Examination Paediatrics, 4th Edition

Examination Paediatrics

4th Edition

By Wayne Harris, MBBS, MRCP(UK), FRACP, Senior Staff Specialist in Paediatrics, West Moreton South Burnett Health Service District; Senior Lecturer, Department of Paediatrics and Child Health, University of Queensland, Australia


Dedication v
Foreword ix
Preface xi
Preface to the first edition xiii
Acknowledgements xv
Abbreviation xvii
Introduction xxxiii

1 Approach to the examination 1

2 The long case 7

3 The short case 14

4 Achievement psychology 17

5 Behavioural and developmental paediatrics 25
Long Cases
Anorexia nervosa 25
Attention deficit hyperactivity disorder (ADHD) 35
Autistic disorder (autism) 49
Short Cases
Child suspected of having
ADHD 61
Child with possible autism/autistic spectrum disorder (ASD) 64

6 Cardiology 67
Long Case
Cardiac disease 67
Short Case
The cardiovascular system 91

7 Endocrinology 107
Long Cases
Congenital adrenal hyperplasia 107
Diabetes mellitus 116
Short Cases
Disorders of Sexual Development (ambiguous genitalia) 132
Diabetes 135
Short stature 136
Tall stature 150
Obesity 157
Normal puberty 163
Precocious puberty 164
Delayed puberty 169
Disorders of Sexual Development
(virilisation in the postneonatal period) 177
Thyroid disorders 182
Thyroid disorders in infants 186

8 Gastroenterology 190
Long Cases
Inflammatory bowel disease 190
Chronic liver disease (CLD) 200
Malabsorption/maldigestion 212
Short Cases
Gastrointestinal system 217
The abdomen 222
Jaundice 229
Nutritional assessment 236
Failure to thrive 244
Poor feeding 246
Weight loss-older child/adolescent 246

9 Genetics and dysmorphology 253
Long Cases
Down syndrome 253
Turner syndrome 265
Short Case
The dysmorphic child 277

10 Haematology 287
Long Cases
Haemophilia 287
Sickle cell disease (SCD) 297
Th alassaemia: -thalassaemia major 311
Short Cases
The haematological system 321
Thalassaemia 329

11 Neonatology 332
Short Cases
The neonatal examination 332
The 6-week check 337

12 Nephrology 338
Long Cases
Chronic kidney disease (CKD) 338
Nephrotic syndrome 356
Short Cases
Renal examination 365
Hypertension 369
Oedema 374

13 Neurology 377
Long Cases
Cerebral palsy 377
Dystrophinopathies: Duchenne muscular dystrophy (DMD) 391
Seizures and epileptic syndromes 403
Spina bifi da 420
Short Cases
Developmental assessment 430
Eye examination 432
Motor cranial nerves 438
Neurological assessment of the upper limbs 439
Gait: a short-case approach 443
Neurological assessment of the lower limbs 444
Cerebellar function 447
Large head 447
Small head 450
Seizures 459
Facial weakness 462
Floppy infant 464
Hemiplegia 469
Intellectual impairment 472
Involuntary movements 475
Neurofi bromatosis, type 1 (NF-1) 477
Neuromuscular assessment 479
Scoliosis 480
Spina bifida 482

14 Oncology 487
Long Case
Oncology 487
Short Case
Late effects of oncology treatment 498

15 The respiratory system 503
Long Cases
Asthma 503
Neonatal intensive care unit graduate: chronic lung disease/bronchopulmonary dysplasia (CLD/BPD) 513
Cystic fi brosis (CF) 521
Obstructive sleep apnoea (OSA) 546
Short Cases
The respiratory system 552
The chest 556
Stridor 556
Chest X-rays 558

16 Rheumatology 561
Long Cases
Juvenile idiopathic arthritis (JIA) 561
Juvenile idiopathic inflamatory myopathies (JIIMs): juvenile dermatomyositis (JDM) 577
Systemic lupus erythematosus (SLE) 587
Short Case
Joints 598
Suggested reading 604
Quick Reference Mnemonics 607
Picture Credits 623
Index 625
Contents