The 5 Minute Pediatric Consult PDF
Preview The 5 Minute Pediatric Consult
P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO LWBK983-FM LWBK983-Schwartz March26,2012 18:56 The 5-Minute Pediatric Consult SIXTH EDITION i P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO LWBK983-FM LWBK983-Schwartz March26,2012 18:56 ASSOCIATE EDITORS Petar Mamula, MD AssociateProfessorofPediatricsatthe Louis M. Bell, Jr., MD UniversityofPennsylvania ProfessorofPediatricsattheUniversityofPennsylvania DivisionofGastroenterology,HepatologyandNutrition AssociateChairofClinicalActivities Children’s HospitalofPhiladelphia Chief,DivisionofGeneralPediatrics Philadelphia,Pennsylvania TheDepartmentofPediatrics Children’s HospitalofPhiladelphia Philadelphia,Pennsylvania Maria R. Mascarenhas, MBBS AssociateProfessorofPediatricsatthe UniversityofPennsylvania Peter M. Bingham, MD DivisionofGastroenterology,HepatologyandNutrition AssociateProfessor Children’s HospitalofPhiladelphia DepartmentofPediatricNeurology Philadelphia,Pennsylvania UniversityofVermont Burlington,Vermont Ronn E. Tanel, MD Esther K. Chung, MD, MPH AssociateProfessorofPediatrics ProfessorofPediatrics UCSFSchoolofMedicine JeffersonMedicalCollege,ThomasJeffersonUniversity Director,PediatricArrhythmiaCenter Nemours–Philadelphia DivisionofPediatricCardiology Philadelphia,Pennsylvania UCSFChildren’s Hospital Nemours/A.I.duPontHospitalforChildren SanFrancisco,California Wilmington,Delaware David F. Friedman, MD ASSISTANT EDITOR ClinicalAssistantProfessorofPediatricsattheUniversity ofPennsylvania Charles I. Schwartz, MD PerelmanSchoolofMedicine ClinicalAssistantProfessorofPediatrics DivisionofPediatricHematology UniversityofPennsylvaniaSchoolofMedicine Children’s HospitalofPhiladelphia Philadelphia,Pennsylvania Philadelphia,Pennsylvania Kathleen M. Loomes, MD MANAGING EDITOR AssociateProfessorofPediatrics,PerelmanSchoolof MedicineattheUniversityofPennsylvania Cheryl Polchenko DivisionofGastroenterology,HepatologyandNutrition GeneralPediatrics TheChildren’s HospitalofPhiladelphia Children’s HospitalofPhiladelphia Philadelphia,Pennsylvania Philadelphia,Pennsylvania ii P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO LWBK983-FM LWBK983-Schwartz March26,2012 18:56 The 5-Minute Pediatric Consult SIXTH EDITION Editor M.WilliamSchwartz,MD EmeritusProfessorofPediatrics PerelmanSchoolofMedicineUniversityofPennsylvania Formerly,SeniorPhysician Children’sHospitalofPhiladelphia Philadelphia,Pennsylvania iii P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO LWBK983-FM LWBK983-Schwartz April12,2012 13:18 AcquisitionsEditor:RebeccaGaertner ManagingEditor:NicoleWalz ProjectManager:BridgettDougherty SeniorManufacturingManager:BenjaminRivera MarketingManager:KimberlySchonberger DesignCoordinator:TeresaMallon ProductionServices:Aptara,Inc. 6thEdition (cid:2)C 2012byLippincottWilliams&Wilkins,aWoltersKluwerbusiness 530WalnutStreet Philadelphia,PA19106 LWW.com 5thEdition(cid:2)c 2008byLippincottWilliams&Wilkins;4thEdition(cid:2)c 2005byLippincottWilliams&Wilkins Allrightsreserved.Thisbookisprotectedbycopyright.Nopartofthisbookmaybereproducedinanyform orbyanymeans,includingphotocopying,orutilizingbyanyinformationstorageandretrievalsystemwithout writtenpermissionfromthecopyrightowner,exceptforbriefquotationsembodiedincriticalarticlesand reviews. The5-MinuteLogo isaregisteredtrademarkofLippincottWilliams&Wilkins.Thismarkmaynotbe usedwithoutwrittenpermissionfromthepublisher. PrintedinChina LibraryofCongressCataloging-in-PublicationData The5-minutepediatricconsult/[editedby]M.WilliamSchwartz;associateeditors, LouisM.Bell,Jr....[etal.];assistanteditor,CharlesI.Schwartz.–6thed. p.;cm.–(5-minuteconsultseries) Five-minutepediatricconsult Includesbibliographicalreferencesandindex. ISBN978-1-4511-1656-4(hardback:alk.paper) ISBN978-1-4511-8338-2 I.Schwartz,M.William,1935- II.Title:Five-minutepediatricconsult. III.Series:5-minuteconsult. [DNLM:1.Pediatrics–Handbooks.WS39] 618.92–dc23 2012012664 Carehasbeentakentoconfirmtheaccuracyoftheinformationpresentedandtodescribegenerally acceptedpractices.However,theauthors,editors,andpublisherarenotresponsibleforerrorsoromissions orforanyconsequencesfromapplicationoftheinformationinthisbookandmakenowarranty,expressed orimplied,withrespecttothecurrency,completeness,oraccuracyofthecontentsofthepublication. Applicationofthisinformationinaparticularsituationremainstheprofessionalresponsibilityofthe practitioner. Theauthors,editors,andpublisherhaveexertedeveryefforttoensurethatdrugselectionanddosage setforthinthistextareinaccordancewithcurrentrecommendationsandpracticeatthetimeofpublication. 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VisitLippincottWilliams&WilkinsontheInternet:atLWW.com.LippincottWilliams&Wilkinscustomer servicerepresentativesareavailablefrom8:30amto6pm,EST. 10 9 8 7 6 5 4 3 2 1 iv P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO LWBK983-FM LWBK983-Schwartz March26,2012 18:56 WS: To Susan, David, Charlie, Brandie, Mitchell, Caroline, and Chloe LB: To my mom and dad, Deasue and Louis. Thank you for all of the intangibles PB: For Nishan, at the beginning EC: In Memory of Dr. Ed Baik Chung and Dr. Okhyung Kang and Dennis, Marissa and Emma Lee DF: To Marisa, Elias, Henry, and Isabel KML: To my mother Joan PM: To my family and patients MM: To my wonderful family. Thanks for all your support RT: To Sarah, Meghan, Lauren, and my many teachers and mentors v P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO LWBK983-FM LWBK983-Schwartz March26,2012 18:56 vi P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO LWBK983-FM LWBK983-Schwartz March26,2012 18:56 PREFACE ThissixtheditionofThe5-MinutePediatricConsult atteststo not want to be remembered as the old man with a poor memory thecontinuingvaluetothereadersofthecontentandinnova- who stayed too long. One day he got a tap on his shoulder; he tiveformat.Asixthedition!Wow!Ilookbackonthehistoryof knew what that meant. Our memories of him remain positive. On thistextandnowwebsitewithprideandmuchpleasure.Whenthe theotherhand,ourformerchiefofpediatricswouldsleepthrough firsteditionwasproposedin1995,thenewformatofthe5-Minute grandroundsandwhenproddedtoansweraquestion,hebeganto seriesintriguedme.Theinnovativedesign,fittingwellintotheevolv- talkabouthisfavoritedisease,eventhoughitwasnotthetopicof ingcomputertechnology,firstPersonalDigitalAssistantsandthen thesession;somuchforhisreputation.Thesecontrastingobser- the internet, has led to wide acceptance of this presentation that vationshavehelpedformsomeofmyprofessionalphilosophies.I provideseasyaccesstoimportantinformation.ThepopularityofThe alwaysmadesurethatIdidnotstaytoolong,mainlytoallowforthe 5-MinutePediatricConsult isatestimonytotheexcellentworkof nextgenerationtohaveopportunitiesthatIwasfortunatetohave theauthorsandeditorswhowritethechapters,andtotheeditorial in my career. Therefore, with this sixth edition, I am retiring from and production staff who transform the pages into the final book editorshipofThe5-MinutePediatricConsultandlooktothefuture andwebsite. ofthebookunderthenewteam. Thiseditioncontainsmanychaptersrewrittenbyagroupofnew Before I go, I do want to express my appreciation and special authorsaswellasrefinementofallchapters.Thereareanumberof thankstoCherylPolchenko,managingeditorandagoodpal,who newtopicswrittenbychildpsychiatristssuchasseparationanxiety, has held all the pieces together and assured the completion of substanceabuse,andobsessivecompulsivedisorders.Mythanks theseeditions.Ineverygroupthereisaspecialpersonwhoquietly toPaceDucketforrecruitingtheseauthors.Weaddednewtopics standsout,Cherylisthatperson.Graziemille! Likewise,thatstaff such as narcolepsy, dental trauma, fragile X syndrome, thoracic at Wolters Kluwer Health (that was Lippincott that was Williams insufficiencysyndrome,andvaccinereactions. & Wilkins). My friends and associates at Wolters Kluwer Health Ihavebeenfortunatetohaveateamofassociateeditors,many made working on this project a great pleasure. Thanks to Sonya have been on this project for all six editions, while others joined Seigafuse,RebeccaGaertner,andNicoleWalzwhoworkedonthe uslaterbutcontinuedthehighlevelofprofessionalismanddedica- sixth edition and to Tim Hiscock, Katie Millet, and Joyce Murphy tiontothisbook.IappreciatetheeffortsofLouBell,PeterBingham, fromthepasteditions.Iappreciatethembeingsohelpful.Sandhya Esther Chung, David Friedman, Kathy Loomes, Petar Mamula, Joshiheadedtheproductionteamthatturnedthemanuscriptsinto Maria Mascarenhas, and Ronn Tanel. My gratitude to all of them thisbook.Moltegrazietoallofthem. fortheireffortstocontinuethereputationofhighqualityknownin At this time of reflection, I also want to acknowledge people, The5-MinutePediatricConsult. One of the principles for working most of whom are no longer with us but their influence on me onthisprojectisitshouldbefun.Iknowithasbeenenjoyablefor remains.Firstmyparentswhowerebookloversandsetagreatex- me.Astheinternetandnotebooksbecomemorepopular,myold ampleforthejoysofreadingandthevalueofeducation.Thenmy fashioned bias for real books will continue despite the prediction teachers,mentors,andcolleaguesincludingWillisHunt,aneccen- thatbookswillbeobsoleteinthefuture.Ihopenot. tricbutlovablebiologyteacher,IsaacStarr,myresearchmentorwho Being involved in many ways with educating medical students showedthatonecouldbeafirstratescientistaswellagentleman at Penn and residents at Children’s Hospital of Philadelphia, and (Ilovedhisadvicethat“alltheeasythingshavebeendonealready.”), visitingmanyhospitals,Iwasabletoseefirsthandhowthisbookwas HaroldFarmer,ageneralinternistwhodemonstratedanenthusiasm helpfultotrainees,primarycarepediatricians,andnurses,andthus, forteachingandfordelvingintomedicalhistory,andFrancisWood justifyingthenameofThe5-MinutePediatricConsult.Thespread whosettheexamplethatexcellentmedicalcarehastobecombined ofthebooktoothercountriesinmanytranslationswasgratifying withcompassionatedoctor–patientcommunication.Myfondmem- andexceededmyinitialexpectations. ories of training at Children’s Hospital of Philadelphia include my At a recent medical school reunion, I was struck by the mem- mentors:DavidCornfeld,JohnHope,BobKaye,AlfredBongiovani, ories of my classmates who all shared similar experience in the BillRashkind,andHenryCecilaswellascolleagues,MikeGenel, 4 years of school but had quite a diverse record of recollections Tom Moshang, Bill Sharrar, Fred Burg, and Ed Chaney, all great that they entered into the reunion booklet. One of my memories friends.AspecialrecognitionofBruceTempest,formerroommate, was the experience at grand rounds where the chief of medicine sourceofmanygoodinsights,bothmedicalandculturalandaninte- related the story that he asked his mentor and previous chief of gralpartofhelpingmedicalstudentslearnfirsthandaboutNavajo medicine to continue to come to grand rounds and participate in culture. Of course, I value the lessons from patients and families thedepartment’s activities.Theolderdoctoragreedwiththepro- whotaughtmethemostaboutpatientcare.Thankstoall. visothatwhenhebegantorepeathimselfandshowsomemajor memory defects, that he would get a tap on the shoulder as an WILLIAMSCHWARTZ,MD indicatorofitwastimetostepoffthestage.Theformerchiefdid Philadelphia2012 vii P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO LWBK983-FM LWBK983-Schwartz March26,2012 18:56 viii P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO LWBK983-FM LWBK983-Schwartz April17,2012 10:43 CONTRIBUTING AUTHORS NicholasS.Abend,MD LeeAtkinson-McEvoy,MD ChristinaBales,MD AssistantProfessorofNeurologyand AssociateClinicalProfessorofPediatrics AssistantProfessorofClinicalMedicine Pediatrics AssociateDivisionChief,General PerelmanSchoolofMedicineofthe PerelmanSchoolofMedicineatthe Pediatrics UniversityofPennsylvania UniversityofPennsylvania UCSFBenioffChildren’sHospital AttendingPhysician Children’sHospitalof SanFrancisco,California DivisionofGastroenterology,Hepatology, Philadelphia andNutrition EdwardF.Attiyeh,MD Philadelphia,Pennsylvania DepartmentofPediatrics AssistantProfessorofPediatrics TheChildren’sHospitalofPhiladelphia AkinyemiAjayi,MD,FCCP,FAASM Children’sHospitalofPhiladelphia Philadelphia,Pennsylvania Children’sLung,AsthmaandSleep PerelmanSchoolofMedicineatthe SpecialistsandtheChildren’sSleep UniversityofPennsylvania Laboratory Philadelphia,Pennsylvania DianeBarsky,MD Orlando,Florida AttendingPhysician J.ChristopherAustin,MD,FAAP,FACS DivisionofGastroenterology,Hepatology AliAl-Omari,MD AssociateProfessor andNutrition PediatricOrthopaedicFellow DepartmentofUrology Children’sHospitalofPhiladelphia DepartmentofOrthopaedicSurgery PediatricUrology Philadelphia,Pennsylvania TheChildren’sHospitalofPhiladelphia OregonHealthandScienceUniversity Philadelphia,Pennsylvania Portland,Oregon HamidBassiri,MD,PhD LindseyG.Albenberg,DO OluwakemiB.Badaki-Mukan,MD,CM ClinicalAssociateandAttending DivisionofGastroenterology,Hepatology, InstructorofPediatrics DivisionofInfectiousDiseases andNutrition DepartmentofPediatrics Children’sHospitalofPhiladelphia Children’sHospitalofPhiladelphia PediatricEmergencyMedicineResearch Philadelphia,Pennsylvania Philadelphia,Pennsylvania Fellow CraigA.Alter,MD DepartmentofEmergencyMedicine SuzanneE.Beck,MD DivisionofEndocrinologyandDiabetes AssociateProfessorofClinicalPediatrics MarkL.Bagarazzi,MD TheChildren’sHospitalofPhiladelphia UniversityofPennsylvaniaSchoolof ChiefMedicalOfficer ProfessorofClinicalPediatrics Medicine InovioPharmaceuticals,Inc. ThePerelmanSchoolofMedicine Philadelphia,Pennsylvania BlueBell,Pennsylvania UniversityofPennsylvania Philadelphia,Pennsylvania CharlesBailey,MD,PhD JuliaBelkowitz,MD TimothyAndrews,MD DivisionsofHematology&Oncology AssistantRegionalDeanforStudent PrivatePractice DepartmentofPediatrics Affairs AllergyandAsthmaAssociates Children’sHospitalofPhiladelphia AssistantProfessorofClinicalPediatrics Arnold,Maryland Philadelphia,Pennsylvania UniversityofMiamiMillerSchoolof Medicine WilliamAnninger,MD NaomiBalamuth,MD Miami,Florida AssistantProfessorofOphthalmology AssistantProfessor Children’sHospitalofPhiladelphia DepartmentofPediatrics AmandaK.Berry,MSN,CRNP PerelmanSchoolofMedicineatthe TheChildren’sHospitalofPhiladelphia PediatricNursePractitioner UniversityofPennsylvania Philadelphia,Pennsylvania DivisionofUrology Philadelphia,Pennsylvania RobertN.Baldassano,MD TheChildren’sHospitalofPhiladelphia GarrickA.Applebee,MD Professor Philadelphia,Pennsylvania AssistantProfessorofNeurologyand UniversityofPennsylvania,Schoolof Pediatrics Medicine TimothyBeukelman,MD,MSCE UniversityofVermontCollegeofMedicine Director AssociateProfessor MedicalDirector CenterforPediatricInflammatoryBowel DepartmentofPediatrics VermontRegionalSleepCenter Disease DivisionofRheumatology FletcherAllenHealthCare TheChildren’sHospitalofPhiladelphia UniversityofAlabamaatBirmingham Burlington,Vermont Philadelphia,Pennsylvania Birmingham,Alabama ix P1:OSO/OVY P2:OSO/OVY QC:OSO/OVY T1:OSO LWBK983-FM LWBK983-Schwartz April17,2012 10:43 x (cid:2) (cid:2) (cid:2) Contributing Authors AnitaBhandari,MD LeeJ.Brooks,MD AndrewC.Calabria,MD AssistantProfessorofPediatrics ClinicalProfessorofPediatrics AttendingPhysician DivisionofPediatricPulmonology UniversityofPennsylvania DivisionofEndocrinologyandDiabetes ConnecticutChildren’sMedicalCenter AttendingPhysician TheChildren’sHospitalofPhiladelphia Hartford,Connecticut Children’sHospitalofPhiladelphia AssistantProfessorofPediatrics Philadelphia,Pennsylvania PerelmanSchoolofMedicine SumitBhargava,MD UniversityofPennsylvania ClinicalAssociateProfessor JeffreyP.Brosco,MD,PhD Philadelphia,Pennsylvania DepartmentofPediatrics Director StanfordSchoolofMedicine PediatricsProgram RobertM.Campbell,Jr,MD AttendingPulmonologistandSleep ProfessorofClinicalPediatrics Physician DepartmentofPediatrics Director LucillePackardChildrensHospital UniversityofMiamiMillerSchoolof TheCenterforThoracicInsufficiency PaloAlto,California Medicine Syndrome Miami,Florida PediatricOrthopaedist DianaX.Bharucha-Goebel,MD DivisionofOrthopaedicSurgery DivisionofNeurology KurtBrown,MD TheChildren’sHospitalofPhiladelphia Children’sHospitalofPhiladelphia SeniorDirector ProfessorofOrthopaedicSurgery Philadelphia,Pennsylvania ClinicalResearch TheUniversityofPennsylvaniaSchoolof GroupDirector Medicine GilBinenbaum,MD,MSCE NeuroscienceTherapeuticArea Philadelphia,Pennsylvania AttendingSurgeon AstraZeneca TheChildren’sHospitalofPhiladelphia Wilmington,Delaware DouglasA.Canning,MD AssistantProfessorofOphthalmology Director ThePerelmanSchoolofMedicineatthe ValerieI.Brown,MD,PhD DivisionofUrology UniversityofPennsylvania AssistantProfessor TheChildren’sHospitalofPhiladelphia Philadelphia,Pennsylvania DivisionofPediatricHematology/ ProfessorofUrologyinSurgery Oncology MercedesM.Blackstone,MD DepartmentofPediatrics PerelmanSchoolofMedicine,University AttendingPhysician VanderbiltChildren’sHospital ofPennsylvania PediatricEmergencyMedicine Vanderbilt-IngramCancerCenter Philadelphia,Pennsylvania Children’sHospitalofPhiladelphia Nashville,Tennessee AssistantProfessorofClinicalPediatrics WilliamB.Carey,MD PerelmanSchoolofMedicineatthe AnnB.Bruner,MD DirectorofBehavioralPediatrics UniversityofPennsylvania MountainManorTreatmentCenter DivisionofGeneralPediatrics Philadelphia,Pennsylvania Baltimore,Maryland TheChildren’sHospitalofPhiladelphia ClinicalProfessorofPediatrics PeterMatthewKennedydeBlank,MD, LeahBurke,MD UniversityofPennsylvaniaSchoolof MSCE AssociateProfessor Medicine Neuro-OncologyFellow DepartmentsofPediatricsandMedicine Philadelphia,Pennsylvania DivisionofOncology UniversityofVermontCollegeofMedicine Children’sHospitalofPhiladelphia AttendingPhysician Philadelphia,Pennsylvania FletcherAllenHealthCare VanessaS.Carlo,MD Burlington,Vermont AssistantProfessorofPediatrics ChristopherP.Bonafide,MD,MSCE ThomasJeffersonUniversity GenevieveL.Buser,MD,MSHP AssistantProfessorofPediatrics Philadelphia,Pennsylvania UniversityofPennsylvania PediatricInfectiousDiseasesFellow DivisionofGeneralPediatrics Children’sHospitalofPhiladelphia TheChildren’sHospitalofPhiladelphia Philadelphia,Pennsylvania MichaelC.Carr,MD,PhD Philadelphia,Pennsylvania AssociateDirector FrancescaByrne,MD PediatricUrology JamesBoyd,MD DepartmentofPediatricCardiology Children’sHospitalofPhiladelphia AssistantProfessorofNeurology UniversityofCalifornia,SanFrancisco Philadelphia,Pennsylvania UniversityofVermontCollegeofMedicine SanFrancisco,California Burlington,Vermont MichaelD.Cabana,MD,MPH LeslieCastelo-Soccio,MD,PhD LauraK.BrennanMD ProfessorofPediatrics AttendingPhysician,Pediatricsand AttendingPhysician Epidemiology&Biostatistics Dermatology DivisionofGeneralPediatrics UniversityofCalifornia,SanFrancisco SectionofDermatology TheChildren’sHospitalofPhiladelphia DepartmentofPediatrics TheChildren’sHospitalofPhiladelphia Philadelphia,Pennsylvania SanFrancisco,California Philadelphia,Pennsylvania
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