Pediatrics: Merck Manual Professional

THE MERCK MANUAL MEDICAL LIBRARY: The Merck Manual of Diagnosis and Therapy

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Section		Pediatrics

Pediatrics

	Introduction

Approach to the Care of Adolescents

	Approach to the Care of Adolescents
			Physical Growth
			Sexuality
			Intellectual Growth
			Emotional Growth
			Physical Problems
			Psychosocial Disorders

Approach to the Care of Normal Infants and Children

Introduction
Colic
		Evaluation
			History and physical examination
			Testing
		Treatment
Constipation
		Evaluation
			History
			Physical examination
			Testing
		Treatment
Crying
		Evaluation
			History
			Physical examination
			Testing
		Treatment
Diarrhea
		Etiology
		Evaluation
			History
			Physical examination
			Testing
		Treatment
Evaluation and Care of the Normal Neonate
		The First Few Hours
		The First Few Days
			Physical examination
			Screening
			Routine care and observation
			Hospital discharge
Fever
		Etiology
		Evaluation
			History
			Physical examination
			Testing
		Treatment
Health Supervision of the Well Child
	Physical Examination
			Growth
			Blood pressure
			Head
			Heart
			Abdomen
			Spine and extremities
			Genital examination
	Screening
			Blood tests
			Hearing
			Other screening tests
	Vaccination
	Prevention
			Safety
			Nutrition
			Exercise
Nutrition
			Feeding problems
	Breastfeeding
			Technique
			Infant complications
			Maternal complications
			Drugs
			Weaning
	Formula Feeding
	Solid Foods
Separation and Stranger Anxiety
			Separation anxiety
			Stranger anxiety
Sleeping
		Evaluation
			History
			Physical examination and testing
		Treatment
Spitting Up and Vomiting
		Evaluation
			History
			Physical examination
			Testing
		Treatment
Toilet Training

Behavioral Concerns and Problems

Introduction
		Evaluation
			Problem identification
			Problem interpretation
		Treatment
Breath-Holding Spells
Eating Problems
Temper Tantrums
Toileting Problems
	Nocturnal Enuresis
		Diagnosis
		Treatment
	Encopresis
		Treatment
Violence

Bone and Connective Tissue Disorders in Children

Introduction
Congenital Hypophosphatasia
Cutis Laxa
		Symptoms and Signs
		Diagnosis and Treatment
Ehlers-Danlos Syndrome
		Symptoms, Signs, and Diagnosis
		Prognosis and Treatment
Idiopathic Scoliosis
		Symptoms and Signs
		Diagnosis and Treatment
Knee Pain
Marfan Syndrome
		Symptoms and Signs
		Diagnosis
		Treatment
Nail-Patella Syndrome
Osteochondrodysplasias
		Diagnosis and Treatment
Osteochondroses
	Köhler's Bone Disease
	Legg-Calvé-Perthes Disease
		Diagnosis and Treatment
	Osgood-Schlatter Disease
		Diagnosis and Treatment
	Scheuermann's Disease
		Diagnosis and Treatment
Osteogenesis Imperfecta
Osteopetroses
	Craniotubular Dysplasias
			Metaphyseal dysplasia (Pyle's disease)
			Craniometaphyseal dysplasia
			Frontometaphyseal dysplasia
	Craniotubular Hyperostoses
			Endosteal hyperostosis (van Buchem's syndrome)
			Sclerosteosis
			Diaphyseal dysplasia (Camurati-Engelmann disease)
	Osteosclerosis
			Osteopetrosis with delayed manifestations (Albers-Schönberg disease)
			Osteopetrosis with precocious manifestations
			Osteopetrosis with renal tubular acidosis
			Pyknodysostosis
Slipped Capital Femoral Epiphysis (SCFE)
		Symptoms and Signs
		Diagnosis and Treatment

Caring for Sick Children and Their Families

	Introduction
	Children with Chronic Health Conditions
				Effects on the child
				Effects on the family
				Care coordination
	Death and Dying
				Death of a child
				Death of a family member or friend
	The Sick Neonate

Child Maltreatment Chromosomal Anomalies Congenital Cardiovascular Anomalies

Introduction
	Pathophysiology
		Left-to-right shunts
		Obstructive lesions
		Cyanotic heart anomalies
		Heart failure
	Symptoms and Signs
	Diagnosis
	Treatment
Atrial Septal Defect (ASD)
	Symptoms and Signs
	Diagnosis
	Treatment
Atrioventricular Septal Defect
	Symptoms and Signs
	Diagnosis
	Treatment
Coarctation of the Aorta
	Symptoms and Signs
	Diagnosis
	Treatment
Complex and Rare Abnormalities
Eisenmenger's Syndrome
	Symptoms and Signs
	Diagnosis
	Treatment
Hypoplastic Left Heart Syndrome
	Symptoms and Signs
	Diagnosis
	Treatment
Patent Ductus Arteriosus (PDA)
	Symptoms and Signs
	Diagnosis
	Treatment
Persistent Truncus Arteriosus
	Symptoms and Signs
	Diagnosis
	Treatment
Tetralogy of Fallot
	Symptoms and Signs
	Diagnosis
	Treatment
Transposition of the Great Arteries
	Symptoms and Signs
	Diagnosis
	Treatment
Tricuspid Atresia
	Symptoms and Signs
	Diagnosis
	Treatment
Ventricular Septal Defect (VSD)
	Symptoms and Signs
	Diagnosis
	Treatment

Congenital Craniofacial and Musculoskeletal Abnormalities Congenital Gastrointestinal Anomalies Congenital Neurologic Anomalies Congenital Renal and Genitourinary Anomalies Cystic Fibrosis (CF)

Cystic Fibrosis
	Pathophysiology
		Pulmonary
	Symptoms and Signs
	Diagnosis
	Prognosis
	Treatment
		End-of-life care

Dehydration and Fluid Therapy Endocrine and Metabolic Disorders in Children

Introduction
Congenital Adrenal Hyperplasia
	21-Hydroxylase Deficiency
		Symptoms and Signs
		Diagnosis
		Treatment
	11β-Hydroxylase Deficiency
		Symptoms and Signs
		Diagnosis and Treatment
Congenital Goiter
		Etiology
			Dyshormonogenesis
			Transplacental passage of maternal antibodies
			Transplacental passage of goitrogens
		Symptoms and Signs
		Diagnosis and Treatment
Delayed Puberty
Hyperthyroidism
			Hyperthyroidism during infancy
			Hyperthyroidism during childhood and adolescence
Hypothyroidism
			Hypothyroidism during infancy and early childhood
			Hypothyroidism during later childhood and adolescence
Male Hypogonadism in Children
		Classification
			Primary
			Secondary
		Symptoms and Signs
		Diagnosis
		Treatment
Precocious Puberty
		Etiology
			GnRH-dependent precocious puberty
			GnRH-independent precocious puberty
		Symptoms, Signs, and Diagnosis
		Treatment

Eye Defects and Conditions in Children

	Introduction
	Amblyopia
			Etiology
			Symptoms and Signs
			Diagnosis
			Prognosis and Treatment
	Congenital Cataract
	Primary Infantile Glaucoma
	Strabismus
			Etiology
			Symptoms and Signs
			Diagnosis
			Prognosis and Treatment

Gastrointestinal Disorders in Neonates and Infants Hereditary Periodic Fever Syndromes

	Introduction
	Familial Mediterranean Fever
			Etiology
			Symptoms and Signs
			Diagnosis
			Prognosis and Treatment
	Hyper-IgD Syndrome
	TNF Receptor–Associated Periodic Syndrome

Infections in Infants and Children

Introduction
Erythema Infectiosum
	Symptoms and Signs
	Diagnosis and Treatment
Human Immunodeficiency Virus (HIV) Infection in Children
	Epidemiology
		Transmission
		Classification
	Symptoms and Signs
		Complications
	Diagnosis
		HIV-specific tests
		Other tests
	Prognosis
	Treatment
		Indications
		Monitoring
		Vaccination in symptomatic HIV infection
		Vaccination in asymptomatic HIV infection
		Vaccination for seronegative children living with a patient with symptomatic HIV infection
	Prevention
		Prevention of perinatal transmission
		Prevention of adolescent transmission
		Prevention of opportunistic infections
Occult Bacteremia
		Organisms
	Symptoms, Signs, and Diagnosis
	Prognosis and Treatment
Urinary Tract Infection (UTI)
	Etiology and Pathophysiology
	Symptoms and Signs
	Diagnosis
		Urine tests
		Blood tests
		Urinary tract imaging
	Prognosis
	Treatment
		Vesicoureteral reflux

Infections in Neonates

Introduction
			Risk factors
			Antibacterial therapy
Congenital and Perinatal Cytomegalovirus Infection (CMV)
		Etiology
		Symptoms and Signs
		Diagnosis
		Prognosis and Treatment
		Prevention
Congenital Rubella
		Symptoms and Signs
		Diagnosis
		Treatment
		Prevention
Congenital Syphilis
		Symptoms and Signs
		Diagnosis
			Early congenital syphilis
			Late congenital syphilis
			Follow up
		Treatment
			Pregnant women
			Early congenital syphilis
			Older infants and children with newly diagnosed congenital syphilis
		Prevention
Congenital Toxoplasmosis
		Etiology
		Symptoms and Signs
		Diagnosis
		Prognosis and Treatment
		Prevention
Neonatal Conjunctivitis
		Etiology
		Symptoms and Signs
		Diagnosis
		Treatment
		Prevention
Neonatal Hepatitis B Virus Infection
		Etiology
		Symptoms, Signs, and Diagnosis
		Prognosis and Treatment
		Prevention
Neonatal Herpes Simplex Virus (HSV) Infection
		Symptoms and Signs
		Diagnosis
		Prognosis
		Treatment
Neonatal Hospital-Acquired Infection
		Etiology
		Prevention
Neonatal Listeriosis
		Symptoms and Signs
		Diagnosis
		Prognosis and Treatment
		Prevention
Neonatal Meningitis
		Etiology
		Symptoms and Signs
		Diagnosis
		Prognosis
		Treatment
Neonatal Pneumonia
		Etiology
		Symptoms, Signs, and Diagnosis
		Treatment
	Chlamydial Pneumonia
Neonatal Sepsis
		Etiology
		Pathophysiology
		Symptoms and Signs
		Diagnosis
			CBC, differential, and smear
			Lumbar puncture (LP)
			Blood cultures
			Urinalysis and culture
			Other tests for infection and inflammation
		Prognosis
		Treatment
			Antibiotics
			Other treatment
		Prevention
Perinatal Tuberculosis (TB)
		Symptoms, Signs, and Diagnosis
		Treatment
			Pregnant women with a positive tuberculin test
			Infants with a positive tuberculin test
			Pregnant women with active TB
			Asymptomatic infants of women with active TB
			Neonates with active TB
		Prevention

Inherited Disorders of Metabolism

Introduction
Amino Acid and Organic Acid Metabolism Disorders
	Phenylketonuria (PKU)
			Variant forms
		Symptoms and Signs
		Diagnosis
		Prognosis and Treatment
	Disorders of Tyrosine Metabolism
			Transient tyrosinemia of the newborn
			Tyrosinemia type I
			Tyrosinemia type II
			Alkaptonuria
			Oculocutaneous albinism
	Disorders of Branched-Chain Amino Acid Metabolism
			Maple syrup urine disease
			Isovaleric acidemia
			Propionic acidemia
			Methylmalonic acidemia
	Disorders of Methionine Metabolism
			Classic homocystinuria
			Other forms of homocystinuria
			Cystathioninuria
			Sulfite oxidase deficiency
	Urea Cycle Disorders
		Symptoms and Signs
		Diagnosis and Treatment
Approach to the Patient With a Suspected Inherited Disorder of Metabolism
		Evaluation
			History and physical examination
			Testing
Carbohydrate Metabolism Disorders
	Glycogen Storage Diseases
	Galactosemia
			Galactose-1-phosphate uridyl transferase deficiency
			Galactokinase deficiency
			Uridine diphosphate galactose 4-epimerase deficiency
		Diagnosis and Treatment
	Disorders of Fructose Metabolism
			Fructose 1-phosphate aldolase (aldolase B) deficiency
			Fructokinase deficiency
			Deficiency of fructose-1,6-bisphosphatase
	Disorders of Pyruvate Metabolism
			Pyruvate dehydrogenase deficiency
			Pyruvate carboxylase deficiency
	Other Disorders of Carbohydrate Metabolism
Fatty Acid and Glycerol Metabolism Disorders
	Disorders of the β-Oxidation Cycle
			Medium-chain acyl dehydrogenase deficiency (MCADD)
			Long-chain hydroxyacyl-CoA dehydrogenase deficiency (LCHADD)
			Very long-chain acyl-coA dehydrogenase deficiency (VLCADD)
			Glutaric acidemia type II
	Disorders of Glycerol Metabolism
Lysosomal Storage Disorders
			Mucopolysaccharidoses
			Sphingolipidoses
	Gaucher's Disease
		Diagnosis and Treatment
	Niemann-Pick Disease
		Diagnosis and Treatment
	Tay-Sachs Disease and Sandhoff's Disease
			Tay-Sachs disease
			Sandhoff's disease
	Krabbe's Disease
	Metachromatic Leukodystrophy
	Fabry's Disease
	Cholesteryl Ester Storage Disease and Wolman's Disease
Mitochondrial Oxidative Phosphorylation Disorders
			Leber's hereditary optic neuropathy (LHON)
			Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS)
			Myoclonic epilepsy with ragged-red fibers (MERRF)
			Kearns-Sayre syndrome and chronic progressive external ophthalmoplegia (CPEO)
			Neurogenic muscle atrophy and retinitis pigmentosa (NARP) and Leigh disease
Peroxisomal Disorders
			Zellweger syndrome (ZS), neonatal adrenoleukodystrophy, and infantile Refsum's disease (IRD)
			Rhizomelic chondrodysplasia punctata
			X-linked adrenoleukodystrophy
			Classic Refsum's disease
Purine and Pyrimidine Metabolism Disorders
	Disorders of Purine Salvage
			Lesch-Nyhan syndrome
			Adenine phosphoribosyltransferase deficiency
	Disorders of Purine Nucleotide Synthesis
			Phosphoribosylpyrophosphate synthetase superactivity
			Adenylosuccinase deficiency
	Disorders of Purine Catabolism
			Myoadenylate deaminase deficiency (or muscle adenosine monophosphate deaminase deficiency)
			Adenosine deaminase deficiency
			Purine nucleoside phosphorylase deficiency
			Xanthine oxidase deficiency
	Disorders of Pyrimidine Metabolism
			Uridine monophosphate synthase deficiency (hereditary orotic aciduria)

Inherited Muscular Disorders Learning and Developmental Disorders Mental Disorders in Children and Adolescents

Introduction
		Evaluation
Anxiety Disorders
		Symptoms, Signs, and Diagnosis
		Prognosis and Treatment
	Generalized Anxiety Disorder
	Social Phobia
	Separation Anxiety Disorder
		Symptoms and Signs
		Diagnosis and Treatment
	Obsessive-Compulsive Disorder (OCD)
		Symptoms and Signs
		Prognosis and Treatment
	Panic Disorder and Agoraphobia
		Diagnosis
		Prognosis and Treatment
	Acute and Posttraumatic Stress Disorders (PTSD)
		Symptoms, Signs, and Diagnosis
		Prognosis and Treatment
Childhood Schizophrenia
Depressive Disorders
		Symptoms and Signs
		Diagnosis
		Prognosis and Treatment
	Bipolar Disorder
		Symptoms, Signs, and Diagnosis
		Prognosis and Treatment
Disruptive Behavioral Disorders
	Oppositional Defiant Disorder
		Symptoms, Signs, and Diagnosis
		Prognosis and Treatment
	Conduct Disorder
		Symptoms, Signs, and Diagnosis
		Prognosis and Treatment
Suicidal Behavior
			Risk factors
		Treatment
		Prevention
	Self-Injurious Behavior

Metabolic, Electrolyte, and Toxic Disorders in Neonates Miscellaneous Disorders in Infants and Children Neurologic Disorders in Children Pediatric Cancers Perinatal Hematologic Disorders Perinatal Physiology

	Perinatal Physiology
				Bilirubin
				Cardiovascular
				Endocrine
				Hemoglobin
				Immunologic
				Pulmonary
				Renal

Perinatal Problems

Introduction
Birth Injuries
	Head Injuries
	Cranial Nerve Injury
	Brachial Plexus Injuries
	Other Peripheral Nerve Injuries
	Spinal Cord Injury
	Intracranial Hemorrhage
		Diagnosis
		Prognosis
		Treatment
	Fractures
	Soft-Tissue Injuries
Hypothermia
		Etiology and Pathophysiology
		Treatment and Prevention
Large-for-Gestational-Age (LGA) Infant
		Symptoms, Signs, and Treatment
			Delivery complications
			Infants of diabetic mothers
Neonatal Resuscitation
			Assessment
			Resuscitation
Postmature Infant
		Pathophysiology
		Symptoms, Signs, and Diagnosis
		Prognosis and Treatment
Premature Infant
		Etiology
		Symptoms, Signs, and Diagnosis
			Initial testing
			Subsequent screening
		Complications
			Lungs
			CNS
			Infection
			Cardiac
			Temperature regulation
			GI tract
			Kidneys
			Eyes
			Metabolic problems
		Prognosis and Treatment
			Feeding
		Prevention
Retinopathy of Prematurity
		Diagnosis, Treatment, and Prevention
Small-for-Gestational-Age (SGA) Infant
		Etiology
		Symptoms and Signs
			Complications
		Prognosis and Treatment

Physical Growth and Development

	Introduction
	Development
				Motor development
				Language development
				Cognitive and social/emotional development
	Physical Growth
				Length
				Weight
				Head circumference
				Body composition
				Tooth eruption
	Sexual Development

Principles of Drug Treatment in Children

	Introduction
				Adverse effects and toxicity
	Nonadherence
	Pharmacokinetics
				Absorption
				Distribution
				Metabolism and elimination
				Drug dosing

Renal Transport Abnormalities

	Introduction
	Cystinuria
			Pathophysiology
			Symptoms, Signs, and Diagnosis
			Prognosis and Treatment
	Fanconi Syndrome
			Etiology
			Pathophysiology, Symptoms, and Signs
			Diagnosis and Treatment
	Hartnup Disease
			Symptoms, Signs, and Diagnosis
			Treatment
	Hypophosphatemic Rickets
			Symptoms, Signs, and Diagnosis
			Treatment

Respiratory Disorders in Neonates, Infants, and Young Children

Introduction
Apnea of Prematurity
	Etiology and Pathophysiology
	Diagnosis
	Prognosis and Treatment
Bacterial Tracheitis
Bronchiolitis
	Etiology and Pathophysiology
	Symptoms and Signs
	Diagnosis
	Prognosis and Treatment
Bronchopulmonary Dysplasia (BPD)
	Prognosis and Treatment
	Prevention
Croup
	Etiology
	Symptoms and Signs
	Diagnosis
	Prognosis and Treatment
Meconium Aspiration Syndrome
	Etiology and Pathophysiology
	Symptoms and Signs
	Diagnosis
	Prognosis and Treatment
Persistent Pulmonary Hypertension of the Newborn
	Etiology and Pathophysiology
	Symptoms and Signs
	Diagnosis
	Prognosis and Treatment
Pulmonary Air-Leak Syndromes
		Pulmonary interstitial emphysema
		Pneumomediastinum
		Pneumopericardium
		Pneumoperitoneum
		Pneumothorax
Respiratory Distress Syndrome
	Etiology and Pathophysiology
	Symptoms and Signs
	Diagnosis
	Treatment
	Prevention
Respiratory Support
		Oxygen
		Continuous positive airway pressure
		Mechanical ventilation
		Extracorporeal membrane oxygenation (ECMO)
Transient Tachypnea of the Newborn

Rheumatic Fever

Rheumatic Fever
		Etiology and Pathophysiology
			Joints
			Heart
			Skin
			CNS
		Symptoms and Signs
			Joints
			Heart
			Skin
			CNS
			Other
		Diagnosis
		Prognosis
		Treatment
	Poststreptococcal Reactive Arthritis

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