Problems in. Paediatrics

Transcription

1 Problems in Paediatrics

2 Problems in Practice Series PROBLEMS IN ARTHRITIS AND RHEUMATISM - D. N. Golding PROBLEMS IN CARDIOLOGY - C. F. P. Wharton PROBLEMS IN GASTROENTEROLOGY - M. Lancaster-Smith and K. G. D. Williams PROBLEMS IN GERIATRIC MEDICINE - A. Martin PROBLEMS IN GYNAECOLOGY - E. P. W. Tatford PROBLEMS IN OPHTHALMOLOGY - M. G. Glasspool PROBLEMS IN OTOLARYNGOLOGY - P. Ratnesar PROBLEMS IN PAEDIATRICS - J. Hood PROBLEMS IN PERIPHERAL VASCULAR DISEASE - P. E. A. Savage PROBLEMS IN RESPIRATORY MEDICINE - P. Forgacs PROBLEMS IN SOCIAL CARE - J. Mogridge SERIES INDEX VOLUME

3 Problems In Practke Series SerIes Editors: J.Fry K.G.DWllllams M.Lancaster -Srrilth Problems In Paediatrics John Hood MRCp, MRCS Consultant Paediatrician Queen Mary's Hospital Sidcup, Kent MT~l LIMITED International Medical Publi hers

4 Published by MTP Press Limited Falcon House Lancaster, England Copyright 1962 J. Hood Softcover reprint of the hardcover lst edition 1982 First published 1962 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior permission from the publishers. British Library Cataloping in PubHcation nata Hood, John Problems in paediatrics.-(problems in practice series) 1. Pediatrics I. Title II. Series RJ45 ISBN -13: DOl: / e-isbn-13: Typesetting by Swiftpages Ltd, Liverpool and printed by Butler 8r: Tanner Ltd, Frome and London

5 Contents Preface 9 Foreword J. P. Horder OBE 11 1 Infant feeding 13 Breast feeding - Bottle feeding - Vitamins - Regurgitation - Vomiting - Colic - The hungry baby - The baby who does not feed 2 Respiratory diseases 23 Upper respiratory tract infection Tonsillitis - Otitis media - Stridor - Croup - Acute epiglottitis Chest infections Pneumonias - Lobar pneumonia - Airways obstruction - Asthma 3 Gastrointestinal problems 33 Gastroenteritis and related problems - Malabsorption - Chronic inflammatory bowel disease - Congenital abnormalities - Large bowel obstruction - Appendicitis - Differential diagnosis 4 Urinary tract 47 Urinary tract infection - Congenital abnormalities - Glomerular disease - Renal tubular disorders 5 Fits in childhood 59 Neonatal fits - Febrile fits - Epilepsy - Infantile spasms - Differential diagnosis of peculiar turns 5

6 Problems in Paediatrics 6 Heart disease in children Innocent murmurs - Basic cardiac parameters - Congestive cardiac failure - Ventricular septal defect - Patent ductus arteriosus - Atrial septal defect - Co-arctation of the aorta - Transposition of the great vessels - Tetralogy of Fallot - Pulmonary stenosis - Aortic stenosis - Truncus arteriosus - Tricuspid atresia - Precautions against infection 7 Metabolic disorders Diabetes mellitus Clinical manifestations - Stabilization - Insulin - Oral hypoglycaemic agents - Diet - Education - Urine testing - Blood glucose monitoring - Useful services Thyroid disorders Thyrotoxicosis - Carcinoma of the thyroid - Hypothyroidism Congenital adrenal hyperplasia Growth problems Short stature - Differential diagnosis of short stature - Tall children Common symptoms and problems of doubtful origin Abdominal pain - Headaches - Nocturnal enuresis - Faecal soiling and encopresis The problem child The crying baby - Breath-holding attacks - Temper tantrums - The overactive child - The child who does not sleep - The child who does not eat - School problems Developmental assessment and the handicapped child Neonatal developmental assessment - Newborn reflexes and reactions - Special senses - General objectives in the assessment of the handicapped - Useful information Surgical conditions Common surgical conditions - Abnormalities of the female external genitalia - The umbilicus - Hare lip,

7 Contents cleft palate and tongue tie - Swellings in the neck - Ear. nose and throat surgery - The eyes - Neurosurgical conditions - Orthopaedic problems 12 Emergencies in paediatrics 153 Respiratory emergencies - Cardiac emergencies - Fits and coma - Metabolic emergencies - Gastro-intestinal emergencies - Genito-urinary emergencies - Miscellaneous emergencies Index 169 7

8 Preface This book has been written with general practitioners primarily in view, describing common paediatric conditions that present in the outpatient clinics and those that require admission to hospital. The book is neither a textbook of paediatrics nor a handbook but is aimed to provide guidelines for the more commonplace conditions. Some aspects therefore, have been dealt with in detail, where felt relevant, while others are omitted on grounds of probable rare encounter. It is hoped that this volume will provide the family practitioner with an insight in the paediatrician's approach to many of the common problems in chifdren and to help him decide on the best course of action to follow. The care of children constitutes a significant and important part of a family doctor's work and practitioners are keen to promote optional care in all circumstances. It is hoped that the endeavours of this book will go in some small way to help put across the practitioner's approach. John Hood 9

9 Series Foreword This series of books is designed to help general practitioners. So are other books. What is unusual in this instance is their collective authorship; they are written by specialists working at district general hospitals. The writers derive their own experience from a range of cases less highly selected than those on which textbooks are traditionally based. They are also in a good position to pick out topics which they see creating difficulties for the practitioners of their district, whose personal capacities are familiar to them; and to concentrate on contexts where mistakes are most likely to occur. They are all well-accustomed to working in consultation. All the authors write from hospital experience and from the viewpoint of their specialty. There are, therefore, matters important to family practice which should be sought not within this series, but elsewhere. Within the series much practical and useful advice is to be found with which the general practitioner can compare his existing performance and build in new ideas and improved techniques. These books are attractively produced and I recommend them. J. P. Horder OBE President, The Royal College of General Practitioners 11