Manual of clinical problems in pediatrics : with annotated key references

553 Pages·2001·3.06 MB·English

by  Kenneth B. Roberts MD

Manual of Clinical 
Problems in Pediatrics with 
annotated key references 

Fifth Edition
2001
Lippincott Williams & Wilkins
Philadelphia
530 Walnut Street, Philadelphia, PA 19106 USA, LWW.com
0-7817-2893-2
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including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright
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Printed in the USA
Library of Congress Cataloging-in-Publication Data
Manual of clinical problems in pediatrics: with annotated key references / edited by Kenneth B. Roberts.—5th ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 0-7817-2893-2
1. Pediatrics—Handbooks, manuals, etc. I. Roberts, Kenneth B., 1944-
[DNLM: 1. Pediatrics—Handbooks. WS 39 M294 2001]
RJ48 .M36 2001
618.92—dc21
00-042823
Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However,
the authors, editor, and publisher are not responsible for errors or omissions or for any consequences from application of the
information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of
the contents of the publication. Application of this information in a particular situation remains the professional responsibility of the
practitioner.
The authors, editor, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in
accordance with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in
government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to
check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is
particularly important when the recommended agent is a new or infrequently employed drug.
Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in
restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device
planned for use in their clinical practice.
10 9 8 7 6 5 4 3 2 1
Editor
University of North Carolina School of Medicine, Chapel Hill;
Kenneth B. Roberts M.D.
Director, Pediatric Teaching Program, Moses Cone Health
Professor of Pediatrics System, Greensboro, North Carolina
Secondary Editors
Timothy Y. Hiscock Manufacturing Manager
Acquisitions Editor Patricia Gast
Cover Designer
Selina M. Bush
Circle Graphics
Developmental Editor Compositor
John C. Vassiliou
R.R.Donnelley-Crawfordsville
Production Editor Printer
Benjamin Rivera
CONTRIBUTING AUTHORS
Olakunle B. Akintemi M.B.B.S. Assistant Professor of Pediatrics
University of North Carolina School of Medicine, Chapel Hill;
Associate Professor of Pediatrics
Active Staff Physician of Pediatrics, Pediatric Teaching
University of North Carolina School of Medicine, Chapel Hill;
Program, Moses Cone Health System, Greensboro, North
Attending Physician, Pediatric Teaching Program, Moses Cone
Carolina
Health System, Greensboro, North Carolina
Craig A. Alter M.D. Richard A. Cohn M.D.
Assistant Professor of Pediatrics Associate Professor of Pediatrics
University of Pennsylvania School of Medicine; Pediatric Northwestern University Medical School; Medical Director,
Endocrinologist, Department of Pediatrics, Children's Kidney Transplantation, Children's Memorial Hospital,
Hospital of Philadelphia, Philadelphia, Pennsylvania Chicago, Illinois
Julie Blatt M.D. William Jerry Durbin M.D.
Professor of Pediatric Hematology-Oncology Professor of Pediatrics and Medicine
University of North Carolina School of Medicine, Chapel Hill, University of Massachusetts Medical School; Director,
North Carolina Pediatric Infectious Disease, University of Massachusetts
Memorial Healthcare, Worcester, Massachusetts
Maria T. Britto M.D., M.P.H.
Marian F. Earls M.D., F.A.A.P., M.T.S.
Assistant Professor of Pediatrics and Internal Medicine
University of Cincinnati College of Medicine; Assistant Clinical Associate Professor of Pediatrics
Professor, Division of Adolescent Medicine, Children's University of North Carolina School of Medicine, Chapel Hill;
Hospital Medical Center, Cincinnati, Ohio Medical Director, Guilford Child Health, Inc., Moses Cone
Health System, Greensboro, North Carolina
Rosalind S. Brown M.D., F.R.C.P.
E. Kaye Gable M.D.
Professor of Pediatrics
University of Massachusetts Medical School; Director, Clinical Associate Professor of Pediatrics
Division of Pediatric Endocrinology/Diabetes, University of University of North Carolina School of Medicine, Chapel Hill;
Massachusetts Memorial Health Care, Worcester, Associate Program Director, Pediatric Teaching Program,
Massachusetts Moses Cone Health System, Greensboro, North Carolina
Evan Charney M.D. Kristen B. Geib R.N., M.S.N., C.P.N.P., C.P.O.N.
Professor of Pediatrics Clinical Assistant Professor of Pediatrics
University of Massachusetts Medical School; Chair Emeritus, University of North Carolina School of Medicine, Chapel Hill,
Department of Pediatrics, University of Massachusetts North Carolina
Memorial Medical Center, Worcester, Massachusetts
Laura L. Gibson M.D.
Conrad J. Clemens M.D., M.P.H.
Fellow in Infectious Disease
University of Massachusetts Medical School; Fellow in
Resident in Pediatrics
Infectious Disease, University of Massachusetts Memorial
University of Massachusetts Medical School; Resident in
Health Care, Worcester, Massachusetts
Pediatrics, University of Massachusetts Memorial Health Care,
Worcester, Massachusetts
Stuart H. Gold M.D.
Associate Professor of Pediatrics Pamela J. Reitnauer M.D., Ph.D.
University of North Carolina School of Medicine, Chapel Hill,
Assistant Professor of Pediatrics
North Carolina
University of North Carolina School of Medicine, Chapel Hill;
Assistant Professor, Pediatric Teaching Program, Moses Cone
Adda Grimberg M.D.
Health System, Greensboro, North Carolina
Assistant Professor of Pediatrics
University of Pennsylvania Abramson Research Center; Kenneth B. Roberts M.D.
Attending Physician, Division of Pediatric Endocrinology,
Professor of Pediatrics
Children's Hospital of Philadelphia, Philadelphia,
University of North Carolina School of Medicine, Chapel Hill;
Pennsylvania
Director, Pediatric Teaching Program, Moses Cone Health
System, Greensboro, North Carolina
Lawrence K. Jung M.D.
Associate Professor of Pediatrics/Rheumatology and Beth A. Rosen M.D.
Immunology Assistant Professor of Pediatrics
Creighton University School of Medicine; Head, Division of Tufts University School of Medicine, Boston; Pediatric
Rheumatology and Immunology, Children's Hospital, Omaha, Neurologist, Baystate Medical Center, Springfield,
Nebraska Massachusetts
Andrea Kelly M.D. Denver Sallee M.D.
Fellow in Pediatric Endocrinology Assistant Professor of Pediatrics
University of Pennsylvania School of Medicine; Fellow in Case Western Reserve University School of Medicine;
Pediatric Endocrinology, Children's Hospital of Philadelphia, Pediatric Cardiologist, Rainbow Babies and Children's
Philadelphia, Pennsylvania Hospital, Cleveland, Ohio
John R. Lane M.D. Dennis C. Stokes M.D.
Assistant Professor of Pediatrics and Medicine Associate Professor of Pediatrics
Case Western Reserve University School of Medicine; Vanderbilt University School of Medicine; Director,
Attending Physician, Departments of Pediatrics and Medicine Vanderbilt Cystic Fibrosis Center, Vanderbilt University
(Cardiology), University Hospitals of Cleveland, Cleveland, Medical Center, Nashville, Tennessee
Ohio
Spencer G. Weig M.D.
Chon Lee M.D.
Associate Professor of Neurology
Clinical Assistant Professor of Pediatrics Albany Medical College; Section Head, Child Neurology,
University of North Carolina School of Medicine, Chapel Hill; Albany Medical Center, Albany, New York
Active Staff Physician of Pediatrics, Moses Cone Health
System, Greensboro, North Carolina Stuart A. Weinzimer M.D.
Assistant Professor of Pediatrics
Margaret E. Mohrmann M.D., Ph.D.
University of Pennsylvania School of Medicine; Attending
Associate Professor of Medical Education and Pediatrics Physician of Pediatrics, Division of Pediatric
University of Virginia School of Medicine; Pediatrician, Endocrinology/Diabetes, Children's Hospital of Philadelphia,
University of Virginia Hospital, Charlottesville, Virginia Philadelphia, Pennsylvania
Brian P. O'Sullivan M.D. Brent W. Weston M.D.
Associate Professor of Pediatrics Associate Professor of Pediatrics
University of Massachussetts Medical School; Pediatric University of North Carolina School of Medicine; Attending
Pulmonologist, University of Massachusetts Memorial Helath Physician of Pediatric Hematology/Oncology, University of
Care, Worcester, Massachusetts North Carolina Hospitals, Chapel Hill, North Carolina
Alan P. Picarillo M.D. Robert D. White M.D.
Assistant Clinical Professor of Pediatrics
Indiana University School of Medicine, Indianapolis; Director,
Regional Newborn Program, Memorial Hospital, South Bend,
Indiana
Karen Wiss M.D.
Associate Professor of Medicine (Dermatology) and Pediatrics
University of Massachusetts Medical School; Director,
Pediatric Dermatology, University of Massachusetts Memorial
Health Care, Worcester, Massachusetts
Kathryn R. Wyatt Ph.D.
Clinical Assistant Professor of Pediatrics
University of North Carolina School of Medicine, Chapel Hill;
Pediatric Psychologist, Pediatric Teaching Program, Moses
Cone Health System, Greensboro, North Carolina
Kenneth G. Zahka M.D.
Associate Professor of Pediatrics
Case Western Reserve University School of Medicine; Director,
Pediatric Cardiology, Rainbow Babies and Children's Hospital,
Cleveland, Ohio
Dedication
From inability to let well alone; from too much zeal for the new and contempt for what is old; from putting knowledge before
wisdom, science before art, and cleverness before common sense, from treating patients as cases, and from making the cure of the
disease more grievous than the endurance of the same, Good Lord, deliver us.
SIR ROBERT HUTCHISON
British Medical Journal 1:671, 1953
May those who use the information in this book apply it wisely and gently.
–FROM THE SECOND EDITION
PREFACE
WHY DO YOU NEED THIS MANUAL? There are other small texts, of course, and there is Medline. So why is this Manual unique and
useful? Mainly because the text is brief and compact, so you don't need to wade through lengthy chapters, and the references have
been carefully selected and are annotated, so you don't have to spend hours with Medline trying to identify which articles are worth
your time. That's the overview; here are some details:
• Basic material is included in the text; sources of more advanced or detailed information are listed in the annotated
references at the end of each chapter.
• General principles of treatment are provided in the text, but specifics are not. (Consult the annotated references or The
Children's Hospital of Boston Manual of Pediatric Therapeutics in the Lippincott Williams & Wilkins Spiral Manual series.)
• The references are categorized, progressing from general reviews to specific issues. Frequently, though, the best discussion
of a specific issue is provided in an article or collection listed with the general reviews. Therefore, check the beginning
section of the references first.
• In selecting references, preference was given to those most easily accessible and to reviews, both editorial and
comprehensive, with good bibliographies. These criteria permitted the number of references to be limited to 20 to 30 per
chapter. We could not resist sneaking in additional references, however, for a total of well over 3,000.
The contributing authors have been most gracious in accepting editorial comments. I am grateful to them, to medical librarian-
extraordinaire, Leslie Mackler for her expertise and generous, helpful assistance, and to Ellen Roberts, who helped put this Manual
together just as she has kept me together for more than 30 years.
Enjoy!
Kenneth B. Roberts M.D.
Contents
Dedication
PREFACE
Contents
I EMERGENCIES
1. CARDIOPULMONARY ARREST AND RESUSCITATION
2. BACTEREMIA AND SEPTICEMIA
3. MENINGITIS
4. UPPER AIRWAY OBSTRUCTION
5. RESPIRATORY FAILURE AND STATUS ASTHMATICUS
6. DIABETIC KETOACIDOSIS
7. ACUTE ABDOMEN
8. ACUTE RENAL FAILURE
9. INCREASED INTRACRANIAL PRESSURE
10. STATUS EPILEPTICUS
11. HEAD TRAUMA
12. ACCIDENTAL INJURIES AND INJURY CONTROL
13. ACUTE POISONING
14. FEVER AND ANTIPYRESIS
15. LEAD POISONING
16. CHILD ABUSE AND NEGLECT
17. SUDDEN INFANT DEATH SYNDROME
II GROWTH, DEVELOPMENT, AND BEHAVIOR
18. CHILD HEALTH SUPERVISION
19. PHYSICAL GROWTH
20. INFANT FEEDING AND NUTRITION
21. FAILURE TO THRIVE
22. OBESITY
23. DEVELOPMENT AND DEVELOPMENTAL DISABILITIES
24. ATTENTION DEFICIT HYPERACTIVITY DISORDER
25. SLEEP
26. BOWEL TRAINING, CONSTIPATION, AND ENCOPRESIS
27. BLADDER CONTROL AND ENURESIS
28. RECURRENT PAIN SYNDROMES: ABDOMINAL PAIN, HEADACHE, AND CHEST PAIN
29. SEXUAL DEVELOPMENT
30. ADOLESCENT GYNECOLOGY
31. EATING DISORDERS
32. SUBSTANCE USE AND ABUSE
33. SUICIDE
34. DEATH, DYING, AND MOURNING
III THE NEONATE
35. ASSESSMENT OF THE NEWBORN
36. RESPIRATORY DISTRESS SYNDROME
37. CHRONIC LUNG DISEASE
38. APNEA IN THE PREMATURE INFANT
39. CYANOTIC HEART DISEASE
40. CONGESTIVE HEART FAILURE IN THE NEONATE
41. TRANSIENT METABOLIC DISTURBANCES
42. NEONATAL SEIZURES
43. HYPERBILIRUBINEMIA
44. NUTRITION IN THE ILL NEONATE
45. NECROTIZING ENTEROCOLITIS
46. SURGICAL EMERGENCIES
47. CONGENITAL INFECTIONS
48. NEONATAL SEPSIS
49. INTRACRANIAL HEMORRHAGE IN THE NEWBORN
50. RETINOPATHY OF PREMATURITY
IV CARDIOVASCULAR DISORDERS
51. SYSTOLIC MURMURS
52. LEFT-TO-RIGHT SHUNTS: VENTRICULAR SEPTAL DEFECT AND PATENT DUCTUS ARTERIOSUS
53. TETRALOGY OF FALLOT
54. TRANSPOSITION OF THE GREAT ARTERIES
55. ARRHYTHMIAS
56. MYOPERICARDITIS AND CARDIOMYOPATHY
57. BACTERIAL ENDOCARDITIS
58. HYPERTENSION