained from previous editions of Pediatric Secrets . Bone marrow failure 1 What are the types of bone marrow failure? Bone marrow failure is manifested by pancytopenia or, at times, by cytopenia of a single cell type. It can be acquired (acquired aplastic anemia) or…
Acknowledgment The editors gratefully acknowledge contributions by Drs. Elaine H. Zackai, JoAnn Bergoffen, Alan E. Donnenfeld, and Jeffrey E. Ming that were retained from previous editions of Pediatric Secrets . Clinical Issues 1 Which disorders with ethnic and racial predilections most commonly warrant maternal screening for carrier status? See Table 8.1 . Table 8.1 Maternal Screening According to Ethnic and Racial Predilections Disorder Ethnic or Racial…
Acknowledgment The editors gratefully acknowledge contributions by Drs. Douglas Jacobstein, Candi Jump, Chris A. Liacouras, Peter Mamula, Jonathan E. Markowitz, Amanda Muir, David A. Piccoli, Orith Waisbourd-Zinman, and Danielle Wendel that were retained from previous editions of Pediatric Secrets . Clinical issues 1 What is the definition of failure to thrive? Failure to thrive (FTT) is a sign, not a diagnosis, and not a syndrome. It…
Acknowledgment We would like to thank Dr. Daniel E. Hale for his significant contributions to this text as one of the original authors of the chapter, as well as Dr. Mary Patricia Gallagher and Dr. Marisa Censani for their work in the most recent prior versions. Adrenal disorders 1 What are the symptoms of adrenal insufficiency? Newborns: Nonspecific findings of vomiting, irritability, and poor weight gain;…
Acknowledgment The editors gratefully acknowledge contributions by Dr. Jane Lavelle and Dr. Fred Henretig that were retained from previous editions of Pediatric Secrets . Bioterrorism 1 Why are children more vulnerable to biologic agents than adults? Anatomic and physiologic differences: Thinner dermis, increased surface area–to–volume ratio, smaller relative blood volume, higher minute ventilation Developmental considerations: Inability to flee dangerous situations, possible increased risk for posttraumatic stress…
Acknowledgment The editors gratefully acknowledge contributions by Dr. Robert Hayman, Dr. Leonard Kristal, and Dr. Vivian Lombillo that were retained from previous editions of Pediatric Secrets. Acne 1 When is acne most likely to develop? The development of microcomedones is typically the earliest sign of acne. Studies have shown that comedones occur in three-fourths of premenarchal girls at an average age of 10 years and in…
Acknowledgment The editors gratefully acknowledge the contributions by Dr. Bernard J. Clark III that were retained from previous editions of Pediatric Secrets . Clinical issues 1 Is cardiac disease the most common cause of chest pain in children? A cardiac cause of chest pain is very uncommon and represents less than 1% of cases in a published series. The most common identifiable causes involve musculoskeletal pain…
Acknowledgment The editors gratefully acknowledge contributions by Drs. Nathan J. Blum, Mark Clayton, and James Coplan that were retained from previous editions of Pediatric Secrets . Attention-deficit/hyperactivity disorder 1 What are the characteristics of attention-deficit/hyperactivity disorder (ADHD)? ADHD is a chronic neurodevelopmental and behavioral disorder, considered to have neurobiologic origins, that is diagnosed on the basis of the number, severity, and duration of three clusters of…
Clinical issues 1 How does the “HEEADSSSS” mnemonic assist in adolescent interviewing? This mnemonic allows for a systematic approach to the evaluation of multiple health issues and risk factors that affect teenagers: H–Home (living arrangement, family relationships, support) E–Education (school issues, study habits, achievement, expectations) E–Eating (healthy eating lifestyle, binge, purge, restricting, food security) A–Activities (recreation, friends, exercise, employment) D–Drugs (alcohol, tobacco, marijuana, cocaine, pills, etc.)…
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Introduction Although ☆ Editor’s note: In this chapter the authors share how to set up a headache clinic that is multidisciplinary and comprehensive. They show the data that these clinics work to improve outcome for patients and families. They give advice on how to convince skeptics that such an approach is helpful. I would add that in addition to sharing data, bringing a patient and family…
Health-care transition from a child-centered to an adult-oriented health system is a planned process aimed at ensuring continuity of care and patients’ adherence to medical care, with an emphasis on promoting active involvement of the patients, whenever possible. The lack of a structured transition plan can lead to disruption of health care, higher emergency room and hospital visits, higher health-care costs, and poor medical compliance. Similar…
Headache expert perspective Migraine is the most common neurological disease and, in adults, it has the largest overall impact after stroke, and the largest effect on disability. Relative to its huge impact, society allocates to migraine only a small fraction of the resources it should be getting from the research community and the treatment infrastructure. This is in part due to the stigmatization of the headache…
Epidemiology Loss of smell is increasingly being recognized by the fifth decade of life, and an inability to smell or a diminished sense of smell is present in 3 to 20% of the population. Nevertheless, these disorders are often neglected because they are not fatal and, unlike abnormalities of vision and hearing, are not considered serious handicaps. Recently, however, loss of taste and smell has been…