Pediatric Rotations - A Quick Guide for Medical Students (Aug 5, 2024)_(3031598725)_(Springer)

Preface
Contents
Chapter 1: The Power of Play
	Introduction
	Establishing Rapport
		Equip Yourself for Success Prior to Meeting the Patient
		Introductions
		“I Spy.” Finding Commonalities and Shared Experiences
		Body Language and Nonverbal Cues
		Verbal Communication
	Incorporating Play into Your Practice: Why Play?
	Decreasing Anxiety
		Redirection
		Relaxation
		Caregiver’s Presence
	Play to Help Meet Goals
		Recap
	Further Reading
Chapter 2: Taking a Pediatric History
	History of Present Illness (HPI)
	Birth History
	Developmental History
	Past Medical History
	Feeding History
	Surgical History
	Family History
	Social History
	Review of Systems
	Special Considerations
		The Nonverbal Child
	References
Chapter 3: Age-Based Strategies for Physical Exams
	Background
	Considerations for the Physical Exam of the Newborn/Early Infant
	Considerations for the Physical Exam of the Older Infant/Toddler
	Considerations for the Physical Exam of Pre-school/School-Aged Children
	Considerations for the Physical Exam of Tween/Teens
	Focusing on the Pediatric Ear Exam
	Approach to the Ear Exam If Caregiver Assistance/Restraint Is Needed
	Genital and Breast Exam
	Examining the Child with Developmental/Intellectual Disabilities or Limited Verbal Communication
	Pain Assessment in Pediatric Patients
	Further Readings
Chapter 4: Challenging Conversations in Pediatrics
	Introduction
	Specific Patient Scenarios
		Breaking Bad News/Sharing Life Altering News
		De-escalating Upset Families
		Tricky Topics-Gun Safety, Vaccine Hesitancy, Child Abuse Concerns
			Gun Safety
		Why Guns Are a Risk
		Safety Steps
		How to Make Counseling Relevant to Milestones
		Vaccine Hesitancy
		Child Abuse Concerns
	Addressing Students’ Feelings
		Second Victim Syndrome/Phenomenon
		Building Resilience
	Reference
		Further Reading
Chapter 5: Presenting Patients
	Background
	Presenting Patients
		New Admission to Inpatient Service
		Daily Presentation in Inpatient Service
	Family-Centered Rounds
	Outpatient Oral Presentation
		New Outpatient Visit
		Well Child Check
		Follow-Up Patient’s Visits
		Patients Presenting for an Acute Problem to the Primary Care Physician (PCP)
	Special Considerations when Presenting Pediatric Patient
		Intake and Output
		Growth and Weight Gain in Infants and Children
		Using Z-Scores
		Caloric Requirements for Infants and Children
		Vital Signs
	Further Reading
Chapter 6: Note Writing
	Note Writing
	Problem-Based vs. Systems-Based Plans
	History and Physical Exam Note
	Inpatient Daily Progress Notes
	Discharge Summaries
	Outpatient Notes
	References
Chapter 7: Consults and Handoffs
	Requesting Expert Consultation
		Preparation
		Additional Tips:
		Pitfalls:
		Special Situations
			Curbside Consults
			The Reluctant Consultant
	Patient Handoffs
		Additional Tips:
		Pitfalls:
	References
Chapter 8: Interprofessional Communication
	Professionalism, Collaboration, and Communication
	The Healthcare System’s Contribution to Communication Complexities
		Groupthink
		Modes of Interprofessional Communication
	Navigating Interprofessional Communication
	Conclusion
	Bibliography
Chapter 9: How to Promote Your Learning
	Pre-rotation Activities
	Setting Expectations
	Mid-rotation
	End of Rotation/Post Rotation
	The Clinical Setting
	Inpatient Rotations
	Pre-rounding
	Rounds
	Post-rounds
	Outpatient Rotations
	The Daily Flow
	Conclusion
	Reference
Chapter 10: Abdominal Pain
	Background
	Pathophysiology
	History
	Physical Examination
	Laboratory Assessment
	Imaging
		Traumatic Abdominal Injuries
		Surgical Pathology or Prior Abdominal Surgery
		Colicky Pain
		Palpable Masses
		Abnormal Uterine Bleeding
	Differential Diagnosis
	Causes of Acute Abdominal Pain <5 Years Old
		Necrotizing Enterocolitis (NEC)
		Intussusception
		Malrotation/Volvulus
		Henoch-Schönlein Purpura (HSP)
		Constipation
	Causes of Acute Abdominal Pain >5 Years Old
		Appendicitis
		Gastroesophageal Reflux Disease
		Functional Abdominal Pain
	Management
		Conditions Requiring Immediate Surgical Consultation
		Conditions with Initial Medical Management
		Conditions with Medical Management
	Anticipatory Guidance
	Further Reading
Chapter 11: Acid–Base and Electrolyte Disorders
	Background
	Pathophysiology
		Metabolic Acidosis and Respiratory Acidosis
		Metabolic Alkalosis and Respiratory Alkalosis
		Hypernatremia
		Hyponatremia
	History
		Hydration Status
		Ingestions
		Growth and Development
	Physical Exam
		Vitals
		Weight
	Laboratory Assessment/Imaging
		Hypernatremia and Hyponatremia
	Key Differential Diagnosis
		Metabolic Acidosis: High Anion Gap Acidosis (HAGMA)
		Diabetic Ketoacidosis (DKA)
		Ingestions
		Metabolic Acidosis: Normal Anion Gap Metabolic Acidosis (NAGMA)
		Metabolic Alkalosis
		Respiratory Acidosis and Alkalosis
		Hypernatremia
		Hyponatremia
	Management
		Metabolic Acidosis
		Metabolic Alkalosis
		Respiratory Acidosis and Alkalosis
		Hypernatremia
		Hyponatremia
	Anticipatory Guidance
		Acid/Base Disorders
		Hyponatremia/Hypernatremia
	Further Reading
Chapter 12: Asthma and Status Asthmaticus, Allergies, and Eczema
	Asthma and Status Asthmaticus
		Background/Pathophysiology
		History
		Physical Examination
		Laboratory Assessment/Imaging
		Key Differential Diagnosis
		Management
		Anticipatory Guidance
	Allergic Rhinitis
		Background
		Pathophysiology
		Clinical History
		Physical Examination
		Laboratory Assessment/Imaging
		Key Differential Diagnosis
		Management
			Allergen Avoidance Measures
			Immune Modulation
		Anticipatory Guidance
	Eczema
		Background and Pathophysiology
		History
		Physical Examination
		Laboratory Assessment/Imaging
		Key Differential Diagnosis
		Management
		Anticipatory Guidance
	Further Reading
Chapter 13: Bronchiolitis
	Background/Pathophysiology
	History
	Physical Exam
	Workup
	Key Differential Diagnoses
	Management
	Anticipatory Guidance
	Further Reading
Chapter 14: Burns and Wounds
	Wounds
		History
		Physical Exam
		Laboratory Assessment/Imaging
		Differential Diagnosis
		Management
		Complications and Other Considerations
	Burns
		Background
		Pathophysiology
		History
		Physical Exam
		Laboratory Assessment/Imaging
		Management
		Anticipatory Guidance for Wounds
	Further Reading
Chapter 15: Common Procedures
	Introduction
		Obtaining Consent
		Pre-procedural Diet Guidelines
	Procedures
		Peripheral and Central Venous Access
		Enteral Feeding Tubes
		Lumbar Puncture
		Laceration Repair
		Incision and Drainage
	Further Reading
Chapter 16: Common Testing
	Cardiovascular
		Electrocardiogram
		Critical Congenital Heart Disease Screen
		Lipid Screen
	Respiratory
		Chest Radiography
	GI/Fluid, Energy, Nutrition
		Ultrasound
		Abdominal Radiography
		Liver Function Tests
	CNS
		Neuroimaging: Head CT and MRI
		CSF Studies
	Hematologic
		Complete Blood Count
		Iron Studies
		Coagulation Panel
		Lead
	Renal/Urinary System
		Electrolytes
		Urinalysis
		Blood Pressure Measurement
	Endocrine/Metabolism
		Vitamin D
		Bone Age
		Hemoglobin A1c
		Newborn Metabolic Screen
	Musculoskeletal
		Skeletal Survey
	Reproductive
		Testing for Sexually Transmitted Infections (STIs)
	Infectious
		Blood, Urine, CSF Cultures
		Inflammatory Markers
		Group A Streptococcus Culture
		Respiratory Infection Array
		Gastrointestinal Infection Array
	Further Reading
Chapter 17: Cystic Fibrosis
	Background
	Pathophysiology
	Diagnostic Testing
		Newborn Screening
		Gold Standard Testing
	Outpatient Management of CF
		Care Centers
		Lung Health in CF
		Nutritional Health in CF
		Emerging Therapies
	Acute Illness Management in CF
	Medical Emergencies in CF
		Respiratory Failure
		Hemoptysis
		Acute Intestinal Obstruction
	Further Reading
Chapter 18: Depression, Anxiety, and Suicide
	Depression
		Background
		History
			SIGECAPS
			Risk Factors for Depression
			Key Focused Review of Systems (ROS)
		Physical Exam
		Work-Up
			Laboratory Assessment
			Screening Tools for Depression
		Differential Diagnosis
		Management
	Anxiety
		Background
		History
		Physical Examination
		Work-Up
			Laboratory Assessment
			Screening Tools for Anxiety
		Differential Diagnosis
		Management
	Suicide
		Background
		History
			Risk Factors for Suicidality
		Management
	Further Reading
Chapter 19: Disordered Eating
	Background/Epidemiology
	Diagnostic Criteria
		Summarized DSM-5 Criteria for Anorexia Nervosa
		Summarized DSM-5 Criteria for Bulimia Nervosa
		Summarized DSM-5 Criteria for Avoidant/Restrictive Food Intake Disorder
	History
	Physical Exam
	Differential Diagnosis
	Management
		Outpatient vs. Inpatient Management
		Criteria for Hospitalization
		Management Approach
		Electrolyte Management
		Fluid Management in Malnourished States
		Pharmacotherapy
		Psychotherapy
	Prognosis
Chapter 20: Weight-Faltering in Infants and Children (Failure to Thrive)
	Background
	Definitions
	Pathophysiology (Etiology)
	History
	Physical Exam
	Laboratory and Imaging Assessment or Workup
		Red Flags as an Exception
	Key Differential Diagnosis
	Management
		Outpatient
		Nutritional and Behavioral Evaluation and Management
		Diagnostic Evaluation
		Inpatient
	Anticipatory Guidance (Caregivers/Families)
	Further Reading
Chapter 21: Fever of Unknown Origin
	Background
	Relevant History Elements to Address
		How Were the Temperatures Measured?
		What are the Fever Characteristics?
		What Potential Exposures to Infectious Agents Exist in the Home and Social Environments?
		Any Family History of Infections, Autoimmune Conditions, Inflammatory Bowel Disease, or Malignancy at a Young Age?
		What is the Family Background or Ethnicity?
		Has There Been Any Ingestion of Raw Meat, Fish, or Unpasteurized Milk?
		Has There Been a Travel History to Other Regions, Other Countries, Including Past Residences in Those Locations?
		What is the Home Water Supply?
		What Other Medical Conditions Exist and What Medications are Used?
	Etiology and Differential Diagnosis of Pediatric FUO
	Physical Exam Findings
	Laboratory Assessment and Imaging
	Management
	Anticipatory Guidance
	Further Reading
Chapter 22: Hematology
	Anemia
	Iron Deficiency
	Sickle Cell Disease
	Immune Thrombocytopenia
	Leukocyte Disorders
		Differential Diagnosis of Neutropenia
	Reference
		Further Reading
Chapter 23: Hyperbilirubinemia in the Neonate
	Background
	Pathophysiology
		Bilirubin Metabolism
	History
		Intake and Output
		Key Focused Review of Systems (ROS)
		Birth History
		Risk Factors for Significant Hyperbilirubinemia
	Physical Exam
	Laboratory Assessment
		Measuring Bilirubin Levels
		Other Laboratory Assessments (Table 23.4)
	Differential Diagnosis
		Suboptimal Intake vs Breastmilk Jaundice
	Management
		Neurotoxicity Risk Factors
		Phototherapy
		Escalation of Care
		Home Phototherapy
	Anticipatory Guidance
	References
Chapter 24: Infectious Diseases: Common Inpatient Considerations
	Skin and Soft Tissue Infections (Cellulitis/Abscess)
		Background
		Pathogenesis
		Diagnosis
		Management
	Retropharyngeal Abscess (RPA)
		Background
		Pathophysiology
		History/Diagnosis
		Treatment/Management
	Orbital Cellulitis
		Background
		Pathophysiology and Etiology
		Diagnosis
		Management
	Croup (Laryngotracheitis)
		Background
		Pathophysiology
		History
		Birth History
		Family History
		Risk Factors for Croup
			Physical Exam
		Laboratory Assessment
		Differential Diagnosis
		Management
	Acute Osteomyelitis
		Background
		Pathophysiology
		History/Signs and Symptoms
		Physical Exam
		Laboratory Assessment and Diagnosis
		Differential Diagnosis
			Management
	COVID-19
		Background/Pathophysiology
		History
		Physical Examination
		Laboratory Assessment/Imaging
		Differential Diagnosis
		Management
			Vaccines
	References
Chapter 25: Infectious Diseases: Common Outpatient Considerations
	Infectious Pharyngitis
		Background
		History
		Physical Exam/Differential Diagnosis
		Laboratory Assessment/Imaging (Workup)
		Management
		Anticipatory Guidance (For Parents/Families)
	Acute Otitis Media
		Background/Pathophysiology
		History and Exam
		Key Differential Diagnoses
		Laboratory/Imaging (Workup)
		Management
		Anticipatory Guidance (For Parents/Families)
	Urinary Tract Infections
		Background/Pathophysiology
		History and Physical Exam
		Key Differential Diagnoses
		Laboratory Assessment/Imaging (Workup)
		Management
		Anticipatory Guidance (For Parents/Families)
	Periorbital and Orbital Cellulitis
		Background/Pathophysiology
		History and Physical Exam
		Key Differential Diagnoses
		Laboratory Assessment/Imaging (Workup)
		Management
		Anticipatory Guidance (For Parents/Families)
	Toxic or Transient Synovitis
		Background/Pathophysiology
		History
		Physical Exam
		Laboratory Assessment/Imaging (Workup)
		Key Differential Diagnosis
		Management
		Anticipatory Guidance (For Parents/Families)
	Infectious Rashes [1, 13]
	Immunodeficiencies [14, 15]
	References
Chapter 26: Inflammatory Diseases
	Juvenile Idiopathic Arthritis
		Epidemiology/Pathophysiology
		Clinical Manifestations
		Laboratory Assessment/Imaging
		Differential Diagnosis
		Management
	Henoch-Schönlein Purpura
		Epidemiology/Pathophysiology
		Clinical Manifestations
		Laboratory Assessment/Imaging
		Differential Diagnosis
		Management
	Kawasaki Disease
		Epidemiology/Pathophysiology
		Clinical Manifestations
		Laboratory Assessment/Imaging
		Differential Diagnosis
		Management
	Multisystem Inflammatory Syndrome in Children
		Epidemiology/Pathophysiology
		Clinical Manifestations
		Laboratory Assessment/Imaging
		Differential Diagnosis
		Management
	Further Reading
Chapter 27: Medical Devices
	Background
	Enteric Tubes
		Oral and Nasal Tubes
		Gastrostomy Tubes
		Common Complications with Gastrostomy Tubes
	Tracheostomies
		Indications
		Tracheostomy Tubes
		Management of the Tracheostomy Tube
		Complications
		Intentional Decannulation
	Ostomies
		Intestinal Ostomies
	Urinary Diversion
		Urostomies
		Mitrofanoff
		Complications
	Central Venous Catheters
		Complications
	Further Reading
Chapter 28: Medications and Fluid Management
	Medications and Weight-Based Dosing
		Background
		The Importance of Milliliters (mL) vs Milligrams (mg) When Prescribing Medications
		Common Pediatric Medications and Their Dosing
	Fluid Selection
		Dehydration
		Phases of Rehydration
	Fluid Types
		Complications of Intravenous Fluid Use
	Fluid Calculations
		Resuscitative Phase
		Titration and Maintenance Phase
		Convalescent Phase
	Further Reading
Chapter 29: Oncology
	Overview
	Meeting a Childhood Cancer Patient as a Medical Student
	Anticipatory Guidance for Cancer Patients
	Leukemias
	Lymphomas
	Neuroblastoma (NBL)
	Wilms Tumor (WT)
	Bone Tumors: Osteosarcoma (OS) and Ewing’s Sarcoma (ES)
	Central Nervous System (CNS) Tumors
	Oncologic Emergencies
		Fever and Neutropenia
		Tumor Lysis Syndrome (TLS)
		Mediastinal Mass
		Spinal Cord Compression (SCC)
	Supportive Care
	Psychosocial Care
	Survivorship
	Summary
	Further Reading
Chapter 30: Murmurs
	Background
	History
	The Pediatric Cardiac Exam
		Observation
		Palpation
		Auscultation
			General
			S1 and S2
			S3 and S4
	Murmurs
		Intensity
		Pitch
		Timing
			Systolic Murmurs
			Diastolic Murmurs
			Continuous Murmurs
		Location
		Effect of Position Changes
	Innocent Murmurs
		Still’s Murmur
			Still’s Murmur Fast Facts
		Peripheral Pulmonary Branch Stenosis Murmur
			PPS Murmur Fast Facts
		Venous Hum
			Venous Hum Fast Facts
		Pulmonary Flow Murmur
			Pulmonary Flow Murmur Fast Facts
	Pathologic Murmurs
		Murmur Red Flags
		Ventricular Septal Defect
		Atrial Septal Defect
		Patent Ductus Arteriosus
		Pulmonic Stenosis
		Aortic Stenosis
	Further Reading
Chapter 31: Pneumonia
	Background
	Pathophysiology
	History
		History of Present Illness
		Past Medical History
		Family History
		Social History
		Review of Systems
	Physical Exam
	Workup
		Laboratory Assessment
		Imaging
	Key Differential Diagnoses
	Management
		Criteria for Admission
	Complications
	Anticipatory Guidance
	Further Reading
Chapter 32: Poisonings and Intoxications
	Background
		Epidemiology
		Pathophysiologic Considerations
	History
		Substance Exposure Questions
		Symptoms and Review of Systems Questions
		Involvement of Poison Control
		Prior Therapies
		Social History
	Physical Exam
		Vitals
		Exam
	Toxidromes
	Electrocardiograms
	Laboratory Assessment
		Conventional Testing
		Toxicology Testing
	Imaging
	Management
		Supportive Care
		Specific Therapies
	Summary of Selected Poisonings
	Anticipatory Guidance
	Further Reading
Chapter 33: Seizures and Status Epilepticus
	Background
		Epidemiology
	Pathophysiology
	History
	Physical Exam
	Laboratory Assessment/Imaging
	Key Differential Diagnosis
	Management
	Anticipatory Guidance
	Febrile Seizures: Simple and Complex
		Background
		Pathophysiology
	History
	Physical Exam
	Laboratory Assessment/Imaging
	Key Differential Diagnosis
	Management
	Anticipatory Guidance
	Further Reading
Chapter 34: Sepsis
	Background
	Pathophysiology
	History
	Physical Exam
	Key Differential Diagnosis
	Initial Evaluation of Shock
	Management of Shock
	Special Considerations
		Neonates
		Meningitis/Encephalitis
		Bacteremia
		Pyelonephritis
	Conclusion and Key Points
	Further Reading
Chapter 35: Social Determinants of Health
	What Are Social Determinants of Health (SDOH)?
	How Do These Factors Impact Children?
	What Can Be Done?
		SDOH Screening
		What Are Some Factors to Consider Before Starting SDOH Screening?
		How Do You Screen for SDOH?
		Referral to Programs
	What Are the Ethics of SDOH Screening?
		Beneficence
		Non-malfeasance
		Autonomy/Resilience/Permission
		Justice
	Defining Adverse Childhood Experiences (ACEs)
		Screening for ACEs
	Advocacy
	References
Chapter 36: Trauma Injuries
	Major/Multisystem Trauma Overview: Initial Assessment
	Special Considerations in Pediatric Trauma
		Non-accidental Trauma (Child Abuse)
		Head Injuries
		Cervical Spine Injuries
		Dental
	Long Bone Injuries
	Radiation Risk
	Further Reading
Chapter 37: Approach to Well Child Checks (WCC)
	Presentation to the Clinic
		Before Going into the Room
		The Sick Child Presenting for a WCC
		In the Patient Room
	Growth and Nutrition
		Monitoring Growth Parameters
		Nutrition
		Obesity Prevention and Treatment
	Developmental Milestones
		Developmental Delays
		School Age Children
		Social History
	The Adolescent Well Visit
	Well Child Physical Exam
		Conducting a Genital and Breast Exam in Children and Adolescents
	Preventative Care and Anticipatory Guidance
	Immunizations
		Vaccine Hesitancy
	Special Populations
		Children with Chronic Disease
		Children with Medical Complexity
		Children in Immigrant Families
		LGBTQ and Gender Diverse Youth
	References
Chapter 38: Newborn Care
	Introduction
	Newborn Transitional Period
	Newborn History
	Perinatal Infections
	Newborn Physical Examination
	Ballard Scale
	Common Newborn Skin Findings
		Birth Sequelae and Injuries
		Routine Prophylaxis in the Newborn
		Routine Newborn Care
		Feeding
		Newborn Screenings
		Hospital Discharge
	Reference
		Suggested Readings
Chapter 39: Neonatal Intensive Care
	Classification of Neonates According to Birth Weight and Gestational Age
	The Late Preterm Infant
	Nutritional Needs of Late Preterm Infants
	Neonatal Thermoregulation
	Neonatal Hypoglycemia
	Fluid Management in Neonates
	Bronchopulmonary Dysplasia
	Respiratory Distress in the Neonate
	Neonatal Resuscitation
	Enteral and Parenteral Nutrition
	Apnea, Bradycardia, and Desaturations
	Necrotizing Enterocolitis
	NICU Procedures
	References
Chapter 40: Pediatric Critical Care
	Introduction
	Epidemiology/Indications for PICU Admission
		Epidemiology
		PICU Admission Criteria
	Systems-Based Presentations
		Introduction
		System-Based Presentation Basics
		Tips for a Successful Presentation
	Shock and Vasoactive Agents
		Introduction
	Sedation and Analgesia
		Introduction
		Discontinuing Sedation
	PICU Procedures
		Introduction
		Central Venous Lines
		Arterial Lines
		Thoracostomy Tubes
	Conclusion
	Further Reading
Chapter 41: Respiratory Interventions in Emergent and ICU Settings
	Introduction
	Respiratory Support in the PICU
		Non-Invasive Respiratory Support
			Introduction
			High Flow Nasal Cannula
		Non-invasive Positive Pressure Ventilation
		Intubation and Invasive Mechanical Ventilation
			Indications
			Procedural Considerations
			Routine Care and Monitoring of the Intubated Patient
			Extubation Readiness
		Extracorporeal Membrane Oxygenation
	Respiratory Support in the NICU
		Introduction
		Non-invasive Respiratory Support
			Introduction
			Nasal Continuous Positive Airway Pressure
			High Flow Nasal Cannula
			Nasal Intermittent Positive Pressure Ventilation
		Intubation and Invasive Mechanical Ventilation
			Introduction
			Surfactant Administration
			Types of Mechanical Ventilation
			High Frequency Ventilation
			High Frequency Oscillatory Ventilation (HFOV)
			High Frequency Jet Ventilation
		Pulmonary Hypertension and Nitric Oxide
		Neonatal ECMO
	Further Reading
Chapter 42: Emergency Care
	Introduction
	General Strategies
		First Shift
	Preparing for the Patient-Encounter and Establishing Rapport
	History of Present Illness (HPI)
	Social History and Family History
	Review of Systems (ROS) and Physical Exam
		Presenting in the ED
		Making the Most of your Time in the ED
	Common Clinical Scenarios: HPI, Physical Exam, Diagnostics, and Treatment
		Abdominal Pain
			Constipation
	Cough and URI Symptoms
		Respiratory Distress
		Fever
		Ear Pain
		Oropharyngeal Pain
		Head Injury
		Limp/Extremity Pain
	Further Reading
Index