Nelson TEXTBOOK OF PEDIATRICS
17th Edition
Preface
The publication of this 17th Edition of Nelson Textbook of Pediatrics provides a new and comprehensive update and synthesis of pediatric medicine and related science. It continues to represent the "state of the art" on the broad spectrum of normal and abnormal growth and development and of disorders and diseases that affect children and youth.
This is a time of great opportunity. The promise of medicine, biologic sciences, and technology is greater than ever before. Knowledge of human development, behavior, and disease from molecular to sociologic levels is increasing exponentially. This has led to greater understanding of health and illness in children and youth and substantial improvements in the quality of their care. These advances also hold promise of effectively addressing the new and re-emerging diseases threatening children and their families.
Unfortunately, many children worldwide have not yet benefited from the significant advances in the prevention and treatment of health problems, primarily because of a lack of political will and misplaced priorities. Poverty, war, and bioterrorism present additional substantial risks. In order for our increasing knowledge to benefit all children and youth, good medicine needs to be coupled with effective advocacy.
This edition provides the knowledge that practitioners, house staff, medical students, and others involved in pediatric medicine need to address the enormous range of biopsychosocial problems that children and youth may face. As in previous editions, our goal is to be comprehensive, concise, and reader friendly within a single volume, embracing both the science and the art of pediatrics in our presentation.
The 17th Edition represents a substantial revision and reorganization of the textbook based on a complete review of the field of pediatrics. There are many new chapters and substantial expansion or significant modification of others. Every subject has been scrutinized for possible improvement in its exposition, and no chapter has been left unimproved. Although to an ill child and his or her family and physician even the rarest disorder is of central importance, all health problems cannot be covered with the same degree of detail in one general textbook of pediatrics. Thus, leading articles and subspecialty texts are referenced and should be consulted when more information is desired.
The value of this textbook is due to its expert contributors, and we are indebted to ours for their hard work, knowledge, thoughtfulness, and good judgment. Our sincere appreciation also goes to Judy Fletcher, Deborah Thorp, and Robin Davis at Elsevier and to Carolyn Redman at the Pediatric Department of the Medical College of Wisconsin. All of us have worked hard to produce an edition that will be helpful to those who provide care for children and youth and to those desiring to know more about children's health worldwide.
In this edition we have had informal assistance from many faculty and house staff of the departments of pediatrics at Stanford University, the Medical College of Wisconsin, and Eastern Virginia Medical School. The help of these individuals and of the many practicing pediatricians from around the world who have taken the time to offer thoughtful suggestions is greatly appreciated.
Last and certainly not least, we especially wish to thank our wives for their patience and understanding without which this textbook would not have been possible.
Richard E. Behrman MD
Robert M. Kliegman MD
Hal B. Jenson MD
What's New
# Includes completely revised sections on allergic disorders
# the upper respiratory tract
# the lower respiratory tract
# neoplastic diseases and tumors
# diabetes mellitus in children
# neuromuscular disorders
# behavioral and psychological disorders
# and the ear.
# Features enhanced and redrawn artwork for enhanced clarity, additional boxes and tables that highlight key points, and an enhanced 2-color design.
# Presents fresh perspectives from a wealth of new contributors.
# Offers completely updated and streamlined content from cover to cover.
Back to top
Contents
Part I: The Field of Pediatrics
1. Overview of Pediatrics 2. Ethics in Pediatric Care 3. Cultural Issues in Pediatric Care 4. Child Health in the Developing World 5. Preventative Pediatrics 6. The Well Child
Part II: Growth and Development
7. Overview and Assessment of Variability 8. Fetal Growth and Development 9. The Newborn 10. The First Year 11. The Second Year 12. Preschool Years 13. Middle Childhood 14. Adolescence 15. Assessment of Growth 16. Developmental Assessment
Part III: Psychological Disorders
17. Assessment and Interviewing 18. Psychiatric Considerations of Central Nervous 19. Psychosomatic Illness 20. Vegetative Disorders 21. Habit Disorders 22. Anxiety Disorders 23. Mood Disorders 24. Suicides and Attempted Suicide 25. Disruptive Behavioral Disorders 26. Sexual Behavior and its Variations 27. Pervasive Developmental Disorders and Childhood Psychosis 28. Psychologic Treatment of Children and Adolescents 29. Neurodevelopmental Dysfunction in the School-Aged Child
Part IV: Social Issues
30. Adoption 31. Foster Care 32. Child Care 33. Separations and Death 34. Impact of Violence on Children 35. Abuses and Neglect of Children
Part V: Children with Special Health Needs
36. Failure to Thrive 37. Developmental Disabilities and Chronic Illness: An Overview 38. Pediatric Palliative Care: The Care of Children with Life-Limiting Illness 39. Children at Special Risk
Part VI: Nutrition
40. Nutritional Requirements 41. The Feeding of Infants and Children 42. Food Insecurity, Hunger, and under nutrition 43. Obesity 44. Vitamin Deficiencies and Excesses
Part VII: Pathophysiology of Body Fluids and Fluid Therapy
45. Electrolyte and Acid-Base Disorders 46. Maintenance and Replacement Therapy 47. Deficit Therapy 48. Fluids and Electrolyte Treatment of Specific Disorders
Part VIII: The Acutely Ill Child
49. Evaluation of the Sick Child in the Office and Clinic 50. Injury Control 51. Emergency Medical Services for Children 52. Pediatric Critical Care: An Overview 53. Interfacility Transfer of the Critically Ill Infant and Child 54. Effective Communication With Families in the PICU 55. Monitoring Techniques for the Critically Ill Infant and Child 56. Scoring Systems and Predictors of Mortality 57. Stabilization of the Critically Ill Child 58. Acute (Adult) Respiratory Distress Syndrome; ARDS 59. Continuous Hemofiltration 60. Transplantation Issues in the PICU 61. Drowning and Near Drowning 62. Burn Injuries 63. Cold Injuries 64. Withdrawal or Withholding of Life Support, Brain Death and Organ Procurement 65. Anesthesia and Perioperative Care 66. Pain Management in Children
Part IX: Human Genetics
67. The Molecular Basis of Genetic Disorders 68. Molecular Diagnosis of Genetic Diseases 69. Patterns of Inheritance 70. Chromosomal Clinical Abnormalities 71. Gene Therapy 72. Genetic Counseling
Part X: Metabolic Diseases
73. An Approach to Inborn Errors of Metabolism 74. Defects in Metabolism of Amino Acids 75. Defects in Metabolism of Lipids 76. Defects in Metabolism of Carbohydrates 77. Mucopolysaccharidoses 78. Disorders of Purine and Pyrimidine Metabolism 79. Progeria 80. The Porphyrias 81. Hypoglycemia
Part XI: The Fetus and Neonatal Infant
Section 1. Noninfectious Disorders 82. Overview of Mortality and Morbidity 83. The Newborn Infant 84. High-Risk Pregnancies 85. The Fetus 86. The High-Risk Infant 87. Clinical Manifestations of Diseases in the Newborn Period 88. Nervous System Disorders 89. Delivery Room Emergencies 90. Respiratory Tract Disorders 91. Digestive System Disorders 92. Blood Disorders 93. Genitourinary System 94. The Umbilicus 95. Metabolic Disturbances 96. The Endocrine System 97. Dysmorphology Section 2. Infections of the Neonatal Infant 98. Pathogenesis and Epidemiology
Part XII: Special Health Problems During Adolescence
99. The Epidemiology of Adolescent Health Problems 100. Delivery of Health Care to Adolescents 101. Depression 102. Suicide 103. Violent Behavior 104. Anorexia Nervosa and Bulimia 105. Substance Abuse 106. The Breast 107. Menstrual Problems 108. Contraception 109. Pregnancy 110. Sexually Transmitted Diseases 111. Chronic Fatigue Syndrome
Part XIII: The Immunologic System and Disorders
Section 1. Evaluation of the Immune Systems 112. Evaluation of Suspected Immunodeficiency Section 2. The T-, B-, and NK-Cell Systems 113. T Lymphocytes, B Lymphocytes, and Natural Killer Cells 114. Primary Defects of Antibody Production 115. Primary Defects of Cellular Immunity 116. Primary Combined Antibody and Cellular Immunodeficiencies Section 3. The Phagocytic System 117. Neutrophils 118. Monocytes and Macrophages 119. Eosinophils 120. Disorders of Phagocyte Function 121. Leukopenia 122. Leukocytosis Section 4. The Complement System 123. The Complement System 124. Disorders of the Complement System Section 5. Hematopoietic Stem Cell Transplantation 125. Clinical Indications 126. Matching and Rejection 127. Graft vs Host Disease (GVHD) 128. Principles of Immune Suppression 129. Late Effects of Bone Marrow Transplantation
Part XIV: Allergic Disorders
130. Allergy and the Immunologic Basis of Atopic Disease 131. Diagnosis of Allergic Disease 132. Principles of Treatment of Allergic Disease 133. Allergic Rhinitis 134. Childhood Asthma 135. Atopic Dermatitis (Atopic Eczema) 136. Urticaria and Angioedema (Hives) 137. Anaphylaxis 138. Serum Sickness 139. Adverse Reactions to Drugs 140. Insect Allergy 141. Ocular Allergies 142. Adverse Reactions to Foods
Part XV: Rheumatic Diseases of Childhood (Connective Tissue Diseases, Collagen Vascular Disease
143. Evaluation of Suspected Rheumatic Disease 144. Treatment of Rheumatic Diseases 145. Juvenile Rheumatoid Arthritis 146. Ankylosing Spondylitis and Other Spondyloarthropathies 147. Postinfectious Arthritis and Related Conditions 148. Systemic Lupus Erythematosus 149. Juvenile Dermatomyositis 150. Scleroderma 151. BehVet’s Disease 152. Sjögren’s Syndrome 153. Familial Mediterranean Fever 154. Amyloidosis 155. Sarcoidosis 156. Kawasaki Disease 157. Vasculitis Syndromes 158. Musculoskeletal Pain Syndromes 159. Miscellaneous Conditions Associated With Arthritis
Part XVI: Infectious Diseases
Section 1. General Considerations 160. Diagnostic Microbiology 161. Fever 162. Fever without a Focus 163. Sepsis and Shock 164. Infections in Immunocompromised Hosts 165. Infections Associated with Medical Devices Section 2. Gram-Positive Bacterial Infections 166. Staphylococcus 167. Streptococcus Pneumonia (Pneumococcus) 168. Group A Strptococcus 169. Group B Streptococcus 170. Non-Group A or B Streptococcus 171. Enterococcus 172. Diphtheria (Corynebacterium Diphtheriae) 173. Listeria monocytogenes 174. Actinomyces 175. Nocardia Section 3. Gram Negative Bacterial Infections 176. Neisseria meningitidis (Meningococcus) 177. Neisseria gonorrhoeae (Gonococcus) 178. Haemophilus influenzae 179. Chancroid (Haemophilus ducreyi) 180. Pertussis (Bordetella pertussis and B. parapertussis) 181. Salmonella 182. Shigella 183. Escherichia coli 184. Cholera (Vibrio cholerae) 185. Campylobacter 186. Yersinia 187. Aeromonas and Plesiomonas 188. Pseudomonas, Burkholderia, and Stenotrophomonas 189. Tularemia (Francisella tularensis) 190. Brucella 191. Legionella 192. Bartonella Section 4. Anaerobic Bacterial Infections 193. Botulism (Clostridium botulinum) 194. Tetanus (Clostridium tetani) 195. Clostridium difficile–Associated Diarrhea 196. Other Anaerobic Infections Section 5. Mycobacterial Infections 197. Tuberculosis (Mycobacterium tuberculosis) 198. Hansen’s Disease (Mycobacterium leprae) 199. Nontuberculous Mycobacteria Section 6. Spirochetal Infections 200. Syphilis (Treponema pallidum) 201. Nonveneral Treponemal Infections 202. Leptospira 203. Relapsing Fever (Borrelia) 204. Lyme Disease (Borrelia burgdorferi) Section 7. Mycoplasmal Infections 205. Mycoplasma pneumoniae 206. Genital Mycoplasmas (Mycoplasma hominis and Ureaplasm urealyticum) Section 8. Chlamydial Infections 207. Chlamydia pneumoniae 208. Chlamydia trachomatis 209. Psittacosis (Chlamydia psittaci) Section 9. Rickettsial Infections 210. Spotted Fever Group Rickettsioses 211. Scrub Typhus (Orientia tsutsugamushi) 212. Typhus Group Rickettsioses 213. Ehrlichioses 214. Q Fever (Coxiella burnetii) Section 10. Mycotic Infections 215. Candida 216. Cryptococcus neoformans 217. Malassezia 218. Aspergillus 219. Histoplasmosis (Histoplasma capsulatum) 220. Blastomycosis (Blastomyces dermatitidis) 221. Coccidioidomycosis (Coccidioides immitis) 222. Paracoccidioides brasiliensis 223. Sporotrichosis (Sporothrix schenckii) 224. Zygomycosis Section 11. Viral Infections 225. Measels 226. Rubella 227. Mumps 228. Polioviruses 229. Nonpolio Enteroviruses 230. Parvovirus B19 231. Herpes Simplex Virus 232. Varicella-Zoster Virus 233. Epstein-Barr Virus 234. Cytomegalovirus 235. Roseola (Human Herpesviruses 6, 7) 236. Human Herpesvirus 8 237. Influenza Viruses 238. Parainfluenza Viruses 239. Respiratory Syncytial Virus 240. Adenoviruses 241. Rhinoviruses 242. Rotavirus and Other Agents of Viral Gastroenteritis 243. Papillomaviruses 244. Arboviral Encephalitis of North America 245. Arboviral Encephalitis Outside North America 246. Dengue Fever and Dengue Hemorrhagic Fever 247. Yellow Fever 248. Other Viral Hemorrhagic Fevers 249. Lymphocytic Choriomeningitis Virus 250. Hantaviruses 251. Rabies 252. Polyomaviruses 253. Transmissible Spongiform Encephalopathies 254. Acquired Immunodeficiency Syndrome (Human Immunodeficiency Virus) 255. Human T-Cell Lymphotropic Viruses Types I and II Section 12. Protozoan Diseases 256. Primary Amebic Meningoencephalitis 257. Amebiasis 258. Giardiasis and Balantidiasis 259. Spore-Forming Intestinal Protozoa 260. Trichomoniasis (Trichomonas vaginalis) 261. Leishmaniasis (Leishmania) 262. African Trypanosomiasis (Sleeping Sickness; Trypanosoma brucei complex) 263. American Trypanosomiasis (Chagas Disease; Trypanosoma cruzi) 264. Malaria (Plasmodium) 265. Babesiosis (Babesia) 266. Toxoplasmosis (Toxoplasma gondii) 267. Pneumocystis carinii Section 13. Helminthic Diseases 268. Ascariasis (Ascaris lumbricoides) 269. Hookworms (Ancylostoma and Necator americanus) 270. Trichuriasis (Trichuris trichuria) 271. Enterobiasis (Enterobius vermicularis) 272. Strongyloidiasis (Strongyloides stercoralis) 273. Lymphatic Filariasis (Brugia malayi, B. timori, and Wuchereria bancrofti) 274. Other Tissue Nematodes 275. Toxocariasis (Visceral and Ocular Larva Migrans) 276. Trichinosis (Trichinella spiralis) 277. Schistosomiasis (Schistosoma) 278. Flukes: (Liver, Lung, and Intestinal) 279. Adult Tapeworm Infections 280. Cysticercosis 281. Echinococcosis (Echinococcus granulosus and E. multilocularis) Section 14. Preventive Measures 282. Immunization Practices 283. Infection Control and Prophylaxis 284. Childcare and Communicable Diseases 285. Health Advice for Children Traveling Internationally
Part XVII. The Digestive System
Section 1. Clinical Manifestations of Gastrointestinal Disease 286. Normal Digestive Tract Phenomena 287. Major Symptoms and Signs of Digestive Tract Disorders Section 2. The Oral Cavity 288. Development and Developmental Anomalies of the Teeth 289. Disorders of the Oral Cavity Associated with Other Conditions 290. Malocclusion 291. Cleft Lip and Palate 292. Syndromes with Oral Manifestations 293. Dental Caries 294. Periodontal Diseases 295. Dental Trauma 296. Common Lesions of the Oral Soft Tissues 297. Diseases of the Salivary Glands and Jaws 298. Diagnostic Radiology in Dental Assessment Section 3. The Esophagus 299. Embryology, Anatomy, and Function of the Esophagus 300. Congenital Anomalies: Esophageal Atresia and Tracheoesophageal Fistula 301. Obstructing and Motility Disorders of the Esophagus 302. Dysmotility 303. Hiatal Hernia 304. Gastroesophageal Reflux Disease (GERD) 305. Non-GERD Esophagitis 306. Esophageal Perforation 307. Esophageal Varices 308. Ingestions Section 4. Stomach and Intestines 309. Normal Development, Structure, and Function 310. Pyloric Stenosis and Other Congenital Anomalies of the Stomach 311. Intestinal Atresia, Stenosis, and Malrotation 312. Intestinal Duplications, Meckel Diverticulum and Other Remnants of the Omphalomesenteric Duct 313. Motility Disorders and Hirschsprung Disease 314. Ileus, Adhesions, Intussusception, and Closed-Loop Obstructions 315. Foreign Bodies and Bezoars 316. Peptic Ulcer Disease on Children 317. Inflammatory Bowel Disease 318. Food Allergy (Food Hypersensitivity) 319. Eosinophilic Gastroenteritis 320. Malabsorptive Disorders 321. Gastroenteritis 322. Chronic Diarrhea 323. Recurrent Abdominal Pain of Childhood 324. Acute Appendicitis 325. Surgical Conditions of the Anus, Rectum, and Colon 326. Tumors of the Digestive Tract 327. Inguinal Hernias Section 5. Exocrine Pancreas 328. Embryology, Anatomy, and Physiology 329. Pancreatic Function Tests 330. Disorders of the Exocrine Pancreas 331. Treatment of Pancreatic Insufficiency 332. Pancreatitis 333. Pseudocyst of the Pancreas 334. Pancreatic Tumors Section 6. The Liver and Biliary System 335. Morphogenesis of the Liver and Biliary System 336. Manifestations of Liver Disease 337. Cholestasis 338. Metabolic Diseases of the Liver 339. Viral Hepatitis 340. Liver Abscess 341. Liver Disease Associated with Systemic Disorders 342. Reye Syndrome and the Mitochondrial Hepatopathies 343. Autoimmune (Chronic) Hepatitis 344. Drug- and Toxin-Induced Liver Injury 345. Fulminant Hepatic Failure 346. Cystic Diseases of the Biliary Tract and Liver 347. Diseases of the Gallbladder 348. Portal Hypertension and Varices 349. Liver Transplantation Section 7. Peritoneum 350. Malformations 351. Ascites 352. Peritonitis 353. Diaphragmatic Hernia 354. Epigastric Hernia
Part XVIII: Respiratory System
Section 1. Development and Function 355. Development of the Respiratory System 356. Regulation of Respiration 357. Respiratory Pathophysiology 358. Defense Mechanisms and Metabolic Functions of the Lung 359. Diagnostic Approach to Respiratory Disease 360. Sudden Infant Death Syndrome Section 2. Upper Respiratory Tract 361. Congenital Disorders of the Nose 362. Acquired Disorders of the Nose 363. Nasal Polyps 364. The Common Cold 365. Sinusitis 366. Pharyngitis 367. Retropharyngeal Abscess, Lateral Pharyngeal (Parapharyngeal) Abscess, and Peritonsillar Cellulitis/Abscess) 368. Tonsils and Adenoids 369. Obstructive Sleep Apnea and Hypoventilation in Children Section 3. Disorders of the Lungs and Lower Airway 370. Chronic or Recurrent Respiratory Symptoms 371. Acute inflammatory Upper Airway Obstruction 372. Congenital Anomalies of the Larynx 373. Foreign Bodies of the Airway 374. Neoplasms of the Larynx, Trachea, and Bronchi 375. Inflammatory Disorders of the Small Airways 376. Wheezing in Infants 377. Emphysema and Overinflation 378. α1-Antitrypsin Deficiency and Emphysema 379. Other Distal Airway Disease 380. Congenital Disorders of the Lung 381. Pulmonary Edema 382. Aspiration Syndromes 383. Chronic Recurrent Aspiration 384. Gastroesophageal Reflux and Respiratory Disorders 385. Parenchymal Disease with Prominent Hypersensitivity, Eosonophilic Infiltration, or Toxin-Mediated Injury 386. Pneumonia 387. Slowly Resolving Pneumonia 388. Bronchiectasis 389. Pulmonary Abscess 390. Cystic Fibrosis 391. Primary Ciliary Dyskinesia (Immotile Cilia Syndrome) 392. Interstitial Lung Disease 393. Pulmonary Alveolar Proteinosis 394. Inherited Disorders of Surfactant Protein Metabolism 395. Pulmonary Hemosiderosis 396. Pulmonary Hemorrhage, Embolism, and Infarction 397. Atelectasis 398. Pulmonary Tumors 399. Pleurisy 400. Pneumothorax 401. Pneumomediastinum 402. Hydrothorax 403. Hemothorax 404. Chylothorax 405. Bronchopulmonary Dysplasia 406. Skeletal Diseases Influencing Pulmonary Consequences 407. Neuromuscular Diseases with Pulmonary Consequences 408. Extrapulmonary Diseases with Pulmonary Manifestations 409. Chronic Severe Respiratory Insufficiency
Part XIX: The Cardiovascular System
Section 1. Developmental Biology of the Cardiovascular System 413. Cardiac Development 414. The Fetal to Neonatal Circulatory Transition Section 2. Evaluation of the Cardiovascular System 415. History and Physical Examination 416. Laboratory Evaluation Section 3. Congenital Heart Disease 417. Epidemiology of Congenital Heart Disease 418. Evaluation of the Infant or Child 419. Acyanotic Congeital Heart Disease: The Left Ventricular Septal Defect to-Right Shunt Lesions 420. Acyanotic Congenital Heart Disease: The Obstructive Lesions 421. Acyanotic Congenital Heart Disease: Regurgitant Lesions 422. Cyanotic Congenital Heart Disease: Evaluation of the Critically Ill Neonate with Cyanosis and Respiratory Distress 423. Cyanotic Congenital Heart Lesions: Lesions Associated with Decreased Pulmonary Blood Flow 424. Cyanotic Congenital Heart Disease: Lesions Associated with Increased Pulmonary Blood Flow 425. Other Congenital Heart and Vascular Malformations 427. General Principles of Treatment of Congenital Heart Disease Section 4. Cardiac Arrhythmias 428. Disturbances of Rate and Rhythm of the Heart Section 5. Acquired Heart Disease 429. Infective Endocarditis 430. Rheumatic Heart Disease Section 6. Diseases of the Myocardium and Pericardium 431. Diseases of the Myocardium 432. Diseases of the Pericardium 433. Tumors of the Heart Section 7. Cardiac Therapeutics 434. Heart Failure 435. Pediatric Heart and Heart-Lung Transplantation Section 8. Diseases of the Peripheral Vascular System 436. Diseases of the Blood Vessels (Aneurysms and Fistulas) 437. Systemic Hypertension
Part XX: Diseases of the Blood
Section 1. The Hematopoietic System 438. Development of the Hematopoietic System 439. The Anemias Section 2. Anemias of Inadequate Production 440. Congenital Hypoplastic Anemia (Diamond-Blackfan Anemia 441. Pearson Marrow-Pancreas Syndrome 442. Acquired Pure Red Blood Cell Anemias 443. Anemia of Chronic Disorders (ACD) and Renal Disease 444. Congenital Dyserythropoietic Anemias (CDA) 445. Physiologic Anemia of Infancy 446. Megaloblastic Anemias 447. Iron Deficiency Anemia 448. Other Microcytic Anemias Section 3. Hemolytic Anemias 449. Definitions and Classification of Hemolytic Anemias 450. Hereditary Spherocytosis 451. Hereditary Elliptocytosis 452. Hereditary Stomatocytosis 453. Other Membrane Defects 454. Hemoglobin Disorders 455. Enzymatic Defects 456. Hemolytic Anemias Resulting from Extracellular Factors 457. Hemolytic Anemias Secondary to Other Extracellular Factors Section 4. Polycythemia (Erythrocytosis) 458. Primary Polycythemia (Polycythemia Rubra Vara) 459. Secondary Polycythemia Section 5. The Pancytopenias 460. The Constitutional Pancytopenias 461. The Acquired Pancytopenias Section 6. Risks of Blood Component Transfusions 462. Red Blood Cell Transfusions and Erythropoietin Therapy 463. Platelet Transfusions 464. Neutrophil (Granulocyte) Transfusions 465. Fresh Frozen Plasma Transfusions 466. Risks of Blood Transfusions Section 7. Hemorrhage and Thrombotic Diseases 467. Hemostasis 468. Hereditary Clotting Factor Deficiencies (Bleeding Disorders) 469. von Willebrand Disease 470. Hereditary Predisposition to Thrombosis 471. Acquired Thrombotic Disorders 472. Postneonatal Vitamin K Deficiency 473. Liver Disease 474. Acquired Inhibitors of Coagulation 475. Disseminated Intravascular Coagulation (Consumptive Coagulopathy 476. Platelet and Blood Vessel Disorders Section 8. The Spleen 477. Anatomy and Function of the Spleen 478. Splenomegaly 479. Hyposplenism, Splenic Trauma, and Splenectomy Section 9. The Lymphatic System 480. Anatomy and Function of the Lymphatic System 481. Abnormalities of Lymphatic vessels 482. Lymphadenopathy
Part XXI: Cancer and Benign Tumors
483. Epidemiology of Childhood and Adolescent Cancer 484. Molecular and Cellular Biology of Cancer 485. Principles of Diagnosis 486. Principles of Treatment 487. The Leukemias 488. Lymphoma 489. Brain Tumors in Children 490. Neuroblastoma 491. Neoplasms of the Kidney 492. Soft Tissue Sarcomas 493. Neoplasms of Bone 494. Retinoblastoma 495. Gonadal and Germ Cell Neoplasms 496. Neoplasms of the Liver 497. Benign Vascular Tumors 498. Rare Tumors 499. Histiocytosis Syndromes of Childhood
Part XXII: Nephrology
Section 1. Glomerular Disease 500. Introduction to Glomerular Diseases Section 2. Conditions Particularly Associated with Hematuria 501. Clinical Evaluation of the Child with Hematuria 502. Isolated Glomerular Disease with Recurrent Gross Hematuria 503. Glomerulonephritis Associated with Infections 504. Membranous Glomerulopathy 505. Membranoproliferative (Mesangiocapillary) Glomerulonephritis 506. Glomerulonephritis Associated With Systemic Lupus Erythematosus 507. Henoch-Schonlein Purpura Nephritis 508. Rapidly Progressive (Crescentic) 509. Goodpasture Disease 510. Hemolytic-Uremic Syndrome 511. Upper Urinary Tract Causes of Hem 512. Hematologic Diseases Causing Hemturia 513. Anatomic Abnormalities Associated with hematuria 514. Lower Urinary Tract Causes Section 3. Conditions Particularly Associated with Proteinuria 515. Introduction to the Child with Proteinuria 516. Transient Proteinura 517. Orthostatic (Postural) Proteinuria 518. Fixed Proteinuria 519. Nephrotic Syndrome Section 4. Tubular Disorders 520. Tubular Function 521. Renal Tubular Acidosis 522. Nephrogenic Diabetes Insipidus 523. Bartter/Gitelman Syndromes and Other Inherited Tubular Transport 524. Tubulointerstitial Nephritis Section 5. Toxic Nephropathies-Renal Failure 525. Toxic Nephropathy 526. Cortical Necrosis 527. Renal Failure 528. Renal Transplantation
Part XXIII: Urologic Disorders in Infants and Children
529. Congenital Anomalies and Dysgenesis of the Kidneys 530. Urinary Tract Infections 531. Vesicoureteral Reflux 532. Obstructions of the Urinary Tract 533. Anomalies of the Bladder 534. Neuropathic Bladder 535. Voiding Dysfunction 536. Anomalies of the Penis and Urethra 537. Disorders and Anomalies of the Scrotal Contents 538. Trauma to the Genitourinary Tract 539. Urinary Lithiasis
Part XXIV: Gynecologic Problems of Childhood 540. History and Physical Examination 541. Vulvovaginitis 542. Bleeding 543. Breast Disorders 544. Hirsutism and Polycystic Ovarian Syndrome 545. Neoplasms 546. Vulvovaginal and Mullerian Anomalies 547. Athletic Gynecologic Problems 548. Special Gynecologic Needs 549. Gynecologic Imaging
Part XXV: The Endocrine System
Section 1: Disorders of the Hypothalamus and Pituitary Gland 550. Hormones of the Hypothalamus and Pituitary 551. Hypotituitarism 552. Diabetes Inspidus 553. Other Abnormalities of Arginine Vasopressin Metabolism and Action 554. Hyperpituitarism, Tall Stature, and Overgrowth Syndromes 555. Physiology of Puberty 556. Disorders of Pubertal Development Section 2: Disorders of the Thyroid Gland 557. Thyroid Development and Physiology 558. Defects of Thyroxine-Binding Globulin 559. Hypthyroidism 560. Throiditis 561. Goiter 562. Hyperthyroidism 563. Carcinoma of the Thyroid Section 3: Disorders of the Parathyroid Glands 564. Hormones and Peptides of Calcium Hemeostasis and Bone Metabolism 565. Hypoparathyroidism 566. Pseudohypoparathyroidism (Albright Hereditary Osteodystrophy) 567. Hyperparathyroidism Section 4: Disorders of the Adrenal Glands 568. The Physiology of the Adrenal Gland 569. Adrenocortical Insufficiency 570. Congenital Adrenal Hyperplasia and Related Disorders 571. Cushing’s Syndrome 572. Primary Aldosteronism 573. Adrenal Tumors 574. Pheochromocytoma 575. Adrenal Masses Section 5. Disorders of the Gonads 576. Development and Function of the Gonads 577. Hypofunction of the Testes 578. Pseudoprecocity Resulting from Tumors of The Testes 579. Gynecomastia 580. Hypofunction of the Ovaries 581. Pseudoprecocity Due to Lesions of the Ovary 582. Intersex Section 6. Diabetes Mellitus In Children 583. Diabetes Mellitus
Part XXVI: The Nervous System
584. Neurologic Evaluation 585. Congenital Anomalies of the Central Nervous System 586. Seizures in Childhood 587. Conditions that Mimic Seizures 588. Headaches 589. Neurocutaneous Syndromes 590. Movement Disorders 591. Encephalopathies 592. Neurodegenerative Disorders of Childhood 593. Acute Stroke Syndromes 594. Central Nervous System Infections 595. Brain Abscess 596. Pseudotumor Cerebri 597. Spinal Cord Disorders
Part XXVII: Neuromuscular Disorders
598. Evaluation and Investigation 599. Developmental Disorders of Muscle 600. Muscular Dystrophies 601. Endocrine Myopathies 602. Metabolic Myopathies Myopathy 603. Disorders of Neuromuscular Transmission and of Motor Neurons 604. Hereditary Motor-Sensory Neuropathies 605. Toxic Neuropathies 606. Autonomic Neuropathies 607. Guillain-Barre Syndrome 608. Bell Palsy
Part XXVIII: Disorders of the Eye
609. Growth and Development 610. Examination of the Eye 611. Abnormalities of Refraction and Accommodation 612. Disorders of Vision 613. Abnormalities of Pupil and Iris 614. Disorders of Eye Movement and Alignment 615. Abnormalities of the Lids 616. Disorders of the Lacrimal System 617. Disorders of the Conjunctiva 618. Abnormalities of the Cornea 619. Abnormalities of the Lens 620. Disorders of the Uveal Tract 621. Disorders of the Retina and Vitreous 622. Abnormalities of the Optic Nerve 623. Childhood Glaucoma 624. Orbital Abnormalities 625. Injuries to the Eye
Part XXIX: The Ear
626. Clinical Manifestations 627. Hearing Loss 628. Congenital Malformations 629. Diseases of the External Ear 630. Otitis Media 631. The Inner Ear and Diseases of the Bony Labyrinth 632. Traumatic Injuries of the Ear and Temporal Bone 633. Tumors of the Ear and Temporal Bone
Part XXX: The Skin
634. Morphology of the Skin 635. Evaluation of the Patient 636. Principles of Therapy 637. Diseases of the Neonate 638. Cutaneous Defects 639. Ectodermal Dysplasias 640. Vascular Disorders 641. Cutaneous Nevi 642. Hyperpigmented Lesions 643. Hypopigmented Lesions 644. Vesiculobullous Disorders 645. Eczematous Disorders 646. Photosensitivity 647. Diseases of the Epidermis 648. Disorders of Keratinization 649. Diseases of the Dermis 650. Diseases of Subcutaneous Tissue 651. Disorders of the Sweat Glands 652. Disorders of Hair 653. Disorders of the Nails 654. Disorders of the Mucous Membranes 655. Cutaneous Bacterial Infections 656. Cutaneous Fungal Infections 657. Cutaneous Viral Infections 658. Arthropod Bites and Infestations 659. Acne 660. Tumors of the Skin 661. Nutritional Dermatoses
Part XXXI: Bone and Joint Disorders
Section 1. Orthopaedic Problems 662. Growth and Development 663. Evaluation of the Child 664. The Foot and Toes 665. Torsional and Angular Deformities 666. Leg Length Discrepancy 667. The Knee 668. The Hip 669. The Spine 670. The Neck 671. The Upper Limb and Finger 672. Arthrogryposis 673. Common Fractures 674. Osteomyelitis and Suppurative Arthritis Section 2. Sports Medicine 675. Epidemiology and Prevention 676. Management of Musculoskeletal Injury 677. Head and Neck Injuries 678. Heat Injuries 679. Female Athletes: Menstrual Problems and Risk for Osteopenia 680. Ergogenic Aids 681. Specific Sports and Associated Injuries Section 3. The Skeletal Dysplasias 682. General Considerations 683. Disorders of Involving Cartilage Matrix Proteins 684. Disorders Involving Transmembrane Receptors 685. Disorders Involving Ion Transporter 686. Disorders Involving Transcription Factors 687. Disorders Involving Defective Bone Resorption 688. Disorders for Which Defects Are Poorly Understood or Unknown 689. Osteogenesis Imperfecta (OI) 690. Marfan Syndrome Section 4. Metabolic Bone Disease 691. Bone Structure, Growth, and Hormonal Regulation 692. Primary Chondrodystrophy (Metaphyseal Dysplasia) 693. Idiopathic Hypercalcemia 694. Hypophosphatasia 695. Hyperphosphatasia 696. Familial Hypophosphatemia (Vitamin D--Resistant Rickets, X-Linked Hypophosphatemia) 697. Vitamin D-Dependent Rickets (Pseudovitamin D Deficiency, Hypocalcemic Vitamin D--Resistant Rickets) 698. Oncogenous Rickets (Primary Hypophosphatemic Rickets Associated with Tumor) 699. Osteoporosis
Part XXXII: Environmental Health Hazards
700. Pediatric Radiation Injuries 701. Chemical Pollutants 702. Heavy Metal Intoxication 703. Lead Poisoning 704. Poisonings: Drugs, Chemicals, and Plants 705. Nonbacterial Food Poisoning 706. Biologic and Chemical Terrorism 707. Animal and Human Bites 708. Envenomations
PART XXXIII: Laboratory Medicine, Drug Therapy, and Reference Tables
709. Laboratory Testing in Infants and Children 710. Reference Ranges for Laboratory Tests and Procedures 711. Principles of Drug Therapy 712. Medications 713. Herbal Medicines
