Request PDF on ResearchGate | On Nov 1, , Susanne Suter and others published Lissauer T, Clayden G: Illustrated textbook of paediatrics, 2nd edition. Apr 7, Illustrated Textbook of Paediatrics 5th Edition Pdf Download Free - By Tom Lissauer MB BChir FRCPCH, Will Carroll MD MRCP MRCPCH Bm BCh . Illustrated Textbook of Paediatrics Tom Lissauer, Will Carroll. Java Projects 2nd Edition Pdf Download Free Book - By Peter Verhas Java Projects Learn how.
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Paediatrics. Fourth Edition. Edited by. Dr Tom Lissauer MB BChir FRCPCH. Honorary Consultant Paediatrician, Imperial College Healthcare Trust,. London, UK. Illustrated Textbook of Paediatrics. 5th Edition. Editors: Tom Lissauer Will Carroll. eBook ISBN: eBook ISBN: Paperback. Illustrated Textbook of Paediatrics Tom Lissauer. the British Medical Association book awards' first prize in the paediatrics category! صيغة الكتاب: pdf.
Paperback Published: Click on the cover image above to read some pages of this book! New edition of this best-selling paediatrics textbook, translated into 8 languages and winner of BMA and RSM awards in paediatrics. Thoroughly revised and updated New sections on child protection and global paediatrics s of figures, summary boxes and clinical pictures. Case studies Online access.
Care of the sick child and young person 6. Paediatric emergencies 7. Accidents and poisoning 8.
Child protection 9. Genetics Perinatal medicine Neonatal medicine Growth and puberty Nutrition Gastroenterology Infection and immunity Allergy Respiratory disorders Cardiac disorders Kidney and urinary tract disorders It shall be a violation of this Honor Code for a student to cheat.
It shall be a violation of this Honor Code for a student to knowingly circumvent any course requirement. It shall be a violation of this Honor Code for a student to steal. It shall be a violation of this Honor Code for a student to purposely impair another student's educational opportunity.
It shall be a violation to act in a manner which is detrimental to the moral and ethical standards of the medical profession. It shall be a violation for a student to knowingly deceive another student, faculty member, or professional associate with the intent to gain advantage, academic or otherwise, for said student or for any other student. It shall be a violation for any student to fail to report any infraction of the Honor System to an appropriate representative.
This should be done during the first week of class. This syllabus and other class materials are available in alternative format upon request.
Clinical and Educational Duties: There are no unexcused absences. Excused absences must come from Dr. Marc Kahn, Dr. Scott Davis or the clerkship director at your assigned site. Pediatric Grand Rounds: Students on Inpatient services at the main Tulane campus or the Ochsner campus are required to attend Pediatric Grand Rounds at the respective institutions when they are held. Students on their NICU, nursery, and ambulatory rotations should view them if possible by videoconference or streaming audio with slides on the web.
Preceptor: Attendance at the student s designated small group discussion section is mandatory unless excused by the preceptor or the student affairs office. Clinical activities take precedence over didactic presentations. They are intended for use only by students registered and enrolled in this course and only for instructional activities associated with and for the duration of the course. They may not be retained in another medium or disseminated further.
Clerkship director reserves the right to require extra days if missed days are in the one week rotations Attire Students should look professional at all times. Clothes should be clean and not wrinkled. Ties for men are encouraged but not required. If worn, a tie should be tight around the neck with the top collar buttoned.
Shirts should have collars for the men. Clothes should not be too tight, too revealing, too gaudy, or too casual e. Personal Protection Universal Precautions: Your risk of acquiring a serious infection from a patient by exposure to body fluids is probably less than on some of the services you have or will be on because you will not have many opportunities to do procedures on your patients.
However, the risk is not zero and you should always be aware of the need for universal precautions and obtain the appropriate protective equipment. Consider calling campus security at the numbers listed below for a complementary ride to your car.
PC2: Gather essential and accurate information about their patients. PC3: Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment.
PC4: Develop and carry out patient management plans. PC5: Counsel and educate patients and their families. PC6: Use information technology to support patient care decisions and patient education. PC7: Perform competently all medical and invasive procedures considered essential for the area of practice. PC8: Provide health care services aimed at preventing health problems or maintaining health. PC9: Work with health care professionals, including those from other disciplines, to provide patient-focused care.
MK2: Know and apply the basic and clinically supportive sciences, which are appropriate to their discipline. PBL2: Practice-based Learning and Improvement: Locate, appraise, and assimilate evidence from scientific studies related to their patients health problems.
PBL3: Practice-based Learning and Improvement: Obtain and use information about their own population of patients and the larger population from which their patients are drawn.
PBL4: Practice-based Learning and Improvement: Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness.
PBL5: Practice-based Learning and Improvement: Use information technology to manage information, access on-line medical information; and support their own education. PBL6: Practice-based Learning and Improvement: Facilitate the learning of students and other health care professionals.
ICS2: Use effective listening skills and elicit and provide information using effective nonverbal, explanatory, questioning, and writing skills. ICS3: Work effectively with others as a member or leader of a health care team or other professional group. P2: Professionalism: Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices.
P3: Professionalism: Demonstrate sensitivity and responsiveness to patients culture, age, gender, and disabilities.
SBP2: Systems-based Practice: Know how types of medical practice and delivery systems differ from one another, including methods of controlling health care costs and allocating resources.
SBP3: Systems-based Practice: Practice cost-effective health care and resource allocation that does not compromise quality of care. SBP4: Systems-based Practice: Advocate for quality patient care and assist patients in dealing with system complexities.
SBP5: Systems-based Practice: Know how to partner with health care managers and health care providers to assess, coordinate, and improve health care and know how these activities can affect system performance.
Health Supervision Prerequisite 1. Principles of prevention in clinical medicine 2. Understanding of appropriate use of screening in clinical medicine and the characteristics of a good screening test Learning Objectives Activities A.
Describe circumstances when immunizations should or should not be administered. Version 23 B. Normal Growth of the Infant, Child, and Adolescent Prerequisites Knowledge of genetic, endocrine, environmental, and psychosocial factors that affect growth.
Learning Objectives B. Basic knowledge of the appropriate developmental tasks of each stage of childhood and adolescence. Learning Objectives Activities C. Describe the normal sequence of physical maturation and sexual maturity rating Tanner scale in adolescents C. Nutrition Prerequisites 1. The basic biochemistry of proteins, lipids, and carbohydrates and the caloric content of each. The basic vitamin groups and their common dietary sources.
The physiology of glucose metabolism including glucolysis and gluconeogenesis. Learning Objectives D. Activities Determine whether a formulafed infant is receiving adequate calories D. Issues Unique to Adolescence Prerequisites 1. Version 28 F. Issues Unique to Adolescence F.
Version 29 G. Issues Unique to Newborns Prerequisites 1. Understanding of transition from fetal to neonatal physiology Learning Objectives G.
Activities Lecture on Approach to the newborn G. Medical Genetics and Congenital Malformations Prerequisites 1. Basic knowledge of gene structure and function 2. Basic mechanisms of inheritance: multifactorial inheritance, the carrier state, genes and linkage 3.
Basic embryology Learning Objectives H. Trisomy 21! Turner s syndrome, Klinefelter syndrome, Fragile X syndrome! Cystic fibrosis, sickle cell disease! Spina bifida H. Alpha fetoprotein, amniocentesis H. Methylmalonic acidemia Version 32 I. Common Pediatric Illnesses Prerequisites 1. Pathophysiology of common diseases 2. Fundamentals of disease epidemiology 3. Principles of pharmacology, including knowledge of major drug and medication classes and types 4.
Basic clinical data gathering skills Learning Objectives Activities I. Common Pediatric Problems: Acute Illnesses cont.
Therapeutics Prerequisites 1. Basic pharmacology and the pathophysiology of common illnesses 2. Basic human growth and development 3. Physiologic and behavioral changes that occur during development from infancy to adolescence Learning Objectives J. Specifically address drug absorption, distribution, metabolism, and elimination Activities Lecture on pharmacologic principles in pediatrics J.
Fluid and Electrolyte Management Prerequisites 1. Water and electrolyte distribution in body compartments 2. Change in total body water with age: newborn, less than 2 years of age, greater than 2 year of age 3. Relationship between basal metabolic rate and daily water requirements 4. Daily glucose requirements to prevent ketosis 5.
Role of the adrenal gland and antidiuretic hormone ADH in maintaining serum sodium, glucose, and body water 6. An understanding of renal function and the ability to distinguish between renal and pre-renal azotemia K. Routes of absorption of toxins 2. Basic mechanisms of action of common toxic substances e.
Aspirin, organophosphates, acetaminophen, iron, tricyclics. Learning Objectives L. Severe respiratory distress! Head and cervical spine trauma! Child Abuse Physical and Sexual Prerequisites 1.
Basic clinical data-gathering skills 2. Knowledge of physical growth and development from birth through adolescence 3. Knowledge of infant, child and adolescent behavior 4.
Knowledge of adult depressive disorders, domestic abuse, elder abuse and family dysfunction N. FOCUS: 1. The ideal situation is the preparation of a report on a history and physical examination performed solely by the student at or near the time of admission.
The following are acceptable alternatives to this general rule: a joint history and physical examination performed by an intern or resident with the student, b individual history and physical examination performed by the student on the day after admission e.
If it is hand-written, it should be neat and legible. If it is hard to read, one point may be deducted from the score. A brief one or two paragraph discussion explaining the rationale behind the differential diagnosis selected by the student should follow the treatment plan.
Please turn in graded cover sheet Rhonda Bell, student coordinator. Present Illness: Elicit the facts of the illness, particularly the time and nature of the onset. Arrange these facts in a chronological order and relate them in a narrative fashion, tracing the course of events up to the time of the visit.
What was done for the child; what drugs were given and what were the results of such treatment? Pay special attention to recording pertinent negative data as well as positive information. This includes physical exams, laboratory evaluations and treatments which occurred before the present admission.
How has the illness affected the patient s lifestyle? The HPI should conclude with a description of the visit to clinic or emergency department which resulted in the present admission. Details of labor and delivery. Resuscitation formulas should be used to initiate therapy. However, the IV fluid resuscitation rate should be reevaluated on an hourly basis and IV rate adjusted accordingly. Both over-and under-resuscitation are equally problematic in pediatric burn-injured patients.
Under-resuscitation leads to burn shock, suboptimal tissue perfusion, end-organ failure, and death [ 29 ]. Pruitt in and is known to occur when burn patients are over-resuscitated with excessive amounts of fluid [ 30 ]. Despite acknowledging that over-resuscitation is occurring, it has continued to be a problem with the h crystalloid volumes of three recent studies ranged from 4. Over-resuscitation can lead to abdominal compartment syndrome [ 32 ], compartment syndrome of the limbs [ 33 ], and pulmonary edema leading to tracheostomy that might not otherwise be necessary [ 34 ].
In order to ensure that patients are not being either over- or under-resuscitated, IV fluid rates need to be adjusted based on urinary output UO. Hourly UO continues to be the most commonly used endpoint in guiding the administration of resuscitation fluids [ 35 ]. Urine volumes less than or greater than this require adjustment in fluid resuscitation rates. Despite our reliance on this measure, the optimal hourly UO goal has never been accurately defined. Despite a focus on urine output as an endpoint, it is not the only factor in determining adequacy of resuscitation.
As a resuscitation endpoint, UO is practical and works well in many cases, but it is far from perfect. The correlation between UO and measures of oxygen delivery or tissue perfusion is not strong [ 37 ]. In fact, in practitioners who do not have a lot experience, UO may be prone to misinterpretation especially in the presence of IAH or ACS where oliguria may be due to diminished renal perfusion rather than hypovolemia [ 38 , 39 ].
Sheridan et al. In modern burn units, there are far more sophisticated methods to measure response to burn resuscitation than UO. Many of these monitoring tools are able to assess the moment-to-moment physiological state of the patient. For example, abnormal admission arterial lactate levels and base excess values correlate with the magnitude of injury and are now recognized as markers of global poor perfusion and uncompensated shock [ 41 ].
Failure of these values to correct over time predicts mortality [ 42 — 44 ]. There are, however, no prospective studies to support the use of lactate clearance to guide fluid resuscitation in adult or pediatric burn patients. Additionally, measures such as ScvO2 that have shown promise in guiding early goal directed therapy in the septic patient have not been examined or validated in monitoring burn resuscitation [ 45 ]. Novel methods of measuring physiologic parameters are being developed and utilized in both pediatric and adult burn patients.
They found that in these patients, the hyperdynamic circulation that is classically found in burn patients begins within the first week of hospitalization and continues through their entire ICU course. They did not attempt in this study to guide resuscitation using the hemodynamic parameters that they obtained.
This is another area of possible study for the use of TPTD in pediatric patients. Children receiving IV fluid rates twice that were predicted by the Parkland formula, with continued inadequate urine output, are likely to have either heart failure or other complications of over-resuscitation, including abdominal compartment syndrome or pleural effusion [ 48 ]. In general, the treatment for hypotension in pediatric burn-injured patients is fluid resuscitation.
However, even proper fluid resuscitation of burn shock may not achieve complete normalization of physiologic variables due to the fact that burn injury leads to continued cellular and hormonal changes in the patient [ 4 ]. In these cases, the use of vasopressors may be warranted. One study in adults suggests that dobutamine may be a pressor of choice for burn patients as it increases the cardiac index which is shown to be low in patients who have poor outcomes [ 49 ].
Other studies suggest the use of norepinephrine for burn shock refractory to fluid resuscitation [ 50 ]. To date, there are no papers specifically on the use of pressors in the resuscitation of pediatric burn patients. While it is known that pressors are required in some burn patients, their role and choice of vasopressor remains an area in need of investigation.
Areas of controversy and future directions Colloid The use of colloids in burn resuscitation is an area where considerable controversy exists.