Pediatric Clinical Skills

Front Cover......Page 1
Pediatric Clinical Skills......Page 4
Copyright Page......Page 5
Dedication......Page 6
Foreword......Page 8
Preface......Page 10
Acknowledgements......Page 12
Contents......Page 16
Contributors......Page 14
What Do Families Want?......Page 18
Interviewing and History-Taking Skills......Page 19
Obtaining the Initial History......Page 23
Case History......Page 27
Interviewing and Examining Adolescents......Page 28
Clinical Skills for Special Situations......Page 30
Recommended Reading......Page 32
Cultural Disadvantage in Health Care......Page 33
Communication......Page 34
Consent for Treatment......Page 35
Special Features of Cross-Cultural History-Taking......Page 36
Recommended Reading......Page 38
Measurements and Growth Charts......Page 39
A Language for Communicating Information About Children's Growth......Page 45
Growth (Height) Velocity......Page 46
Staging Pubertal Development......Page 47
Nutritional Assessment......Page 49
Evaluating the Obese Child......Page 50
Summary......Page 53
Recommended Reading......Page 54
Approach to Physical Examinations of the Newborn: When, Why, and How......Page 55
Clinical Observations and What They Mean......Page 57
Primitive Reflexes......Page 59
Weighing and Measuring......Page 60
Assessing Gestational Age......Page 61
The Head......Page 62
The Neck......Page 66
The Abdomen......Page 67
The Genitalia......Page 68
The Extremities......Page 69
Skin of the Newborn......Page 70
Recommended Reading......Page 72
The Logic Behind the Diagnostic Approach......Page 73
Definition of Terms......Page 74
Obtaining The History......Page 77
Approach To the Physical Examination......Page 79
Recommended Reading......Page 86
Developmental Surveillance and the Developmental/Behavioral History......Page 87
Family History......Page 88
Behavior Problems......Page 95
Direct Developmental Examination......Page 96
Case Histories......Page 100
Summary......Page 104
Websites......Page 105
Approach to the Physical Examination of the Head......Page 106
Case History......Page 107
Recommended Reading......Page 117
Normal Visual System in Infants and Children......Page 118
Obtaining the History......Page 123
Approach to the Physical Examination......Page 124
Specific Examination Techniques......Page 126
Case Histories......Page 132
Recommended Reading......Page 138
Obtaining the History......Page 139
Approach to the Physical Examination......Page 144
Case History......Page 152
Recommended Reading......Page 153
Case History......Page 154
History of Present Illness and Cardiac Functional Inquiry in the Infant and Young Child......Page 155
Approach to Cardiovascular Examination of the Infant......Page 157
Approach to the Cardiovascular Assessment of the Older Child......Page 162
Approach to the Cardiovascular Examination of the 3- to 5-Year-Old Child......Page 163
Cardiovascular Examination of the School-Aged Child......Page 170
Cardiac Assessment of the Teenager......Page 173
Summary......Page 175
Recommended Reading......Page 176
General Appearance......Page 181
Examination of the Abdomen......Page 182
Case History......Page 183
Percussion......Page 186
Common Gastrointestinal Symptoms......Page 187
Case History......Page 191
Case History......Page 192
Case History......Page 194
Case History......Page 195
Recommended Reading......Page 196
Clinical Conditions by Typical Age of Occurrence......Page 197
Presenting Clinical Features......Page 204
Summary......Page 206
Obtaining the History......Page 207
Observation......Page 208
The Physical Examination......Page 210
Cortical Function......Page 212
Cranial Nerve II (Optic)......Page 213
Cranial Nerve V (Trigeminal)......Page 215
Cranial Nerves IX And X (Glossopharyngeal and Vagus)......Page 216
Physical Examination of the Trunk and Extremities......Page 217
Case Histories......Page 223
Suggested Readings......Page 226
Clinical Interview......Page 227
Obtaining the Presenting History......Page 229
Assessing Symptoms......Page 231
Suggested Readings......Page 235
Normal Musculoskeletal Variants......Page 236
Slipped Capital Femoral Epiphysis......Page 238
Case History......Page 239
The Child with a Single Swollen Joint......Page 241
Significant Common Skeletal Deformities......Page 242
Obtaining the History......Page 243
Approach to the Physical Examination......Page 245
Approach to the Examination of Specific Joints......Page 249
Suggested Readings......Page 256
Chief Characteristics of the Child with Growth Hormone Deficiency......Page 257
Approach to the Physical Examination of a Child with Possible Growth Hormone Deficiency......Page 258
Chief Characteristics of Thyroid Disorders in Children......Page 259
Approach to the Physical Examination of the Child with a Thyroid Disorder......Page 261
Approach to the Physical Examination of a Hypocalcemic Child......Page 265
Chief Characteristics of Adrenal Disorders in Children......Page 266
Chief Physical Characteristics......Page 267
Congenital Adrenal Hyperplasia......Page 268
Hirsutism......Page 270
Approach to the Physical Examination of a Child with Adrenal Insufficiency......Page 272
Pubertal Development: Precocious, Delayed, and Normal Variants......Page 273
Testicular Examination......Page 274
Clinical Characteristics of Diabetes Mellitus in Children......Page 275
Summary......Page 276
Suggested Readings......Page 278
Puberty......Page 279
Starting the Interview......Page 280
Interview with Parents......Page 283
Summary......Page 284
Suggested Readings......Page 285
Approach to the Physical Examination......Page 286
Obtaining the History......Page 289
Approach to the Pelvic Examination......Page 290
Adolescent Contraception......Page 293
Suggested Readings......Page 295
Obtaining the History of Skin Problems......Page 296
Approach to the Physical Examination......Page 298
Approach to the Examination of Mucosa and Skin Appendages......Page 303
Case Histories......Page 304
Suggested Readings......Page 306
First Disclosure of the Diagnosis to Parents......Page 307
Special Skills for Continuing Care......Page 309
Physical Examination of a Child with a Chronic Condition......Page 310
Suggested Readings......Page 311
Mandated Reporting......Page 312
The First Few Moments of the Meeting......Page 313
Obtaining the History......Page 314
Obtaining Pertinent History......Page 315
Physical Examination......Page 317
Case Histories......Page 321
Assessing Children for Physical Abuse and Neglect......Page 322
Functional Inquiry......Page 323
Notes on Photography......Page 326
Suggested Readings......Page 327
The Doctor-Patient Relationship in Pediatrics......Page 336
Evolving Understanding of Respectful Involvement of Children in Medical Decisions......Page 337
Assessing the Appropriate Role for Children in Health Decisions......Page 338
Case Histories......Page 339
Suggested Readings......Page 345
The Broad Scope of Palliative Care......Page 346
Case Histories......Page 347
Suggested Readings......Page 350
Index......Page 351
Color Plate......Page 360