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Nelson Essentials of Pediatrics
EIGHTH EDITION
KAREN J. MARCDANTE, MD
Professor
Department of Pediatrics
Medical College of Wisconsin
Children's Hospital of Wisconsin
Milwaukee, Wisconsin
ROBERT M. KLIEGMAN, MD
Professor and Chair Emeritus
Department of Pediatrics
Medical College of Wisconsin
Children's Hospital of Wisconsin
Milwaukee, Wisconsin
Table of Contents
Cover image
Title Page
Copyright
Dedication
Contributors
Preface
Acknowledgments
Section 1 Profession of Pediatrics
Care of Children in Society
Current Challenges
Landscape of Health Care for Children in the United States
Other Health Issues That Affect Children in the United States
Health Disparities in Health Care for Children
Changing Morbidity: Social/Emotional Aspects of Pediatric Practice
Culture
Concept of Professionalism
Professionalism for Pediatricians
Ethics in Health Care
Ethical Principles Related to Infants, Children, and Adolescents
Legal Issues
Ethical Issues in Practice
Palliative and End-of-Life Care
Bereavement
Cognitive Issues in Children and Adolescents: Understanding Death and Dying
Cultural, Religious, and Spiritual Concerns About Palliative Care and End-of-Life Decisions
Ethical Issues in End-of-Life Decision-Making
Organ Donation in Pediatrics
Suggested Readings
Pearls for Practitioners
Section 2 Growth and Development
Health Maintenance Visit
Physical Development
Newborn Period
Later Infancy
School Age/Preadolescent
Adolescence
Developmental Milestones
Psychosocial Assessment
Modifying Psychosocial Behaviors
Temperament
Developmental Surveillance and Screening
Other Issues in Assessing Development and Behavior
Evaluating Developmental and Behavioral Issues
Screening Tests
Immunizations
Dental Care
Nutritional Assessment
Anticipatory Guidance
Multifaceted Team Assessment of Complex Problems
Management of Developmental Problems
Selected Clinical Problems: the Special Needs Child
Suggested Readings
Pearls for Practitioners
Section 3 Behavioral Disorders
Normal Development
Colic
Etiology
Epidemiology
Clinical Manifestations
Differential Diagnosis
Anticipatory Guidance and Management
Etiology
Epidemiology
Differential Diagnosis
Complications
Anticipatory Guidance
Normal Development of Elimination
Enuresis
Functional Constipation and Soiling
Acknowledgment
Adolescent Sleep
Sleep Disorders
Suggested Readings
Pearls for Practitioners
Section 4 Psychiatric Disorders
Bipolar and Related Disorders
Schizophrenia Spectrum and Other Psychotic Disorders
Suggested Readings
Pearls for PrActioners
Section 5 Psychosocial Issues
Etiology
Diagnosis and Clinical Manifestations
Treatment
Complications
Psychosocial Short Stature
Neglect
Physical Abuse
Sexual Abuse
Management
Development of Sexuality
Homosexuality
Development of Gender Identity
Gender Dysphoria
Family Functions
Family Structure
Family Dysfunction: Physical Needs
Family Dysfunction: Emotional Support, Education, and Socialization
Intimate Partner Violence and Children
Youth Violence
Assault and Bullying
Dating Violence and Date Rape
Violence and Technology
Trauma Informed Care
Divorce
Separations From Parents
Death of a Parent or Family Member and Bereavement
Suggested Readings
Pearls for Practitioners
Section 6 Pediatric Nutrition and Nutritional Disorders
Breast Feeding
Formula Feeding
Complementary Foods
Nutrition Issues for Toddlers and Older Children
Milk
Juices
General Recommendations
Salt Intake
Iron Intake
Nutrition Issues for Adolescents
Definitions
Epidemiology
Clinical Manifestations
Assessment
Prevention
Treatment
Failure to Thrive
Marasmus
Kwashiorkor
Mixed Marasmus-Kwashiorkor
Treatment of Malnutrition
Complications of Malnutrition
Water-Soluble Vitamins
Fat-Soluble Vitamins
Minerals
Suggested Readings
Pearls for Practitioners
Section 7 Fluids and Electrolytes
Body Composition
Regulation of Intravascular Volume and Osmolality
Maintenance Fluids
Replacement Therapy
Dehydration
Monitoring and Adjusting Therapy
Indications
Access for Parenteral Nutrition
Composition of Parenteral Nutrition
Complications
Hyponatremia
Hypernatremia
Hypokalemia
Hyperkalemia
Clinical Assessment of Acid-Base Disorders
Metabolic Acidosis
Metabolic Alkalosis
Respiratory Acid-Base Disturbances
Suggested Readings
Pearls for Practitioners
Section 8 Acutely Ill or Injured Child
Initial Assessment
History
Physical Examination
Common Manifestations
Initial Diagnostic Evaluation
Resuscitation
Cardiopulmonary Arrest
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Prevention
Etiology and Epidemiology
Hypovolemic Shock
Distributive Shock
Cardiogenic Shock
Obstructive Shock
Dissociative Shock
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Prevention
Epidemiology and Etiology
Education for Preventing Injuries
Assessment and Resuscitation
Etiology and Epidemiology
Laboratory and Imaging Studies
Clinical Manifestations and Treatment
Complications
Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Complications
Prognosis
Prevention
Etiology and Epidemiology
Clinical Manifestations
Complications
Laboratory and Imaging Studies
Treatment
Prognosis
Prevention
Assessment
Pain and Analgesia
Suggested Readings
Pearls for Practitioners
Section 9 Human Genetics and Dysmorphology
Types of Genetic Disorders
Introduction to Genetics and Genomics
Other Types of Genetic Disorders
Teratogenic Agents
Preconception and Prenatal Counseling
General Approach to Patients
Abnormalities in Number (Aneuploidy)
Syndromes Involving Chromosomal Deletions
Syndromes Involving Chromosome Duplication
Definitions
History and Physical Examination
Laboratory Evaluation
Diagnosis
Suggested Readings
Pearls for Practitioners
Section 10 Metabolic Disorders
Signs and Symptoms
Types of Clinical Presentation of Inborn Errors
Clinical Assessment and Laboratory Testing
Genetic Aspects of Inborn Errors
Identification of Inborn Errors by Neonatal Screening
Overview of Treatment
Glycogen Storage Diseases
Galactosemia
Disorders of Amino Acid Metabolism
Phenylketonuria
Tyrosinemias
Homocystinuria
Maple Syrup Urine Disease
Disorders of Ammonia Disposal
Disorders of Amino Acid Transport That Affect Specific Transport Mechanisms in the Kidney
and Intestine
Disorders of Organic Acid Metabolism
Propionic Acidemia and Methylmalonic Acidemia
Isovaleric Acidemia
Glutaric Acidemia I
Biotinidase Deficiency and Holocarboxylase Deficiency
Disorders of Fatty Acid Oxidation
Glutaric Aciduria Type II
Carnitine Deficiency
Peroxisomal Disorders
Lysosomal Storage Disorders
Diagnostic Testing
Treatment Strategies
Mitochondrial Function
Signs and Symptoms of Genetic Disorders of Mitochondrial Function
Biochemical Abnormalities in Mitochondrial Function
Genetics of Mitochondrial Disorders
Treatment of Mitochondrial Disorders
Suggested Readings
Pearls for Practitioners
Section 11 Fetal and Neonatal Medicine
Assessment of the Mother
Fetus and Newborn
Assessment of the Fetus
Assessment of the Newborn
Neurological Assessment
Miscellaneous Disorders
Antiphospholipid Syndrome
Idiopathic (Immune) Thrombocytopenia
Systemic Lupus Erythematosus
Neonatal Hyperthyroidism
Diabetes Mellitus
Other Conditions
Intrauterine Growth Restriction and Small for Gestational Age
Hydrops Fetalis
Respiratory Distress Syndrome (Hyaline Membrane Disease)
Complications of Respiratory Distress Syndrome
Transient Tachypnea of the Newborn
Meconium Aspiration Syndrome
Primary Pulmonary Hypertension of the Newborn
Apnea of Prematurity
Anemia
Hyperbilirubinemia
Neonatal Seizures
Intracranial Hemorrhage
Hypoxic-Ischemic Encephalopathy
Toxoplasmosis
Rubella
Cytomegalovirus
Herpes Simplex Virus
Congenital Syphilis
Human Immunodeficiency Virus
Hepatitis B
Neisseria Gonorrhoeae
Chlamydia
Mycobacterium Tuberculosis
Zika Virus
Suggested Readings
Pearls for Practitioners
Section 12 Adolescent Medicine
Interviewing Adolescents
Physical Growth and Development of Adolescents
Psychological Growth and Development of Adolescents
Early Adolescence (Ages 10-14 Years)
Middle Adolescence (Ages 15-17 Years)
Late Adolescence (Ages 18-21 Years)
Pelvic Examination
Normal Variants of Puberty
Menstrual Disorders
Pregnancy
Contraception
Rape
Anorexia Nervosa
Bulimia Nervosa
Acute Overdose
Acute and Chronic Effects
Treatment
Suggested Readings
Pearls for Practitioners
Section 13 Immunology
History
Physical Examination
Differential Diagnosis
Diagnostic Evaluation
Etiology and Clinical Manifestations
Treatment
Prevention and Newborn Screening
Etiology and Clinical Manifestations
Laboratory Diagnosis
Treatment
Prognosis and Prevention
Etiology
Laboratory Studies
Treatment
Complications
Suggested Readings
Pearls for Practitioners
Section 14 Allergy
History
Physical Examination
Initial Diagnostic Evaluation
Diagnostic Imaging
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis and Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment and Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Prevention
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Diagnosis
Treatment
Complications
Prognosis and Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Prevention
Suggested Readings
Pearls for Practitioners
Section 15 Rheumatic Diseases of Childhood
History
Physical Examination
Common Manifestations
Initial Diagnostic Evaluation
Laboratory Testing
Diagnostic Imaging
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Etiology
Epidemiology
Clinical Presentation
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications
Prognosis
Growing Pains
Benign Hypermobility
Myofascial Pain Syndromes and Fibromyalgia
Suggested Readings
Pearls for Practitioners
Section 16 Infectious Diseases
Initial Diagnostic Evaluation
Differential Diagnosis
Screening Tests
Diagnostic Imaging
Immunization
Prophylaxis
Fever in Infants Younger Than 3 Months of Age
Fever in Children 3 Months to 3 Years of Age
Fever of Unknown Origin
Measles (Rubeola)
Rubella (German or 3-Day Measles)
Roseola Infantum (Exanthem Subitum)
Erythema Infectiosum (Fifth Disease)
Varicella-Zoster Virus Infection (Chickenpox and Zoster)
Superficial Bacterial Infections
Superficial Fungal Infections
Superficial Viral Infections
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Differential Diagnosis
Laboratory and Imaging Studies
Treatment
Complications and Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory Evaluation
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Treatment
Complications and Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory Studies and Imaging
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Etiology and Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
Complications and Prognosis
Prevention
Etiology
Epidemiology
Clinical Manifestations
Laboratory and Imaging Studies
Differential Diagnosis
Treatment
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