Coma Nicholas S. Abend INTRODUCTION Consciousness is a state of arousal (wakefulness) with awareness of self and surroundings. Arousal is mediated by the brainstem and subcortical structures, including the ascending…

Child Abuse Cindy W. Christian INTRODUCTION Physicians are responsible for identifying cases of suspected abuse and reporting them to the proper authorities for investigation. Diagnosing physical abuse can be challenging….

Chest Pain Kan N. Hor Bradley S. Marino INTRODUCTION Chest pain in children and adolescents is common and produces a high level of anxiety in both patients and families because…

Bleeding and Purpura Kim Smith-Whitley INTRODUCTION Purpura, that is, petechiae and ecchymoses (bruises), and excessive bleeding are caused by disruptions in one or more of the three stages of normal…

Ataxia Lawrence W. Brown INTRODUCTION Ataxia is a disturbance of coordination or balance that is not caused by a problem of muscle strength. Ataxia is characterized by errors of motor…

Ascites Evelyn K. Hsu INTRODUCTION Ascites is the pathologic accumulation of fluid in the peritoneal cavity. It can be caused by decreased plasma oncotic pressure, obstructed lymphatic or venous drainage,…

Apnea Thomas Mollen INTRODUCTION The 1986 Consensus Statement on Infantile Apnea and Home Monitoring from the National Institute of Health (NIH) describes an apparent life-threatening event (ALTE) as “an episode…

Animal Bites Toni Gross INTRODUCTION Humans have contact with animals in a variety of occupational and recreational settings, and over half of households in the United States have at least…

Amenorrhea Valerie Lewis INTRODUCTION Amenorrhea, defined as the absence of menses, is common during adolescence. Determining the underlying cause of amenorrhea necessitates an understanding of the normal menstrual cycle. Although…

Ambiguous Genitalia Jennifer A. Danzig Lorraine E. Levitt Katz INTRODUCTION Genitalia are defined as ambiguous when it is not possible to categorize the gender of the child based on outward…