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Signs and Symptoms in Pediatrics PDF

1054 Pages·2015·9.62 MB·English
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Signs S Signs & Symptoms in Pediatrics i g n & s Editors & Henry M. Adam, MD, FAAP Jane Meschan Foy, MD, FAAP Symptoms S y T raditionally, medical textbooks have been organized by areas of m specialty: infectious diseases, cardiology, pulmonary medicine, p and so on. For the practicing physician, however, this presentation has t its limits. Very few parents or children come to their pediatrician’s office o I N P E D I A T R I C S m with a chief complaint of nephrosis, for instance, or of psoriasis. Rather, they will say, “My son’s feet and face are swollen,” “My daughter has a s rash,” or even, “My child has been struggling in school.” i n Signs and Symptoms in Pediatrics organizes information to reflect the way practice really happens. It is a comprehensive guide to the evalua- P e tion and treatment of more than 80 signs and symptoms—physical d and behavioral—including i a • Abdominal pain t • Disruptive behavior and aggression r i • Facial dysmorphism c s • Fever of unknown origin • Learning difficulty • Speech and language concerns • Vomiting • Weight loss A D Each chapter begins with contextual information on areas like patho- A M physiology and epidemiology and provides a guide to the history, physical examination, and laboratory and imaging studies that generate an appro- • F priate differential diagnosis. Next are approaches to initial management O Y and suggestions about when to refer or admit. Signs and Symptoms in Pediatrics is an ideal resource for pediatricians, family physicians, residents, residency program directors, pediatric nurse practitioners, physician assistants, medical students, and nurses. EDITORS For other pediatric resources, visit the American Academy of Pediatrics at Henry M. Adam, MD, FAAP shop.aap.org. Jane Meschan Foy, MD, FAAP AAP American Academy of Pediatrics Signs & Symptoms I N P E D I A T R I C S Editors Henry M. Adam, MD, FAAP Jane Meschan Foy, MD, FAAP American Academy of Pediatrics Publishing Staff Director, Department of Publishing: Mark Grimes Director, Division of Professional and Consumer Publishing: Jeff Mahony Senior Product Development Editor: Chris Wiberg Editorial Assistant: Carrie Peters Director, Division of Editorial and Production Services: Sandi King, MS Manager, Publishing and Production Services: Th eresa Wiener Manager, Art Direction and Production: Peg Mulcahy Manager, Editorial Services: Jason Crase Director, Department of Marketing and Sales: Mary Lou White Brand Manager, Clinical and Professional Publications: Linda Smessaert Published by the American Academy of Pediatrics 141 Northwest Point Blvd, Elk Grove Village, IL 60007-1019 847/434-4000 Fax: 847/434-8000 www.aap.org Library of Congress Control Number: 2013949735 ISBN: 978-1-58110-850-7 eBook: 978-1-58110-855-2 MA0703 Th is book has been developed by the American Academy of Pediatrics. Th e authors, editors, and contribu- tors are expert authorities in the fi eld of pediatrics. No commercial involvement of any kind has been solic- ited or accepted in the development of this publication. Th e recommendations in this publication do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate. Every eff ort has been made to ensure that the drug selection and dosage set forth in this text are in accor- dance with the current recommendations and practice at the time of publication. It is the responsibility of the health care provider to check the package insert of each drug for any change in indications and dosage and for added warnings and precautions. Th e mention of product names in this publication is for informational purposes only and does not imply endorsement by the American Academy of Pediatrics. Th e American Academy of Pediatrics is not responsible for the content of the resources mentioned in this publication. Web site addresses are as current as possible but may change at any time. Th e publishers have made every eff ort to trace the copyright holders for borrowed material. If they have inadvertently overlooked any, they will be pleased to make the necessary arrangements at the fi rst opportunity. © 2015 by the American Academy of Pediatrics. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior permission from the publisher. Printed in the United States of America 9-349/0215 1 2 3 4 5 6 7 8 9 10 Editors Henry M. Adam, MD, FAAP Jane Meschan Foy, MD, FAAP Bronx, New York Professor of Pediatrics Wake Forest University School of Medicine Winston-Salem, North Carolina Tools Editors Rebecca Baum, MD, FAAP Kelly J. Kelleher, MD, MPH, FAAP Department of Pediatrics Professor of Pediatrics, Psychiatry, and Th e Ohio State University Public Health Nationwide Children’s Hospital Th e Ohio State University Columbus, Ohio Nationwide Children’s Hospital Columbus, Ohio Contributors Jeff rey R. Avner, MD, FAAP Department of Dermatology Professor of Clinical Pediatrics Boston, Massachusetts Codirector, Medical Student Education in 3: Alopecia and Hair Shaft Anomalies Pediatrics 43: Hyperhidrosis Albert Einstein College of Medicine 61: Pruritus Chief, Pediatric Emergency Medicine Th e Children’s Hospital at Montefi ore Rebecca Baum, MD, FAAP Bronx, New York Department of Pediatrics 32: Gastrointestinal Hemorrhage Th e Ohio State University Nationwide Children’s Hospital Sarah Bagley, MD Columbus, Ohio Addiction Medicine Fellow 54: Medically Unexplained Symptoms Boston University Medical Center Boston, Massachusetts Peter F. Belamarich, MD, FAAP 75: Substance Use: Initial Approach in Director, Division of General Pediatrics Primary Care Th e Children’s Hospital at Montefi ore Associate Professor of Clinical Pediatrics Nancy K. Barnett, MD, FAAP Albert Einstein College of Medicine Dermatology of Cape Cod Bronx, New York Falmouth, Massachusetts 1: Abdominal Distention Affi liate, Tufts Medical Center 11: Constipation iii iv Contributors John P. Bent, MD Department of Psychiatry and Behavioral Director, Pediatric Otolaryngology-Head Health and Neck Surgery Columbus, Ohio Professor, Albert Einstein College of 54: Medically Unexplained Symptoms Medicine Th e Children’s Hospital at Montefi ore Jayanthi Chandar, MD Bronx, New York Associate Professor of Clinical Pediatrics 74: Stridor University of Miami Miller School of Medicine Robert J. Bidwell, MD Medical Director, Pediatric Kidney Associate Clinical Professor of Pediatrics Transplant Program University of Hawai`i John A. Burns Miami Transplant Institute School of Medicine Miami, Florida Honolulu, Hawai`i 40: High Blood Pressure 33: Gender Expression and Identity Issues Marcela Del Rio, MD Diane E. Bloomfi eld, MD, FAAP Department of Pediatrics Department of Pediatrics Montefi ore Medical Center Th e Children’s Hospital at Montefi ore Bronx, New York Bronx, New York 37: Hematuria 84: Weight Loss Linda M. Dinerman, MD, PC Joel S. Brenner, MD, MPH, FAAP Adolescent and Young Adult Medicine Director, Sports Medicine and Adolescent Private Practice Medicine Huntsville, Alabama Children’s Hospital of Th e King’s 18: Dysmenorrhea Daughters 82: Vaginal Discharge Associate Professor of Pediatrics Eastern Virginia Medical School Elaine A. Dinolfo, MD, MS, FAAP Norfolk, Virginia Assistant Clinical Professor of Pediatrics 8: Back Pain Columbia University College of Physicians and Surgeons Michael G. Burke, MD, MBA, FHM, Attending Physician, Department of FAAP Pediatrics Department of Pediatrics Harlem Hospital Center Johns Hopkins University School of New York, New York Medicine 84: Weight Loss Saint Agnes Hospital Baltimore, Maryland Mary Iftner Dobbins, MD, FAAP 24: Extremity Pain Department of Family and Community Medicine John Campo, MD Southern Illinois University School of Professor and Chair Medicine Ohio State University Wexner Medical Carbondale, Illinois Center 27: Family Dysfunction Contributors v Sarah Edwards, DO Jack Gladstein, MD Assistant Professor Professor of Pediatrics and Neurology Director of Training, Child and Adoles- University of Maryland School of cent Psychiatry Fellowship Medicine Medical Director of Child and Adolescent Baltimore, Maryland Psychiatry Hospital Services 34: Headache Division of Child and Adolescent Psychiatry Mary Margaret Gleason, MD, FAAP University of Maryland School of Associate Professor Medicine Child Psychiatry and Pediatrics Baltimore, Maryland Tulane University School of Medicine 69: Self-stimulating Behaviors New Orleans, Louisiana 76: Symptoms of Emotional Disturbance in Mohammad F. El-Baba, MD Young Children Division Chief, Pediatric Gastroenterology Fellowship Program Director Beatrice Goilav, MD Children’s Hospital of Michigan Assistant Professor of Pediatrics Wayne State University Director, Pediatric Nephrology Training Detroit, Michigan Program 19: Dysphagia Division of Pediatric Nephrology Th e Children’s Hospital at Montefi ore Lisa Figueiredo, MD Albert Einstein College of Medicine Division of Pediatric Hematology/ Bronx, New York Oncology 21: Dysuria Th e Children’s Hospital at Montefi ore Bronx, New York David L. Goldman, MD 58: Petechiae and Purpura Associate Professor of Pediatrics Assistant Professor of Microbiology Barbara L. Frankowski, MD, MPH, Th e Children’s Hospital at Montefi ore FAAP Albert Einstein College of Medicine Department of Primary Care Pediatrics Bronx, New York University of Vermont Children’s Hospital 64: Recurrent Infections Burlington, Vermont 49: Learning Diffi culty Waseem Hafeez, MBBS, FAAP Associate Professor of Clinical Pediatrics Mariam Gangat, MD Albert Einstein College of Medicine Department of Pediatrics Attending Physician Division of Pediatric Endocrinology Division of Pediatric Emergency Rutgers Robert Wood Johnson Medical Medicine School Th e Children’s Hospital at Montefi ore New Brunswick, New Jersey Bronx, New York 41: Hirsutism, Hypertrichosis, and 46: Irritability and Fussiness Precocious Sexual Hair Development vi Contributors Caroline Breese Hall, MD† Alain Joff e, MD, MPH, FAAP 52: Lymphadenopathy Director, Student Health and Wellness Center David C. Hanson, MD Johns Hopkins University Assistant Professor Associate Professor of Pediatrics Divison of General Pediatrics Johns Hopkins University School of Department of Pediatrics Medicine University of Minnesota Masonic Baltimore, Maryland Children’s Hospital 4: Amenorrhea Minneapolis, Minnesota 81: Vaginal Bleeding 24: Extremity Pain 82: Vaginal Discharge J. Peter Harris, MD Paul Kaplowitz, MD, PhD, FAAP Professor Emeritus Division of Endocrinology Department of Pediatrics Children’s National Medical Center University of Rochester Medical Center George Washington University School of Rochester, New York Medicine and Health Sciences 9: Cardiac Arrhythmias Washington, DC Nancy Heath, PhD 70: Short Stature Department of Educational and Counselling Psychology Frederick J. Kaskel, MD, PhD McGill University Professor and Vice Chair of Pediatrics Montreal, Quebec Albert Einstein College of Medicine 68: Self-harm Director, Division and Training Program in Pediatric Nephrology Sebastian Heersink, MD, FACS Th e Children’s Hospital at Montefi ore Eye Center South Bronx, New York Dothan, Alabama 21: Dysuria 65: Red Eye/Pink Eye Diana King, MD, FAAP Norman T. Ilowite, MD Assistant Professor of Clinical Pediatrics Professor of Pediatrics Albert Einstein College of Medicine Albert Einstein College of Medicine Attending Physician Department of Pediatrics Division of Pediatric Emergency Medicine Division of Rheumatology Children’s Hospital at Montefi ore Th e Children’s Hospital at Montefi ore Th e Bronx, New York Bronx, New York 46: Irritability and Fussiness 50: Limp Robert A. King, MD Ginger Janow, MD Professor of Child Psychiatry Department of Pediatrics Yale Child Study Center Division of Rheumatology Yale University School of Medicine Joseph M. Sanzari Children’s Hospital New Haven, Connecticut Hackensack, New Jersey 79: Tics 50: Limp †Deceased. Contributors vii Genna W. Klein, MD Bronx, New York Division of Pediatric Endocrinology 5: Anemia and Pallor Joseph M. Sanzari Children’s Hospital 58: Petechiae and Purpura Hackensack University Medical Center Hackensack, New Jersey Paul A. Levy, MD, FACMG, FAAP 41: Hirsutism, Hypertrichosis, and Attending Geneticist Precocious Sexual Hair Development Assistant Professor of Pediatrics and Pathology Robert K. Kritzler, MD Th e Children’s Hospital at Montefi ore Deputy Chief Medical Offi cer Bronx, New York Johns Hopkins HealthCare LLC 22: Edema Assistant Professor, Johns Hopkins University Sharon Levy, MD, MPH, FAAP Glen Burnie, Maryland Director, Adolescent Substance Abuse 62: Puberty: Normal and Abnormal Program Boston Children’s Hospital Daniel Krowchuk, MD, FAAP Assistant Professor of Pediatrics Department of Pediatrics Harvard Medical School Wake Forest School of Medicine Boston, Massachusetts Winston-Salem, North Carolina 75: Substance Use: Initial Approach in 63: Rash Primary Care Erik Langenau, DO, MS, FACOP, Samuel M. Libber, MD, FAAP FAAP Department of Pediatrics Department of Learning Technologies Johns Hopkins University School of Philadelphia College of Osteopathic Medicine Medicine Baltimore, Maryland Philadelphia, Pennsylvania 59: Polyuria 57: Odor (Unusual Urine and Body) Steven E. Lipshultz, MD, FAHA, FAAP Judith B. Lavrich, MD Schotanus Professor of Pediatrics and Chair Associate Surgeon Carman and Ann Adams Department Department of Pediatric Ophthalmology of Pediatrics and Ocular Genetics Wayne State University School Wills Eye Hospital of Medicine Clinical Instructor Pediatrician-in-Chief Sidney Kimmel Medical College Children’s Hospital of Michigan Th omas Jeff erson University President, University Pediatricians Philadelphia, Pennsylvania Detroit, Michigan 65: Red Eye/Pink Eye 40: High Blood Pressure Adam S. Levy, MD Anthony M. Loizides, MD Associate Professor of Clinical Pediatrics Assistant Professor of Pediatrics Th e Children’s Hospital at Montefi ore Albert Einstein College of Medicine Albert Einstein College of Medicine Attending Physician viii Contributors Division of Pediatric Gastroenterology Bethany Marston, MD and Nutrition Department of Pediatrics and Medicine Th e Children’s Hospital at Montefi ore University of Rochester Bronx, New York Rochester, New York 2: Abdominal Pain 48: Joint Pain Dominique Long, MD Anne May, MD, FAAP Division of Pediatric Endocrinology Assistant Professor of Clinical Pediatrics Department of Pediatrics Th e Ohio State University Johns Hopkins Children’s Center Nationwide Children’s Hospital Baltimore, Maryland Columbus, Ohio 62: Puberty: Normal and Abnormal 71: Sleep Disturbances (Nonspecifi c) Michael G. Marcus, MD Jay H. Mayefsky, MD, MPH, FAAP Vice Chair, Pediatric Ambulatory Network Professor of Pediatrics and Family and Director, Division of Pulmonary Medicine Preventive Medicine and Pediatric Allergy and Immunology Rosalind Franklin University of Medicine Maimonides Infants and Children’s and Science Hospital Associate Medical Director Brooklyn, New York School Based Health Centers 12: Cough Heartland Health Centers Chicago, Illinois Ronald V. Marino, DO, MPH, FAAP 20: Dyspnea Professor of Pediatrics Stony Brook University Medical School Alicia K. McFarren, MD, FAAP College of Osteopathic Medicine at the Department of Pediatric Hematology, New York Institute of Technology Oncology, and Blood and Marrow Associate Chairman, Department Transplantation of Pediatrics Children’s Hospital Los Angeles Winthrop University Hospital Los Angeles, California Mineola, New York 5: Anemia and Pallor Pediatric Residency Director Good Samaritan Hospital Medical Center Nancy McGreal, MD West Islip, New York Assistant Professor of Medicine and 66: School Absenteeism and School Refusal Pediatrics Divisions of Adult and Pediatric Robert W. Marion, MD Gastroenterology Chief, Division of Genetics Duke University Medical Center Professor of Pediatrics and Obstetrics and Durham, North Carolina Gynecology and Women’s Health 51: Loss of Appetite Th e Children’s Hospital at Montefi ore 83: Vomiting Albert Einstein College of Medicine Bronx, New York 25: Facial Dysmorphism Contributors ix Sarah E. Messiah, PhD, MPH Philip O. Ozuah, MD, PhD, FAAP Research Associate Professor Professor of Pediatrics Perinatal/Pediatric Epidemiologist Professor of Epidemiology and Population University of Miami Miller School of Health Medicine Albert Einstein College of Medicine Department of Pediatrics President Division of Pediatric Clinical Research Montefi ore Health System Batchelor Children’s Research Institute Bronx, New York Miami, Florida 28: Fatigue and Weakness 40: High Blood Pressure 39: Hepatomegaly 73: Splenomegaly Ryan S. Miller, MD 80: Torticollis Division of Pediatric Endocrinology Department of Pediatrics Lane S. Palmer, MD, FACS, FAAP Johns Hopkins University School of Division of Pediatric Urology Medicine Cohen Children’s Medical Center of Baltimore, Maryland New York 59: Polyuria Hofstra North Shore-LIJ School of Medicine Timothy R. Moore, PhD, LP, BCBA-D Long Island, New York Clinical Director 67: Scrotal Swelling and Pain Minnesota Life Bridge Debra H. Pan, MD Cambridge, Minnesota Assistant Professor of Pediatrics 68: Self-harm Albert Einstein College of Medicine Attending Physician Joshua P. Needleman, MD, FAAP Division of Pediatric Gastroenterology Pediatric Pulmonary Medicine and Nutrition Maimonides Medical Center Th e Children’s Hospital at Montefi ore Brooklyn, New York Bronx, New York 85: Wheezing 47: Jaundice Katherine Atienza Orellana, DO Sanjay R. Parikh, MD, FACS Pediatric Gastroenterology Division of Pediatric Otolaryngology Valley Medical Group Seattle Children’s Hospital Ramsey, New Jersey Associate Professor 2: Abdominal Pain Department of Otolaryngology–Head and Neck Surgery Philip Overby, MD, DABPN University of Washington Department of Pediatrics and Neurology Seattle, Washington New York Medical College 42: Hoarseness Valhalla, NY 7: Ataxia

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Evaluate diverse pediatric complaints efficiently and accurately with this all-new resource from the American Academy of Pediatrics! This convenient handbook helps you effectively evaluate patient complaints, and develop sound differential diagnoses and management strategies. This practice-focused n
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Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.