Rimoin DL, Connor JM, Pyeritz RE, eds. Emergy adn Rimoin's Principles and Practice of Medical Genetics. 4th ed. New York, NY: Churchill Livingstone; 2002
Ryan S, Scriver CR. Phenylalanine hydroxylase deficiency. GeneReviews. Seattle, Wash: Children's Health System and University of Washington; 2003.
Haslam RH. Seizures in childhood. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. 16th ed. Philadelphia, Pa: WB Saunders Co, 2000;1813-1829
Sabo-Graham T, Seay AR. Managemnt of status epilepticus in children. Pediatr Rev. 1998;19:306-309
Conners GP, Chamberlain JM, Ochsenschlager DW. Symptoms and spontaneous passage of esophageal coins. Arch Pediatr Adolesc Med. 1995;149:36-39
Macpherson RI, Hill JG, Otherson HB, Tagge EP, Smith CD. Esophageal foreign bodies in children: diagnosis, treatment, and complications. AJR Am J Roentgenol. 1996;166:919-924
Haddad GG. Primary ciliary dyskinesia. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. 16th ed. Philadelphia, Pa: WB SaundersCo; 2000:1327-1328
Baskin MN. Injury-knee. In:Fleisher GR, Ludwig S, eds. Textbook of Pediatric Emergency Medicine. 4th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2000:339-347
Staheli LT. Hip. In: Fundamentals of Pediatric Ortopoedics. 2nd ed. Philadelphia, Pa: Lippincott-Raven; 1998:68-71.
Davidson M, Wasserman R. The irritable colon of childhood (chronic nonspecific diarrhea syndrome). J Pediatr. 1996;69:1027-1038
Kneepkens CM, Hoekstra JH. Chronic nonspecific diarrhea of childhood: pathophysiology and management. Pediatr Clin North Am. 1996;43:375-390
DeNicola LK, Falk JL, Swanson ME, Gayle MO, Kissoon N. Submersion injuries in children and adults. Crit Care Clin. 1997;13:477-502.
Fisher DH. Near-drowning. Pediatr Rev. 1993;14:148-151.
Shaw KN, Briede CA. Submersion injuries: drowning and near-drowning. Emerg Med Clin North Am. 1989;7:355-370.
Classic presentation: breastfeeding failure with umbilical stump and gastrointestinal bleeding by postnatal day 7. Oozing from circumcision, venipuncture, and heel sticks is also common. Beware bleeding into the scalp or intracranial space.
Due to essential vitamin K deficiency which exists at birth as the fetus receives little vitamin K from the uteroplacental circulation. It is responsible for impaired neonatal clotting function (deficiency of factors II, VII, IX, and X).
Prevented by a single intramuscular dose of 1mg vitamin K in the first few hours following delivery.
American Academy of Pediatrics Committee on Fetus and Newborn. Controversies concerning vitamin K and the newborn. Pediatrics. 2003;112:191-192.
American Academy of pediatrics, the American College of Obstetricians and Gynecologists. Care of the neonate. In: Gilstrap LC, Oh W, eds. Guidelines for Perinatal Care. 5th ed. Elk Grove Village, Ill, Wash DC: American Academy of Pediatrics, teh American College of Obstetricians and Gynecologists; 2002:187-236.
Pancytopenia manifests as a decrease in the erythroid, myeloid, and megakaryocytic cell lines that appears as a decrease in red blood cells, white blood cells, and platelents on complete blood count analysis.
Pancytopenia is an absolute indication for bone marrow aspiration and biopsy to delineate and treat the cause.
Gerson SL, Lazarus HM. Hematopoietic emergencies. Semin Oncol. 1989;16:532-542.
2006 Report of the Committee on Infectious Diseases. American Academy of Pediatrics.
Keywords: Hemolytic-uremic syndrome (HUS) (PubMed Search)
Hemolytic-uremic syndrome (HUS)
Keywords: Acute Laryngotracheobronchitis, Croup (PubMed Search)
Parainfluenza viruses (types 1, 2, 3) account for more than 65% of all cases. The different serotypes have seasonal patterns, with type 1 and 2 occuring in the autumn and being the most common pathogens associated with croup while type 3 is more frequent in the spring and summer and is associated with pneumonia and bronchiolitis.
Infections are rarely associated with high fever and usually last 4 to 5 days. There are no distinctive laboratory abnormalities, and diagnosis is generally made clinically. Chest and neck xray may demonstrate a “steeple sign” from narrowing of the subglottic region. Viral cultures and immunofluorescent rapid antigen identification can be obtained from respiratory secretions. Specific antiviral therapy is not available. Aerosolized epinephrine can be given to severely affected, hospitalized patients to decrease airway obstruction. Parental (>0.3mg/kg) and oral ((0.15mg/kg) dexamethasone have been demonstrated to lessen the severity and duration of symptoms and hospitalization in patients with moderate to severe croup.
American Academy of Pediatrics. Parainfluenza viral infections. In: Pickering LK, ed Red Book: 2006 Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village, Ill: American Academy of Peditrics; 2006
Rocky Mountain spotted fever (RMSF)
Systemic small vessel vasculitis caused by R rickettsii which is transmitted by a tick bite.
Clinical features: fever, headache, myalgia, nausea, vomiting, and characteristic rash. Rash usually appears before the sixth day of the illness initially on the wrists and ankles, and spreads to the trunk within hours. Initially. It is erythematous and macular, later becoming petechial.
Laboratory findings: thrombocytopenia, anemia, and hyponatremia.
Complications: meningitis, multiorgan involvement, DIC, shock, and death.
Treatment: doxcycycline (even despite the risk of dental staining in children younger than 8 years old)
Krogstad P. Osteomyelitis and septic arthritis. In: Feigin RD, Cherry JD, Demmler GJ, Kaplan SL, eds. Textbook of Pediatric Infectious Diseases. Philadelphia, Pa: WB Saunders Co; 2004713-736.
Tan TQ. Osteomyelitis and septic arthritis. In: Perkin RM, Swift JD, Newton DA, eds. Pediatric Hospital Medicine: Textbook of Inpatient Management. Philadelphia, Pa: Lippincott Williams & Wilkins; 2003:497-500.
Yagupsky P, Bar-Ziv Y, Howard CB, Dagan R. Epidemiology, etiology, and clinical features of septic arthritis in children younger than 24 months. Arch Pediatr Adolesc Med. 1995; 149:537-540.
Keywords: Epstien Barr Virus, Mononucleosis (PubMed Search)
Epstein-Barr virus (EBV)-associated infectious mononucleosis (IM)
Most commonly presenting clinical findings: fever, fatigue, exudative pharyngitis, lymphadenopathy, and hepatosplenomegaly.
Self-limited illness that lasts an average of 2 - 3 weeks.
Treatment is primarily supportive. Use of ampicillin, amoxicillin, or penicillin during the acute phase not indicated and may result in the development of a morbilliform rash, which studies have suggested may occur in more than 50% of the cases. Antiviral therapy is not recommended. Splenic rupture occurs in about 1 - 2:1000 cases. Therefore, avoidance of activities that increase the risk for injury is recommended until splenomegaly has resolved.
Hickey SM, Strasburger VC. What every pediatrician should know about infectious mononucleosis in adloscents. Pediatr Clin North Am. 1997;44:1541-1556.
Katz BZ. Epstein-Barr virus. In: Long SS, Pickering LK, Prober CG, eds. York, NY: Churchill Livingstone; 2—3:1059-1068
Peter J, Ray CG. Infectious mononucleosis. Pediatr Rev. 1998; 19:276-279.
2012 PREP Self-Assessment, Pediatrics Review and Education Program