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Part I: The Field of Pediatrics (^) Chapter Page Diaper Dermatitis: As the most common skin disorder of infancy and one of the most visible problems in infant care, diaper rash is frequently discussed well child visits.
Part II: Growth and Development Skeletal Maturation: The most commonly used standards are those of Gruelich and Pyle, which require radiographs of the left hand and wrist; knee films are sometimes added for younger children.
Dental Development: Delayed eruption is usually considered when there are no teeth by approximately 13 mo. of age. Common causes include hypothy- roid, hypoparathyroid, familial and (the most common ) idiopathic.
Diagnostic Assessment: The medical evaluation for mental retardation and autism should include chromosomal and molecular biologic testing for fragile X, the most commonly identified genetic cause of mental retardation.
Part III: Psychologic Disorders Assessment and Interviewing: The clinical interview is the most common procedure in medicine, but the nature of the process is often poorly defined. The most common deficiency within an interview is the failure of the clinician to define clearly the goals of the particular encounter.
Psychosomatic illness - Conversion disorder: …pseudoseizures are the most common conversion symptom. 19 71 Vegetative Disorders – Enuresis: The most common cause of daytime enuresis in the preschool child is waiting until the last minute to void urine (mictu- ration deferral).
Anxiety Disorders – Obsessive-compulsive disorder: The most common compulsions are handwashing, continual checking of locks, and touching. 22 77 Suicide and Attempted Suicide: Among preadolescents, jumping from heights is the most common method, followed by self-poisoning, hanging, stabbing and running into traffic.
Disuptive Behavioral Disorders – Truancy and Run-away behavior: During the latency years, the most common causes are related to abuse and neglect within the home.
Reading Dysfunction: Most commonly , subtle or blatant language dysfunctions are present in children with significant reading delays. 29 97 Specific reading disability: Dyslexia is the most common and most comprehensively studied of the learning disabilities, …. Dyslexia may be the most common neurobehavioral disorder affecting children, ….
Part IV: Social Issues Abuse and Neglect of Children: Nutritional neglect is the most common cause of underweight in infancy and may account for > ½ of the cases of FTT. Bruises are the most common manifestation of child abuse and may be found on any body surface. The most common cause of death from physical abuse is head trauma.
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Intra-abdominal injuries from impacts are the second most common cause of death in battered children. 113 Chapter Page Part V : Children with Special Needs Failure to thrive: In developed countries, the most common presentation is poor growth detected in an ambulatory setting; in developing countries, recur- rent infections, marasmus, and kwashiorkor are more common presentations.
Part VI: Nutrition Part VII: Pathophysiology of Body Fluids and Fluid Therapy Perioperative Fluids: The most common error in administering parenteral fluid during and after surgery is excessive administration , particularly of dex- trose in water, rather than use of isotonic solutions.
Tetany: The most common disorder of parathyroid function is transient physiologic hypoparathyroidism of the newborn infant , sometimes referred to as neonatal hypocalcemia.
Part VIII: The Acutely Ill Child Injury control: Injuries are the most common cause of death during childhood beyond the first few months of life and represent one of the most important causes of preventable pediatric morbidity and mortality.
Fire and burn-related injuries: Fire and burn-related injuries are the third most common cause of unintentional injury death in the United States, with about 6,000 burn injury deaths occurring each year.
Firearm injuries: Injuries to children and adolescents involving firearms occur in 3 different situations: nonintentional injury, suicide attempt, and assault. Suicide is now the third most common cause of trauma death in teenage males and fourth in females.
Part IX: Human Genetics Sex Chromosome Anomalies – Turner Syndrome: This is one of the most common monosomies in liveborn humans. 78 330 Fragile Sites: The fragile site located on the distal long arm of chromosome X at Xq27.3 has been associated with the fragile X syndrome, which is the most common form of mental retardation in males.
Part X: Metabolic Diseases OCA 2 (Tyrosinase-Positive Albinism): This is the most common form of generalized albinism. 82.2 350 Homocytinuria due to cystathionine synthase deficiency (Homocystinuria Type I, Classic Homocystinuria) : This is the most common inborn error of methionine metabolism.
Hartnup Disorder: Hartnup defect, with an overall prevalence of 1/24,000 ranks among the most common amino acid disorders in humans. 82.5 353 Nonketotic hyperglycinemia (NKH) : Neonatal NKH – this is the most common form of NKH. 82.7 362 Ornithine Transcarbamylase (OTC) Deficiency: This is probably the most common of all urea cycle disorders. 82.11 370 Disorders of Mitochondrial Fatty Acid oxidation: The most common presentation is an acute attack of life-threatening coma and hypoglycemia induced 83.1 377
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the exception of inhalants in younger teenagers (8th^ grade). Chapter Page The Breast: The most common adolescent breast disorder is a mass, the majority of which are benign cysts or fibroadenomas. 115 573 Primary Amenorrhea: When primary amenorrhea occurs with advanced pubertal development, a structural anomaly of the mullerian duct system should be suspected. Imperforate hymen is most common and is associated with recurrent (monthly) abdominal pain and, after some time has passed, a midline lower abdominal mass, the blood-filled vagina, or hematocolpos.
Injectible progestin (Depo-Provera, DMPA): The most common side effect of DMPA is menstrual disturbance, either amenorrhea or abnormal vaginal bleeding.
Emergency Contraception: The Yuzpe method is most commonly used in the United States, consisting of combination pills totaling 200ug of ethinyl estradiol and 2.0 mg of norgestrel or 1.0 mg levonorgestrel. … The most common side effect is nausea (50%) and vomiting.
Pregnancy – Diagnosis: The most commonly used method is a qualitative measurement of beta subunit for the hCG by blood or urine. The results are positive in 98% of women within 7 days of implantation.
Sexually Transmitted Diseases: HIV and HepaB – aymptomatic patients = Asymptomatic infections with viral pathogens, such as HIV, HSV, and hepati- tis B are the most common presentations of these disease.
Orthopedic Problems: The most common presentation for most of the (previously mentioned) conditions is pain. 121 587 Part XIII: The Immunologic System and Disorders B-Cells: Selective IgA deficiency, the most common B-cell defect, can be ruled out by measuring serum IgA. 122 589 Selective IgA Deficiency: An isolated absence or near absence (i.e.<10mg/dL) of serum and secretory IgA is the most common well-defined immunode- ficiency disorder, with a frequency of 1/333 reported among apparently healthy blood donors.
X-linked Severe Combined Immunodeficiency (XSCID): XSCID is the most common form of SCID in the United States, accounting for approximately 47% of cases.
Allergic Diseases: Allergy is the most common cause of eosinophilia in children in the United States. 129 614 Chronic Granulomatous Disease: Pneumonias, lymphadenitis, and skin infections are the most common infections encountered. The most common pathogen is S. aureus.
Drug-induced neutropenia: Drug use remains one of the most common causes of neutropenia. 131 621 Acute lymphoblastic leukemia (ALL): ALL is the most common malignancy of childhood, and approximately 70% of cases cured by conventional chemotherapy.
Neuroblastoma: The most common extracranial solid tumor in children is neuroblastoma. 135 636 Brain tumors: Tumors of the CNS are the most common solid tumors in children, accounting for 20% of childhood malignancies. 135 637 Part XIV: Allergic Disorders/ Part XV: Rheumatic Diseases of Childhood (Connective Tissue Diseases, Collagen-Vascular Diseases)
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Juvenile Rheumatoid Arthritis (JRA): JRA is one of the most common rheumatic diseases of children and a major cause of chronic disability. 156 704 Chapter Page Juvenile Dermatomyositis (JDM): JDM, the most common of the pediatric inflammatory myopathies, is a systemic vasculopathy with characteristic cutaneous findings and focal areas of myositis resulting in progressive proximal muscle weakness that is responsive to immunosuppressive therapy.
Henoch-Schönlein Purpura (HSP): HSP, also known as anaphylactoid purpura., is a vasculitis of small vessels. It is the most common cause of non- thrombocytopenic purpura in children.
Part XVI: Infectious Diseases Enterotoxigenic E. coli (is) the most common (commonest) cause of traveler’ s diarrhea. 171 740 Clostridium difficile , (is) the most common bacterial cause of nosocomial diarrhea. 171 740 Antimicrobial susceptibility testing: The most common technique is the agar disk diffusion method (Bauer-Kirby method), in which a standardized inoculum of the organism is seeded onto an agar plate.
Fever in patients with sickle cell anemia: Infection is the most common cause of death among children with sickle cell anemia. 172 743 CNS infections: Acute infection of the CNS is the most common cause of fever associated with signs and symptoms of CNS disease in children. 174 751 Viral Meningoencephalitis: The most common arbovirus responsible for CNS infection in the United States are St. Louis and California enceph virus. Varicella-zoster virus may cause CNS infection…. The most common manifestation of CNS involvement is cerebellar ataxia, and the most severe is an acute encephalitis.
Eosinophilic Meningitis: The most common cause of worldwide eosinophilic pleocytosis is CNS infection with helminthic parasites. The most common cause is human infection with the rat lungworm Angiostrongylus cantonensis.
Pneumonia: The most common microbiologic causes of pneumonia in normal children include respiratory viruses, Mycoplasma pneumonia , and selected bacteria. Respiratory viruses are the most common cause of pneumonia during the first several years of life. The most common bacterial causes of pneumonia in normal children are S.pneumonia, Streptococcus pyogenes (grp.A Streptococcus ), and Staphylococcus aureus. Viral Pneumonia: The most common viruses causing pneumonia include respiratory syncytial virus (RSV), parainfluenza, influenza, and adenovirus. RSV is the most common cause of viral pneumonia, especially during infancy. Bacterial Pneumonia: S. pneumoniae is still the most common cause of bacterial infection of the lungs.
Gastroenteritis: G.lamblia is the most common parasitic cause of diarrhea in the United States. 176 766 Hepatitis in the neonates: HBV, the most common hepatotropic virus that infects neonates, usually results in an asymptomatic infection. The most common sequence of events is for an infant to have no clinical evidence of disease and to become chronically infec-
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ambulatory peritoneal dialysis. Chapter Page Streptococcus pneumoniae (Pneumococcus): S. pneumoniae is the most common cause of meningitis in adults. S. pneumoniae is the most frequent bacterial cause of bacteremia, pneumonia, and otitis media and the second most common cause of meningitis in infants and children.
Group A Streptococcus: Streptococci are among the most common causes of bacterial infection in infancy and childhood. Group A Streptococcus, the most common bacterial cause of acute pharyngitis, also produces diverse other infections as well as Non-suppurative sequelae such as rheumatic fever and glomerulonephritis. The most common infections caused by group A β-hemolytic streptococci involve the respiratory tract, skin, soft tissues & blood. The most common form of skin infection due to group A β-hemolytic streptococci is superficial pyoderma (impetigo).
Rheumatic Fever: Subcutaneous nodules: These lesions occur frequently and are most commonly observed in patients with severe carditis. Laboratory: The most commonly used test is the ASO test.
Nocardia: Nocardiosis is a pulmonary disease in 75% of all cases. Metastatic lesions may occur anywhere in the body, but the brain is the most common secondary site, affected in 15-40% of cases. Brain abscess is the most common presentation, with meningitis the second most common , as manifested by pleocytosis, elevated CSF protein, and hypoglycorrhachia.
Neisseria gonorrhea (Gonococcus): Disseminated Gonococcal Infection (DGI) – The most common manifestations are asymmetric arthralgia, petechial or pustular acral lesions, tenosynovitis, suppurative arthritis, …. The most common initial symptoms are acute onset of polyarthralgia with fever.
Haemophilus influenzae: The mode of transmission is most commonly by direct contact or inhalation of respiratory tract droplets containing H.influenzae. Suppurative Arthritis: Large joints, such as the knee, hip, ankle, and elbow, are affected most commonly. Otitis media: Acute otitis media is one of the most common infectious diseases of childhood. The most common bacterial pathogens are S. pneumoniae, H. influenzae, and Moraxella catarrhalis. Conjunctivitis: Acute infection of the conjunctiva is the most common eye infection in childhood.
Nontyphoidal Salmonellosis: Acute Gastroenteritis – This is the most common clinical presentation. Bacteremia – S. typhimurium is the most common serotype causing Salmonella bacteremia in the United States. Extraintestinal focal infections – Extraintestinal infections are most common in the first 3 months of life, in those with sickle cell disease, and in those who have had prior gastrointestinal surgery. The most common focal infections involve the skeletal system, meninges, and intravascu-
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lar sites. Chapter Page Enteric Fever: In developing countries, S. typhi is often the most common Salmonella isolate, with an incidence that can reach 500/100,000. Ingestion of foods or water contaminated with human feces is the most common mode of transmission.
Shigella: … the most common form of epidemic dysentery… Although infection can occur at any age, it is most common in the 2nd^ and 3rd^ year of life. In industrialized societies, S. sonnei is the most common cause of bacillary dysentery with S. flexneri , second in frequency. In preindustrial societies, S. flexneri is most common , with S. sonnei second in frequency. Neurologic findings are among the most common extraintestinal manifestations of bacillary dysentery, occurring in as many as 40% of hospita- lized infected children. The most common complication of shigellosis is dehydration with its attendant risks of renal failure and death.
Escherichia coli: The most common shigatoxin-producing E.coli (STEC) serotypes are E.coli 0157:H7, E.coli 0111:NM, and E.coli 026:H11. 198 851 Campylobacter: Human campylobacterioses most commonly result from ingestion of contaminated food or water, from direct acquisition from other environmental sources, or from person-to-person transmission.
Yersinia enterocolitica: Disease is usually manifested in younger children as an acute enteritis. The most common presenting signs and symptoms are fever (40-50%), occasionally to 40oC, abdominal pain (20-80%), that is usually colicky and sometimes localized to the right lower quadrant, and diarrhea (80-95%)
Aeromonas: The most common clinical manifestation of infection with Aeromonas spp. is gastroenteritis. Some studies suggest that it is the third or fourth most common cause of childhood bacterial diarrhea. A. hydrophilia and A. sobria are the most common species causing septicemia.
Francisella tularensis: The illness caused by F. tularensis is manifested by different clinical syndromes, the most common of which consists of an ulcerative lesion at the site of inoculation with regional lymphadenopathy or lymphadenitis. The most common portal of entry for human infection is through the skin or mucous membrane. Bacteremia may also be present, and although any organ of the body may be involved, the reticuloendothelial system is the most commonly affected. Patchy segmental infiltrates, hilar adenopathy, and pleural effusions are the most common abnormalities demonstrated by chest roentgenograms.
Brucella: If abnormalities are demonstrated on physical examination, the bones and joint frequently are involved, with the sacroiliac joint as well as the hips, knees and ankles being the most common.
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Isoniazid: the most common physical manifestation of peripheral neuritis (INH side effect) is numbness and tingling in the hands or feet. Corticosteroids: the most commonly prescribed regimen is prednisone, 1-2 mg/kg/24hr in 1-2 div. doses for 4-6 wks w/ gradual tapering. Drug Susceptible TB: the most common regimen is INH, RIF, EMB.
Chapter Page Nonvenereal Treponemal Infections: Yaws (caused by Treponema pertenue ) is the most common of the nonvenereal spirochetal diseases. 216.1 907 Borrelia burgdorferi (Lyme Disease): Lyme Disease is the most common vector-borne disease in the United States. 219 910 Mycoplasma pneumoniae: Bronchopneumonia is the most commonly recognized clinical syndrome occurring after M. pneumoniae infections. 220 915 Cryptococcus neoformans: Cryptococcosis - Cryptococcus neoformans var. neoformans is the most common etiologic agent worldwide and is the predo- minant pathogenic fungal infection among individuals infected with HIV. Pneumonia is the most common form of cryptococcosis. HIV infection is the most common predisposing factor for disseminated cryptococcosis. Subacute or chronic meningitis is the most common clinical manifestation of disseminated cryptococcosis.
Invasive Aspergillus infection: Sinusitis: Fever, cough, epistaxis, headache, and sinus pain are the most common clinical signs. Pneumonia and Disseminated infection: Invasive pulmonary aspergillosis is the most common form of Aspergillus infec- tion and usually occurs in immunocompromised patients. Bone: Involvement of the vertebrae is most common.
Blastomyces dermatitidis: Acute pneumonia is the most common form of human blastomycosis. 235 941 Rubella: Congenital Rubella affects virtually all organ systems. The most common manifestation is intrauterine growth retardation. 241 952 Mumps: Enzyme immunoassay for mumps immunoglobulin IgG and IgM antibodies are most commonly used for diagnosis. Complications: Meningoencephalomyelitis is the most frequent. Arthritis most commonly affects the knees, ankles, shoulders and wrists.
Poliomyelitis : Differential diagnosis: Guillain-Barré is the most common diseases and the most difficult to distinguish from poliomyelitis. 243.1 958 Nonpolio Enteroviruses: Clinical Manifestations: Vomiting is most common in meningitis and least common in pleurodynia (Bornholm’ s disease) and uncomplicated exanthematous disease. Aseptic meningitis resulting from enterovirus occurs in epidemics and as isolated cases. Epidemics have most commonly with Coxsackievirus B5 and echovirus 4, 6, 9, and 11. In pericarditis and myocarditis, the group B Coxsackieviruses have been most frequently implicated, and B5 has been the most common causative agent. In orchitis and epididymitis, Group B coxsackieviruses are second only to mumps as causative agents of orchitis; B5 is the most commonly associated Coxsackievirus, but B2 and B4 (can be also).
Parvovirus B19: The most common manifestation of parvovirus B19 is erythema infectiosum, also known as fifth disease, which is a benign, self-limited 244 965
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exanthematous illness of childhood. Herpes Simplex Virus: Acute Herpetic Gingivostomatitis – this primary infection, probably the most common cause of stomatitis in children 1-3 yr. of age, can also occur in older children and adults.
Chapter Page Cytomegalovirus (CMV): CMV is the most common congenital infection, which occasionally causes the syndrome of cytomegalic inclusion disease (hepatosplenomegaly, jaundice, petechia, purpura, and microcephaly). Clinical manifestation: In immunocompromised hosts, illness with a primary infection includes pneumonitis ( most common ) hepatitis, chorioretinitis, gastrointestinal disease, or fever with leucopenia as isolated entities or as manifestations of generalized disease, which is often fatal.
Human herpesvirus 8 (HHV8)) : 3 malignancies occurring primarily in adults with AIDS are associated with HHV8: Kaposi Sarcoma (KS), multicentric Castleman disease and primary effusion lymphoma. KS is the most common neoplasm associated with AIDS(adults).
Respiratory Syncytial Virus (RSV): Bronchiolitis is the most common clinical diagnosis in infants hospitalized with RSV infections, although the syndrome is often indistinguishable from RSV pneumonia in infants, and indeed, the two frequently coexist.
Adenovirus: Mucosal surfaces are the primary target early in infection and typically the site of the most common pathology. Acute respiratory disease is the most common manifestation of adenovirus infection in children and adults. Adenovirus is one of the most common causes of follicular conjunctivitis and keratoconjunctivitis.
Rhinoviruses: Rhinoviruses are collectively the most common cause of the “ common cold” in adults. 255 995 Rotavirus and other agents of viral gastroenteritis: Isotonic dehydration with acidosis is the most common finding in children with severe viral enteritis. 256 997 Dengue Fever/ Dengue Hemorrhagic Fever: The most common hematologic abnormalities during dengue hemorrhagic fever and dengue shock syndrome are hemoconcentration with an increase of more than 20% in hematocrit, thrombocytopenia, prolonged bleeding time, and moderately decreased prothrombin level that is seldom less than 40% of control.
Acquired Immunodeficiency Syndrome (HIV): Clinical manifestations: Bacterial infections: The most common serious infections are bacteremia, sepsis, and pneumonia, accounting for more than 50% of infections in HIV-infected children. Fungal infections: Oral candidiasis is the most common fungal infection seen in HIV-infected children. CNS: The most common presentation is progressive encephalopathy with loss or plateau of develop- mental milestones, cognitive deterioration, impaired brain growth resulting in acquired microcephaly, and symmetric motor dysfunction. Respiratory tract: Lymphocytic interstitial pneumonitis (LIP) is the most common chronic lower res- piratory tract abnormality, occurring in 30-50% of HIV-infected children. Most HIV-infected children experience at least one episode of pneumonia. S.
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The fourth ventricle is the most common site for obstruction and symptoms. Child care and Communicable Diseases: Skin Diseases – The most commonly recognized skin infections or infestations in children in childcare are impetigo due to Staphylococcus aureus or group A Streptococcus, pediculosis, scabies, and tinea capitis and tinea corporis (ringworm).
Part XVII: The Digestive System Chapter Page Gastrointestinal hemorrhage: Erosive damage to the mucosa of the GI tract is the most common cause of bleeding, although variceal bleeding secondary to portal hypertension occurs frequently enough to require consideration.
Malocclusion: Class II occlusion (receding chin/ retrognathia) , is the most common occlusal discrepancy with approximately 45% of the population exhibiting some degree of this condition.
Other Disorders of the Esophagus: External compression – the most common masses impinging on the esophagus are enlarged lymph nodes in the subca- rinal area, which may be due to tuberculosis, histoplasmosis, other forms of pulmonary suppuration, or lymphoma.
Esophagitis: Peptic Esophagitis due to reflux of gastric acid with pain, blood loss, and occasional stricture formation is the most common form of esophagitis. Esophageal candidiasis (moniliasis) is the most common esophageal infection and is not limited to immunocompromised patients.
Foreign bodies in the esophagus: Coins are the most commonly ingested object, especially in children younger than 5 yr. 327 1127 Pyloric stenosis and other congenital anomalies of the stomach: The most common cause of non-bilous vomiting is infantile hypertrophic pyloric stenosis. The most common clinical manifestations of gastric duplication are associated with partial or complete gastric outlet obstruction.
Duodenal obstruction: The membranous form of (duodenal) atresia is most common , with obstruction occurring distal to the ampulla of Vater in the majority of patients.
Malrotation: The most common type of malrotation involves failure of the cecum to move into the right lower quadrant. 330.3 1136 Intestinal Duplication: Localized duplications may occur in any area of the GI tract but are most common in the ileum and jejunum. 331.1 1137 Meckel Diverticulum: Meckel diverticulum is the most common of these structures (remnants of the omphalomesenteric duct) and is the most frequent congenital GI anomaly, occurring in 2-3% of all infants. The most common mechanism of obstruction occurs when the diverticulum acts as the lead point of an intussusception.
Chronic intestinal pseudo-obstruction: The most common symptoms are abdominal distention and vomiting, which are present in 75% of affected infants. 332.1 1138 Congenital Aganglionic Megacolon (Hirschsprung Disease): Hirschsprung Disease is the most common cause of lower intestinal obstruction in neonates, with an overall incidence of 1/5,000 live births.
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Intussusception: Intussusception is the most common cause of intestinal obstruction between 3 mos. and 6 yr. of age. 333.3 1142 Foreign bodies in the stomach and intestine: Coins are the most common foreign body ingested by young children. In older children, teenagers, and adults, fish or chicken bones are the most common objects accidentally ingested.
Inflammatory bowel disease (IBD): The most common time of onset of IBD is during adolescence and young adulthood. 337 1150 Chapter Page Crohn Disease: Among children with Crohn disease, the initial presentation most commonly involves ileum and colon (ileocolitis) but may involve the small bowel alone in about 40% (50% of these patients have terminal ileitis alone) or colon alone in about 10%(granulomatous colitis)
Malabsorptive disorders: The disaccharidase deficiencies are the most common of these entities. Intestinal Infections: Giardiasis is the most common infectious cause of chronic malabsorption. Other Malabsorptive Disorders: Cystic fibrosis (pancreatic insufficiency) is the most common congenital disorder associated with malabsorption. The next most common cause of pancreatic insufficiency in children, although much rarer, is Shwachman syndrome. Microvillus inclusion disease (Congenital Microvillus Atrophy) appears to be the most common cause of persistent diarrhea that begins in the neonatal period.
Chronic Diarrhea: The most common cause of chronic diarrhea associated with malabsorption is postgastroenteritis malabsorption syndrome. 341 1176 Acute Appendicitis: Acute appendicitis is the most common condition requiring emergency abdominal operation in childhood. 343 1178 Juvenile Colonic Polyp (Retention polyp, Inflammatory polyp): This is the most common childhood bowel tumor, present in 3-4% of people younger than 21 yr.
Peutz-Jeghers Syndrome: Cancer develops in up to 50% of people having Peutz-Jeghers Syndrome, most commonly middle-aged adults. 345 1184 Lymphoma: Lymphoma is the most common malignancy of the gastrointestinal tract in children. About 30% of children with non-hodgkin lymphoma present with abdominal tumors.
Inguinal Hernias: An inguinal hernia is the most common condition requiring operation in the pediatric age group. The most common inguinal hernia in children is an indirect inguinal hernia.
Disorders of the Exocrine Pancreas: Cystic Fibrosis - is the most common lethal genetic disease and the most common cause of malabsorption among white American children.
Pancreatitits: After cystic fibrosis, acute pancreatitis is probably the most common pancreatic disorder in children. 351 1191 Neonatal Cholestasis: Alagille syndrome (arteriohepatic dysplasia) is the most common syndrome incorporating intrahepatic bile duct paucity. 356.1 1204 Liver Abscess: Hepatic abscesses occur in infants in association with sepsis, umbilical vein infection, or vessel cannulation. Beyond infancy, hepatic abscesses occur most commonly in immunocompromised patients.
Cholestasis associated with Total parenteral nutrition (TPN) : The most common metabolic complication of total parenteral nutrition in premature 359 1213
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Chronic Subglottic Stenosis: The most common cause is neonatal endotracheal intubation. 387.2 1282 Neoplasms of the Larynx and Trachea: Papilloma is the most common tumor of the larynx in childhood; it rarely becomes malignant and often disappears after puberty.
Bronchiolitis: Bronchiolitis occurs most commonly in male infants between 3 and 6 mo of age who have not been breast-fed and who live in crowded conditions. The condition most commonly confused with acute bronchiolitis is asthma.
Chapter Page Aspiration pneumonias and GER-related respiratory disease.: The most common mechanism is increasing the gastroesophageal pressure gradient by increasing intragastric pressure, as occurs when the abdominal muscles are tensed with coughing and forced expiratory maneuvers, for example, in cystic fibrosis, BPD, or asthma.
Silo Filler’ s Disease.: The acute and subacute interstitial pneumonia of Silo Filler’ s disease is caused by inhalation of oxides of nitrogen, gases most commonly encountered in freshly filled silos, especially corn silos.
Pulmonary Hemosiderosis: During infancy and prepubertal childhood, infections, trauma, and foreign bodies are probably the most common causes of pulmonary hemorrhage.
Subcutaneous emphysema: Whenever free air finds its way into the subcutaneous tissue , most commonly as a result of pneumomediastinum or pneumo- thorax, subcutaneous emphysema occurs.
Bronchiectasis: Cystic fibrosis is the most common underlying disease in children with generalized bronchial involvement. 410 1308 Recurrent or persistent cough: The most common cause in children is reactive airways (asthma). 415 1312 Cystic Fibrosis: It is the most common life-limiting recessive genetic trait among whites. 416 1315 Pleurisy: The most common cause of pleural effusion in children is bacterial pneumonia. 418 1329 Serofibrinous pleurisy: Serofibrinous pleurisy is most commonly associated with infections of the lung or with inflammatory conditions of the abdomen or mediastinum.
Part XIX: The Cardiovascular System The most common innocent murmur is a medium-pitched, vibratory or “ musical” , relatively short systolic ejection murmur which is heard best along the left lower and midsternal border and has no significant radiation to the apex, base or back.
Acyanotic congenital heart lesions: The most common lesions are those that produce a volume load, and the most common of these are the left-to-right shunt lesions. The second major class of lesions causes and increase in pressure load , most commonly secondary to ventricular outflow obstruction (pulmonic or aortic valve stenosis) or narrowing of one of the great vessels (coarctation of the aorta.
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Lesions resulting in increased volume load: The most common lesions in these group are those that cause left-to-right shunting: ASD, VSD, AVSD, PDA. Regurgitation of the atrioventricular valves is most commonly encountered in patients with partial or complete atrioventricular septal defects (atrioseptal defects, atrioventricular canal).
Lesions resulting from increased pressure load: The most common are obstructions to ventricular outflow: valvar pulmonic stenosis, valvar aortic stenosis, and coarctation of the aorta.
Chapter Page Cyanotic lesions with increased pulmonary blood flow: Cyanosis is caused by either abnormal ventricular– arterial connections or by total mixing of systemic venous blood within the heart. Transposition of the great vessels is the most common of the former group of lesions.
Ostium Secundum Defect: Ostium secundum defect, in the region of the fossa ovalis, is the most common form of ASD and is associated with structural- ly normal atrioventricular (AV) valves.
Ventricular Septal Defect: VSD is the most common cardiac malformation, accounting for 25% of congenital heart disease. Defects may occur in any portion of the ventricular septum; the majority are of the membranous type.
Pulmonary valve stenosis with intact ventricular septum: The most common is isolated valvular pulmonary stenosis, accounting for between 7-10% of all congenital heart defects.
Aortic Stenosis: A bicuspid aortic valve is one of the most common congenital heart lesions overall, identified in up to 2% of adults. In the most common form, valvular aortic stenosis , the leaflets are thickened, and the commissures are fused to varying degrees.
Congenital mitral stenosis: Congenital mitral stenosis is a rare anomaly that can be isolated or associated with other defects, the most common being aortic stenosis and coarctation of the aorta.
Total Anomalous Pulmonary venous return: In TAPVR, there is no direct pulmonary venous connection into the left atrium. The pulmonary veins may drain above the diaphragm …or may drain below the diaphragm …. This latter form of anomalous venous drainage is most commonly associated with obstruction….
Pulmonary arteriovenous fistula: The most common form of this unusual condition is the Osler-Weber-Rendu syndrome (hereditary hemorrhagic telangiectasia), which is also manifested by angiomas of the nasal and buccal mucous membranes, GI, or liver.
Ectopia Cordis: In the most common thoracic form of ectopia cordis, the sternum is split and the heart protrudes outside the chest. 439.4 1408 Infective endocarditis: Previously, Streptococcus viridans was the agent most commonly responsible for endocarditis in pediatric patients. Staphylococ- cus aureus is now the leading causative agent in some series, accounting approximately 39% of episodes. Complications: … the most common is heart failure caused by vegetations involving the aortic or mitral valve.
Doxorubicin (Adriamycin) Cardiotoxicity: The most common manifestation is a severe, chronic, dose-dependent cardiomyopathy, which occurs in 30% (Dilated cardiomyopathy) of patients when the total cumulative dose exceeds 550 mg/m^2 but may be seen occasionally, even in
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von Willebrand disease: von Willebrand disease is the most common hereditary bleeding disorder, with some reports suggesting that it is present in 1 - 2% of the general population. The most common form of von Willebrand disease is type I (85% of cases).
Acquired inhibitors of coagulation: The most common inhibitor is the “ lupus inhibitor” that is found in patients with SLE, other collagen vascular disea- ses, or, most often, common viral infections, including HIV.
Idiopathic Thrombocytopenic Purpura: The most common cause for acute onset of thrombocytopenia in an otherwise well child is (autoimmune) idiopathic thrombocytopenic purpura (ITP).
Chapter Page Acquired disorders of platelet function: …. most commonly liver disease, kidney disease (uremia), and those disorders that trigger increased amounts of fibrin degradation products. Many drugs alter platelet function. The most commonly used drug that alters platelet function in adults is acetyl- salicylic acid (aspirin).
Splenectomy: Encapsulated bacteria such as Streptococcus pneumoniae (>60% of cases), Haemophilus influenzae , and Neisseria meningitides are the most common organisms associated with postsplenctomy sepsis.
Part XXI: Neoplastic Diseases and Tumors Leukemias: The most common childhood cancers, account for about one third of pediatric malignancies. Relapse: The bone marrow is the most common site of relapse, although any site can be affected.
Lymphoma: Lymphoma is the 3rd^ most common cancer in children in the United States, with an annual incidence of 13.2 per million children. Hodgkin’ s Disease: Painless, firm, cervical or supraclavicular adenopathy is the most common presenting sign.
Neuroblastoma (NB): NB accounts for about 8% of childhood cancers and is the most common solid tumor of children outside of the CNS. 504 1552 Wilms’ Tumor: An important feature of Wilms’ tumor is its association with congenital anomalies, the most common being genitourinary anomalies (4.4%), hemihypertrophy (2.9%), and sporadic aniridia (1.1%).
Rhabdomyosarcoma: The most common pediatric soft tissue sarcoma, rhabdomyosarcoma accounts for 5-8% of childhood cancers. The most common presenting feature is a mass that may or may not be painful. When the tumor arises in the middle ear, the most common early signs are pain, hearing loss, chronic otorrhea, or a mass in the ear canal.
Nonrhabdomyosarcoma Soft Tissue Sarcomas (NRSTS): Fibrosarcoma: The most common soft tissue sarcoma in children younger than 1 yr. Malignan fibrous histiocytoma: Most commonly arises in the trunk and extremities, deep in the subcutaneous layer. Synovial sarcoma: The most common NRSTS in some series. Leiomyosarcoma: The most common pediatric retroperitoneal soft tissue tumor. 506.2 1557t
THE “ MOST COMMON” ……. ACCORDING TO NELSON, 16
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Neoplasms of the bone: Osteosarcoma is the most common primary malignant bone tumor in children and adolescents, followed by Ewing’ s sarcoma. Osteosarcoma: Pain and swelling are the most common presenting manifestations.
Salivary gland tumors: The most common is the benign mixed tumor, which most commonly occurs in adolescent females and is curable by surgery. 511.1 1565 Carcinoma of the adrenal gland: The most common syndromes are Cushing’ s, virilization and hyperaldosteronism. 512 1566 Benign Tumors: Osteochondroma (exostosis) is one of the most common benign tumors in children. Eosinophilic granuloma - usually occurs during the first 3 decades of life and is most common in boys between 5 and 10 yr of age. The skull is the most commonly affected, but any bone may be involved.
Chapter Page Hemangiomas: Hemangiomas are the most common benign tumors of infancy and are found in 1% of neonates. The most common lymphatic malformation seen in children is cystic hygroma of the neck, which presents as a painless soft tissue swelling.
Part XXII: Nephrology Glomerular Diseases: Pathogenesis : Immunologic injury is the most common cause and results in glomerulonephritis, which is both a generic term for several diseases and a histopathologic term signifying inflammation of the glomerular capillaries. Pathology: … certain forms of glomerulonephritis show glomerular exudation of blood cells, most commonly neutrophils, ….
Evaluation of the Child with hematuria: In children, microscopic hematuria is most commonly discovered at periodic health examinations, by dipstick or or by microscopic examination of the urine sediment.
Recurrent Gross Hematuria : Alport Syndrome: This is the most common of several types of hereditary nephritis. Patients with Alport Syndrome most commonly present with asymptomatic microscopic hematuria, but recurrent episodes of hematuria are common.
Acute Poststreptococcal Glomurolenephritis: It was the most common cause of gross hematuria in children; IgA nephropathy is now the most common cause of gross hematuria.
Membranous Glomerulopathy: Membranous glomerulopathy is the most common cause of nephritic syndrome in adults, but it is uncommon in childhood and a rare cause of hematuria. In children, membranous glomerulopathy is most common in the 2nd^ decade of life.
Systemic Lupus Erythematosus: Kidney disease, one of the most common manifestations of SLE in childhood, may occasionally be the only manifestation. WHO class IV (diffuse proliferative lupus nephritis) is the most common and most severe form of lupus nephritis.
Membranoproliferative (Mesangiocapillary) glomerulonephritis: Membranoproliferative glomerulonephritis (MPGN) is the most common cause of chronic glomerulonephritis in older children and young adults. Type I MPGN is the most common form; the glomeruli reveal an accentuation of the
