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Current essentials: pediatrics by Judith Sondheimer

By Judith Sondheimer

Use present necessities: Pediatrics as a brief reference at the wards and within the health facility! This concise, alphabetically-organized reference offers synoptic info for greater than four hundred universal or vital illnesses and syndromes noticeable in young ones, from delivery via infancy and early life. "Nutshell" details at the analysis and remedy of greater than four hundred clinical issues One Pearl and one disorder in line with web page Covers ambulatory and inpatient medication comprises all key specialties in pediatrics convenient skinny trim dimension slips simply into lab coat pocket Use as a spouse to present prognosis and remedy in Pediatrics (McGraw-Hill, nineteenth variation, 2007)!

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Treat respiratory illness aggressively Assess peak flow rates daily to anticipate exacerbations Mild intermittent symptoms respond to short-course corticosteroids, short-acting inhaled β2-agonists Moderate persistent symptoms may be treated with cromolyn, leukotriene modifiers, sustained release theophylline, longer course corticosteroids, β2-agonists, anticholinergics Pearl Mortality and morbidity (measured by hospital admissions) of asthma in the United States are three to four times higher in African American children than other ethnic groups.

Bronchoscopy may be indicated. 1 10 Current Essentials: Pediatrics 1 Pulmonary Embolism ■ Essentials of Diagnosis • • • • • ■ Differential Diagnosis • • • • ■ Occurs in sickle cell anemia, rheumatic fever, bacterial endocarditis, schistosomiasis, bone fracture, dehydration, polycythemia, nephrotic syndrome, atrial fibrillation, contraceptive use, cancer chemotherapy, shock Risk of embolism increased if there is underlying hypercoagulability— inflammatory bowel disease, antiphospholipid antibodies, protein S or protein C deficiency, factor V Leiden Symptoms—acute-onset dyspnea, tachypnea, pleuritic pain, splinting, cyanosis, tachycardia Radiographs often normal.

Diagnosis confirmed by echocardiogram. ECG shows right axis deviation and paucity of LV forces Differential Diagnosis Other causes of heart failure in the first month—coarctation, cardiomyopathy • Severe acute pulmonary disease • Multiorgan failure from septicemia • ■ Treatment • • • • • ■ Continuous IV prostaglandin E1 maintains patency of ductus arteriosus Nitrogen added to inhaled air lowers inspired O2 to <21%, increases pulmonary vascular tone, and improves systemic perfusion Surgical palliation—Norwood operation uses the RV as the systemic ventricle with an aortopulmonary shunt for pulmonary blood flow Cardiac transplantation is a second surgical option Prophylaxis for endocarditis required after the Norwood operation Pearl Only 50% of children with hypoplastic left heart in the United States are diagnosed prenatally by in utero ultrasound.

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