Paediatrics

Front Cover
Inside Front Cover
Crash Course: Paediatrics
Copyright
Series Editors’ foreword
Preface
Acknowledgements
Series Editors’ acknowledgements
Contents
1 History and examination
	Paediatric history taking
		Presenting complaint
		Medical history
		Drug history
		Birth history
		Developmental history
		Family history
		Social history
	Adolescent history
	Neonatal history
		Antenatal events
		Birth
		Postnatal events
	Paediatric examination
		General examination
		Respiratory system
			Inspection
			Palpation
			Percussion
			Auscultation
		Cardiovascular system
			Inspection
			Palpation
			Auscultation
		Gastrointestinal system
			Inspection
			Palpation
			Percussion
			Auscultation
		Nervous system
		Ear, nose and throat
	The neonatal examination
		General inspection
		Skin
		Head and neck
		Face
		Chest
		Abdomen
		Genitalia and anus
		Limbs and spine
		Neurology
	Medical sample clerking
	Further reading
2  Investigations
	Urine tests
	Blood tests
		Haematology
			Full blood count
			Haemoglobin electrophoresis
			Coagulation studies
		Biochemical analysis
			Urea and electrolytes
				Sodium (Na +)
				Potassium (K +)
				Chloride (Cl –)
				Urea
				Creatinine
			Liver function tests
				Bilirubin
				Enzymes
					Transaminases (aminotransferases)
					Alkaline phosphatase
					γ -Glutamyltranspeptidase
				Albumin
			Glucose
			Calcium and phosphate
			Blood gases and acid–base metabolism
		Immunology
			Tests for immunodeficiency
				Immunoglobulins
				Differential white cell count
				Lymphocyte subsets
				Autoantibodies
					Antinuclear antibodies
					Rheumatoid factors
					Thyroid antibodies
			Diagnostic serology
				Viral antibody tests
					Epstein–Barr virus
					Mycoplasma pneumoniae
					Antistreptolysin O titre
			Acute-phase reactants
			Microbiology
				Urine culture
				Blood culture
				Upper respiratory culture
	Cerebrospinal fluid
		Appearance
		Microbiology
			Microscopy
			Culture and sensitivity
		Biochemistry
			Protein
			Glucose
		Rapid diagnostic techniques
			Polymerase chain reaction and DNA hybridization
	Imaging
		X-rays
			Chest X-ray
				Indications for doing a CXR
			Abdominal X-ray
				Indications for doing an AXR
			Skull X-ray
			Computed tomography
		Ultrasound
			Antenatal ultrasound
			Neonatal cranial ultrasound
			Abdominal and renal ultrasound
			Hip ultrasound
		Magnetic resonance imaging
		Micturating cystourethrograms
		Dimercaptosuccinic acid scans
	Further reading
3 Cardiovascular system
	Congenital heart disease
		History
		Examination
			Cyanosis
			Murmurs
				Innocent murmurs
				Significant murmurs
			Cardiac failure
				Clinical features
				Causes
		Investigation
		Classification
			Acyanotic congenital heart disease
				Left-to-right shunts (L to R)
					Ventricular septal defect
						Small VSD
						Medium VSD
						Large VSD
					Atrial septal defect
						Clinical features
						Diagnosis
					Patent ductus arteriosus
						Clinical features
						Diagnosis
				Obstructive lesions
					Coarctation of the aorta
						Preductal coarctation
						Postductal coarctation
					Aortic stenosis
					Pulmonary stenosis
			Cyanotic congenital heart disease
				Tetralogy of Fallot
					Clinical features
					Diagnosis
					Management
				Transposition of the great arteries
					Clinical features
					Management
	Rheumatic fever
		Clinical features
		Diagnosis
		Management
		Complications
	Cardiac infections
		Infective endocarditis
			Clinical features
			Diagnosis
			Management
		Myocarditis
		Kawasaki disease
	Cardiac arrhythmias
		Supraventricular tachycardia
			Clinical features
			Diagnosis
				Management
	Further reading
4 Respiratory system
	Presentation of paediatric respiratory disease
		Cough
			History
		Stridor
		Wheeze
		Respiratory distress
		Apnoea
	Upper respiratory tract infections
		Sore throat: pharyngitis and tonsillitis
			Clinical features
			Management
		Croup
			Clinical features
			Management
		Acute epiglottitis
			Clinical features
			Management
		Bacterial tracheitis
		Diphtheria
		Whooping cough
			Clinical features
			Investigations
			Management
			Complications
	Lower respiratory tract infections
		Bronchiolitis
			Clinical features
			Investigations
			Management
			Complications
		Pneumonia
			Clinical features
			Investigations
			Management
			Complications
	Asthma
		Epidemiology
		Aetiology
		Pathophysiology
		Clinical presentation
		Investigations
		Management
			Nonpharmacological management
			Medication
				Steroid therapy in asthma
				Long-acting β 2 agonists
				Leukotriene receptor antagonists
				Theophylline
				Antiimmunoglobulin E monoclonal antibody
			Acute severe asthma
		Prognosis of asthma
	Cystic fibrosis
		Incidence and aetiology
		Clinical features
		Investigations
		Management
			Respiratory management
			Nutritional management
		Prognosis
	Ears, nose and throat
		Ears
			Ear pain or discharge
			Acute otitis media
				Clinical features
				Management
			Hearing impairment
			Otitis media with effusion
				Assessment of hearing
				Clinical features
				Management
		Nose
			Nasal discharge and bleeding
		Throat
			Snoring and obstructive sleep apnoea
	Further Reading
5 Gastrointestinal and hepatobiliary systems
	Presentation of gastrointestinal disease
		Acute abdominal pain
			History
			Examination
			Investigations
		Recurrent abdominal pain
			Investigations
			Treatment
		Vomiting
			History
			Examination
		Haematemesis
		Acute diarrhoea
		Chronic diarrhoea
			History
			Examination
			Investigations
		Constipation
			History
			Examination
			Management
		Faltering growth
	Important gastrointestinal conditions
		Infantile colic
		Gastro-oesophageal reflux
			Clinical features
			Investigations
			Management
		Pyloric stenosis
			Clinical features
			Investigations
			Management
		Acute appendicitis
			Clinical features
			Investigations
			Management
		Mesenteric adenitis
		Intussusception
			Clinical features
			Investigations
			Management
		Meckel diverticulum
		Hirschsprung disease (congenital aganglionic megacolon)
			Clinical features
			Investigations
			Management
		Bowel obstruction
		Gastroenteritis
			Causes
			Clinical features
			Investigations
			Management
		Inflammatory bowel disease
			Aetiology
			Pathophysiology
				Clinical features
			Investigations
			Management
		Coeliac disease
			Clinical features
			Investigations
			Management
		Food intolerance
			Lactose intolerance
	Liver disease
		Jaundice
			Causes of jaundice after infancy
		Hepatomegaly
	Further Reading
6 Renal and genitourinary conditions
	Haematuria
		Causes
		History
		Examination
		Investigations
	Proteinuria
		Definition of proteinuria
		Causes
		Examination
		Investigations
	Urinary tract anomalies
		Renal anomalies
		Obstructive lesions of the urinary tract
			Pelviureteric junction obstruction
			Vesicoureteric junction obstruction
			Posterior urethral valves
		Vesicoureteric reflux
			Clinical features
			Investigation
			Management
	Urinary tract infection
		Causes
		Clinical features
		Diagnosis
		Treatment of the acute infection
		Further investigation
	Acute nephritis
		Causes
		Clinical presentation
		Investigation
		Management
	Nephrotic syndrome
		Causes
		Clinical features
		Investigation
		Management
	Acute kidney injury
		Haemolytic–uraemic syndrome
	Chronic kidney disease
	Genital conditions
		Inguinoscrotal disorders
			Undescended testis
				Examination
				Investigation
				Management
			Inguinal hernias and hydroceles
				Hydroceles
				Inguinal hernias
			The acute scrotum
		Penile conditions
			Hypospadias
			Phimosis and paraphimosis
			Circumcision
		Ambiguous genitalia
	Further Reading
7 Endocrine system and growth
	Hypothalamus and the pituitary gland
		Anterior pituitary disorders
		Posterior pituitary disorders
			Diabetes insipidus
			Syndrome of inappropriate secretion of ADH
	Growth
		Short stature
			Causes
			History
			Examination
			Management
	Puberty
		Variations of sex differentiation
		Puberty
			Precocious puberty
			Delayed puberty
	Adrenal disorders
		Cushing syndrome
			Clinical presentation
			Management
		Adrenocortical insufficiency
			Clinical presentation
			Management
		Congenital adrenal hyperplasia
			Clinical features
			Investigations
			Treatment
	Thyroid disorders
		Hypothyroidism
			Congenital hypothyroidism
				Clinical features
				Management
			Acquired hypothyroidism
				Clinical presentation
			Management
		Hyperthyroidism
			Neonatal hyperthyroidism
				Causes
				Clinical presentation
				Management
			Acquired hyperthyroidism
				Clinical presentation
				Management
	Diabetes mellitus
		Causes
		Pathophysiology
		Clinical presentation
		Investigations
		Management
			Education and psychological support
			Insulin replacement
			Diet and exercise
			Monitoring
			Management of complications
				Hypoglycaemia
				Diabetic ketoacidosis
				Late complications of diabetes
	Inborn errors of metabolism
		Clinical features
		Investigations
		Treatment
		Phenylketonuria
			Clinical presentation
			Management
		Galactosaemia
		Glycogen storage diseases
		Mucopolysaccharidoses
	Polyendocrinopathies
		Multiple endocrine neoplasia
		Autoimmune polyendocrine syndromes
	Further Reading
8 Haematology
	Haematopoiesis
		Normal developmental changes in haemoglobin
	Anaemia
		History
		Examination
		Investigations
			Iron-deficiency anaemia
				Iron requirements
				Causes of iron deficiency
				Clinical features
				Diagnosis
				Management
			Thalassaemias
				β -Thalassaemia
					β -Thalassaemia major
						Clinical features
						Diagnosis
						Treatment
					β -Thalassaemia trait
				α -Thalassaemia
	Haemolytic anaemia
		Hereditary spherocytosis
			Clinical features
			Diagnosis
			Management
		Sickle cell disease
			Clinical features
				Vasoocclusive crises
			Management
			Sickle cell trait
		Red cell enzyme deficiencies
			G6PD deficiency
				Clinical features
				Management
			Pyruvate kinase deficiency
	Splenomegaly
		History
		Examination
		Investigations
	Bleeding disorders
		Disorders of blood vessels
			Henoch–Schönlein purpura
				Clinical features
				Diagnosis and management
		Disorders of platelets
			Thrombocytopaenia
			Idiopathic thrombocytopaenic purpura
				Clinical features
				Diagnosis
				Treatment
	Coagulation disorders
		Haemophilia A (factor VIII deficiency)
			Clinical features
			Diagnosis
			Management
		Haemophilia B (factor IX deficiency, Christmas disease)
		von Willebrand disease
		Disseminated intravascular coagulation
			Clinical features
			Diagnosis and management
	Thrombotic disorders in childhood
	Further reading
9 Oncology
	Childhood cancer
		Aetiology
			Genetic causes of childhood cancer
			Infections
			Environmental
		Clinical features
		Investigations
		Management
			Supportive care
	The leukaemias
		Investigations
		Acute lymphocytic leukaemia
		Clinical features
		Prognosis
		Management
		Acute myeloid leukaemia
	Lymphomas
		Non-Hodgkin lymphoma
			Clinical features
			Management
		Hodgkin lymphoma
			Clinical features
			Diagnosis
			Management
	Brain tumours
		Diagnosis
		Astrocytomas (40%)
			Clinical features
			Diagnosis and management
		Medulloblastoma (20%)
		Craniopharyngioma (4%)
	Neuroblastoma
		Clinical features
		Diagnosis
		Treatment
	Wilms tumour (nephroblastoma)
		Clinical features
		Genetics and aetiology
		Diagnosis
		Treatment
	Soft-tissue sarcomas
	Bone tumours
		Osteosarcoma
			Clinical features
			Diagnosis
			Treatment
		Ewing sarcoma
			Clinical features and diagnosis
			Treatment
	Retinoblastoma
	Langerhans cell histiocytosis
	Further reading
10 Fever, infectious diseases and immunodeficiency
	Fever
		History
		Examination
		Investigations
		Management
		The child with fever and a petechial rash
			Meningococcal sepsis
		Pyrexia of unknown origin
			Kawasaki disease
				Incidence
				Clinical features
				Investigations
				Management
	Viral infections
		Viral exanthems
			Measles
				Clinical features
				Complications
				Management
			Rubella
				Clinical features
				Complications
				Management
				Congenital rubella
			Erythema infectiosum or slapped cheek disease (fifth disease)
				Clinical features
				Complications
				Management
			Roseola infantum (sixth disease)
				Clinical features
				Complications
				Management
		Herpes infections
			Herpes simplex virus 1 (HSV1, HHV-1)
				Management
			Herpes simplex virus 2 (HSV2, HHV-2)
			Varicella zoster virus (HHV-3)
				Clinical features
				Complications
				Management
				Congenital varicella
				Herpes zoster (shingles)
			Epstein–Barr virus (HHV-4, EBV)
				Clinical features
				Management
			Cytomegalovirus (HHV-5, CMV)
				Clinical features
				Management
				Congenital CMV
		Other viruses
			Mumps
				Clinical features
				Complications
				Management
			Enteroviruses
				Hand, foot and mouth disease
				Polio
		Viral hepatitis
			Hepatitis A virus
				Clinical features
				Investigations
				Treatment
			Hepatitis B virus
				Clinical features
				Investigations
				Management
				Perinatal exposure
	Bacterial infections
		Streptococcal infections
			Alpha-haemolytic streptococci
			Beta-haemolytic streptococci
				Scarlet fever
				Erysipelas
		Staphylococcal infections
			Impetigo
			Boils and abscesses
			Staphylococcal scalded skin syndrome
		Gram-negative infections
			Typhoid and paratyphoid fever
				Clinical features
				Diagnosis
				Management
		Tuberculosis
			Pathophysiology
			Clinical features
				Tuberculous infection: asymptomatic infection
				Tuberculous disease: symptomatic infection
				Haematogenous dissemination
			Diagnosis
				Tuberculin testing
				Interferon-gamma testing
				Culture and histology
				Polymerase chain reaction
				Radiology
			Treatment and prevention
	Parasitic infections
		Malaria
			Pathophysiology
			Clinical features
			Diagnosis
			Management
		Toxocariasis
			Clinical features
			Management
		Worms (nematodes)
			Threadworm
				Clinical features
				Diagnosis
				Management
	Immunodeficiency
		Primary immunodeficiencies
			X-linked agammaglobulinaemia (Bruton disease)
			Common variable immunodeficiency
			IgA deficiency
			Severe combined immunodeficiency
			Chronic granulomatous disease
			Management
		Secondary immunodeficiency
			Immunosuppressive therapy
			Human immunodeficiency virus
				Transmission
				Clinical features
				Diagnosis
				Management
				Prevention
	Further reading
11 Allergy and anaphylaxis
	Epidemiology
	Pathophysiology
		IgE-mediated allergy
		Non-IgE-mediated allergy
		Cross-reactivity
	Aetiology
	Clinical aspects of allergy
		History
		Examination
		Investigations
			Skin-prick testing
			Serum-specific IgE
			Food challenge
		Management
	Anaphylaxis
		Pathophysiology
		Causes
		Clinical presentation
		Management
		Prevention
	Further reading
12 Dermatology
	The child with a rash
		Causes
		History
		Examination
			Site and distribution
			Morphology
		Investigations
	Specific rashes
		Eczema
			Atopic eczema
				Clinical features
				Investigations
				Management
				Complications
			Infantile seborrhoeic eczema
			Napkin dermatitis
				Nappy rash
				Candidiasis
		Acne vulgaris
			Clinical features
			Management
		Pityriasis rosea
		Erythema multiforme
		Erythema nodosum
	Skin infections
		Bacterial skin infections
		Viral skin infection
			Viral warts
			Molluscum contagiosum
		Fungal skin infections
			Dermatophytoses (tinea capitis, corporis, pedis and unguium)
			Candidiasis (thrush)
	Infestations
		Scabies
			Clinical features
			Management
		Head lice ( Pediculosis capitis)
			Clinical features
			Management
	Further reading
13 Nervous system
	Fits, faints and funny turns
		History
			Provoking events
			Description of the episodes
			Other important features
		Examination
			The well child
			Acute presentations
		Seizures
		Faints (vasovagal syncope)
		Funny turns
			Breath-holding attacks
			Reflex anoxic seizures
			Rigors
	The unconscious child
		Examination
			Systemic examination
			Neurological examination
	Epilepsy
		Classification of seizures
			General onset seizures
				Tonic–clonic seizures
				Absence seizures
			Focal onset seizures
		Classification of epilepsies and epilepsy syndromes
			Childhood absence epilepsy
			Infantile spasms (West syndrome)
		Aetiology
		Diagnosis
		Investigations
			EEG
			Neuroimaging
			Other investigations
		Management of epilepsy
			Antiepilepsy drugs
	Febrile convulsions
		Clinical features
		Management
		Prognosis
	Headache
		History
		Examination
			Tension headaches
			Migraine
				Management
			Raised intracranial pressure
				Management
	Infections of the central nervous system
		Meningitis
			Bacterial meningitis
				Clinical features
				Diagnosis
				Treatment
				Prevention
				Complications
		Encephalitis
			Clinical features
			Diagnosis
			Management
		Postinfectious syndromes
			Guillain–Barré syndrome
				Clinical features
				Management
	Malformations of the central nervous system
		Hydrocephalus
			Clinical features
			Diagnosis
			Treatment
		Neural tube defects
	Cerebral palsy
		Clinical features
		Diagnosis
		Classification
			Spastic cerebral palsy (70%)
			Ataxic cerebral palsy (10%)
			Dyskinetic cerebral palsy (10%)
		Management
	Neurocutaneous syndromes
		Neurofibromatosis type 1 (von Recklinghausen disease)
		Neurofibromatosis type 2
		Tuberous sclerosis
		Sturge–Weber syndrome
	Neurodegenerative disorders of childhood
		Clinical features
	Neuromuscular disorders
		Clinical features
		Diagnosis
		Muscular dystrophies
			Duchenne muscular dystrophy
				Clinical features
				Diagnosis
				Management
			Becker muscular dystrophy
			Myotonic dystrophy
				Clinical features
			Spinal muscular atrophies
	Further reading
14 Musculoskeletal system
	Limp
		Differential diagnosis
		History
		Examination
		Investigations
			Blood tests
			Imaging
	Disorders of the hip and knee
		Developmental dysplasia of the hip
			Cause
			Diagnosis
			Management
		Transient synovitis (irritable hip)
			Diagnosis
			Management
			Perthes disease
			Clinical features
			Diagnosis
			Management
		Slipped upper femoral epiphysis
	Disorders of the spine
		Back pain
		Scoliosis
		Idiopathic scoliosis
		Torticollis
	Disorders of the upper limbs
		Pulled elbow
	Disorders of the skull
		Craniosynostosis
	Fractures
	Bone and joint infections
		Osteomyelitis
			Clinical features
			Diagnosis
			Treatment
		Septic arthritis
			Clinical features
			Investigation
			Management
	Rheumatic disorders
		Juvenile idiopathic arthritis
			Systemic (previously Still disease)
			Polyarticular
				Rheumatoid factor-negative polyarticular JIA
				Rheumatoid factor-positive polyarticular JIA
			Oligoarticular
				Diagnosis
				Management
		Juvenile dermatomyositis
		Systemic lupus erythematous
			Diagnosis
			Management
	Genetic skeletal dysplasias
		Achondroplasia
		Osteogenesis imperfecta (brittle bone disease)
	Further reading
15 The newborn
	Definitions
	Maternal and fetal health
	Fetal assessment and antenatal diagnosis
	Maternal conditions affecting the fetus
		Maternal diseases
			Diabetes mellitus
			Hypertension
			Maternal thyroid disease
		Maternal drugs affecting the fetus
		Maternal infections and the fetus
			Cytomegalovirus
			Rubella
			Varicella zoster virus
			Human immunodeficiency virus
			Toxoplasmosis
	Normal neonatal anatomy and physiology
		Size and growth
		Skin
		Head
		Respiratory system
		Cardiovascular system
		Gastrointestinal system
		Genitourinary system
		Haematopoietic and immune system
		Central nervous system
	Birth
		Assessment and care at a normal birth
		Perinatal asphyxia
		Hypoxic–ischaemic encephalopathy
	Birth injury
	The newborn
		Size and gestational age
			Small for gestational age
			Large for gestational age infants
		Feeding difficulties
			Breastfeeding
			Bottle feeding
			Weight gain in infants
		Vomiting
		Neonatal jaundice
			Jaundice in the first 24 hours
				Rhesus (Rh) haemolytic disease of the newborn
				ABO incompatibility
			Jaundice at 2 days to 2 weeks
			Prolonged jaundice ( > 2 weeks)
			Management of neonatal jaundice
				Phototherapy
				Exchange transfusion
			Biliary atresia
				Clinical features
				Investigations
				Management
	Disorders of the term infant
		Respiratory disorders
			Transient tachypnoea of the newborn
			Pneumonia
				Management
			Laryngomalacia
			Pneumothorax
			Chylothorax
			Meconium aspiration
			Persistent pulmonary hypertension of the newborn
				Management
			Aspiration
		Gastrointestinal and hepatic disorders
			Cleft lip and palate
			Oesophageal atresia
			Bowel obstruction
			Small bowel obstruction
				Duodenal atresia
				Midgut volvulus and malrotation
				Meconium ileus
			Large bowel obstruction
				Hirschsprung disease
				Anorectal atresia
		Cardiovascular disorders
		Haematological disorders
			Haemorrhagic disease of the newborn
		Neurological disorders
			Neonatal seizures
				Initial investigations
			Neonatal abstinence syndrome
				Clinical features
				Diagnosis
				Management
		Infections
			Minor infections
				Skin pustules and paronychia
				Acute mastitis
				Conjunctivitis
				Thrush (moniliasis)
			Major infections
				Septicaemia
					Diagnosis
				Group B streptococcal infection
					Treatment
				Meningitis
					Diagnosis
					Treatment and outcome
				Pneumonia
				Urinary tract infection
	The preterm infant
		General care of the preterm infant
			Predelivery care
			Stabilization at birth
			Body temperature
			Avoiding infection
			Nutrition and fluids
				Which milk for preterm infants?
				Supplements
	Disorders of the preterm infant
		Respiratory disorders
			Surfactant deficiency (hyaline membrane disease, RDS)
				Clinical features
				Management
			Apnoeic attacks
		Cardiovascular problems
			Patent ductus arteriosus
				Management
		Neurological problems
			Intracranial haemorrhage
			Periventricular leukomalacia
		Gastrointestinal problems
			Jaundice
			Necrotizing enterocolitis
				Management
			Long-term prognosis
			Retinopathy of prematurity
			Chronic lung disease
				Management
			Neurodevelopmental problems
	Congenital malformations
		Craniofacial
			Craniosynostosis
			Cleft lip and palate
		Respiratory
			Cystic adenomatoid malformation of the lung
			Congenital diaphragmatic hernia
		Gastrointestinal
			Gastroschisis (1:5000)
			Exomphalos (1:2500)
		Central nervous system
			Neural tube defects
				Spina bifida occulta
				Meningocele
				Myelomeningocele
			Urogenital
			Musculoskeletal
				Congenital talipes equinovarus (club foot)
				Developmental dysplasia of the hip
	Further reading
16 Genetics
	Basic genetics
	Single-gene disorders
	Autosomal dominant disorders
		Achondroplasia
		Marfan syndrome
	Autosomal recessive disorders
	X-linked disorders
		Fragile X syndrome
		Ornithine transcarbamylase deficiency
	Multifactorial disorders
	Chromosomal disorders
		Chromosomal abnormalities
			Down syndrome (Trisomy 21)
				Nondisjunction
				Translocation
				Mosaicism
				Clinical features
				Management and prognosis
			Edwards syndrome (trisomy 18)
			Patau syndrome (trisomy 13)
		Sex chromosome disorders
			Turner syndrome
				Clinical features and diagnosis
				Management
			Klinefelter syndrome
		Structural chromosomal abnormalities
	Mitochondrial inheritance
	Genetic counselling
17 Developmental assessment and developmental day
	History
	Examination
		Key gross motor milestones
		Key fine motor and visual milestones
		Key speech and hearing milestones
		Key social and cognitive milestones
	Signs of abnormal development
		Global developmental delay
			Investigation and management
		Specific developmental delay
			Delayed walking
				Examination
				Investigations
			Speech and language delay
	Further reading
18 Child and adolescent mental health
	Attachment
	Problems of early childhood
		Babies
		Toddlers
			Sleep-related problems
				Difficulty in getting to sleep at night
				Nightmares and night terrors
			Food refusal
			Tantrums
			Breath-holding spells
	Autism spectrum disorders
		Clinical presentation
		Assessment and diagnosis
		Management
	Attention deficit hyperactivity disorder
		Incidence and aetiology
		Clinical features
		Investigations
		Management
			Behavioural therapy
			Drug therapy
			Alternative therapies
		Prognosis
	Behavioural problems
		Conduct disorder
		Oppositional defiant disorder
	Continence problems
		Enuresis
			History
			Examination
			Investigations
			Management
		Encopresis (faecal soiling)
			History
			Examination
			Management
	Affective disorders
		Depression
			Clinical features
			Management
		Self-harm and suicide
	Anxiety
		School refusal
		Selective mutism
	Psychosis
	Eating disorders
		Aetiology
		Anorexia nervosa
			Clinical features
			Investigations
			Management
			Prognosis
		Bulimia nervosa
	Medically unexplained physical symptoms
		Chronic fatigue syndrome
			Management
		Recurrent pain syndromes
			Management
	Further reading
19 Community paediatrics, public health and child protection
	Prevention in child health
		Screening
		Child health promotion
			Neonatal examination
			1–2-Week check
			6–8-Week check
			9–12-Month review
			2–2.5-Year review
			School entry
		Immunization
			Active immunization
			Passive immunization
			Routes of administration
			Immunization schedule
			Indications and contraindications to immunization
				False’ contraindications
		Sudden infant death syndrome
			Brief resolved unexplained events
	Children with disabilities
		Causes of childhood disability
		Assessment and diagnosis
		Management: the multidisciplinary team
		Education, health and care plan
	Child protection
		Types of abuse
			Physical abuse or nonaccidental injury
			Sexual abuse
			Emotional abuse
			Neglect
		Diagnosis
		Management
	Children and the law
		The Children Act
		Parental responsibility
		Foster care
		Adoption
		Consent to medical care
		Confidentiality
	Further reading
20 Accidents and emergencies
	Emergencies
		The seriously ill child
			Assessment
				Airway
				Breathing
				Circulation
				Disability
		Cardiorespiratory arrest
			Basic paediatric life support
			Airway manoeuvres
				Rescue breaths
				Assessing for signs of life
				Chest compressions
			Advanced paediatric life support
		Neurological emergencies
			Reduced level of consciousness
				Assessment
				Diagnosis
				Management
			Seizures
				History
				Examination
				Management
		Cardiac emergencies
		Respiratory emergencies
			Upper airways obstruction
				Croup
				Acute epiglottitis
				Foreign body inhalation
					Management
			Lower airways obstruction
				Acute asthma
				Bronchiolitis
		Shock (circulatory failure)
			Clinical features
			Management
			Specific shock syndromes
				Anaphylactic shock
			Septic shock
				Clinical features
				Management
			Diabetic ketoacidosis
				Clinical features
				Diagnosis
				Management
					Fluids
					Insulin
				Complications
	Accidents
		Trauma
			Major trauma
				Management
					Immediate
					Focused
					Detailed review
		Head injury
			Clinical features
			Diagnosis
			Management
		Burns and scalds
			Assessment
			Management
			Nonaccidental injury consideration in burns and scalds
		Near drowning
			Management
			Prognostic indicators of near drowning
		Poisoning
			Clinical features
			Diagnosis
			Management
			Deliberate self-poisoning in older children
	Further reading
21 Nutrition, fluids and prescribing
	Nutrition
		Normal nutritional requirements
		Infant feeding
			Breastfeeding
			Weaning
			Special milks
		Malnutrition
			Assessment of nutritional status
			Dietary history
			Anthropometry
			Laboratory investigations
			Management
		Vitamin deficiencies
			Vitamin D deficiency: rickets
				Diagnosis
				Treatment
			Vitamin A (retinol) deficiency
		Obesity
			Management
	Fluids and electrolytes
		Basic physiology
		Fluid compartments
			Normal requirements
		Intravenous fluids
			Important features of intravenous solutions
		Specific fluid and electrolyte problems
			Sodium
			Potassium
	Paediatric pharmacology and prescribing
		Absorption and administration
		Metabolism and excretion
	Further reading
Part: Self-Assessment
	Single best answer (SBA) questions
	Extended matching questions (EMQs)
	SBA answers
	EMQ answers
Glossary
Index
Inside Back Cover