CURRENT ESSENTIALS PEDIATRICS - part 1 pps

a LANGE medical book
CURRENT
ESSENTIALS
PEDIATRICS
Judith M. Sondheimer, MD
Professor Emeritus
Department of Pediatrics
Section of Pediatric Gastroenterology, Hepatology and Nutrition
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
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DOI: 10.1036/0071412565
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Contents
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xxiii
1. Respiratory Tract. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2. Cardiovascular Disorders . . . . . . . . . . . . . . . . . . . . . . . . . 21
3. Gastrointestinal Tract . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
4. Liver and Pancreas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
5. Kidney and Urinary Tract. . . . . . . . . . . . . . . . . . . . . . . . . . 91
6. Neurological and Neuromuscular Disorders. . . . . . . . . . . . 107
7. Hematologic Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . 127
8. Oncology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
9. Immunodeficiency Disorders . . . . . . . . . . . . . . . . . . . . . . 159
10. Endocrine Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
11. Inborn Errors of Metabolism . . . . . . . . . . . . . . . . . . . . . . 201
12. Genetics and Dysmorphology. . . . . . . . . . . . . . . . . . . . . . 223
13. Dermatology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249
14. Ophthalmology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
15. Dental and Oral Medicine . . . . . . . . . . . . . . . . . . . . . . . . 279
16. Ear, Nose, and Throat . . . . . . . . . . . . . . . . . . . . . . . . . . . 285
17. Rheumatic Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . 295
18. Orthopedics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307
For more information about this title, click here
vi Contents
19. Sports Medicine and Rehabilitation . . . . . . . . . . . . . . . . . 329

20. Neonatal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341
21. Adolescent Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . 357
22. Developmental and Behavioral Disorders . . . . . . . . . . . . . 363
23. Psychiatric Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . 371
24. Child Abuse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 385
25. Emergencies and Injuries . . . . . . . . . . . . . . . . . . . . . . . . 391
26. Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 399
27. Bacterial and Spirochetal Infections . . . . . . . . . . . . . . . . . 423
28. Viral and Rickettsial Infections . . . . . . . . . . . . . . . . . . . . 449
29. Parasitic Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . 469
30. Fungal Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 481
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .487
viii Contributors
Timothy A. Benke, MD, PhD
Assistant Professor, Departments of Pediatrics, Neurology, and
Pharmacology
Director, Division of Child Neurology Residency Training Program
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Timothy J. Bernard, MD
Department of Pediatrics and Neurology
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Mark Boguniewicz, MD
Professor, Divisions of Pediatric Allergy-Immunology
Department of Pediatrics, National Jewish Medical and Research
Center
University of Colorado School of Medicine

Denver, Colorado
Robert M. Brayden, MD
Associate Professor, Department of Pediatrics
Section of General and Academic Pediatrics
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Jeffrey M. Brown, MD, MPH
Professor, Department of Pediatrics
University of Colorado School of Medicine
Director, General Pediatrics Division
Denver Health Medical Center
Denver, Colorado
Joanna M. Burch, MD
Assistant Professor, Departments of Dermatology and Pediatrics
University of Colorado School of Medicine
Denver, Colorado
Todd C. Carpenter, MD
Associate Professor, Department of Pediatrics
Section of Pediatric Critical Care Medicine
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Contributors ix
Keith Cavanaugh, MD
Assistant Professor, Department of Pediatrics
Section of Pediatric Pulmonary Medicine
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado

H. Peter Chase, MD
Professor, Department of Pediatrics
Clinical Director Emeritus, Barbara Davis Center for Childhood
Diabetes
University of Colorado School of Medicine
Denver, Colorado
Matthew F. Daley, MD
Assistant Professor, Department of Pediatrics
Section of General and Emergency Medicine Pediatrics
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Richard C. Dart, MD, PhD
Professor, Department of Surgery
University of Colorado School of Medicine
Director, Rocky Mountain Poison and Drug Center
Denver, Colorado
Bert Dech, MD
Clinical Instructor, Department of Psychiatry
The Children's Hospital
Denver, Colorado
Robin R. Deterding, MD
Associate Professor, Department of Pediatrics
Section of Pediatric Pulmonary Medicine
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Emily L. Dobyns, MD
Associate Professor, Department of Pediatrics
Section of Pediatric Critical Care Medicine

University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
x Contributors
Arlene Drack, MD
Associate Professor, Departments of Ophthalmology and Pediatrics
University of Colorado School of Medicine
Rocky Mountain Lions Eye Institute
The Children's Hospital
Aurora, Colorado
Robert E. Eilert, MD
Clinical Professor, Department of Orthopedic Surgery
University of Colorado School of Medicine
Chairman, Department of Orthopedic Surgery
The Children’s Hospital
Denver, Colorado
George S. Eisenbarth, MD, PhD
Professor, Department of Pediatrics
Executive Director, Barbara Davis Center for Childhood Diabetes
University of Colorado School of Medicine
Denver, Colorado
Ellen R. Elias, MD
Associate Professor, Departments of Pediatrics and Genetics
Section of Clinical Genetics and Metabolism
University of Colorado School of Medicine
Director, Special Care Clinic
The Children’s Hospital
Denver, Colorado
Glenn Faries, MD
Assistant Professor, Department of Pediatrics

Co-Director, Core Clerkship Block in Urgent Care/Emergency
Medicine
University of Colorado School of Medicine
Medical Director, Continuing Medical Education
The Children’s Hospital
Denver, Colorado
Margaret A. Ferguson, MD
Clinical Assistant Professor, Department of Pediatrics
Section of Pediatric Critical Care Medicine
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Contributors xi
Douglas M. Ford, MD
Professor, Department of Pediatrics
Section of Pediatric Renal Medicine
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Nicholas K. Foreman, MD
Professor, Department of Pediatrics
Section of Hematology/Oncology/Bone Marrow Transplant
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Norman R. Friedman, MD
Professor, Department of Otolaryngology
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado

Roger H. Giller, MD
Professor, Department of Pediatrics
Section of Pediatric Hematology/Oncology/Bone Marrow Transplant
Director, Pediatric BMT Program
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Neil A. Goldenberg, MD
Assistant Professor, Departments of Pediatrics and Medicine
Center for Cancer and Blood Disorders
Associate Director, Mountain States Regional Hemophilia and
Thrombosis Center
Aurora, Colorado
University of Colorado at Denver and Health Sciences Center
The Children’s Hospital
Denver, Colorado
Edward Goldson, MD
Professor, Department of Pediatrics
Section of Developmental and Behavioral Pediatrics
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
xii Contributors
Doug K. Graham, MD, PhD
Assistant Professor, Department of Pediatrics
Section of Pediatric Hematology/Oncology/Bone Marrow Transplant
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Eva N. Grayck, MD

Associate Professor, Department of Pediatrics
Section of Pediatric Critical Care Medicine
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Brian S. Greffe, MD
Associate Professor, Department of Pediatrics
Section of Pediatric Hematology/Oncology/Bone Marrow Transplant
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Jennifer Hagman, MD
Associate Professor, Department of Psychiatry
University of Colorado School of Medicine
Co-Director, Eating Disorders Treatment Program
The Children’s Hospital
Denver, Colorado
Taru Hays, MD
Professor, Department of Pediatrics
Section of Pediatric Hematology/Oncology/Bone Marrow Transplant
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Francis Hoe, MD
Instructor, Department of Pediatrics
Section of Pediatric Endocrinology
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Contributors xiii

J. Roger Hollister, MD
Professor, Departments of Pediatrics and Medicine
Head, Section of Pediatric Rheumatology
University of Colorado School of Medicine
The Children’s Hospital Senior Staff Physician, National Jewish
Medical and Research Center
Denver, Colorado
Candice E. Johnson, MD, PhD
Professor, Department of Pediatrics
Section of General Academic Pediatrics
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Richard B. Johnston, Jr., MD
Professor of Pediatrics, Section of Immunology
Associate Dean for Research Development
Executive Vice President for Academic Affairs
National Jewish Medical and Research Center
University of Colorado School of Medicine
Denver, Colorado
Carol S. Kamin, MS, EdD
Associate Professor, Department of Pediatrics
Director, Medical Education Research & Development
Director, Project L.I.V.E (Learning through Interactive Video
Education.)
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
David W. Kaplan, MD, MPH
Professor, Department of Pediatrics

Head, Section of Adolescent Medicine
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Michael S. Kappy, MD, PhD
Professor, Department of Pediatrics
Head, Section of Pediatric Endocrinology
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
xiv Contributors
Paritosh Kaul, MD
Assistant Professor, Department of Pediatrics
Director, Denver School Based Health Centers
Section of Adolescent Medicine
University of Colorado School of Medicine
The Children’s Hospital
Denver Health Medical Center
Denver, Colorado
Amy K. Keating, MD
Fellow, Department of Pediatrics
Section of Pediatric Hematology/Oncology/Bone Marrow Transplant
Center for Cancer and Blood Disorders
The University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Peggy E. Kelly, MD
Associate Professor, Department of Otolaryngology
University of Colorado School of Medicine
The Children’s Hospital

Denver, Colorado
Gwendolyn S. Kerby, MD
Assistant Professor, Department of Pediatrics
Section of Pediatric Pulmonary Medicine
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Nancy F. Krebs, MD, MS
Professor, Department of Pediatrics
Head, Section of Nutrition
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Richard D. Krugman, MD
Professor, Department of Pediatrics
Dean, University of Colorado School of Medicine
Denver, Colorado
Myron J. Levin, MD
Professor, Departments of Pediatrics and Medicine
Section of Pediatric Infectious Diseases
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Contributors xv
Andrew H. Liu, MD
Associate Professor, Department of Pediatrics
Section of Allergy & Clinical Immunology
National Jewish Medical & Research Center
University of Colorado School of Medicine
Denver, Colorado

Kathryn A. Love-Osborne, MD
Assistant Professor, Department of Pediatrics
Section of Adolescent Medicine
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Gary M. Lum, MD
Professor, Departments of Pediatrics and Medicine
Head, Section of Pediatric Renal Medicine
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Kelly Maloney, MD
Associate Professor, Department of Pediatrics
Section of Pediatric Hematology/Oncology/Bone Marrow Transplant
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
David K. Manchester, MD
Professor, Department of Pediatrics
Section of Clinical Genetics and Metabolism
University of Colorado School of Medicine
Co-Director, Division of Genetic Services
The Children’s Hospital
Denver, Colorado
Dennis J. Matthews, MD
Professor and Chairman, Department of Rehabilitation Medicine
University of Colorado School of Medicine
Chairman and Medical Director
The Children’s Hospital Rehabilitation Center

Denver, Colorado
xvi Contributors
Elizabeth J. McFarland, MD
Associate Professor, Department of Pediatrics
Section of Pediatric Infectious Diseases
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Shelley D. Miyamoto, MD
Instructor, Department of Pediatrics
Section of Pediatric Cardiology
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Paul G. Moe, MD
Professor, Departments of Pediatrics and Neurology
Division of Child Neurology
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Joseph G. Morelli, MD
Professor, Departments Dermatology and Pediatrics
University of Colorado School of Medicine
Denver, Colorado
Peter M. Mourani, MD
Assistant Professor, Department of Pediatrics
Section of Pediatric Critical Care Medicine
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado

William A. Mueller, DMD
Clinical Associate Professor
University of Colorado School of Dentistry
The Children’s Hospital
Denver, Colorado
Kristen Nadeau, MD
Assistant Professor, Department of Pediatrics
Section of Pediatric Endocrinology
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Contributors xvii
Michael R. Narkewicz, MD
Professor, Department of Pediatrics
Section of Pediatric Gastroenterology, Hepatology and Nutrition
The Pediatric Liver Center
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Ann-Christine Nyquist, MD, MSPH
Associate Professor, Department of Pediatrics
Section of Pediatric Infectious Diseases
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
John W. Ogle, MD
Professor, Department of Pediatrics
Section of Pediatric Infectious Diseases
University of Colorado School of Medicine
The Children’s Hospital Director, Department of Pediatrics

Denver Health Medical Center
Denver, Colorado
Christopher C. Porter, MD
Fellow, Section of Hematology/Oncology/Bone Marrow Transplant
Department of Pediatrics
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Laura E. Primak, RD, CNSD, CSP
Professional Research Assistant
Nutritionist, Section of Nutrition
Department of Pediatrics
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Ralph R. Quinones, MD
Associate Professor, Department of Pediatrics
Section of Pediatric Hematology/Oncology/Bone Marrow Transplant
Director, Pediatric Blood and Marrow Processing Laboratory
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Ann Reynolds, MD
Assistant Professor, Department of Pediatrics
Child Development Unit
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Adam Rosenberg, MD
Professor, Department of Pediatrics

Section of Neonatology, Medical Director of the Newborn Service
University of Colorado Hospital
Director, Pediatric Residency Training Program
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Barry H. Rumack, MD
Clinical Professor, Department of Pediatrics
University of Colorado School of Medicine
Director Emeritus, Rocky Mountain Poison and Drug Center
Denver Health Authority
Denver, Colorado
Scott D. Sagel, MD
Assistant Professor, Department of Pediatrics
Section of Pediatric Pulmonary Medicine
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Rebecca Sands, MD
Assistant Professor, Department of Ophthalmology
University of Colorado School of Medicine
Rocky Mountain Lions Eye Institute
Denver, Colorado
Kelly D. Sawczyn, MD
Fellow, Department of Pediatrics
Section of Pediatric Hematology/Oncology/Bone Marrow Transplant
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
xviii Contributors

Contributors xix
Eric J. Sigel, MD
Assistant Professor, Department of Pediatrics
Section of Adolescent Medicine
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Eric A. F. Simoes, MD, DCH
Professor, Department of Pediatrics
Section of Pediatric Infectious Diseases
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Georgette Siparsky, PhD
Supervisor, Clinical Chemistry Laboratory
Department of Pathology
The Children’s Hospital
Denver, Colorado
Andrew P. Sirotnak, MD
Associate Professor, Department of Pediatrics
University of Colorado School of Medicine
Director, Kempe Child Protection Team
The Children’s Hospital and Kempe Children’s Center for the
Prevention and Treatment of Child Abuse
Denver, Colorado
Ronald J. Sokol, MD
Professor and Vice-Chair Head, Department of Pediatrics
Section of Pediatric Gastroenterology, Hepatology and Nutrition
The Pediatric Liver Center
Director, Pediatric Clinical Translational Research Center

University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Henry M. Sondheimer, MD
Professor, Department of Pediatrics
Section of Pediatric Cardiology
Associate Dean for Admissions
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
xx Contributors
Judith M. Sondheimer, MD
Professor Emeritus, Department of Pediatrics
Section of Pediatric Gastroenterology, Hepatology and Nutrition
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Kurt R. Stenmark, MD
Professor, Department of Pediatrics, Head
Section of Pediatric Critical Care Medicine
Director, Developmental Lung Biology Lab
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Catherine Stevens-Simon, MD
Professor, Department of Pediatrics
Section of Adolescent Medicine
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado

Lora J. Stewart, MD
Fellow, Department of Pediatrics
Section of Allergy & Clinical Immunology
National Jewish Medical & Research Center
University of Colorado School of Medicine
Denver, Colorado
Elizabeth Thilo, MD
Associate Professor, Department of Pediatrics
Section of Neonatology
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Janet A. Thomas, MD
Assistant Professor, Department of Pediatrics
Section of Clinical Genetics and Metabolism
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Contributors xxi
Sharon H. Travers, MD
Associate Professor, Department of Pediatrics
Section of Pediatric Endocrinology
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Chun-Hui (Anne) Tsai, MD
Associate Professor, Department of Pediatrics
Section of Clinical Genetics and Metabolism
University of Colorado School of Medicine
The Children’s Hospital

Denver, Colorado
Johan L. K. Van Hove, MD, PhD, MBA
Associate Professor, Department of Pediatrics
Section of Clinical Genetics and Metabolism
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Adriana Weinberg, MD
Professor, Departments of Pediatrics and Medicine
Director of Clinical Virology Laboratory
Section of Pediatric Infectious Diseases
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
Pamela E. Wilson, MD
Assistant Professor, Department of Rehabilitation Medicine
University of Colorado School of Medicine
The Children’s Hospital Rehabilitation Center
Denver, Colorado
Angela T. Yetman, MD
Associate Professor, Department of Pediatrics
Section of Pediatric Cardiology
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
xxii Contributors
Patricia L. Yoon, MD
Assistant Professor, Department of Otolaryngology
University of Colorado School of Medicine
The Children’s Hospital

Denver, Colorado
Philip S. Zeitler, MD, PhD
Associate Professor, Department of Pediatrics
Section of Pediatric Endocrinology
University of Colorado School of Medicine
The Children’s Hospital
Denver, Colorado
xxiv Preface
Michael Kappy, Myron Levin, Gary Lum, Kelly Maloney, Kristen
Nadeau, John Ogle, Janet Thomas, Sharon Travers, Rachel Seay (MS3),
Henry Sondheimer, Neal Sondheimer, and Philip Zeitler. Thanks also
to Anne Sydor and Kim Davis at McGraw-Hill for their enthusiasm
and persistence.
Judith M. Sondheimer, MD
Denver, Colorado
December 2007
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