Medicine
Pediatrics

TOPICS COMMONLY ENCOUNTERED IN MEDICINE*

Medical students will likely encounter the following topics and procedures during their interactions with patients on the rotation. Please consider downloading the VC3 app or using the VC3 website as a resource (https://medschool.vanderbilt.edu/vc3/).

 

Healthy Patients Patients with a known disease
Health Promotion Hypertension
  COPD
  HIV Infection
Patients with Symptoms and Signs Congestive Heart Failure
Cough Diabetes Mellitus
Dysuria Dyslipidemia
Back Pain Substance Abuse
Joint Pain Smoking Cessation
Chest Pain Depression
Abdominal Pain Common Cancers
Headache Gastroesophageal reflux
Skin Rash URI
  Somatic Disorders

*Summary of the National Ambulatory Medical Care Survey of Internal Medicine and Family Medicine Offices,1989 Summary; and the National Faculty Survey of Internal Medicine Clerkship Directors, 1994 Survey.

 

PROCEDURES COMMONLY USED IN OFFICE to which you may be exposed

  • urinalysis
  • vaginal wet smears: KOH and saline
  • EKG
  • evaluation for corneal abrasions and foreign bodies
  • basic suturing techniques; incision and drainage procedures
  • throat cultures including rapid strep and agar
  • pregnancy test
  • peak flow tests and administration of hand held nebulizers
  • liquid nitrogen application, podophyllin and trichloracetic acid treatments
  • skin biopsy
  • joint aspiration and injection (knee, shoulder)
  • splinting and taping joints
  • treatment of stasis and decubitus ulcers - unna boots, etc.
  • intramuscular and subcutaneous injections
  • ostomy care

COMMON ACUTE ILLNESSES IN PEDIATRICS:

Organized by presenting complaint followed with lists of common and less common significant causes for the complaint:
 

 

COMMON PEDIATRIC CHRONIC ILLNESSES/DISABILITIES

COUGH

Common Conditions

  1. Upper respiratory infection
  2. Pneumonia
  3. Croup
  4. Bronchiolitis
  5. Bronchitis
  6. Asthma
  7. Sinusitis

Other conditions to consider

  1. Cystic Fibrosis
  2. Pertussis
  3. Tuberculosis
  4. Foreign body aspiration
  5. Gastroesophageal reflux
  6. Chlamidia pneumonitis

Return to list of Common Acute Illnesses
 

FEVER

Common Conditions

  1. Bacteremia--occult
  2. UTI--pyelonephritis
  3. Viral illness (nonspecific)
  4. Viral exanthems (varicella, measles, fifth disease)
  5. Roseola
  6. Scarlet fever

Other conditions to consider

  1. Osteomyelitis
  2. Meningitis
  3. Febrile convulsions
  4. Septic arthritis
  5. Kawasaki's disease
  6. Juvenile rheumatoid arthritis
  7. Viral exanthem (rubella)
  8. Tuberculosis

Return to list of Common Acute Illnesses
 

SORE THROAT

Common Conditions

  1. Pharyngitis--strep, scarlet fever, other
  2. Mononucleosis

Other conditions to consider

  1. Rheumatic fever
  2. Cervical adenitis
  3. Peritonsillar and retropharyngeal abscesses

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OTITIS/EAR PAIN

Common Conditions

  1. Otitis media
  2. Recurrent otitis media*
  3. Middle ear effusion

Other conditions to consider

  1. Deafness*
  2. Speech and language delay*
  3. Mastoiditis

Return to list of Common Acute Illnesses
 

URI

Common Conditions
 

  1. Conjunctivitis
  2. Cellulitis*
  3. Allergic rhinitis
  4. Sinusitis

Other conditions to consider
 

  1. Periorbital/orbital

Return to list of Common Acute Illnesses
 

ABDOMINAL PAIN

Common Conditions

  1. Appendicitis
  2. UTI-->pyelonephritis
  3. Gastroenteritis
  4. Constipation
  5. PID
  6. Colic

Other conditions to consider

  1. Vasculitis (e.g. HSP: Henoch-Schonlein Purpura)
  2. Intussusception
  3. Gastritis
  4. Pregnancy
  5. Encopresis*
  6. Inflammatory bowel disease
  7. Peptic ulcer
  8. Ovarian/testicular torsion
  9. Psychogenic abdominal pain
  10. Malignancy
  11. Incarcerated hernia

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VOMITING

Common Conditions

  1. Gastroesophageal reflux
  2. Pyloric stenosis
  3. Gastroenteritis
  4. As secondary to infections (strep pharyngitis, otitis)

Other conditions to consider

  1. Volvulus/bowel obstruction
  2. DKA
  3. Increased intracranial pressure
  4. Hepatitis
  5. Pyelonephritis
  6. Pregnancy
  7. Congenital adrenal hyperplasia

Return to list of Common Acute Illnesses
 

DIARRHEA +/- VOMITING

Common Conditions

  1. Gastroenteritis
  2. Viral
  3. Bacterial
  4. Giardia

Other conditions to consider

  1. Failure to thrive
  2. Hemolytic/uremic syndrome
  3. Dehydration*

Return to list of Common Acute Illnesses

DERMATITIS/RASH

Common Conditions

  1. Acute urticaria
  2. Atopic dermatitis
  3. Contact dermatitis
  4. Monilial skin infections
  5. Scabies
  6. Impetigo/cellulitis
  7. Tinea infections

Other conditions to consider

  1. Anaphylaxis*
  2. Drug reaction
  3. Stevens-Johnson syndrome
  4. Seborrheic dermatitis

Return to list of Common Acute Illnesses
 

TRAUMA

Common Conditions

  1. Animal bite wounds
  2. Burns
  3. Child abuse

Other conditions to consider

  1. Tetanus*
  2. Rabies

Return to list of Common Acute Illnesses

JOINT/LIMB PROBLEMS

Common Conditions

  1. Tendonitis
  2. Infections (toxic tenosynovitis, septic arthritis, osteomyelitis)
  3. Congenital hip dislocation
  4. Injury

Other conditions to consider
 

  1. Nurse maid's elbow
  2. Arthritis (JRA)
  3. Sickle cell crisis
  4. Rheumatic fever
  5. Leukemia/tumors
  6. Osgood-Schlatter disease
  7. Legg-Calve'-Perthes disease
  8. Slipped femoral capital epiphysis

Return to list of Common Acute Illnesses
 

CNS PROBLEMS

Common Conditions
 

  1. Headaches (migraine, tension)
  2. Seizure disorders, febrile convulsions
  3. Closed head trauma

Other conditions to consider

  1. Increased ICP
  2. Brain tumor
  3. Hydrocephalus

Return to list of Common Acute Illnesses

*Important related condition, not directly a cause of the clinical problem.

Return to Common Acute Illnesses

 

COMMON PEDIATRIC CHRONIC ILLNESSES/DISABILITIES:

Principles of chronic illness diagnosis and management in childhood and adolescence are learned best using commonly occurring chronic illnesses; rare chronic illnesses to supplement the learning experience can then be introduced. To aid one in selection of the most common disorders to study, prevalence data on childhood chronic illnesses are given below:

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PROCEDURES:

  • Measure ht., wt., head circumference, vital signs in an infant <1 year of age and plot growth chart
  • Intramuscular injection
  • Subcutaneous injection
  • Developmental Screening tests
  • Vision/Hearing Screen
  • Throat swab
  • Venipunture
  • Blood culture
  • Start an IV
  • Arterial blood gas
  • Urinary bladder catheterization
  • Urinalysis and urine exam under microscope
  • Lumbar puncture
  • Pulse oximetry
  • Pneumatic otoscopy

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