Contents
Cover
Dedication
Title Page
Copyright Page
OSCE stations
Preface
Acknowledgements
Further reading
How to use your textbook
Features contained within your textbook
The anytime, anywhere textbook
About the companion website
Part 1: Essentials of paediatrics
1: Children and their health
1.1 Global child health
1.2 Child mortality and morbidity in the UK
1.3 Children in society
1.4 Child health in the community
1.5 Social aspects of child health and care
1.6 Children in hospital
Summary
2: Parents and children: listening and talking
2.1 History-taking and diagnosis
2.2 The consultation
2.3 Adolescence
Summary
3: Examination of children
3.1 A system of examination
3.2 Growth and nutrition
3.3 Dental development
3.4 Sexual development
3.5 Systems examination
Summary
4: Emergency paediatrics
4.1 Basic life support
4.2 Recognition of impending or imminent collapse
4.3 Paediatric advanced life support
4.4 Recognition of the ill child
Summary
Part 2: Normal and abnormal in childhood: growth, development, behaviour and prevention
5: Genetics
5.1 The human genome
5.2 Genetic mechanisms of disease
5.3 Investigations
5.4 Approach to suspected genetic disease
Summary
6: Fetal medicine
6.1 Control of fertility
6.2 Antenatal and pre-pregnancy care
6.3 Congenital malformations
6.4 Embryonic and fetal growth and development
Summary
7: Birth and the newborn infant
7.1 The effects of birth on the fetus
7.2 Perinatal asphyxia and its prevention
7.3 Routine care of the normal baby
7.4 Examination of the newborn
7.5 Birth injury (physical trauma)
7.6 Congenital malformations
Summary
8: Disorders of the newborn
8.1 Birth weight and gestation
8.2 The preterm baby
8.3 The small-for-gestational age (SGA) baby
8.4 The newborn term infant
Summary
9: Child development and how to assess it
9.1 Normal development
9.2 Developmental assessment
9.3 Notes and memory aids
9.4 Limitations of developmental assessment
Summary
10: Learning problems
10.1 Medical causes of educational difficulty
10.2 Early diagnosis and assessment
10.3 Conditions
10.4 School difficulties
10.5 Special educational needs
Summary
11: Emotional and behavioural problems
11.1 Attachment
11.2 Types of emotional and behavioural problems
11.3 Causes of emotional and behavioural problems
11.4 Management
11.5 Specific disorders
Summary
References
12: Nutrition
12.1 Infant nutrition
12.2 Nutrition of toddlers and school children
12.3 Feeding problems
12.4 Defective nutrition
12.5 Nutrition in chronic disease
Summary
13: Abnormal growth and sex development
13.1 Abnormal growth
13.2 Abnormal sex development
Summary
14: Immunization and infections
14.1 Immunity
14.2 Immunization
14.3 Anaphylaxis
14.4 Infections
Summary
15: Accidents and non-accidents
15.1 Accidents
15.2 Child abuse and neglect
15.3 Sudden infant death syndrome (SIDS, cot death)
Summary
16: Adolescent health
16.1 Approach to consultation
16.2 Consent
16.3 Physical problems
16.4 Psychological problems
16.5 Social problems
16.6 Transition to adult services
Summary
Reference
Part 3: Systems and specialties
17: Neurology
17.1 Seizures
17.2 Seizure types
17.3 Conditions which may be mistaken for seizures
17.4 Neurodermatoses (neurocutaneous syndromes)
17.5 Infections and infection-related
17.6 Hydrocephalus
17.7 Neural tube defects (spinal dysraphism)
17.8 Cerebral palsy
17.9 Headaches
17.10 Space-occupying lesions
17.11 Progressive neuromuscular disorders
17.12 The floppy infant
Summary
18: Ear, nose and throat
18.1 Ear problems
18.2 Nose and sinuses
18.3 Throat
Summary
19: Respiratory medicine
19.1 Symptoms of respiratory tract disease
19.2 Upper respiratory tract
19.3 Apnoea
19.4 Influenza
19.5 Lower respiratory tract
19.6 The wheezy child
19.7 Asthma
19.8 Cystic fibrosis
Summary
20: Cardiology
20.1 Innocent murmurs
20.2 Changes in circulation at birth
20.3 Congenital heart disease
20.4 Neonatal presentations
20.5 Classification of congenital heart disease
20.6 Surgical treatment of congenital heart disease
20.7 Cardiac failure
20.8 Dysrhythmias
20.9 Hypertension
Summary
21: Gastroenterology
21.1 Symptoms
21.2 Pathologies
Summary
22: Urinary Tract and Genitalia
22.1 Development
22.2 Urine examination
22.3 Congenital anomalies
22.4 Renal disease
22.5 Urinary tract infection (UTI)
22.6 Enuresis
22.7 Male genitalia
22.8 Female genitalia
Summary
23: Bones and joints
23.1 Structural variation and congenital abnormalities
23.2 Bone and joint infection
23.3 Arthritis and arthralgia
23.4 Osteochondritis and epiphysitis
23.5 Slipped upper femoral epiphysis
Summary
24: Skin
24.1 Birthmarks
24.2 Rashes
24.3 Warts
24.4 Infestations
24.5 Other skin problems covered elsewhere
Summary
25: Haematology
25.1 The normal blood picture (Table 25.1)
25.2 Anaemia
25.3 Coagulation disorders
Summary
26: Neoplasia
26.1 Acute leukaemia
26.2 Lymphomas
26.3 Central nervous system tumours
26.4 Neuroblastoma
26.5 Wilms tumour (nephroblastoma)
26.6 Bone tumours
26.7 Treatment of childhood malignancy
Summary
Reference
27: Endocrine and metabolic disorders
27.1 Diabetes mellitus
27.2 Hypoglycaemia
27.3 Thyroid disease
27.4 The adrenal glands
27.5 Growth hormone deficiency
27.6 Diabetes insipidus
27.7 Inborn errors of metabolism
Summary
Part 4: Essentials of paediatrics
28: Preparing for clinical examinations in paediatrics and child health
28.1 Clinical examinations
28.2 Written examinations
Summary
29: Safe prescribing
30: Careers in paediatrics
30.1 Why consider paediatrics?
30.2 Is paediatrics for me?
30.3 Career options
30.4 Training and exams
30.5 Developing your interest
Summary
Self-test
Extended matching questions
Answers to extended matching questions
Paediatric symptom sorter
Index
We dedicate this book to our students, past, present, and future.
This edition first published 2014 © 2014 by John Wiley & Sons Ltd
Previous editions published 1973, 1975, 1978, 1981, 1986, 1991, 2002, 2008 by Blackwell Publishing
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Library of Congress Cataloging-in-Publication Data
Newell, Simon J., author.
Lecture notes. Paediatrics/Simon J. Newell, Jonathan C. Darling. – Ninth edition.
1 online resource.
Paediatrics
Includes bibliographical references and index.
Description based on print version record and CIP data provided by publisher; resource not viewed.
ISBN 978-1-118-81448-2 – ISBN 978-1-118-81449-9 (ePub) – ISBN 978-0-470-65707-2 (pbk.)
I. Darling, Jonathan C., author. II. Title. III. Title: Paediatrics.
[DNLM: 1. Pediatrics–methods. 2. Child Development–physiology. WS 100]
RJ45
618.9’2–dc23
2013030203
A catalogue record for this book is available from the British Library.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.
Cover image Sawayasu Tsuji / iStockphoto.com
Cover design by Grounded Design
OSCE stations
OSCE station 2.1: Counselling
OSCE station 4.1: Shock
OSCE station 9.1: Developmental assessment
OSCE station 10.1: Examination for squint
OSCE station 11.1: History-taking—pain
OSCE station 13.1: Failure to thrive
OSCE station 14.1: Fever and a fit in an infant
OSCE station 14.2: Allergic reaction
OSCE station 15.1: Accidental poisoning
OSCE station 16.1: Discussion of asthma treatment
OSCE station 17.1: Neurological examination of the legs
OSCE station 19.1: Examination of the respiratory system
OSCE station 19.2: Prescribing and explaining asthma treatment
OSCE station 20.1: Examination of the cardiovascular system
OSCE station 21.1: Persistent diarrhoea
OSCE station 21.2: Constipation
OSCE station 22.1: Urine testing
OSCE station 22.2: Enuresis
OSCE station 22.3: Urinary tract infection management and prevention
OSCE station 23.1: Testing for dislocation of the hips
OSCE station 25.1: Assessment of bruising
OSCE station 27.1: Examination of the neck
OSCE station 28.1: Equipment
OSCE station 29.1: Safe prescribing—otitis media and fever
Preface
When Lecture Notes: Paediatrics began over 40 years ago, the notion of a weblink to watch a YouTube video would have been science fiction. (Try http://tinyurl.com/lnpcell ‘ Inner life of the cell’ from Harvard and imagine trying to watch and believe this in 1973.) Looking back at the first edition, it tells of: high mortality from Rhesus disease; life-threatening infections, since abolished by immunization; lead poisoning; frequent admissions for accidental ingestion of drugs, before childproof containers and blister packs; and ‘ At present there is no cure for leukaemia…’.
Paediatrics and child health have come a long way. Children are 20% of the population and are seen in 40% of general practice consultations. We have again set out to focus on the core of the paediatric curriculum that every medical student should learn. We hope our book will also be useful to other health professionals who care for children, especially our colleagues in advanced nursing roles.
In this new edition we have advanced the use of information boxes indicating key points, practice points, treatment guides, learning logs, and web-based support material. Each chapter begins with a chapter map and suggests practical ways of gaining experience in paediatrics in the learning log at the end. This edition offers many updated and new sections, as well as new chapters in adolescent health, genetics, safe prescribing and careers in paediatrics.
Students and teachers all want success in examinations. We have added more OSCE stations, along with OSCE tips at the end of each chapter, to be used alongside the section on Preparing for Clinical Examinations in Paediatrics and Child Health and the extended matching questions (EMQs). We hope you will find these useful.
We have amended the book to give it what we hope will be an easy-to-follow structure: Part 1 takes you through the essentials you need to know at the outset; Part 2 covers normal and abnormal from fetal life through to adolescence; then Part 3 moves to systems and specialties; and finally we explain in Part 4 what happens next – exams and (we hope) careers in paediatrics.
We both used Lecture Notes when we were medical students and it is a popular choice of text at home in the UK and abroad. We hope you will enjoy reading Lecture Notes during your paediatrics and that it will in some way contribute to still higher and better standards for children’s health during your careers in the next 40 years.
Simon Newell
Jonathan Darling
Acknowledgements
This book was conceived by Professor Sir Roy Meadow and Professor Dick Smithells, whose teaching inspired many students in paediatrics.
We are grateful to the European Resuscitation Council for permission to use their illustrations, and algorithms in emergency paediatrics. We thank the focus groups of medical students, whose reflections on the previous edition were so helpful to us.
Further reading
Large comprehensive textbooks:
Kliegman RM, Stanton BMD, St Geme J, Schor NF (eds) (2011) Nelson Textbook of Pediatrics. 19th edition, Elsevier Saunders.
McIntosh N, Helms PJ, Smyth RL, Logan S (eds) (2008) Forfar and Arneil’s Textbook of Pediatrics, 7th edition, Churchill Livingstone.
Rennie JM (ed.) (2012) Rennie & Roberton’s Textbook of Neonatology, 5th edition, Churchill Livingstone.
We have included links to useful supplementary reading and resources throughout the text – look out for the Resources boxes.
How to use your textbook
Features contained within your textbook
Overview pages give a summary of the chapters in each part.
Every chapter begins with a chapter map showing the contents of the chapter and an introduction to the topic.
Treatment boxes give prescribing guidelines and advice.
Key point boxes highlight important information about a topic.
OSCE tip boxes and OSCE stations help you prepare and revise for exams.
Resource boxes point you to useful information in books and online.
Practice point boxes give practical tips on how best to handle a specific scenario.
Each chapter ends with a Summary and a section called For your log which suggests practical ways of gaining experience in paediatrics.
The Emergency and Paediatric symptom sorter quick reference guide sections are clearly indicated for quick reference.
Don’t forget to visit www.lecturenoteseries.com/paediatrics to download the Symptom sorter to your mobile device.
The anytime, anywhere textbook
We hope you enjoy using your new book. Good luck with your studies!
About the companion website
Don’t forget to visit the companion website:
www.lecturenoteseries.com/paediatrics
The website contains a PDF of the Paediatric symptom sorter for you to download and view on your mobile device.
Part 1
Essentials of paediatrics
Chapter 1 Children and their health
Chapter 2 Parents and children: listening and talking
Chapter 3 Examination of children
Chapter 4 Emergency paediatrics