Transcription
OXFORD MEDICAL PUBLICATIONSOxford Handbook ofPaediatrics
Published and forthcoming Oxford HandbooksOxford Handbook for the Foundation Programme 3eOxford Handbook of Acute Medicine 3eOxford Handbook of Anaesthesia 3eOxford Handbook of Applied Dental SciencesOxford Handbook of Cardiology 2eOxford Handbook of Clinical and Laboratory Investigation 3eOxford Handbook of Clinical Dentistry 5eOxford Handbook of Clinical Diagnosis 2eOxford Handbook of Clinical Examination and Practical SkillsOxford Handbook of Clinical Haematology 3eOxford Handbook of Clinical Immunology and Allergy 3eOxford Handbook of Clinical Medicine – Mini Edition 8eOxford Handbook of Clinical Medicine 8eOxford Handbook of Clinical PathologyOxford Handbook of Clinical Pharmacy 2eOxford Handbook of Clinical Rehabilitation 2eOxford Handbook of Clinical Specialties 9eOxford Handbook of Clinical Surgery 4eOxford Handbook of Complementary MedicineOxford Handbook of Critical Care 3eOxford Handbook of Dental Patient Care 2eOxford Handbook of Dialysis 3eOxford Handbook of Emergency Medicine 4eOxford Handbook of Endocrinology and Diabetes 2eOxford Handbook of ENT and Head and Neck SurgeryOxford Handbook of Epidemiology for CliniciansOxford Handbook of Expedition and Wilderness MedicineOxford Handbook of Gastroenterology & Hepatology 2eOxford Handbook of General Practice 3eOxford Handbook of GeneticsOxford Handbook of Genitourinary Medicine, HIV and AIDS 2eOxford Handbook of Geriatric MedicineOxford Handbook of Infectious Diseases and MicrobiologyOxford Handbook of Key Clinical EvidenceOxford Handbook of Medical DermatologyOxford Handbook of Medical ImagingOxford Handbook of Medical Sciences 2eOxford Handbook of Medical StatisticsOxford Handbook of Nephrology and HypertensionOxford Handbook of NeurologyOxford Handbook of Nutrition and Dietetics 2eOxford Handbook of Obstetrics and Gynaecology 2eOxford Handbook of Occupational Health 2eOxford Handbook of Oncology 3eOxford Handbook of Ophthalmology 2eOxford Handbook of Oral and Maxillofacial SurgeryOxford Handbook of Paediatrics 2eOxford Handbook of Pain ManagementOxford Handbook of Palliative Care 2eOxford Handbook of Practical Drug Therapy 2eOxford Handbook of Pre-Hospital CareOxford Handbook of Psychiatry 3eOxford Handbook of Public Health Practice 2eOxford Handbook of Reproductive Medicine & Family PlanningOxford Handbook of Respiratory Medicine 2eOxford Handbook of Rheumatology 3eOxford Handbook of Sport and Exercise MedicineOxford Handbook of Tropical Medicine 3eOxford Handbook of Urology 3e
Oxford Handbook ofPaediatricsSecond EditionEdited byRobert C. TaskerProfessor of Neurology and Anaesthesia (Pediatrics),Harvard Medical School; Chair in Neurocritical Care,Children’s Hospital, Boston, USARobert J. McClureNeonatologist, Paediatrician and Anatomical PathologistQueen Elizabeth Medical Centre, Nedlands,Perth, Western AustraliaCarlo L. AceriniUniversity Senior Lecturer,Cambridge University Clinical School,Cambridge, UK1
3Great Clarendon Street, Oxford, OX2 6DP,United KingdomOxford University Press is a department of the University of Oxford.It furthers the University’s objective of excellence in research, scholarship,and education by publishing worldwide. Oxford is a registered trade mark ofOxford University Press in the UK and in certain other countries Oxford University Press, 2013The moral rights of the author have been assertedFirst edition published 2008Second edition published 2013Impression: 1All rights reserved. No part of this publication may be reproduced,stored in a retrieval system, or transmitted, in any form or by any means,without the prior permission in writing of Oxford University Press,or as expressly permitted by law, or under terms agreed with the appropriatereprographics rights organization. Enquiries concerning reproductionoutside the scope of the above should be sent to the Rights Department,Oxford University Press, at the address aboveYou must not circulate this book in any other binding or cover and you mustimpose the same condition on any acquirerBritish Library Cataloguing in Publication DataData availableISBN 978–0–19–960830–0 (flexicover: alk.paper)Printed in China byC&C Offset Printing Co. Ltd.Oxford University Press makes no representation, express or implied, that the drugdosages in this book are correct. Readers must therefore always check the productinformation and clinical procedures with the most up-to-date published productinformation and data sheets provided by the manufacturers and the most recentcodes of conduct and safety regulations. The authors and the publishers do notaccept responsibility or legal liability for any errors in the text or for the misuse ormisapplication of material in this work. Except where otherwise stated, drug dosagesand recommendations are for the non-pregnant adult who is not breastfeeding.
vForeword to the firsteditionTextbooks have been the mainstay of medical education for centuries.Clearly, the development of the information superhighway via the Internethas changed how we learn, find information, and communicate. What doesyet another paediatric textbook add to the current long list of titles?Drs Tasker, McClure, and Acerini have conceived of and edited a newbook. It is a handbook of paediatrics that joins a stable of similar publications from Oxford University Press. There are 23 contributing editors.Using a well-tested format for presentation, the handbook consists of 31chapters, ranging from sections on epidemiology, evidence, and practice,through the more traditional topics, such as nephrology and neurology,and concluding with international health and travel, and paediatrics, ethics, and the law. Each chapter follows the same format, 5–40 sections, followed by bulleted points. Both signs and symptoms of illness, as well asspecific diseases are covered. Virtually all topics are limited to 1–2 pagesof important information. Tables are carefully inserted, and complement thetext. Doses of important drugs are included in the text and/or the tables.There are a limited number of figures, but like the tables, they supplementthe text and have been carefully chosen to add clarity.The Oxford Handbook of Paediatrics is a worthy addition to your library.It will be particularly appealing to medical students and younger physicians,who have learned to digest a great deal of information quickly and in anabbreviated format. Its availability on a CD-ROM is an added and necessary benefit. Drs Tasker, McClure, and Acerini have done a wonderful jobin ensuring consistency, clarity, and completeness.Professor Howard Bauchner,Boston University School of Medicine/Boston Medical Center,Vice-Chair, Academic Affairs,Editor in Chief, Archives of Disease in Childhood,January 2008
viPrefaceThe first ‘boke’ of paediatrics printed in English was written by ThomasPhaire (1510–1560), a man from East Anglia who studied medicine atOxford University. The book had 56 pages, measured 3 7/8 inches (9.8cm)by 2 5/8 inches (6.7cm), and covered ‘. . . innumerable passions & diseases,wherunto the bodye of man is subiecte, and as well moste commonlythe tender age of chyldren is chefely vexed and greued with these diseases folowyng. Apostume of the brayne, swellyng of the head . . .’.1 In1553, the ‘innumerable passions & diseases’ came to 39 presenting clinical problems. As clinicians, we first met and worked in the heart of EastAnglia (Cambridge University) and have now collaborated with OxfordUniversity Press in this venture, a new handbook of paediatrics. Our similarity with Thomas Phaire has not escaped us, particularly as we see theimportance of basing a text on common presenting clinical problems.Our principal aim is to provide a compact source of information andclinical thinking that can be used in the clinic or hospital ward, at a timewhen the child is being seen. The challenge, therefore, was to distil thecontent of information found in several textbooks into a convenientlysized handbook without the loss of important information. We easilyreached the limit in pages given to us, and so we have had to be strict insifting out key facts crucial to clinical practice. Our intention is that thehandbook be used from the start of one’s education in paediatrics all theway through to higher general training in the field.We have kept with the tradition of providing content and text thatoften exceeds that required by the generalist—we believe it importantfor learners and readers to see the full landscape. There are spaces wheremore notes can be added from lectures, other reading, and personal experience. This is intended. It means that the handbook can be made personal,develop with you, and be used in whatever your chosen practice—hospitalist, generalist, or community and family practice. Above all, wehope that the handbook will give you confidence to manage paediatricclinical problems effectively and safely.RCTRJMCLAApril 2012Reference1 Phaire T (1553). The boke of chyldren. [Reprint edited by Neale AV,Wallis HRE (1965). Edinburgh: E&S Livingstone Ltd, Edinburgh.
viiAuthors’ disclaimerAll reasonable efforts have been undertaken in order to ensure the accuracy of drug doses in this book. UK readers are advised to also consultthe British National Formulary for children (2012; see http://www.bnf.org/bnf/index.htm)). Other readers should refer to their own regionalor national guidelines. The authors cannot be held responsible for anyerrors here in.
viiiAcknowledgementsWe would like to extend our thanks and gratitude to all the contributors.We would also like to thank our colleagues who reviewed and advisedon the content of our chapters, in particular Dr Robert Ross-Russell,Dr Roddy O’Donnell, Jenny Pool, Amy Stewart, Clare Bradley Stevenson,and Liesje Cornwell for their helpful comments. We are also indebted toDr Stephan Sanders for his comments and criticisms of our draft manuscript. We would also like to thank Drs Kim Jones and Tony Jaffa, ProfsDeirdre Kelly and Brett McDermott, and Ms Julia Smith, Kelly Lamour, andLynne Radbone for their contribution to the last edition. We are especiallygrateful to Beth Womack and Elizabeth Reeve at OUP for their help andassistance, and for their patience with us. Finally, but not least, a specialthanks goes to our respective families for their encouragement, support,and understanding throughout the preparation of this book.Robert C. TaskerRobert J. McClureCarlo L. AceriniRJM is indebted to Marge, Hannah, and Thomas, for their endless love,support, and sacrifice.
ixContributorsMr David AlbertDr David CoghillConsultant Otolaryngologist,Great Ormond Street Hospital forChildren NHS Foundation Trust,LondonNinewells Hospital andMedical School,Dundee, UKMiss Louise AllenConsultant Paediatric SurgeonLeeds Teaching Hospitals NHSTrust and Bradford TeachingHospitals NHS Foundation Trust,UKConsultant PaediatricOphthalmologistCambridge University HospitalsNHS Foundation Trust,Cambridge, andAssociate Lecturer, University ofCambridge, UKDr R Mark BeattieConsultant PaediatricGastroenterologistUniversity Hospital SouthamptonSouthampton, UKMr Yogesh BajajConsultant PaediatricOtolaryngologistBarts, and the London Children’sHospital, LondonDr Ian Balfour-LynnConsultant in RespiratoryPaediatricsRoyal Brompton Hospital, LondonDr Tony CaccettaDermatology RegistrarPrincess Margaret Hospital, Perth,Western AustraliaProfessor Imti ChoonaraProfessor in Child Health,Academic Division of ChildHealth, University of Nottingham,Derbyshire Children’s HospitalDerby, UKMr David CrabbeDr Saul N FaustReader in Paediatric Immunologyand Infectious Diseases andDirector, NIHR WellcomeTrust Clinical Research Facility,University of Southampton, UKDr Rob FreemanConsultant Orthopaedic Surgeon,Robert Jones and AgnesHunt Orthopaedic Hospital NHSTrust, Shropshire, UKDr Georgina HallConsultant, PaediatricHaematology/Oncology Unit, JohnRadcliffe Hospital, Oxford, UKDr Peter HeinzConsultant PaediatricianCambridge University HospitalsNHS Foundation Trust,Cambridge, UKDr Ewen D JohnstonConsultant NeonatologistSimpson Centre for ReproductiveHealth, Royal Infirmary ofEdinburgh,UK
xCONTRIBUTORSDr Samir LatifiDr Willie ReardonConsultant in Paediatric IntensiveCare, Akron Children’s HospitalAkron, Ohio, USAConsultant Clinical Geneticist,Our Lady’s Hospital for SickChildren, Dublin, IrelandDr Elaine LewisDr Lesley ReesConsultant CommunityPaediatrician, CambridgeUniversity Hospitals NHSFoundation Trust,Cambridge, UKConsultant PaediatricNephrologistGreat Ormond Street Hospital forChildren Foundation Trust,LondonDr James C NicholsonProfessor Benjamin JStensonConsultant Paediatric OncologistCambridge University HospitalsNHS Foundation Trust,Cambridge, UKDr Roddy O’DonnellConsultant in Paediatric IntensiveCare, Cambridge UniversityHospitals NHS Foundation Trust,Cambridge, UKDr Alasdair ParkerConsultant Paediatric Neurologist,Cambridge University HospitalsNHS Foundation Trust,Cambridge, UKConsultant NeonatologistSimpson Centre for ReproductiveHealth, Royal Infirmary ofEdinburgh, UKDr Robert M R TullohConsultant in PaediatricCardiology, Bristol Royal Hospitalfor Children and Bristol RoyalInfirmary, UK
CONTENTSxiContentsDetailed contents xiiiSymbols and abbreviations sing paediatricsEpidemiology, evidence, and practiceClinical assessmentResuscitationEmergency and high dependency careNeonatologyPractical proceduresCardiovascularRespiratory medicineGastroenterology and nutritionNephrologyEndocrinology and diabetesGrowth and pubertyNeurologyChild developmentChild and family psychiatryHaematologyOncologyInfectious diseasesBones and jointsAdolescent healthDermatologyPaediatric surgerySpecial 651693731793805843893
xiiCONTENTS25262728293031GeneticsInherited metabolic diseaseCommunity child healthChild protectionPharmacology and therapeuticsInternational health and travelPaediatrics, ethics, and the lawIndex 1047925953979997101110211029
xiiiDetailed contents1Practising paediatrics1Reading and learning paediatrics 2Professional conduct and attitudes 3Professional skills 4Knowledge 62Epidemiology, evidence, and practice9Introduction 10Descriptions in populations 10Summary of study designs 11Levels of evidence 12Basics of statistics 14Training and special knowledge skills 16Useful websites and resources 18References 183Clinical assessmentCommunication skills 20Taking a paediatric history: introduction 21The presenting complaint 22History of present illness 24Past health history 25Symptom review 26Family history 28Examining a child: introduction 28General condition 29Vital signs 30Respiratory system 31Cardiovascular system 32Gastrointestinal system 33Genitourinary system 34Musculoskeletal system 3419
xivDETAILED CONTENTS4Resuscitation35Cardiopulmonary arrest 36Rapid cardiopulmonary assessment 36Paediatric basic life support 38Choking children 39Paediatric advanced life support 40Rhythm disturbances 42Treating supraventricular tachycardia 43Following unsuccessful resuscitation 445Emergency and high dependency careThe ABC of high dependency 46Respiratory distress 48Respiratory distress: management 50Foreign-body inhalation 51Drowning 52Circulation: cardiovascular difficulty 53Cardiovascular system difficulty: assessment 54Cardiovascular system difficulty: therapy—1 56Cardiovascular system difficulty: therapy—2 58Cyanosis: assessment 60Cyanosis: management 62Anaphylaxis 64Hypovolaemic shock 65Burns 66Burns: treatment 68Sepsis 70Altered level of consciousness 72Altered level of consciousness: clinical assessment 74Altered level of consciousness: Glasgow coma scale 76Altered level of consciousness: management 78Status epilepticus 80Poisoning 82Poisoning: management 84Poisoning: antidotes and substrates 86Fluid and electrolytes 89Fluid and electrolytes: dehydration 90Fluid and electrolytes: abnormalities 92Renal insufficiency 9445
DETAILED CONTENTSGlucose: hypoglycaemia 96Diabetic ketoacidosis 98Diabetic ketoacidosis: treatment 100Inborn error of metabolism 102Other acid–base problems 104Further reading 1066NeonatologyNewborn life support 108Perinatal definitions 110Small for gestational age 111Large for gestational age 112Prematurity 114Birth at the limit of viability 116Outcome following prematurity 117Basic obstetrics 118Obstetric problems 120Maternal disorders causing neonatal disease 124Birth trauma 126Non-specifically ill neonate 128Neonatal jaundice 130Hypoglycaemia 132Neonatal seizures 134The floppy infant 136Hydrops foetalis 138Routine care of the newborn 140Milk feeding 142Routine neonatal examination 144Normal variations and minor abnormalities 146Newborn fluid and electrolyte balance 148Respiratory distress syndrome 150Acute respiratory diseases 152Neonatal X-rays 156Neonatal respiratory support 160Conventional positive pressure ventilation 162High frequency oscillatory ventilation 164Bronchopulmonary dysplasia 166Circulatory adaptation at birth 168Patent ductus arteriosus 169CNS malformations 170107xv
xviDETAILED CONTENTSHypoxic–ischaemic encephalopathy 172Cerebral haemorrhage and ischaemia 176Necrotizing enterocolitis 178Neonatal infection 180Transplacental (congenital infection) 182Prevention of neonatal infection 184Neonatal abstinence syndrome 186Inborn errors of metabolism 187Retinopathy of prematurity 188Metabolic bone disease 190Orofacial clefts 191Neonatal haematology 192Rh disease (rhesus haemolytic disease) 194Bilirubin encephalopathy (kernicterus) 195Neonatal dermatology 196Perinatal death 1987Practical proceduresCapillary blood sampling 202Venepuncture 203Intravenous cannulation 204Peripheral arterial blood sampling 205Peripheral arterial cannulation 205Umbilical arterial catheter 206Umbilical venous catheter 208Central venous catheterization via a peripheral vein 209Airway management 210Mask ventilation 211Endotracheal intubation 212Insertion of a chest drain 214Intraosseous infusion 216Intracardiac injection 216Pericardiocentesis 217Abdominal paracentesis 217Urethral bladder catheterization 218Suprapubic aspiration of urine 219Lumbar puncture 220Cerebral ventricular tap 221Exchange transfusion 222201
DETAILED CONTENTS8Cardiovascular225Common presentations 226Cyanosis 226Heart failure 226Heart murmurs 228Murmurs: clinical features 230Acyanotic: congenital heart disease 232Left to right shunt: atrial septal defect 233Ventricular septal defect 234Persistent ductus arteriosus 234Right to left shunt: tetralogy of Fallot 235Transposition of the great arteries 236Common mixing: complete atrioventricular septal defect 236Tricuspid atresia 237Aortic stenosis 237Pulmonary stenosis 238Coarctation of the aorta 238Hypoplastic left heart syndrome 239Total anomalous pulmonary venous connection 239Hypertrophic obstructive cardiomyopathy 240Dextrocardia 240Infection: infective bacterial endocarditis 242Rheumatic fever 244Pericarditis 246Myocarditis 248Cardiomyopathy 249Cardiac arrhythmias 2509Respiratory medicineIntroduction 254Common presentation: wheeze 255Common presentation: stridor 256Common presentation: cough 257Common presentation: breathlessness 258Common presentation: snoring 259Investigations 260Asthma 262Asthma: drug delivery devices 264Asthma: clinic management (1) 266253xvii
xviiiDETAILED CONTENTSAsthma: clinic management (2) 268Cystic fibrosis 270Cystic fibrosis: problems 271Cystic fibrosis: management (1) 272Cystic fibrosis: management (2) 274Chronic lung disease of prematurity 276Congenital respiratory tract disorders 278Sleep apnoea 279Allergic rhinitis 280Upper airway infections 282Laryngeal and tracheal inflammation 284Bronchial disease 286Bronchiolitis 288Pneumonia 290Pneumonia: treatment 292Pneumonia: effusion, empyema 293Pulmonary tuberculosis 294Other disorders 29510Gastroenterology and nutritionHealthy eating for children 298Vomiting 300Acute diarrhoea 302Chronic diarrhoea 304Constipation 306Faltering growth (failure to thrive) 308Recurrent abdominal pain 310Gastrointestinal haemorrhage 312Jaundice 314Adverse reactions to food 316Nutritional disorders 320Nutritional support 322Parenteral nutrition 324Oesophageal disorders 326Pancreatitis 328Intestinal disorders 330Inflammatory bowel disease 332Malabsorption 334Coeliac disease 336297
DETAILED CONTENTSGastrointestinal infections 338Intestinal parasites 340Acute hepatitis 342Chronic liver failure 344Alpha1-antitrypsin deficiency 346Wilson’s disease 346Liver transplantation 34711Nephrology349Polyuria and frequency 350Abdominal/renal mass 351Haematuria 352Proteinuria 354Urinary tract infection 356Vesicoureteric reflux 360Acute kidney injury 362Acute kidney injury: diagnosis and treatment 364Chronic kidney disease 366Chronic kidney disease: treatment 368Congenital urinary tract anomalies 370Inherited renal disease 372Glomerulonephritis 374Haemolytic–uraemic syndrome 376Nephrotic syndrome 378Nephrotic syndrome: complications and follow-up 380Renal tubular disorders 382Proximal renal tubular acidosis 384Bartter’s syndrome 386Renal calculi 388Hypertension: definition 390Hypertension: causes and features 394Hypertension: management 39612Endocrinology and diabetesObesity 400Obesity: management 404Type 1 diabetes mellitus 406Type 1 diabetes mellitus: management 408399xix
xxDETAILED CONTENTSType 1 diabetes mellitus: insulin therapy 410Acute complications of Type 1 diabetes mellitus 412Type 1 diabetes mellitus: long-term complications 414Type 1 diabetes mellitus: associated illnesses 415Type 2 diabetes mellitus 416Other forms of diabetes mellitus 418Goitre 420Solitary thyroid nodule 421Thyroid carcinoma 421Medullary thyroid cancer 421Congenital hypothyroidism 422Acquired hypothyroidism 424Hyperthyroidism (thyrotoxicosis) 425Graves’s disease 426Thyroiditis 428Adrenal insufficiency 430Adrenal insufficiency: treatment 432Adrenal excess 434Congenital adrenal hyperplasia 436Mineralocorticoid excess 438Mineralocorticoid deficiency 439Inherited endocrine syndromes 440Hypocalcaemia 442Rickets 444Hypercalcaemia 446Posterior pituitary: syndrome of inappropriate antidiuretichormone secretion 448Hypopituitarism 449Posterior pituitary: diabetes insipidus 450Polycystic ovarian syndrome 45213Growth and pubertyNormal growth 456Normal puberty 458Assessment of growth 460Assessment of puberty 462Short stature 466Constitutional delay in growth and puberty 468Intrauterine growth retardation 468Turner’s syndrome 469455
DETAILED CONTENTSCoeliac disease 469Chronic inflammatory disorders 469Skeletal dysplasias 469Growth hormone deficiency 470Growth hormone deficiency: management 472Tall stature 474Delayed puberty: assessment 476Delayed puberty: management 478Precocious puberty 480Precocious puberty: management 482Variants of normal puberty 484Disorders of sex development 486Disorders of sex development: management 488Androgen insensitivity syndrome 490Micropenis 491Gynaecomastia 49214NeurologyExamination 496Examination: children aged 5 years who can’t walk 498Congenital abnormalities 500Paroxysmal episodes: not epilepsy 502Paroxysmal episodes: general management 504Seizures and childhood epilepsies 505Seizures: management 506Epilepsies: neonatal 508Epilepsies: infantile 510Epilepsies: mid to late childhood (1) 512Epilepsies: mid to late childhood (2) 514Headache 516Headache: migraine 518Bell’s palsy 519Acute disseminated encephalomyelitis 520Stroke in childhood 522Acute abnormal movements 524Subdural haemorrhage in a child under 2 years 526Neurocutaneous disorders 530Macrocephaly and microcephaly 534Degenerative disorders 536Neuromuscular disorders 538495xxi
xxiiDETAILED CONTENTSPeripheral neuropathies 541Guillain–Barré syndrome 542Neuromuscular junction 544Muscular disorders 546Management of neuromuscular junction and musculardisorders 548Cerebral palsy 550Acute encephalopathy 55215Child development555Managing and living with disability 556Normal development 557Gross motor development 558Fine motor development 559Speech and language development 560Social, emotional, and behavioural development 561Developmental assessment 562Neurodevelopmental delay 564Learning difficulties/disabilities 566Developmental co-ordination disorder 566Communication difficulties 56616Child and family psychiatryPrevalence 568Classification, categories, and dimensions 569Comorbidity and causation 570Developmental perspective 571Systemic thinking 572Assessment 573History taking 574Communicating 575Asking the difficult questions 576Depression 578Suicide and non-fatal deliberate self-harm 580Bipolar disorder 582Anxiety disorders 584Post-traumatic stress disorder 586Obsessive compulsive disorder 588Attachment disorder 589567
DETAILED CONTENTSSchizophrenia 590Somatoform disorders and typical consultation–liaisonpresentations 592Anorexia nervosa 594Bulimia nervosa 596Oppositional defiant and conduct disorders 598Attention deficit hyperactivity disorder 600Autism spectrum disorders 602Individual psychotherapy 604Family therapy 605Psychopharmacotherapy 60617HaematologyPeripheral blood film 608Anaemia 610Haemolytic anaemias 612Deficiency anaemias 614Red blood count membrane defect anaemias 616Red blood count enzyme defect anaemias 618Sickle cell disease 620Thalassaemia 622Immune haemolytic anaemia 624Red blood cell fragmentation 625Aplastic anaemia 626Failure of red cell production (pure red cellaplasia) 628Polycythaemia 630Abnormal bleeding or bruising 632Coagulation studies 634Disseminated intravascular coagulation 635Haemophilia A 636Haemophilia B 637von Willebrand disease 638Platelet function disorders 640Thrombocytosis 641Thrombocytopenia 642Acute immune thrombocytopenia 643Thrombophilia 644Blood transfusion 646Blood transfusion reactions 648607xxiii
xxivDETAILED CONTENTS18Oncology651Epidemiology of childhood cancer 652Clinical assessment: history 653Clinical examination 654Key investigations 655Acute lymphoblastic leukaemia 656Acute myeloid leukaemia 658Chronic myeloid leukaemia (adult type) 659Juvenile myelomonocytic leukaemia 659Lymphoma 660Central nervous system tumours (1) 662Central nervous system tumours (2) 664Neuroblastoma 666Wilms’ tumour (nephroblastoma) 668Other renal tumours in childhood 669Bone tumours 670Rhabdomyosarcoma 672Germ cell tumours 673Primary liver tumours 674Other rare tumours 675Langerhans cell histiocytosis 676Haemophagocytic lymphohistiocytosis 677Chemotherapy 678Stem cell transplant 680Radiotherapy 681Surgery 681Acute care 682Acute care: biochemistry 684Acute care: other 685Urgent care 687Principles of follow-up 688Palliative care 69019Infectious diseasesIntroduction 694The child with fever 696Fever: examination and assessment 698Fever: management (green features) 700Fever: management (red or amber features) 701Prolonged fever of unknown cause 702693
DETAILED CONTENTSCommon infections characterized by rash 704Exanthem 1: measles 706Exanthem 2: group A streptococcus 707Exanthem 3: rubella 708Exanthem 4: enteroviruses 708Exanthem 5: parvovirus 709Exanthem 6: human herpes virus 6 709Rash: chickenpox and zoster 710Rash: infectious mononucleosis 711Lyme disease 712Mumps 713Bacteraemia and shock 714Kawasaki disease 716Skin and soft tissues 718Meningitis 720Mycobacteria 722Tropical infections 723Immunodeficiency disorders 724Human immunodeficiency virus 726Immunizations 72820Bones and jointsClinical assessment 732The limping child 734The limping child: differential diagnosis 736Infections: septic arthritis 738Infections: osteomyelitis 740Spinal disorders 742Spine: kyphosis 744Spine: scoliosis 746Hip disorders: developmental dysplasia of the hip 748Hip disorders: Perthes’ disease 750Hip disorders: slipped upper femoral epiphysis 752Knee disorders 754Orthopaedic trauma 758Osteochondroses 760Osteogenesis imperfecta 762Osteopetrosis 764Cleidocranial dysplasia 765Skeletal dysplasias 766731xxv
xxviDETAILED CONTENTSJuvenile idiopathic arthritis 768Juvenile idiopathic arthritis: clinical principles andmanagement 770Systemic arthritis 772Oligoarticular juvenile idiopathic arthritis 773Rheumatoid factor-positive polyarthritis 774Rheumatoid factor-negative polyarthritis 776Psoriatic arthritis 777Enthesitis-related arthritis 778Systemic lupus erythematosus 780Juvenile dermatomyositis 782Mixed connective tissue disease—overlap syndromes 784Scleroderma 786Henoch–Schönlein purpura 788Polyarteritis nodosa 789Wegener’s granulomatosis 790Takayasu’s arteritis (pulseless disease) 79121Adolescent health793Communication 794Adolescence: overview 796Adolescent health problems 798Substance misuse 800Sexual health problems 801Adolescence and chronic illness 80222DermatologyAssessment of a rash 806Atopic eczema/dermatitis 808Red scaly rashes 810Papular rashes (1) 812Papular rashes (2) 814Vesiculobullous rashes 816Red blanching (erythematous) rashes 818Pruritus 820Pustular rashes 822Purpuric rashes 823Lymphoedema 823Blood vessel disorders 824805
DETAILED CONTENTSSkin infection: viral and bacterial 826Fungal skin infections 828Parasitic skin infections 829Protozoal skin infections 829Hair disorders 830Nail disorders 832Photosensitivity and light eruptions 834Pigmentation disorders 836Collagen and elastin disorders 838Connective tissue disorders 839Miscellaneous skin conditions 84023Paediatric surgerySymptoms and signs that should cause concern 844Congenital abnormalities: upper airway 846Congenital abnormalities: tracheo-oesophageal 848Congenital abnormalities: oesophagus 850Congenital abnormalities: lung 851Congenital abnormalities: chest 852Idiopathic hypertrophic pyloric stenosis 854Ingested foreign bodies 856Bezoars 857Midgut malrotation and volvulus 858Intussusception 860Duodenal atresia 862Small bowel atresias 862Meconium ileus 862Acute appendicitis 864Mesenteric adenitis 865Meckel’s diverticulum 865Gastroschisis 866Exomphalos (omphalocele) 866Inguinal hernias 868Hydroceles 868Hirschsprung’s disease 870Rectal prolapse 871Anorectal malformations 872Umbilical anomalies 874Testicular torsion 876Orchitis and epididymitis 877843xxvii
xxvi
Published and forthcoming Oxford Handbooks Oxford Handbook for the Foundation Programme 3e Oxford Handbook of Acute Medicine
