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Pearls in Clinical Pediatrics Pushpendra Magon

SECTION 1: CLINICAL PEDIATRICS
CHAPTER 1:Children are Unique
- UNIQUE DEVELOPMENT AND GROWTH RIGHT FROM THE WOMB
- DISEASE PRESENTATION, DIAGNOSIS AND MANAGEMENT ARE UNIQUE
- AGEWISE THEY ARE UNIQUE
- UNIQUE PARENTING AND PSYCHOPATHOLOGY
CHAPTER 2:Know What is Normal and What is Not?
- WHY TO IDENTIFY WHAT IS NORMAL?
- POINTS TO REMEMBER
CHAPTER 3:Essentials of History-taking and Examination in a Neonate
- STRUCTURE OF THE HISTORY
- STRUCTURE OF EXAMINATION
CHAPTER 4:Outline of Pediatric History and Examination
- STRUCTURE OF PEDIATRIC HISTORY
- STRUCTURE OF EXAMINATION
- POINTS TO REMEMBER
CHAPTER 5:Nutrition
- NUTRIENTS
- WHAT IS RAINBOW DIET = VIBGYOR
- VITAMINS
- MINERALS
- STRUCTURE OF NUTRITIONAL HISTORY
- EXAMINATION (HEAD-TO-TOE)
- PROTEIN ENERGY MALNUTRITION
- ANTHROPOMETRY
- WEIGHT
- HEIGHT
- HEAD CIRCUMFERENCE*
- MID UPPER ARM CIRCUMFERENCE (MUAC)
  - Interpretation
- LABORATORY TESTS
  - To Identify the Presence of Nutritional Deficiencies
  - To Monitor Recovery
- TREATMENT
- PREVENTION OF MALNUTRITION ON NATIONAL SCALE
CHAPTER 6:Developmental Assessment
- DEVELOPMENTAL DELAY—FIVE GROUPS
- DIAGNOSIS OF CEREBRAL PALSY
- HISTORY PROCESS
- PHYSICAL EXAMINATION
- INVESTIGATION
- TOOLS FOR DEVELOPMENTAL ASSESSMENT
- POINTS TO REMEMBER
CHAPTER 7:Central Nervous System
- EMBRYOLOGY
  - Gastrulation (Fig. 7.1)
  - Neurulation (Fig. 7.2)
    - Nerve Cell Migration
- ANATOMICAL AND PHYSIOLOGICAL ASPECTS
- UPPER MOTOR NEURONS
- LOWER MOTOR NEURONS
- AUTONOMIC NERVOUS SYSTEM AND THE BLADDER
  - Sympathetic Chain (T1-L2)
  - Parasympathetic Craniosacral Outflow (CN III, VII, IX, X and S2-4)
    - Pathologies of Autonomic Nervous System
- THE BLADDER
  - Neurogenic Bladder
    - Upper Motor Neuron (UMN) Lesions
    - Lower Motor Neuron (LMN) Lesions
- HISTORY
- EXAMINATION
- NEUROLOGICAL EXAMINATION OF THE INFANT
CHAPTER 8:Cardiovascular System
- AN OVERVIEW OF CARDIOVASCULAR SYSTEM HEART EMBRYOLOGY
- ANATOMY
  - Heart Borders and Relations
- PHYSIOLOGY
- PATHOLOGY
  - Congenital Heart Diseases (CHD)
  - Acquired Heart Diseases
- SYMPTOMATOLOGY
- PATHOPHYSIOLOGY
- APEX BEAT
  - Blood Pressure
- POINTS TO REMEMBER
- STRUCTURE OF HISTORY
- STRUCTURE OF EXAMINATION
  - General Physical Examination
- SYSTEMIC EXAMINATION
- APPROACH TO CARDIOVASCULAR PROBLEMS OF A NEWBORN INFANT
- TREATMENT
  - Medical
  - Surgical
CHAPTER 9:Respiratory System
- INTRODUCTION
- DEVELOPMENTAL PECULIARITIES
- ANATOMICAL PECULIARITIES OF CHILDREN
- UNIQUE RESPIRATORY PHYSIOLOGY AND PATHOLOGY
- OVERVIEW OF HISTORY AND EXAMINATION
  - History
  - Review of Previous Diagnosis, Drug Treatment and Family History
- EXAMINATION
- SUPPURATIVE COMPLICATIONS OF PNEUMONIAS
- BEDSIDE TESTS
CHAPTER 10:An Approach to Abdomen
- ADOPT AN ASK, LOOK, FEEL AND HEAR APPROACH ASK (HISTORY TAKING)
  - Important Points to Note in Child with Abdominal Symptoms
- LOOK
- FEEL (PALPATION)
- FEEL AND HEAR (PERCUSSION)
- HEAR (AUSCULTATION)
- POINTS TO REMEMBER
CHAPTER 11:An Overview on Importance of Dermatology in Diagnosis
- SKIN—A DIAGNOSTIC MARKER
- HAIR
- NAILS
CHAPTER 12:Vaccination
- IMMUNIZATION
  - Active Immunization
  - Passive Immunization
- INFECTIOUS VACCINES
- NONINFECTIOUS VACCINES
- COMBINATION VACCINES
- VACCINES FOR SPECIAL SITUATIONS
- INDIAN ACADEMY OF PEDIATRICS—SCHEDULE FOR VACCINATION (2011)
- BCG (BACILLUS CALMETTE-GUÉRIN)
- POLIO VACCINE
- HEPATITIS B VIRUS (HBV) VACCINE
- NEW HEPATITIS B VACCINE
- DPT VACCINE (DTWP AND DTAP)
- MEASLES AND MMR VACCINE
- HIB VACCINE
- OPTIONAL VACCINES
  - Rotavirus
- ROTAVIRUS VACCINE
  - Efficacy
  - Interactions
  - Rotavirus Vaccine (Rota) in Special Situations
  - Precautions
  - Pneumococcus
- PNEUMOCOCCAL VACCINES
  - Dosing
    - Based on Age of Starting the Vaccination the Number of Doses Vary
    - Side Effects
  - Varicella
- VARICELLA VACCINE
- A KILLED HEPATITIS A VACCINE
- LIVE ATTENUATED HEPATITIS A VACCINE
  - Vaccine Efficacy
    - Contraindications
- ADOLESCENT VACCINATION
  - Recommended Vaccines for Adolescents
    - Dosage Schedule
    - Side Effects
- PROPER STORAGE OF VACCINES
  - Storage Units
  - To Freeze or not to Freeze
  - Where to Store?
  - Stability of Vaccines before Reconstitution at Room Temperature
SECTION 2: AN OVERVIEW OF BEDSIDE TESTING
CHAPTER 13:Blood— Peripheral Smear
- INDICATIONS
  - To Establish a Diagnosis
  - To Give Warning Signals
- COMMON STAINS
- RED BLOOD CELLS (RBCS)
- RETICULOCYTES
- WHITE BLOOD CELLS (WBCS)
- PLATELETS
- POINTS TO REMEMBER
CHAPTER 14:Staining Microbiological Specimens (Part-I)
- GRAM STAINING
  - Fixing
  - Staining (Mnemonic-CGAS)
- POTASSIUM HYDROXIDE PREPARATION
  - The Potassium hydroxide (KOH) Preparation
  - Procedure
    - Microscopic Examination
CHAPTER 15:Staining Microbiological Specimens (Part-II)
- ZN STAINING (MNEMONIC-CSAM)
CHAPTER 16:Culturing Microbiological Specimen
- CULTURE MEDIA
- CLASSICAL MEDIA
  - Types
- BLOOD CULTURE
- URINE CULTURE
- STOOL CULTURE
CHAPTER 17:Cerebrospinal Fluid Examination
- TECHNIQUE
- INDICATIONS
- DIAGNOSTIC INDICATIONS
- THERAPEUTIC INDICATIONS
  - To Relieve Increased Intracranial Pressure
  - To Inject Medications Intrathecally
- ANESTHETIC INDICATIONS
  - For Spinal Anesthesia and Epidural Anesthesia
    - Precautions
- CSF INTERPRETATION
- EARLY CLUES
  - Opening Pressure
  - Color of CSF
- COMPLICATIONS
CHAPTER 18:Urine Examination
- URINE
- AIM OF URINE EXAMINATION
- COLLECTION OF URINE SAMPLE
- NAKED EYE CHARACTERISTICS
  - Urine Volume
  - Color
- MICROBIOLOGICAL TESTS
- CHEMICAL TESTS
- TESTS OF GLOMERULAR FUNCTION
- TESTS OF RENAL TUBULAR FUNCTION
SECTION 3: PROCEDURES
CHAPTER 19:Liver Biopsy
- INDICATIONS
- EQUIPMENT AND PROCEDURE
- CONTRAINDICATIONS
- COMPLICATIONS OF PERCUTANEOUS LIVER BIOPSY
CHAPTER 20:Bone Marrow Tests(Aspiration, Biopsy, Hematopoietic Stem Cell Transplantation)
- INDICATIONS
- EQUIPMENT AND PROCEDURE
- COMPLICATIONS
- TYPES OF STEM CELLS
- SOURCE OF STEM CELLS
- USES OF STEM CELLS
- TYPES OF TRANSPLANT
- COMPLICATIONS
CHAPTER 21:Reading an Electrocardiogram
- INTRODUCTION
- HOW IMPULSE TRAVELS
- HEART RATES (2 METHODS)
- WAVES
- INTERVALS
- ASSESSMENT OF HYPERTROPHY
- RHYTHMS
  - Fast Rhythms
  - Slow Rhythms
SECTION 4: PEDIATRIC IMAGING
CHAPTER 22:CT Scans
- CT FUNDAMENTALS
- SKULL FRACTURES
  - Linear Skull Fractures
  - Growing Skull Fractures
    - CT Findings
- HERPES SIMPLEX VIRUS ENCEPHALITIS
  - Herpes Simplex Virus
  - HSV Encephalitis (Fig. 22.1)
    - CT Findings (Fig. 22.1)
- TUBERCULAR MENINGITIS
- BRAIN EDEMA
- ACUTE EPIDURAL HEMATOMA
- SUBDURAL HEMORRHAGE (FIG. 22.4A)
- SUBARACHNOID HEMORRHAGE (FIG. 22.4B)
- INTRACEREBRAL HEMATOMAS
- SUMMARY
- HYDROCEPHALUS
CHAPTER 23:Chest X-ray(Classical Chest X-rays and Newborn Chest X-rays)
- FIRST OBSERVE THE FOLLOWING POINTS
- READ THE X-RAY IN THIS ORDER
- CARDIOMEGALY ON CHEST X-RAY (FIG. 23.2)
  - Causes
  - Check the Following Points
- TENSION PNEUMOTHORAX (INFANT) (FIG. 23.3)
  - Clinical Features
  - Chest X-ray Findings
- EMPHYSEMA
  - Chest X-ray Findings
- FOREIGN BODY ASPIRATION (FIG. 23.4)
  - Clinical Features
  - Chest X-ray Findings
- CROUP
  - Clinical Features
  - Chest X-ray Findings
- NORMAL CHEST FILM OF A NEWBORN
- NEONATAL PNEUMONIA
  - Chest X-ray Findings
- MECONIUM ASPIRATION SYNDROME
  - Chest X-ray Findings
- HYALINE MEMBRANE DISEASE (FIG. 23.6)
  - Chest X-ray Findings
- TRANSIENT TACHYPNEA OF THE NEWBORN (TTN)
  - Chest X-ray Findings
- DIAPHRAGMATIC HERNIA (FIG. 23.7)
  - Chest X-ray Findings
- PNEUMOTHORAX (NEWBORN) ( FIG. 23.8)
  - Chest X-ray Findings
- CONGENITAL LOBAR EMPHYSEMA
  - Chest X-ray Findings
- SUMMARY
CHAPTER 24:Abdominal X-rays
- INTRODUCTION
- CALCIFICATIONS
- SITES OF CALCIFICATION
- TYPES OF CALCULI
- BONE AND SOFT TISSUES
  - Bone
  - Soft Tissues
- GAS
- AIR FLUID LEVELS
- ANORECTAL MALFORMATIONS
CHAPTER 25:Bone X-rays
- INTRODUCTION
- BONE AGE: USES (MNEMONIC ABCD)
- OTHER USES OF X-RAY OF BONES
- BONE AGE ASSESSMENT
- RADIOGRAPHIC EXAMINATION FOR BONE AGE ESTIMATION
- WRIST X-RAY
- ELBOW X-RAY
- X-RAY LONG BONES
CHAPTER 26:Skull X-rays/Spine X-rays
- INDICATIONS
  - Following Trauma
  - To Aid in Diagnosis
- VIEWS (FIG. 26.2)
- NOTE THE FOLLOWING POINTS ON SKULL X-RAYS (TEN POINTS)
- NOTE THE FOLLOWING POINTS ON SPINE X-RAYS
SECTION 5: EQUIPMENT
CHAPTER 27:Equipment (For Airway Obstruction/For Circulation/For Poisoning/For Supportive Care of Newborns)
- OROPHARYNGEAL AIRWAY (FIG. 27.1)
  - Indications for Oral Airway
- THE SUCTION TRAP (DEE-LEE SUCTION) (FIG. 27.2)
  - Indications for Use
- SUCTION BULB
- SUCTION CATHETER
- SUCTION APPARATUS
- RESUSCITATION BAG (FIG. 27.3)
- NG (NASOGASTRIC) TUBES
- INDICATIONS OR USES OF NG TUBES
  - Complications of NG Feeding
- INCUBATORS (FIG. 27.6)
- RADIANT WARMERS (FIG. 27.7)
- CONVENTIONAL PHOTOTHERAPY (FIG. 27.8)
- OXYGEN SUPPLY DEVICES
  - Low Flow Devices
    - Side Effects
  - Oxygen Hood
SECTION 6: MEDICATIONS
CHAPTER 28:Emergency Drugs
- NEONATAL RESUSCITATION
  - Naloxone
  - Prostaglandin E1
- SUPRAVENTRICULAR TACHYCARDIA
  - Adenosine
- DOCUMENTED METABOLIC ACIDOSIS
  - Sodium Bicarbonate (8.4% Solution W/V)
- NEONATAL SEIZURES
- CARDIAC ARREST
  - Epinephrine
- ANAPHYLAXIS
  - Epinephrine
- SHOCK DESPITE VOLUME RESUSCITATION
  - Epinephrine
- VOLUME OVERLOAD
  - Furosemide
- DIABETIC KETOACIDOSIS
  - Insulin, Regular
- TET SPELLS
  - Morphine Sulfate
- HYPERTENSIVE CRISIS
  - Diazoxide
  - Nitroprusside Sodium
- RAISED INTRACRANIAL TENSION
  - Dexamethasone
  - Mannitol
- CONVULSIONS
  - Diazepam
  - Phenytoin
- POISONINGS
  - Charcoal (Activated as a Slurry)
  - Atropine Sulfate
    - Indications
CHAPTER 29:Calcium Gluconate
- CALCIUM
- CALCIUM GLUCONATE (FIG. 29.1)
- INDICATIONS
- CONTRAINDICATIONS
CHAPTER 30:Sodium Bicarbonate
- SODIUM BICARBONATE
- INDICATIONS
- INJ. SODIUM BICARBONATE (FIG. 30.1)
CHAPTER 31:Phenytoin
- PHENYTOIN (FIG. 31.1)
- INDICATIONS AND DOSAGE
  - For Cardiac Arrhythmias Associated with Digitalis Intoxication
  - For Treatment of Seizures/Trigeminal Neuralgia and Head Injury
- ADVERSE EFFECTS
CHAPTER 32:Aminophylline
- INTRODUCTION
- INDICATIONS AND DOSAGE
- MECHANISM OF ACTION
  - Side Effects (Mnemonic ABCD)
CHAPTER 33:Adrenaline
- ADRENALINE
- INDICATIONS AND DOSAGE
CHAPTER 34:Furosemide
- FUROSEMIDE—A LOOP DIURETIC
- INDICATIONS AND DOSAGE
- SPIRONOLACTONE—A POTASSIUM SPARING DIURETIC
CHAPTER 35:Dopamine
- INTRODUCTION
- ACTIONS
- DRUG EFFECTS
- DOSAGE (INTRAVENOUS DOSAGES HAVE A WIDE RANGE)
CHAPTER 36:Oral Rehydration Solution
- ORAL REHYDRATION SOLUTION (ORS) THERAPY (FIG. 36.1)
- HISTORY
  - Advantages of ORS
- PRINCIPLE OF ORS
  - Bad News
  - Good News
- STANDARD WHO ORS
- REDUCED OSMOLARITY ORS
- KILLER ORS
- GUIDELINES
- FAILURE OF ORAL REPLACEMENT THERAPY
CHAPTER 37:Digoxin
- INDICATIONS AND DOSAGE
- DIGOXIN TOXICITY
CHAPTER 38:Steroids
- INDICATIONS
- TYPES
CHAPTER 39:Antibiotics
- COMMON ANTIBIOTICS AND ANTIBIOTIC GROUPS
CHAPTER 40:Vitamins and Minerals
- AGEWISE INDICATIONS
CHAPTER 41:Asthma Therapy
- STEPS TO ASSESS THE DISEASE
- DRUGS FOR PREVENTION AND MANAGEMENT
CHAPTER 42:Drugs in Seizure Therapy
- TYPES OF SEIZURES
  - Mechanisms of Seizure
  - Aim of Treatment
- DRUG TREATMENT OF EPILEPSY
CHAPTER 43:Drug Treatment of Malaria
- STEPS OF TREATMENT
- DRUG TREATMENT
- NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAM: SUGGESTIONS
- SECOND LINE OF TREATMENT
- THIRD LINE OF TREATMENT
  - In Severe and Complicated Cases
    - 1. Quinine
    - 2. If Non-availability of Quinine, Use Chloroquine
- RESISTANCE
- CHEMOPROPHYLAXIS (PREVENTION BY SUPPRESSION)
- RESERVE DRUGS IN TREATMENT
CHAPTER 44:Drug Treatment of Tuberculosis
- CONSENSUS STATEMENT OF IAP WORKING GROUP (INDIAN PEDIATRICS 1997;34:1093-1096)
CHAPTER 45:Oxygen
- INTRODUCTION
- SOURCES OF OXYGEN
- OXYGEN ADMINISTRATION
- USES OF OXYGEN
SECTION 7: PROBLEM-BASED LEARNING
CHAPTER 46:Anemia
- CASE PRESENTATION
  - History
  - Investigations
- DISCUSSION
- IRON DEFICIENCY ANEMIA (IDA)
- APPROACH TO A CASE OF MICROCYTIC HYPOCHROMIC ANEMIA
CHAPTER 47:Lymphadenopathy
- CASE PRESENTATION
- APPROACH TO A CASE OF LYMPHADENOPATHY
CHAPTER 48:Muscle Disorders
- CASE PRESENTATION
- DISCUSSION
- HIGHLIGHT
CHAPTER 49:Bleeding Disorders
- CASE PRESENTATION
  - Investigations
- DISCUSSION
  - Immune Thrombocytopenic Purpura
  - Management
- PATHOPHYSIOLOGY
- DIFFERENTIATE BETWEEN BLEEDING OR CLOTTING DISORDERS
CHAPTER 50:Acute Rheumatic Fever
- CASE PRESENTATION
- DISCUSSION
CHAPTER 51:NEPHROLOGY CASES
- CASE PRESENTATION
  - Investigations
- DISCUSSION
- CASE PRESENTATION
  - History
  - Investigations
    - Urinalysis:
    - Blood chemistry
- DISCUSSION
SECTION 8: SPOTTERS
CHAPTER 52:Turner's Syndrome
- SPOTTER
- SUMMARY
CHAPTER 53:Achondroplasia
- CARDINAL FEATURES
CHAPTER 54:Mucopolysaccharidosis
- CLINICAL FEATURES
- TYPES
- TREATMENT
CHAPTER 55:Neural Tube Defects
- INTRODUCTION
  - Usual Scenario
  - Etiology
- TYPES OF SPINAL DEFECTS
- SUMMARY
CHAPTER 56:Dental Caries
- CASE PRESENTATION
- DISCUSSION
SECTION 9: MISCELLANEOUS
CHAPTER 57:Fever
- APPROACH TO A CASE OF FEVER
- PYREXIA OF UNKNOWN ORIGIN—A DIAGNOSTIC DILEMMA

INDEX

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Chapter Notes