Examination PAEDIATRICS: A guide to paediatric training 2018


Table of contents : Cover......Page 1
Inside Front Cover......Page 2
Examination Paediatrics......Page 3
examination Paediatrics A guide to paediatric training 5th edition......Page 5
Copyright Page......Page 6
Dedication......Page 11
Foreword to the fifth edition......Page 13
Preface......Page 14
Preface to the first edition......Page 15
Acknowledgements/ Special thanks …......Page 16
Reviewers......Page 17
Abbreviations......Page 19
Positive mindset......Page 37
Body language......Page 38
Dress and grooming......Page 39
Ability to summarise......Page 40
Preparation......Page 41
Equipment......Page 42
Obtaining the history......Page 44
Preparation to meet the examiners......Page 45
Details and history......Page 46
Remaining history......Page 47
Examination......Page 50
3 The Short Case......Page 52
Self-motivation......Page 55
Why do you do the things you do?......Page 56
Goal-setting......Page 57
Affirmation......Page 58
Self-talk......Page 59
Visualisation......Page 60
Mental toughness......Page 61
Failure......Page 62
Further reading......Page 63
Long case: Anorexia nervosa (AN)......Page 64
Background information......Page 65
Behavioural symptoms: the A to F of AN......Page 66
Physical symptoms of AN......Page 67
Past history of AN......Page 68
Investigations......Page 69
Management......Page 71
Indications for admission: paediatric and adolescent......Page 72
Indications for hospital admission: adult medical......Page 73
Food and eating......Page 74
Prognosis......Page 75
Introduction......Page 76
Background information......Page 77
The raine study......Page 81
The question of medication-induced cardiac effects......Page 82
Current symptoms......Page 83
Teacher report......Page 84
Vigilance testing......Page 85
Management......Page 86
School strategies (educational management principles)......Page 87
Short acting: dexamphetamine, methylphenidate (MPH)......Page 88
Long acting (8–12 hours): extended-release MPH tablets, long-acting MPH capsules, lisdexamfetamine dimesilate......Page 89
Other medications previously used: tricyclic antidepressants (TCAs; imipramine, desipramine), bupropion, venlafaxine......Page 90
Alternative treatments......Page 91
Prognosis......Page 92
Long case: Autism spectrum disorder (ASD)......Page 93
Background information......Page 94
Aetiology......Page 95
Current symptoms......Page 97
Current management......Page 99
Diagnosis of autism......Page 100
Diagnostic structured parental interviews......Page 101
Other......Page 102
Pharmacotherapeutic intervention......Page 103
3. Sleep disturbances......Page 104
Intervention......Page 105
Useful websites......Page 106
Background information......Page 107
Stages (mnemonic: DRUM)......Page 108
Congenital variant (Rolando variant)......Page 109
Epilepsy......Page 110
Scoliosis......Page 111
Constipation......Page 112
Screaming episodes......Page 113
Developmental history......Page 114
Important signs in examination of the child with RTT......Page 115
Sleep disorders......Page 116
Surgical interventions for gastrointestinal/feeding problems......Page 117
Short case: Suspected ADHD......Page 118
Eyes......Page 120
Developmental assessment......Page 121
Short case: Suspected ASD......Page 122
8. Skin......Page 123
Short case: Rett syndrome (RTT)......Page 124
5. Eyes (Gaze)......Page 126
11. Abdominal examination (Gas; swallowed air)......Page 127
Neuromuscular assessment......Page 128
Cyanotic congenital heart defects (CCHDs)......Page 130
Aortic disease: bicuspid aortic valve, aneurysmal aortic dilatation......Page 148
Diagnosis......Page 151
Current state of health......Page 152
1. General development, growth and nutrition......Page 153
Dental procedures and dental care......Page 154
Immunisation......Page 155
Recommendations regarding sports participation and exercise......Page 156
Travel......Page 157
Marfan syndrome (MFS)......Page 158
Management of MFS......Page 161
Noonan syndrome (NS)......Page 162
Management of NS......Page 167
22q11.2 deletion syndrome (22q11.2DS): conotruncal defects......Page 168
Williams syndrome (WS)......Page 171
Management of WS......Page 172
Supraventricular tachycardia (SVT)......Page 173
Long QT syndrome (LQTS)......Page 175
Brugada syndrome......Page 177
Dilated cardiomyopathy (DCM)—familial dilated cardiomyopathy (FDC) and idiopathic dilated cardiomyopathy (IDC)......Page 178
Familial hypertrophic cardiomyopathy (FHCM): also called hypertrophic obstructive cardiomyopathy (HOCM) and idiopathic hypertrophic subaortic stenosis (IHSS)......Page 179
Congestive cardiac failure (CCF)......Page 180
Cardiac transplantation......Page 181
Telemedicine......Page 183
Short case: The cardiovascular system......Page 184
CXR......Page 193
ECG......Page 195
QRS and Q wave abnormalities......Page 201
Reference......Page 202
Background information......Page 203
High-risk pregnancies: prenatal diagnosis of 21-OHD CAH......Page 204
Neonatal presentation of 21-OHD CAH at 1–4 weeks......Page 205
Gold standard of diagnosis......Page 206
Progress of the disease......Page 207
Management......Page 208
Other potential approaches to treatment......Page 209
Psychological support......Page 210
21-OHD CAH prenatal diagnosis and intervention......Page 211
Management of acute adrenocortical insufficiency (adrenal crisis)......Page 212
Long case: Type 1 diabetes mellitus (T1DM)......Page 213
Background information......Page 214
Diagnosis......Page 216
Progress of the disease......Page 217
Associated diseases......Page 218
Insulin therapy......Page 219
Short-acting (clear) insulins (neutral/regular/soluble insulin)......Page 220
The glycaemic index (GI)......Page 221
Hypoglycaemic episodes......Page 222
Insulin pumps......Page 223
Diet......Page 224
Glycosylated haemoglobin (HbA1c)......Page 225
Routine follow-up......Page 226
Retinopathy......Page 227
Neuropathy......Page 228
Requirement for psychological support......Page 229
Transition from paediatric to adult care......Page 231
Cerebral oedema (CO)......Page 232
Long case: Hypopituitarism......Page 233
Craniopharyngioma......Page 234
CHARGE syndrome......Page 235
Isolated pituitary hormone deficiencies......Page 236
Acquired (traumatic) brain injury......Page 237
Holoprosencephaly (HPE)......Page 238
Birth history......Page 239
Family history......Page 240
Glucocorticoid hormone replacement therapy......Page 241
Antidiuretic hormone (ADH) replacement therapy......Page 243
Induction of puberty in boys......Page 244
Short case: Disorders of sexual development (DSD) (ambiguous genitalia)......Page 245
Examination for ambiguous genitalia......Page 246
Testicular failure (undervirilised males)......Page 247
Examination......Page 248
Interpretation of the US:LS ratio and arm span......Page 251
Inspect from the side......Page 252
Aetiologies......Page 253
Alternative introduction to short stature—endocrine......Page 254
Measurements......Page 262
Manoeuvres......Page 263
Investigations......Page 264
Observation......Page 269
Examination......Page 272
Pubic hair stages (for females and males)......Page 275
Examination......Page 276
Additional information......Page 277
Short case: Delayed puberty......Page 281
Examination......Page 282
Blood tests......Page 283
Short case: Disorders of sexual development (DSD) (virilisation in post-neonatal period)......Page 288
Short case: Thyroid disorders......Page 293
Examination......Page 294
Short case: Thyroid disorders in infants......Page 296
Examination procedure......Page 300
Blood tests......Page 303
Reference......Page 304
Long case: Inflammatory bowel disease (IBD)......Page 305
Other relevant medical history......Page 306
Investigations......Page 307
Blood......Page 309
Imaging......Page 310
Other......Page 311
Induction therapy for CD: exclusive enteral nutrition (EEN), steroids, biologics......Page 312
CD maintenance: immunomodulators AZA, 6MP, MTX; biologics IFX, ADA......Page 314
Mild disease/distal colitis......Page 315
Severe disease/fulminant distal and extensive colitis/refractory disease......Page 316
Metabolic bone disease......Page 317
Extrahepatic biliary atresia (EHBA)......Page 318
Progressive familial intrahepatic cholestasis (PFIC) disorders......Page 319
Metabolic disease......Page 320
Chronic hepatitis......Page 322
Investigations......Page 323
Nutrition......Page 324
Portal hypertension, varices and variceal haemorrhage......Page 325
Other non-transplantation treatment options......Page 326
Indications for LTx......Page 327
Complications of LTx......Page 328
Hepatic vascular compromise (