Pediatric Emergency Medicine Chief Complaints and Diferential Diagnosis PDF
Preview Pediatric Emergency Medicine Chief Complaints and Diferential Diagnosis
Cambridge University Press 978-1-316-60886-9 — Pediatric Emergency Medicine Edited by Rebecca Jeanmonod , Shellie L. Asher , Blake Spirko , Foreword by Denis R. Pauze Frontmatter More Information Pediatric Emergency Medicine Chief Complaints and Diferential Diagnosis © in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-316-60886-9 — Pediatric Emergency Medicine Edited by Rebecca Jeanmonod , Shellie L. Asher , Blake Spirko , Foreword by Denis R. Pauze Frontmatter More Information Pediatric Emergency Medicine Chief Complaints and Diferential Diagnosis Editedby RebeccaJeanmonod St.Luke’sUniversityHealthNetwork,Bethlehem,PA,USA ShellieAsher AlbanyMedicalCenter,Albany,NY,USA BlakeSpirko BaystateMedicalCenter,Springield,MA,USA DenisR.Pauze´ AlbanyMedicalCenter,Albany,NY,USA © in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-316-60886-9 — Pediatric Emergency Medicine Edited by Rebecca Jeanmonod , Shellie L. Asher , Blake Spirko , Foreword by Denis R. Pauze Frontmatter More Information UniversityPrintingHouse,CambridgeCB28BS,UnitedKingdom OneLibertyPlaza,20thFloor,NewYork,NY10006,USA 477WilliamstownRoad,PortMelbourne,VIC3207,Australia 4843/24,2ndFloor,AnsariRoad,Daryaganj,Delhi-110002,India 79AnsonRoad,#06-04/06,Singapore079906 CambridgeUniversityPressispartoftheUniversityofCambridge. ItfurtherstheUniversity’smissionbydisseminatingknowledgeinthepursuitof education,learning,andresearchatthehighestinternationallevelsofexcellence. www.cambridge.org Informationonthistitle:www.cambridge.org/9781316608869 DOI:10.1017/9781316652923 (cid:2)C CambridgeUniversityPress2018 hispublicationisincopyright.Subjecttostatutoryexception andtotheprovisionsofrelevantcollectivelicensingagreements, noreproductionofanypartmaytakeplacewithoutthewritten permissionofCambridgeUniversityPress. Firstpublished2018 PrintedintheUnitedKingdombyTJInternationalLtd.,Padstow,Cornwall AcatalogrecordforthispublicationisavailablefromtheBritishLibrary ISBN978-1-316-60886-9Paperback CambridgeUniversityPresshasnoresponsibilityforthepersistenceoraccuracy ofURLsforexternalorthird-partyinternetwebsitesreferredtointhispublication, anddoesnotguaranteethatanycontentonsuchwebsitesis,orwillremain, accurateorappropriate. ............................................................................ Everyeforthasbeenmadeinpreparingthisbooktoprovideaccurateand up-to-dateinformationwhichisinaccordwithacceptedstandardsandpracticeat thetimeofpublication.Althoughcasehistoriesaredrawnfromactualcases,every eforthasbeenmadetodisguisetheidentitiesoftheindividualsinvolved. Nevertheless,theauthors,editors,andpublisherscanmakenowarrantiesthatthe informationcontainedhereinistotallyfreefromerror,notleastbecauseclinical standardsareconstantlychangingthroughresearchandregulation.heauthors, editors,andpublishersthereforedisclaimallliabilityfordirectorconsequential damagesresultingfromtheuseofmaterialcontainedinthisbook.Readersare stronglyadvisedtopaycarefulattentiontoinformationprovidedbythe manufacturerofanydrugsorequipmentthattheyplantouse. © in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-316-60886-9 — Pediatric Emergency Medicine Edited by Rebecca Jeanmonod , Shellie L. Asher , Blake Spirko , Foreword by Denis R. Pauze Frontmatter More Information Contents ListofContributors pageviii Preface xi ListofAbbreviations xiii ReferenceValues xv 1 AStatement 1 Case4 49 DenisR.Pauze´ ContributingAuthor:AmandaShorette Case5 52 2 Resuscitation 3 ContributingAuthor:M.BryanDalla Case1 3 Betta ContributingAuthor:EricaEscarcega Case6 55 Case2 7 ContributingAuthors:DanielK.Pauze´ ContributingAuthor:MichaelLeonard andDenisR.Pauze´ Case3 10 Case7 59 ContributingAuthor:DonaldJeanmonod ContributingAuthors:BenChurchand Case4 16 RebeccaJeanmonod ContributingAuthors:DenisR.Pauze´ Case8 64 andWilliamH.Hauda ContributingAuthors:NatalieMooreand Case5 19 RebeccaJeanmonod ContributingAuthors:JohnTranand RebeccaJeanmonod 4 Fever 68 Case6 23 Case1 68 ContributingAuthors:RyanFultonand ContributingAuthor:RebeccaJeanmonod MelanieK.Prusakowski Case7 26 Case2 71 ContributingAuthor:ShellieAsher ContributingAuthor:EdwinLayng Case8 29 Case3 73 ContributingAuthors:DavidH.Longand ContributingAuthor:EricaEscarcega Case9 32 JanetYoung Case4 76 ContributingAuthor:SeanZwiebel Case10 35 ContributingAuthor:ShellieAsher Case5 78 ContributingAuthor:SeanZwiebel Case11 38 ContributingAuthors:KristineMarieJ. CasalandMelanieK.Prusakowski ContributingAuthor:BenChurch Case6 81 3 BreathingComplaints 42 ContributingAuthor:TaylorR.Spencer Case1 42 Case7 85 ContributingAuthor:LaurenSnyder ContributingAuthor:SarahHudgins Case2 45 Case8 88 ContributingAuthor:NatalieMoore ContributingAuthor:RebeccaJeanmonod Case3 47 Case9 91 ContributingAuthor:DorkaM.Jime´nez ContributingAuthors:KeelColemanand Almonte KhaliefHamden v © in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-316-60886-9 — Pediatric Emergency Medicine Edited by Rebecca Jeanmonod , Shellie L. Asher , Blake Spirko , Foreword by Denis R. Pauze Frontmatter More Information Contents Case3 206 Case2 255 ContributingAuthor:DenisR.Pauze´ ContributingAuthor:ShellieAsher Case4 209 Case3 257 ContributingAuthor:RebeccaJeanmonod ContributingAuthor:Abhishek Case5 211 Chaturvedi ContributingAuthors:TomWilliams, Case4 260 EmilyMiller,andDenisR.Pauze´ ContributingAuthor:JenniferPelesz Case6 215 Case5 263 ContributingAuthor:RebeccaJeanmonod ContributingAuthor:PamelaYoung Case7 219 Case6 266 ContributingAuthor:KinseyLeonard ContributingAuthor:LeahA.Perez Case8 221 Case7 269 ContributingAuthor:KinseyLeonard ContributingAuthors:ShellieAsherand RebeccaJeanmonod 10 HeadandNeckPain 224 Case1 224 12 SkinComplaints 273 ContributingAuthor:SonikaRaj Case2 226 Case1 273 ContributingAuthor:RebeccaJeanmonod ContributingAuthor:EfratRosenthal Case3 230 Case2 276 ContributingAuthors:TomDittrich, ContributingAuthor:EfratRosenthal DenisR.Pauze´,andMatthewAdamo Case3 278 Case4 234 ContributingAuthors:SundeepM. ContributingAuthors:AnstGelinand ShuklaandRebeccaJeanmonod JanetYoung Case4 282 Case5 236 ContributingAuthor:AmandaShorette ContributingAuthors:ChristineM. Case5 286 GeorgeandMelanieK.Prusakowski ContributingAuthor:BenjaminKitt Case6 240 Case6 288 ContributingAuthor:CarlDaniel ContributingAuthor:RebeccaJeanmonod Case7 243 Case7 291 ContributingAuthors:MichaelLeonard ContributingAuthor:DorkaM.Jime´nez andRebeccaJeanmonod Almonte Case8 247 ContributingAuthor:JasonSchwaber Case9 249 ContributingAuthors:JamaineOrtizJr., RebeccaJeanmonod,CarlDaniel,Denis CaseKey 295 R.Pauze´,andMatthewAdamo Index 296 11 GenitourinaryComplaints 253 Case1 253 Colorplatesaretobefoundbetweenpages152and ContributingAuthor:ShellieAsher 153 vii © in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-316-60886-9 — Pediatric Emergency Medicine Edited by Rebecca Jeanmonod , Shellie L. Asher , Blake Spirko , Foreword by Denis R. Pauze Frontmatter More Information Contributors MatthewAdamo ChristineM.George AlbanyMedicalCenter,Albany,NY CarilionClinic,Roanoke,VA DorkaM.Jime´nezAlmonte KhaliefHamden BaystateMedicalCenter,Springield,MA CarilionClinic,Roanoke,VA ShellieAsher WilliamH.Hauda AlbanyMedicalCenter,Albany,NY InovaFairfaxHospital,FallsChurch,VA M.BryanDallaBetta SarahHudgins BaystateMedicalCenter,Springield,MA St.Luke’sUniversityHealthNetwork,Bethlehem,PA JasonBlack DonaldJeanmonod St.Luke’sUniversityHealthNetwork,Bethlehem,PA St.Luke’sUniversityHealthNetwork,Bethlehem,PA KristineMarieJ.Casal RebeccaJeanmonod CarilionClinic,Roanoke,VA St.Luke’sUniversityHealthNetwork,Bethlehem,PA AbhishekChaturvedi BrianKelly Pt.B.D.SharmaPGIMS,Rohtak,India St.Luke’sUniversityHealthNetwork,Bethlehem,PA BenChurch BenjaminKitt BaystateMedicalCenter,Springield,MA BaystateMedicalCenter,Springield,MA MichelleClinton EdwinLayng CarilionClinic,Roanoke,VA St.Luke’sUniversityHealthNetwork,Bethlehem,PA KeelColeman KinseyLeonard CarilionClinic,Roanoke,VA BaystateMedicalCenter,Springield,MA CarlDaniel MichaelLeonard AlbanyMedicalCenter,Albany,NY St.Luke’sUniversityHealthNetwork,Bethlehem,PA TomDittrich DavidH.Long RoperSt.FrancisHospital,MountPleasant,SC CarilionClinic,Roanoke,VA EricaEscarcega AngelaMastantuono St.Luke’sUniversityHealthNetwork,Bethlehem,PA CarilionClinic,Roanoke,VA RyanFulton Sade´ McKenzie CarilionClinic,Roanoke,VA AlbanyMedicalCenter,Albany,NY AnstGelin AlyssaMilano CarilionClinic,Roanoke,VA St.Luke’sUniversityHealthNetwork,Bethlehem,PA viii © in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-316-60886-9 — Pediatric Emergency Medicine Edited by Rebecca Jeanmonod , Shellie L. Asher , Blake Spirko , Foreword by Denis R. Pauze Frontmatter More Information ListofContributors EmilyMiller EfratRosenthal AlbanyMedicalCenter,Albany,NY BaystateMedicalCenter,Springield,MA NatalieMoore JasonSchwaber BaystateMedicalCenter,Springield,MA EllisHospital,Schenectady,NY JonathanR.Morgan AmandaShorette CarilionClinic,Roanoke,VA BaystateMedicalCenter,Springield,MA JonathanNogueira SundeepM.Shukla CarilionClinic,Roanoke,VA BaystateMedicalCenter,Springield,MA JamaineOrtizJr. LaurenSnyder St.Luke’sUniversityHealthNetwork,Bethlehem,PA BaystateMedicalCenter,Springield,MA RachelA.Patterson TaylorR.Spencer St.Luke’sUniversityHealthNetwork,Bethlehem,PA EllisHospital,Schenectady,NY DanielK.Pauze´ HollyStankewicz AlbanyMedicalCenter,Albany,NY St.Luke’sUniversityHealthNetwork,Bethlehem,PA DenisR.Pauze´ CaraV.Tillotson AlbanyMedicalCenter,Albany,NY CarilionClinic,Roanoke,VA DorotaPazdrowska JohnTran CarilionClinic,Roanoke,VA St.Luke’sUniversityHealthNetwork,Bethlehem,PA JenniferPelesz TomWilliams AlbanyMedicalCenter,Albany,NY AlbanyMedicalCenter,Albany,NY LeahA.Perez JanetYoung AlbanyMedicalCenter,Albany,NY CarilionClinic,Roanoke,VA MelanieK.Prusakowski PamelaYoung CarilionClinic,Roanoke,VA AlbanyMedicalCenter,Albany,NY SonikaRaj SeanZwiebel AlbanyMedicalCenter,Albany,NY St.Luke’sUniversityHealthNetwork,Bethlehem,PA ix © in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-316-60886-9 — Pediatric Emergency Medicine Edited by Rebecca Jeanmonod , Shellie L. Asher , Blake Spirko , Foreword by Denis R. Pauze Frontmatter More Information Preface Textbooks abound, electronic resources are ubiqui- becauseeveryteenagerishonestaboutsubstanceuse. tous, and there is an app for everything. Where Butweknowbetter. does this book it, as you struggle to “learn” clinical his book strives to ill the gap between tradi- medicine? tional textbooks and bedside medicine. Instead of he issue is always application. Most physicians, being organized by organ system, this book is orga- physicians-in-training, and physician assistants can nizedbychiefcomplaint,basedonpublishedfrequen- takeatest.heyknowhowtolookataquestionwitha cies of the most common pediatric chief complaints listofclosedpossibilitiesandchoosetherightchoice. seen in emergency departments. Each chapter repre- If given four possibilities, the correct answer is oten sents a chief complaint. Each case is presented as an obvious,oratleastrecognizable.Questionbanksand unknown,withahistoricalvignetteandanexamina- questionbooksaredesignedtohelplearnerswiththis, tionandancillarytests,aterwhichwehaveprovided andtheyworkwell. questions for thought. he reader should stop and Textbooks are generally, almost universally, orga- consider the case and really think about these ques- nized by organ system. his is a very rational way tions,thenextsteps,thedilemmasthatarereal,pre- to write a text book. It is straightforward from a sented by these patients that are real, written by the writing perspective, and allows the learner to get in- physicians who actually cared for them. his is fol- depthinformationabouteverythinginagivenorgan lowed by the diagnosis, and a discussion of the dis- system in a step-by-step fashion. When you haven’t easeaswellastheotherdiseasesthatyoushouldhave learned about gastrointestinal physiology, let alone considered, and how to distinguish them from one gastrointestinalpathophysiology,thismakessense,as another. well. Youcanusethisbookonyourown,oryoucanuse Butthepracticeofmedicineisn’treallylikeeither itwithafriend.hebookcaneasilybeusedforcase- ofthesethings.Notreally.Patientscomeinwithcom- based teaching for clerkships, residencies, or small plaints.heircomplaintsdon’tcomewithaclosedlist grouplearning. ofanswerstochoosefrom,andtheydon’tcomewith Whatyouwon’tindisachapteron“staphscalded their organ-system chapter. A complaint may seem skin syndrome,” or a chapter on “new onset dia- to be referable to a speciic organ system, but ulti- betes.”Youwill,however,learnwhentoworryabout mately may be multifactorial. Take, for instance, the a rash, how to resuscitate a baby, which seizure complaint of “shortness of breath.” Your brain wants patientneedslabsandwhatyourdiferentialdiagnosis you to think about the lungs and the airway as the shouldbe,andbasically,howtothinkaboutillnessin source of the problem. But maybe it’s symptomatic children. anemia.Maybeit’scardiac.Maybeit’sacidosisfroman If you happen to ind yourself wanting to read ingestion.Maybeit’srenalfailurewithluidoverload. aboutaspeciicdiseasewithoutthemysteryofthecase, Maybe it’s a foreign body. Maybe it’s traumatic, even wedoprovideakeyatthebackofthebookto“cheat” withnohistoryoftrauma.Ithappens. andindadiscussiononintussusception,orreadingon But most written resources do not invoke the intracranialtumors.Andit’soktodothat,butremem- model of the patient as a mystery, the disease as an berthathumantraditionwasbasedonstories,handed unknown.heypresupposeyouknowit’saGIproblem downthroughgenerationsbythetellingandremem- becausethecomplaintisvomiting,orthatit’satoxin bering. You will learn better from stories than from xi © in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-316-60886-9 — Pediatric Emergency Medicine Edited by Rebecca Jeanmonod , Shellie L. Asher , Blake Spirko , Foreword by Denis R. Pauze Frontmatter More Information Preface tables and graphs. You will retain information when tocloseyourdiferentialprematurely.Youwillbeless you care about the outcome, and the providers who likelytoshort-cutyourexaminationorskiptheimpor- wrote these cases want you to care the way they do. tantquestionsonyourhistory.Andyouwillbeabet- If you use this book as it’s intended, you will have terdoctorandtakebettercareofourmostvulnerable broaderdiferentialdiagnoses.Youwillbelesstempted population.Andwhatcouldbebetterthanthat? xii © in this web service Cambridge University Press www.cambridge.org
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