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Recent episodes
Before You see a Child with Eczema
Mar 25, 2026
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Before You Counsel About Food Allergy Testing
Sep 23, 2025
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Before You Counsel on Introducing Complementary Foods, Including Potentially High Allergen Foods
Jun 13, 2025
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Before Your First Discussion about Infant Formula
Jan 27, 2025
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Before You See a Pediatric Patient with Sore Throat
Sep 5, 2024
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| Date | Episode | Description | Length | ||||||
|---|---|---|---|---|---|---|---|---|---|
| 3/25/26 | ![]() Before You see a Child with Eczema | In this episode, we will discuss everything you need to know before seeing your first pediatric patient with eczema. We will review its pathogenesis, who gets eczema, what to look for on exam, and potential differential diagnoses. We will also elaborate upon the most recent AAP guidelines for treatment of eczema, which focuses on skin care maintenance, topical steroids, and avoidance of triggers. Show Outline: Introduction to Eczema Description of dermatologic terms Defining eczema and atopic dermatitis Pathogenesis Immune dysfunction Histological differences Involvement of filaggrin Racial disparities Who gets eczema? Age of onset Demographics of patients with eczema Atopic disease & “The Atopic March” Clinical Presentation / Diagnosis Characterization of eczematous lesions What to look for in people of color Most likely locations of eczema based on patient age Differential diagnoses Sleep disturbances Utilizing the Patient-Oriented Eczema Measure (POEM) Treatment AAP recently updated treatment guidelines The basic triad for eczema treatment Skin care maintenance Topical anti-inflammatory medications The 5-10-15 Plan Avoidance of triggers Side-effects of topical steroids (very rare) Skin atrophy Steroid withdrawal Complications Secondary infections Tinea Impetigo Eczema herpeticum Closing statements Resources/Links: POEM Eczema Questionnaire: https://www.rchsd.org/documents/2020/08/madp-poem.pdf/ Roduit C, et al. (the PASTURE study group). Phenotypes of Atopic Dermatitis Depending on the Timing of Onset and Progression in Childhood. JAMA Pediatr. 2017 Jul 1;171(7):655-662. doi: 10.1001/jamapediatrics.2017.0556. PMID: 28531273; PMCID: PMC5710337. Schoch JJ, Anderson KR, Jones AE, Tollefson MM; Section on Dermatology. Atopic Dermatitis: Update on Skin-Directed Management: Clinical Report. Pediatrics. 2025 Jun 1;155(6):e2025071812. doi: 10.1542/peds.2025-071812. PMID: 40383540. Links: https://www.rchsd.org/documents/2020/08/madp-poem.pdf/ About the Speaker: Host: Carly Pierson, MD – Carly Pierson, MD is a pediatric resident in the Primary Care Track at UVA Health. She graduated from the University of the Incarnate Word School of Osteopathic Medicine and has interests in allergy and immunology. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 9/23/25 | ![]() Before You Counsel About Food Allergy Testing | In this episode, we will discuss all things related to food allergies, including the difference between IgE-mediated and non-IgE-mediated allergies, clinical manifestations, the important questions to ask when taking a history, the options for doing allergy testing, and treatment. Definition of food allergies Rates of food allergies Possible pathophysiology of food allergies Clinical manifestations of food allergies IgE mediated food allergies Cutaneous symptoms Ocular symptoms Respiratory symptoms GI symptoms Neurological and cardiovascular symptoms Anaphylaxis = involvement of 2 or more systems Non-IgE mediated food allergies Symptoms after 4 hours after ingestion Eosinophilic esophagitis Alpha-gal Food protein induced enterocolitis syndrome (FPIES) Food protein induced proctocolitis (FPIAP) Questions to ask to hone your clinical history Presenting symptoms When did symptoms occur Foods ingested Other symptoms, other exposures Any prior allergy testing Family history? Any food avoidance Testing options for food allergies Clinical history Oral food challenge - gold standard Skin prick/puncture test Serum IgE testing Treatment of food allergy Referral to allergy/immunology specialist and avoidance of offending food until appointment Prescription for epinephrine autoinjector Second generation antihistamines Resources/Links: Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management Scott H. Sicherer, MD, and Hugh A. Sampson, MD New York, NY Mendonca CE, Andreae DA. Food Allergy. Prim Care. 2023 Jun;50(2):205-220. doi: 10.1016/j.pop.2023.01.002. Epub 2023 Mar 27. PMID: 37105602. About the Speaker: Host: Jenna Zuzolo, MD – Jenna Zuzolo, MD is a pediatric resident at the University of Virginia with a focus on allergy and immunology. She attended Marshall University for her undergraduate education. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 6/13/25 | ![]() Before You Counsel on Introducing Complementary Foods, Including Potentially High Allergen Foods | In this episode, we will discuss when and how to advise parents on introducing complementary foods (aka “solids”), including foods that are potentially allergenic. This is a topic that will invariably come up for you during your rotation. We’ll discuss the timing and sequence of introducing solids, and then talk about the rationale behind early introduction of potentially allergenic foods. Definition of “complementary” foods” - a catch all category for “all solid and liquid foods other than breast milk or infant formula”. Also referred to as “solid foods” Definition of potentially allergenic foods - eggs, peanut butters, nut butters, fish, shellfish, etc. When to Introduce solid foods We will start recommending the introduction of solid foods in the form of puree, around the time an infant turns 4-6 months old – Baby should be able to demonstrate adequate head control in the office with us An infant’s renal and gastrointestinal systems can only start to metabolize complementary foods around the age of 4 months. An infant will usually develop motor and dental development skills to sufficiently chew and swallow foods around 6 months. Introducing complementary foods too early can be associated with harmful health side effects, e.g., obesity Importance of introducing complementary foods Breastmilk and infant formula do not contain all the nutrients a growing infant will need to continue growing and developing appropriately. LEAP study – babies less likely to develop peanut allergy if peanut products were introduced at 4-11 months This study had HUGE implications regarding the introduction of potentially high allergen foods into infant’s diets to reduce the risk of developing a food allergy to them. The introduction of complementary foods First offer a variety of single-ingredient foods (such as pureed vegetables, fruits, grains and meats), in any order that parents desire Iron-fortified cereal is often a good choice as iron stores from mother become depleted by about 4-6 months of age. Recommend only providing 1-2 new foods per day in case the child has an adverse reaction The main calorie source for these infants should still be formula or human milkor Important foods to avoid include: honey (due to the risk of botulism), cow’s milk (we transition to cow’s milk instead of formula / breastfeeding at age 12 months but not prior. This is because it has a low absorbable iron content which can lead to iron deficiency anemia, and doesn’t have all of the nutritional value that infant’s need from breastmilk/formula), choking hazards (such as whole nuts, grapes, popcorn, etc). Introduction of potentially allergenic foods: The most common allergenic foods are milk, egg, soy, wheat, fish, shellfish, tree nuts, sesame Start to introduce these foods after the infant has tried and tolerated a few of the non-allergenic complementary foods (this is to make sure that the infant can tolerate non-allergenic foods first and foremost) For children with a history of atopy (or a family hx of atopy) it is recommended to start with a small serving of each of these foods, and then gradually increase the serving size as it is tolerated Avoid cow’s milk in a bottle but instead introduce other cow’s milk based products such as yogurts and cheese Allergic reactions vs contact dermatitis Bowel movements change in color and consistency when solid foods are introduced Summary Resources/Links: Du Toit G, Roberts G, Sayre PH, Bahnson HT, Radulovic S, Santos AF, Brough HA, Phippard D, Basting M, Feeney M, Turcanu V, Sever ML, Gomez Lorenzo M, Plaut M, Lack G; LEAP Study Team. Rando... | — | ||||||
| 1/27/25 | ![]() Before Your First Discussion about Infant Formula | In this episode, we will be reviewing what you need to know before your first discussion about infant formula. We will cover the characteristics and types of formulas, why infants might require different types, the correct way to prepare formula and how much infants need, common concerns from parents, indications for changing formulas, and when to transition away from it. Reasons for formula feeding Human milk is first choice for most infants Concern about lactating parent’s milk supply Workplace conditions make it difficult to sustain human milk feeding Parent preference There are few true contraindications to breastfeeding. Galactosemia Maternal HIV infection that has not achieved an undetectable viral load Maternal phencyclidine (also known as PCP) or cocaine use Active Herpes Simplex virus lesion Active tuberculosis Types of formula: 3 characteristics Caloric density: calories per ounce. Standard term formula is 20 calories/oz. Infants born preterm or have growth failure may need 22-27 calories/oz. Carbohydrate source: Lactose (galactose + glucose) or non-lactose Protein type: Cow-milk based formula proteins are whey and casein. Hydrolyzed formulas: proteins are broken down into smaller protein “chunks” or into individual amino acids, which are hypoallergenic and easily digestible. Other formulas utilize different sources of protein, including soy protein and goat’s milk. Special formulas for infants with specific metabolic conditions: eg. phenylketonuria, maple syrup urine disease, homocystinuria. Forms of formula Powder: most common and least expensive. Usually, 1 scoop of formula powder is mixed with 2 oz water. Liquid concentrate: mixed 1:1 with water. Ready to feed: no mixing required, but most expensive. Be sure that the formula is being mixed correctly! Incorrect formula mixing can result in growth failure or electrolyte abnormalities. How much formula should be given? A good rule of thumb is that infants require between 120-150 calories/kilogram per day. Common myths about formula Lactose intolerance. True congenital lactase deficiency is rare disorder and, in infants, it will usually present with very severe diarrhea. What adults experience as lactose intolerance occurs later in childhood. Developmental lactase deficiency can occur in premature infants, but lasts for a short time after birth and the majority are still able to consume lactose-containing formulas. Infants can develop a temporary, self-resolving lactase deficiency after suffering from a gastroenteritis Increased spit ups (often at around 4 months of age): Generally not a sign of formula intolerance. Gassiness and stomach discomfort after feeding: Normal and usually not a reason to switch formulas. Medical reasons to switch formula type Galactosemia: most often diagnosed after abnormal newborn metabolic screen. Milk protein allergy: usually presents with blood in stool from allergic proctocolitis. Rarely, more severe milk protein allergies can present as hives or even anaphylaxis. Metabolic disorders Usually stop infant formula at 1 year of age and switch to cow’s milk, usually whole milk. Do not switch to cow’s milk before 1 year of age because of solute load on kidneys. Resources/Links: https://www.healthychildren.org/English/ages-stages/baby/formula-feeding/Pages/default.aspx | — | ||||||
| 9/5/24 | ![]() Before You See a Pediatric Patient with Sore Throat | Listen along as we dive into the many causes of sore throat. Learn about the common causes such as allergies and viral illnesses while also what to do when a child with epiglottitis comes in. We will cover CENTOR criteria as well and when you should think about Group A strep testing. Common Causes Viral Presentation HSV Mononucleosis Allergic Presentation Group A Strep CENTOR Criteria Emergency Causes Peritonsillar Abscess Retropharyngeal Abscess Epiglottitis Wrap Up & Conclusion Resources/Links: https://www.chop.edu/conditions-diseases/throat-anatomy-and-physiology https://www.mdcalc.com/calc/104/centor-score-modified-mcisaac-strep-pharyngitis References Aluma Chovel-Sella, Amir Ben Tov, Einat Lahav, Orna Mor, Hagit Rudich, Gideon Paret, Shimon Reif; Incidence of Rash After Amoxicillin Treatment in Children With Infectious Mononucleosis. Pediatrics May 2013; 131 (5): e1424–e1427. 10.1542/peds.2012-1575 Becker JA, Smith JA. Return to play after infectious mononucleosis. Sports Health. 2014 May;6(3):232-8. doi: 10.1177/1941738114521984. PMID: 24790693; PMCID: PMC4000473. Chowdhury MDS, Koziatek CA, Rajnik M. Acute Rheumatic Fever. [Updated 2023 Aug 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK594238/ Esposito, S.; De Guido, C.; Pappalardo, M.; Laudisio, S.; Meccariello, G.; Capoferri, G.; Rahman, S.; Vicini, C.; Principi, N. Retropharyngeal, Parapharyngeal and Peritonsillar Abscesses. Children 2022,9,618. https://doi.org/ 10.3390/children9050618 Martin JM. The Mysteries of Streptococcal Pharyngitis. Curr Treat Options Pediatr. 2015 Jun;1(2):180-189. doi: 10.1007/s40746-015-0013-9. PMID: 26146604; PMCID: PMC4486489. MCMILLAN, J. A. , WEINER, L. B. , HIGGINS, A. M. & LAMPARELLA, V. J. (1993). Pharyngitis associated with herpes simplex virus in college students. The Pediatric Infectious Disease Journal, 12 (4), 280-283. Mohseni M, Boniface MP, Graham C. Mononucleosis. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470387/ Roggen I, van Berlaer G, Gordts F, et al. Centor criteria in children in a paediatric emergency department: for what it is worth. BMJ Open 2013;3: e002712. doi:10.1136/ bmjopen-2013-002712 Links: https://www.chop.edu/conditions-diseases/throat-anatomy-and-physiology https://www.mdcalc.com/calc/104/centor-score-modified-mcisaac-strep-pharyngitis https://www.ncbi.nlm.nih.gov/books/NBK594238/ https://doi.org/ https://www.ncbi.nlm.nih.gov/books/NBK470387/ About the Speaker: Host: Chris Stadnick, MD – Chris Stadnick, MD is a board-certified pediatrician at Metropolitan Pediatrics in Portland, Oregon. He earned his MD from the University of Tennessee Health Science Center and completed his pediatric residency at the University of Virginia. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 6/12/24 | ![]() Before You Care for a Pediatric Patient with Asthma | Asthma is a common chronic disease of childhood that affects 1 in 12 children in the United States. It can range from mild respiratory symptoms to life threatening respiratory failure, with a range of treatment options in-between from the primary care setting to the pediatric ICU. In this episode, we will discuss the underlying pathophysiology, diagnosis, evaluation, and management of patients with asthma, along with some useful clinical pearls to help you take care of these patients! Cause of asthma Genetics: “Atopic triad” of asthma, atopic dermatitis or eczema, and allergic rhinitis Prenatal and childhood environmental factors: maternal smoking and allergen exposure Pathophysiology and diagnosis AAP definition: “episodic and reversible airway constriction and inflammation in response to infection, environmental allergens, and irritants. It is a complex, multifactorial, and immune-mediated process that presents with various clinical phenotypes.” Airway hyperreactivity leads to inflammation of bronchi, increased mucus production, bronchial smooth muscle contraction Key elements of the history – recurrent episodes of cough, wheeze, difficulty breathing, nighttime symptoms, consistent trigger, atopic personal or family history, improvement with asthma treatment. Identification of triggers is important. Common triggers include respiratory infections, mold or pet dander, pollen, intense crying or laughing, exercise, pollution, and cold air. Children from minority and lower-income backgrounds experience an increased asthma burden, likely closely tied to a complex interaction of factors such as decreased access to healthcare, increased rates of obesity, and poor air quality in the areas in which they live. Classification of asthma: determined by the frequency and severity of symptoms when they are not receiving preventative treatment. New 2022 guidelines for asthma treatment Albuterol or other beta 2 agonist as needed for symptoms - relaxes bronchial smooth muscles Daily controller medication (usually inhaled steroid) if symptoms more than twice weekly - inhaled steroid decreases inflammation Inhaled steroid + long-acting beta 2 agonist combination inhaler preferred for those >5 years Asthma action plan should be given to every patient Treatment of acute asthma attack Quick assessment and stabilization of patient is important Treat acute symptoms first, then address chronic control of asthma Albuterol or ipratropium-albuterol, systemic steroids are generally first lines of treatment Supplemental oxygen as needed Other options for medications: magnesium, terbutaline, theophylline, epinephrine Frequent reassessment is needed Resources: Global Initiative for Asthma, Pocket Guide for Asthma Management and Prevention for Adults, Adolescents and Children 6-11 Years. Updated 2023. https://ginasthma.org/wp-content/uploads/2023/07/GINA-2023-Pocket-Guide-WMS.pdf Links: https://ginasthma.org/wp-content/uploads/2023/07/GINA-2023-Pocket-Guide-WMS.pdf About the Speaker: Host: Rebecca Hu, MD – Rebecca Hu, MD is a pediatrician at Signature Healthcare in Brockton, Massachusetts. She completed her pediatric residency at the University of Virginia, where she served as a chief resident with interests in adolescent health and developmental-behavioral pediatrics. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 6/12/24 | ![]() Before You Order Lead Testing for Your Patient | In this episode, we discuss lead toxicity and lead screening. We will talk about what lead is, what happens when a child is exposed to lead, what to ask parents about if you’re worried about lead exposure, how to screen for lead toxicity, and what to do if your patient has an elevated lead level. Sources of lead exposure Ingestion of contaminated food or water Ingestion or breathing in of lead dust Other sources: lead-acid batteries, ammunition, lead-based pigments and paints, stained glass, lead crystal glasses, ceramic glazes, jewelry, toys For families from other cultures, think about ceramic glazes, traditional cosmetics, traditional medicines Government policies to decrease lead exposure Unleaded gasoline Lead-free paint Lead-free solder in food cans Lead-free water pipes Why young children are at risk for lead toxicity Hand-to-mouth behavior Increased absorption of lead Developing nervous system is vulnerable Calcium or iron deficiency increase absorption of lead Effects of lead toxicity in children can be seen at levels as low as 3.5 µg/dL Growth and development delays Lower IQ Learning and behavior problems Hearing and speech problems School underperformance At higher levels, you may see Irritability Loss of appetite, weight loss, fatigue Abdominal pain, vomiting, and/or constipation Anemia Pica Seizures, coma, death Universal lead screening at 1 and 2 years Screening questionnaires are not very sensitive or specific Blood lead test Capillary – get results quickly, but can be falsely elevated Venous – results more accurate, but may take some time to come back Management of elevated lead level Repeat it if it was a capillary sample Review results with family Ask about potential exposures – may need to contact health department, landlord, or independent certified lead inspector to test home for lead Assess risk factors for iron or calcium deficiency Ask about developmental milestones – may need to refer to early intervention services Consider abdominal xray if history of pica For levels >45, may need chelation therapy Resources/Links: CDC, Childhood Lead Poisoning Prevention, https://www.cdc.gov/nceh/lead/default.htm AAP policy statement. Prevention of Childhood Lead Toxicity, Pediatrics 2016: 138(1):e20161493. https://publications.aap.org/pediatrics/article/138/1/e20161493/52600/Prevention-of-Childhood-Lead-Toxicity Mona Hanna-Attisha, What the Eyes Don't See: A Story of Crisis, Resistance, and Hope in an American City, 2018. https://www.amazon.com/What-Eyes-Dont-See-Resistance/dp/0399590838 Links: https://www.cdc.gov/nceh/lead/default.htm https://publications.aap.org/pediatrics/article/138/1/e20161493/52600/Prevention-of-Childhood-Lead-Toxicity https://www.amazon.com/What-Eyes-Dont-See-Resistance/dp/0399590838 About the Speaker: Host: Rachel Moon, MD – Rachel Moon, MD is the Harrison Distinguished Professor of Pediatrics at UVA Health Children's. She is an internationally recognized researcher in sudden unexpected infant death and chairs the AAP Task Force on SIDS. She is also the Chief of General Pediatrics at UVA. Clerkship Ready: Pediatr... | — | ||||||
| 6/12/24 | ![]() Before Your First Time Completing a Neuro Exam | In this episode of Clerkship Ready – Pediatrics Dr. Jared Barkes, a Child Neurology resident at The University of Virginia, will be walking you through how to complete the neurologic exam! Throughout the episode he will cover in detail the different parts of a formal neuro exam while also providing useful tips for remembering commonly tested facts, reviewing specific examples of abnormal findings and common neurologic conditions, and offering helpful advice for completing a neuro exam on a pediatric patient. After listening to this podcast you will have all the tools necessary to shine on your first day of your neurology clerkship! Introduction What is the neuro exam? Review of the “Map” of the neuro system Cortex, Brainstem, Spinal Cord, Motor neuron How to complete a neuro exam and what to look for! General Assessment Mental Status Language Cranial Nerves Strength Sensation Coordination Reflexes Special consideration for pediatrics Closing Resources/Links: “NeuroLogic Exam”, A complete in-depth guide of the neuro exam complete with references and videos produced by Dr. Paul D. Larsen, M.D. and Suzanne S. Stensaas, Ph.D. at The University of Utah. (https://neurologicexam.med.utah.edu/adult/html/home_exam.html). “PediNeurologic Exam” A guide of the neuro exam for children produced by Dr. Paul D. Larsen, M.D. and Suzanne S. Stensaas, Ph.D. at The University of Utah (https://neurologicexam.med.utah.edu/pediatric/html/home_exam.html) Medical Student Resources from the American Academy of Neurology (https://www.aan.com/tools-resources/medical-student-educational-resources). Links: https://neurologicexam.med.utah.edu/adult/html/home_exam.html https://neurologicexam.med.utah.edu/pediatric/html/home_exam.html https://www.aan.com/tools-resources/medical-student-educational-resources About the Speaker: Host: Jared Barkes, MD – Jared Barkes, MD is a Child Neurology Resident at the University of Virginia. He graduated from the Brody School of Medicine at East Carolina University and completed his undergraduate studies at UNC Chapel Hill in Mathematics and Biochemistry, with research interests in medical play and reducing patient anxiety. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 4/1/24 | ![]() Before Your First Neonatal Sepsis Work Up | Sepsis is a clinical syndrome in which an infection leads to an inflammatory response throughout the body that rapidly progresses to organ dysfunction or even death. Worldwide, neonatal sepsis affects 2,202 infants per 100,000 live births, and has a mortality rate of >11%. In the United States, early onset sepsis affects 50 in 100,000 live births, with a mortality rate of about 3%. So it’s a big problem that we don’t want to miss. In this episode, we will define neonatal sepsis, talk about the presentation of sepsis, what a sepsis workup entails, how to make the diagnosis and treatment of neonatal sepsis. Defining Neonatal Sepsis Early Onset Sepsis Late Onset Sepsis Neonatal Early Onset Sepsis Calculator - https://neonatalsepsiscalculator.kaiserpermanente.org/ Presentation of Illness and Physical Exam Pathogenesis Group B Strep Screening and prophylaxis E coli Strep viridans Klebsiella Enterococcus Listeria HSV Screening and prophylaxis Types of Infection Bacteremia Pneumonia Meningitis Work up CBC with differential Blood Culture Urinalysis and Urine Culture Cerebrospinal Fluid culture Chest X-Ray Surface swabs of mucous membranes Antimicrobial coverage Evaluation and Treatment of a Well Appearing Febrile Infant 8-60 days old https://doi.org/10.1542/peds.2021-052228 8-21 days 22-28 days 29-60 days References: Neonatal Early Onset Sepsis Calculator - https://neonatalsepsiscalculator.kaiserpermanente.org/ AAP Guidelines for Evaluation and Treatment of a Well Appearing Febrile Infant 8-60 days old: https://doi.org/10.1542/peds.2021-052228 Links: https://neonatalsepsiscalculator.kaiserpermanente.org/ https://doi.org/10.1542/peds.2021-052228 About the Speaker: Host: Elizabeth (Blair) Davis, MD – Elizabeth Blair Davis, MD, FAAP graduated from the University of Virginia School of Medicine and completed her pediatric residency at UVA. She received her undergraduate education from Washington and Lee University. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 1/18/24 | ![]() Before You See a Child With Possible Iron Deficiency | Iron deficiency is the most common nutritional deficiency that occurs in children in United States. Iron plays a vital role in cellular function in all organ systems. Today, we will be reviewing what you need to know before you first see a patient with possible iron deficiency. We will discuss why iron is so important, when and why iron deficiency occurs, screening, diagnosis, and treatment for iron deficiency. Importance of Iron Iron and Hemoglobin Iron and Neurodevelopment Iron and the Immune System What happens in iron deficiency Reasons that children are at high risk for iron deficiency Rapid Growth . Insufficient dietary intake and limited absorption Increased losses Peaks of Incidence Other risk factors for iron deficiency. Preterm infants Children who suffer from neuro-motor disorders as they often have nutritional deficiency related to swallowing impairment G.I. diseases that cause malabsorption, Diseases predisposing them to bleeding. Lead toxicity. Screening for IDA History: Asking about prematurity, low birth weight, exclusive breastfeeding beyond 4 months of age, weaning to whole milk without addition of iron rich foods, feeding problems, and any past medical conditions. Exposure to lead (i.e. age/ condition of home, recent renovations, a parent who has occupational exposure, concerns about drinking water). Any possible symptoms of anemia, such as fatigue, breath holding spells, pica Physical exam: pallor. Lab testing. Treatment for iron deficiency Oral iron: daily dose of 3 to 6 mg per kilogram of elemental iron divided into three doses is adequate. Give iron supplements with juice - increases iron absorption through the action of ascorbic acid! Juices that are high in ascorbic acid include orange and apple juice. Supplements should be continued for a minimum of three months to reestablish iron stores. After completion of treatment, reassessment of iron status In addition to iron supplementation, the other aspect of treatment is encouraging dietary intake of iron rich foods (meat and fish, cereals, legumes, vegetables, soy, eggs) Follow up Resources/Links: Baker RD, Greer FR, et al. Clinical Report – Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (0-3 years of age). Pediatrics. 2010; 126(5). www.pediatrics.org/cgi/doi/10.1542/peds.2010-2576 Özdemir N. Iron deficiency anemia from diagnosis to treatment in children. Turk Pediatri Ars. 2015 Mar 1;50(1):11-9. doi: 10.5152/tpa.2015.2337. PMID: 26078692; PMCID: PMC4462328. Lozoff B, Beard J, Connor J, Barbara F, Georgieff M, Schallert T. Long-lasting neural and behavioral effects of iron deficiency in infancy. Nutr Rev. 2006 May;64(5 Pt 2):S34-43; discussion S72-91. doi: 10.1301/nr.2006.may.s34-s43. PMID: 16770951; PMCID: PMC1540447. Yadav, D., Chandra, J. Iron Deficiency: Beyond Anemia. Indian J Pediatr 78, 65–72 (2011). https://doi.org/10.1007/s12098-010-0129-7 Links: https://doi.org/10.1007/s12098-010-0129-7 About the Speaker: Host: Riley Calicchia, MD – Riley Calicchia, MD is a pediatric resident at the University of Rochester Medical Center / Golisano Children's Hospital in Rochester, New York. She completed her medical education and began residency training in 2024. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
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| 1/18/24 | ![]() Before You See a Child Who Has Ear Pain | Ear pain is one of the most common chief complaints pediatricians encounter in the outpatient setting and there are quite a few things you need to consider to make a thoughtful diagnosis, assessment, and plan. In this episode, we will discuss the differential diagnosis of ear pain in children, physical exam findings that will help you make a diagnosis, and treatment for the most common causes of ear pain. Ear anatomy Outer ear, tympanic membrane (TM), middle ear, inner ear Eustacian tube in children is smaller in diameter and angled more horizontally than in adults. This makes it more difficult to drain fluid behind the middle ear and why kids are more prone to get ear infections when they get a cold than adults are. The adenoids also are thought to play a role in fluid collection and buildup. Taking a history for patient with chief complaint of ear pain How old is this child? Have they had a fever? Are there any other viral symptoms such as cough, runny nose, or sore throat? Has the child been swimming recently? Has the child put anything in their ears? Has there been any ear drainage or changes in hearing? Ear examination Make sure that the child’s head is as still as possible How to use the otoscope What to look for: Color of the TM. Fluid behind the TM Is the TM bulging or not bulging Light reflex of the TM Ear canal Acute otitis media Infectious causes - bacteria (especially Strep pneumonia, H influenzae, and Moraxella catarrhalis), viruses Treatment Antibiotics vs. “watch and wait approach” Criteria for using antibiotics Antibiotic options Indications for tympanostomy tubes Acute otitis externa (“Swimmer’s ear”) Causes Clinical presentation Treatment Foreign body in ear Mastoiditis Resources and Links: Anatomy and Ear Tubes/Adenoidectomy https://www.texaschildrens.org/departments/ear-nose-and-throat-otolaryngology/conditions-we-treat/dysfunction-eustachian-tube#:~:text=Eustachian%20tubes%20in%20children%20are,cause%20pain%20for%20the%20child. https://www.childrensmn.org/educationmaterials/childrensmn/article/18784/adenoidectomy-and-ear-tubes/#:~:text=The%20adenoid%20is%20located%20next,is%20for%20recurrent%20nasal%20infections https://www.ncbi.nlm.nih.gov/books/NBK570549/#:~:text=The%20middle%20ear%20consists%20of,the%20transmission%20of%20sound%20waves. https://www.ncbi.nlm.nih.gov/books/NBK551658/#:~:t... | — | ||||||
| 12/11/23 | ![]() Before You See a Child Who May Have Been Abused | Child abuse, which is sometimes called non-accidental trauma, is a public health problem with life-long health consequences for survivors and their families. In this episode, we will review what you need to know before you encounter your first patient who may have or has been abused. We will focus on physical and sexual abuse of children. Long term health consequences of child abuse Why identification of child abuse is difficult It is often difficult to distinguish an accidental injury from a non-accidental injury A caregiver who has abused a child rarely confesses to harming the child Child may be brought to medical care by unsuspecting parent It is emotionally difficult for us to confront parents when there are concerns for abuse Mandated reporting of child abuse Potential clues that a child may have been physically abused Medical record review History Physical exam Differential diagnosis of physical abuse Labs and other tests that you may get The role of the child protection team and child protective services Potential clues that a child may have been sexually abused History Physical exam Lab testing Medical documentation Resources/Links: Christian CW; Committee on Child Abuse and Neglect, American Academy of Pediatrics. The evaluation of suspected child physical abuse. Pediatrics. 2015 May;135(5):e1337-54. doi: 10.1542/peds.2015-0356. Pierce MC, Kaczor K, Lorenz DJ, Bertocci G, Fingarson AK, Makorof K, Berger RP, Bennett B, Magana J, Staley S, Ramaiah V, Fortin K, Currie M, Herman BE, Herr S, Hymel KP, Jenny C, Sheehan K, Zuckerbraun N, Hickey S, Meyers G, Leventhal JM (2021) Validation of a clinical decision rule to predict abuse in young children based on bruising characteristics. JAMA Netw Open 4(4):e215832. https://doi.org/10.1001/jamanetworkopen.2021. 5832. Erratum in: JAMA Netw Open. 2021 Sep 1;4(9):e2130136. PMID: 33852003; PMCID: PMC8047759 Smith T, Chauvin-Kimoff L, Baird B, Ornstein A. The medical evaluation of prepubertal children with suspected sexual abuse. Paediatr Child Health. 2020 Apr;25(3):180-194. doi: 10.1093/pch/pxaa019. Epub 2020 Apr 10. PMID: 32296280; PMCID: PMC7147698 Links: https://doi.org/10.1001/jamanetworkopen.2021 About the Speaker: Host: Cindy Christian, MD – Cindy Christian, MD holds the Anthony A. Latini endowed Chair in the Prevention of Child Abuse and Neglect at Children's Hospital of Philadelphia. She is a Professor of Pediatrics at UPenn's Perelman School of Medicine and an internationally recognized expert in child maltreatment. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 10/24/23 | ![]() Before You Counsel About Contraception Options | Discussing menses and pregnancy prevention is an important part of preventative care and reproductive health. Patients and parents come in with a wide range of preconceptions and understanding. It can be daunting to counsel about the many types of contraception to come to a shared decision about what is best for the patient. This podcast will review the following about contraception: Medical contraindications Physiology of hormonal options Efficacy of pregnancy prevention Patient considerations and concerns Emergency contraception Myths Resources/links: CDC MEC: https://www.cdc.gov/reproductivehealth/contraception/pdf/summary-chart-us-medical-eligibility-criteria_508tagged.pdf ACOG contraception chart: https://www.acog.org/womens-health/infographics/effectiveness-of-birth-control-methods https://www.reproductiveaccess.org/ https://www.bedsider.org/ Links: https://www.cdc.gov/reproductivehealth/contraception/pdf/summary-chart-us-medical-eligibility-criteria_508tagged.pdf https://www.acog.org/womens-health/infographics/effectiveness-of-birth-control-methods https://www.reproductiveaccess.org/ https://www.bedsider.org/ About the Speaker: Host: Rebecca Hu, MD – Rebecca Hu, MD is a pediatrician at Signature Healthcare in Brockton, Massachusetts. She completed her pediatric residency at the University of Virginia, where she served as a chief resident with interests in adolescent health and developmental-behavioral pediatrics. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 10/11/23 | ![]() Developmental Milestones for Children | In today’s episode, we are talking about normal child development. We will talk about why this is important and how you will be evaluating children’s development. We will go over major milestones in the 4 developmental domains: movement/physical development – or gross and fine motor, language/communication, cognitive, and social/emotional. We will go over some common cases. Finally, we will briefly discuss what you should do if you suspect developmental delay. Why it is important to learn about developmental delay. Why it is important to learn about development Developmental surveillance versus developmental screening versus diagnosis of developmental issues Developmental domains/categories: Expressive language Receptive language Gross motor: this is how you use all of your big muscles Fine motor: hand/eye coordination Social/emotional: how children interact with others and show emotion. Language/Communication: how children express their needs and share what they are thinking, as well as understand what is said to them. Hearing is important for language/communication development. Cognitive: how children learn new things and solve problems Movement/Physical Development: how children use their bodies. Learning milestones Learn the schedule for well child visits Watch children at different ages to see what they can do. Gross motor milestones: 1 year goal is to be able to walk independently. Fine motor milestones: 1 year goal is to be able to put food into one’s mouth Language and communication milestones: 1 year goal is to be able to say a few words Social and emotional milestones: 1 year goal is to recognize that people are individuals that they can interact withOK, so those are some of the major milestones. Now, let’s go through a few common case scenarios that have some specific teaching points. Cases What if there is developmental delay Resources/Links: CDC’s Developmental Milestones: https://www.cdc.gov/ncbddd/actearly/milestones/index.html Ages and Stages developmental screening tool: https://agesandstages.com/products-pricing/asq3/ Modified Checklist for Autism in Toddlers (MCHAT): https://www.mchatscreen.com/ Links: https://www.cdc.gov/ncbddd/actearly/milestones/index.html https://agesandstages.com/products-pricing/asq3/ https://www.mchatscreen.com/ About the Speaker: Host: Rachel Moon, MD – Rachel Moon, MD is the Harrison Distinguished Professor of Pediatrics at UVA Health Children's. She is an internationally recognized researcher in sudden unexpected infant death and chairs the AAP Task Force on SIDS. She is also the Chief of General Pediatrics at UVA. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 9/29/23 | ![]() Before your first day caring for newborns – understanding neonatal hypoglycemia | Neonatal hypoglycemia is a common and often transient issue for newborns during a period of transition from intrauterine to extrauterine life. Many infants with hypoglycemia are screened for it and treated for it in the nursery, and a handful will require NICU admissions. This podcast will help you understand these things about neonatal hypoglycemia: Why we worry What causes it Which infants are most at risk How to treat it and who needs the NICU Resources/Links: https://downloads.aap.org/AAP/PDF/Seminars_in_Fetal_Neonatal_Medicine.pdf https://publications.aap.org/hospitalpediatrics/article/11/6/595/180015/Practice-Variations-in-Diagnosis-and-Treatment-of https://publications.aap.org/aapnews/news/25073/Myriad-unknowns-regarding-neonatal-hypoglycemia?autologincheck=redirected Links: https://downloads.aap.org/AAP/PDF/Seminars_in_Fetal_Neonatal_Medicine.pdf https://publications.aap.org/hospitalpediatrics/article/11/6/595/180015/Practice-Variations-in-Diagnosis-and-Treatment-of https://publications.aap.org/aapnews/news/25073/Myriad-unknowns-regarding-neonatal-hypoglycemia?autologincheck=redirected About the Speaker: Host: Joanna Parga-Belinkie, MD – Joanna Parga-Belinkie, MD is an Associate Professor of Clinical Pediatrics in Neonatology at the University of Pennsylvania and Attending Physician at Children's Hospital of Philadelphia (CHOP). Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 9/22/23 | ![]() Before Your First ADHD Clinic Visit | Attention deficit-hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children. In this episode, we will discuss ADHD, including the different types, evaluation, management, and follow up. General definition of ADHD and its types Preparing for your first visit Initial evaluation of ADHD vs. med check Reviewing prior visits During an initial visit: Evaluating historical features Behaviors at home, behaviors at school Common misconceptions about ADHD Surrounding factors and comorbidities/misdiagnosis Physical Exam Important features of the exam Observing the child’s behavior Role of the Vanderbilt Scoring a Vanderbilt Treatment Medication vs. non-pharmacologic interventions Overview of different medications Stimulants Nonstimulants Choosing a medication Family history Comorbidities Titrating medications Follow-up visits Symptoms to look for Resources/Links: Vanderbilt Scoring: https://www.uwmedicine.org/sites/stevie/files/2019-11/sodbp_vanderbilt_scoringinstructions.pdf Parent Training in Behavior Management for ADHD: https://www.cdc.gov/ncbddd/adhd/behavior-therapy.html Dosing guidelines when switching from one stimulant to another in the treatment of attention deficit hyperactivity disorder in children and adolescents: https://www.uptodate.com/contents/image?imageKey=PEDS%2F61007 Links: https://www.uwmedicine.org/sites/stevie/files/2019-11/sodbp_vanderbilt_scoringinstructions.pdf https://www.cdc.gov/ncbddd/adhd/behavior-therapy.html https://www.uptodate.com/contents/image?imageKey=PEDS%2F61007 About the Speaker: Host: Lauren Ferguson, MD – Lauren Ferguson, MD is an Assistant Professor of Pediatrics at the University of Utah. She graduated from Virginia Tech Carilion School of Medicine and completed her residency and chief year at UVA, with clinical interests in newborn medicine, breastfeeding, mental health, and ADHD management. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 9/11/23 | ![]() Before You See an Infant with Jaundice | In this episode, we discuss things you’ll need to know and think about before seeing an infant with jaundice. We will focus on infants from birth to 2 months of age. We will discuss the pathophysiology of hyperbilirubinemia, the difference between unconjugated and conjugated hyperbilirubinemia, the differential diagnosis, key elements of the history and physical exam, laboratory and imaging workup, and management. Introduction to jaundice and hyperbilirubinemia Jaundice is the yellowing of skin, sclerae, and mucous membranes caused by hyperbilirubinemia Hyperbilirubinemia can be further separated into unconjugated or conjugated forms, which allows us to further differentiate etiology Review of bilirubin breakdown pathway, to include enterohepatic circulation Unconjugated hyperbilirubinemia etiologies: Excessive or increased production of bilirubin Cephalohematomas Hemolysis: ABO and Rh incompatibilities; Red Blood Cell (RBC) membrane or enzyme defects, RBC oxidative stress (secondary to sepsis, asphyxia, and acidosis) Decreased clearance of bilirubin Breast milk jaundice Prematurity Hypothyroidism Gilbert Syndrome Crigler-Najjar Syndrome Suboptimal Intake Jaundice Medications Combination of both Physiologic jaundice Conjugated hyperbilirubinemia etiologies: Always pathologic Biliary atresia Briefly mentioned the vast range of other etiologies: infectious, genetic, metabolic, and anatomic Key elements of history and physical examination for a jaundiced infant History: Onset Feeding patterns (what, how much/often, quality of feeding) Urine and stool diapers Prenatal history Delivery history Family history Physical exam: Growth curves Assessing liver size: percussion vs scratch test Neurologic exam Review of laboratory and imaging work up for a jaundiced infant Brief discussion on management of unconjugated hyperbilirubinemia etiologies Feeding Phototherapy Review of neurotoxicity risk factors Brief discussion on management of conjugated hyperbilirubinemia, specifically biliary atresia Early referral to Pediatric Gastroenterology Kasai portoenterostomy Liver transplant Maximizing nutrition Resources/Links: Kemper, A. R., Newman, T. B., Slaughter, J. L., Maisels, M. J., Watchko, J. F., Downs, S. M., ... & Russell, T. L. (2022). Clinical practice guideline revision: management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 150(3). Pan, D. H., & Rivas, Y. (2017). Jaundice: newborn to age 2 months. Pediatrics in Review, 38(11), 499-510. Chou, J. PediTools. AAP 2022 Hyperbilirubinemia management guidelines. https://peditools.org/bili2022/. Published 2012. Updated 2023. Accessed Aug 18, 2023. Links: https://peditools.org/bili2022/ About the Speaker: Host: Ashlee Commeree, MD – Ashlee Commeree, MD is a pediatric critical care medicine physician at the University of Utah in Salt Lake City. She completed her pediatric residency at the University of Virginia before pursuing fellowship training in pediatric critical care. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 9/11/23 | ![]() Before the First Time You Order Fluids or Electrolyte Replacement | Many of the pediatric inpatients you care for will need intravenous fluids and electrolytes. This episode describes what you need to know before you order fluids or electrolyte replacement for your patient. We will discuss maintenance fluid needs and talk more in depth about what fluids to order and at what rate. We will also talk about managing patients with dehydration and how to replete fluids. Then we will discuss a few cases where we will work through some more common electrolyte derangements and discuss how to manage them. We will end with additional clinical pearls that will be helpful during your time on the inpatient pediatric service. Introduction Definition of maintenance fluid needs Important considerations about maintenance fluids Discussion regarding which fluids to order for different patient populations and at what rate to administer Role of ADH in hospitalized patients How to order a fluid bolus—amount, composition, and rate administered Assessing your patient with dehydration utilizing physical exam findings, vital signs, and other objective data such as weight Case scenarios: Identification and management of hyperkalemia and hypokalemia Case #1- 12-year old with hyperkalemia following infection with influenza Case #2- 2-year old child with history of neglect and malnutrition Additional clinical pearls including the association between albumin and calcium, acidosis/alkalosis and potassium levels Resources/Links: Clinical Practice Guideline: Maintenance Intravenous Fluids in Children | Pediatrics | American Academy of Pediatrics (aap.org) Links: https://publications.aap.org/pediatrics/article/142/6/e20183083/37529/Clinical-Practice-Guideline-Maintenance?autologincheck=redirected About the Speaker: Host: Lisa Hainstock, MD – Lisa Hainstock, MD is an Associate Professor of Pediatrics and Director of the Pediatric Residency Program at UVA Health. She is board-certified in hospital medicine and general pediatrics with interests in children with medical complexity and medical education. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 9/11/23 | ![]() Breastfeeding 102- Initiation and Management of Common Early Breastfeeding Concerns | This episode is a follow-up to “Before Your First Time Working with a Breastfeeding Mother”. We’ll be reviewing additional details about breastfeeding that can help you to answer some of the most common questions that come up for families. We will discuss strategies to improve milk production, newborn stomach volumes, how to know if baby is getting enough milk, what to do if baby isn’t getting enough milk, and breastfeeding complications. Strategies to improve milk production Latching Newborn stomach volumes How to know if baby is getting enough milk What to do if baby isn’t getting enough milk Manual expression and pumping Breastfeeding complications Resources/Links: Bella Breastfeeding Curriculum on Open Pediatrics (free): www.openpediatrics.org Virginia Department of Health/Breastfeeding Education Consortium Online Course (free for those who live or work in Virginia): https://bfconsortium.org American Academy of Pediatrics Residency Breastfeeding Curriculum: https://www.aap.org/en/learning/breastfeeding-curriculum/ ACOG Statement on Optimizing Support for Breastfeeding: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/10/optimizing-support-for-breastfeeding-as-part-of-obstetric-practice AAP Policy Statement: Breastfeeding and the Use of Human Milk, 2022: https://publications.aap.org/journal-blogs/blog/20699/Welcome-to-the-AAP-s-2022-Policy-on-Breastfeeding?autologincheck=redirected# US Breastfeeding Guidelines for Mothers with HIV: https://clinicalinfo.hiv.gov/en/guidelines/perinatal/infant-feeding-individuals-hiv-united-states NEWT Curve: https://newbornweight.org UpToDate “Initiation of Breastfeeding”: https://www.uptodate.com/contents/initiation-of-breastfeeding Links: https://newbornweight.org/ https://bfconsortium.org https://www.aap.org/en/learning/breastfeeding-curriculum/ https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/10/optimizing-support-for-breastfeeding-as-part-of-obstetric-practice https://publications.aap.org/journal-blogs/blog/20699/Welcome-to-the-AAP-s-2022-Policy-on-Breastfeeding?autologincheck=redirected# https://clinicalinfo.hiv.gov/en/guidelines/perinatal/infant-feeding-individuals-hiv-united-states https://newbornweight.org https://www.uptodate.com/contents/initiation-of-breastfeeding About the Speaker: Host: Emily Fronk – Emily Fronk is a former UVA School of Medicine student who has published research on virtual reality in pediatrics and pain management in pediatric patients. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 9/11/23 | ![]() Before Your First Time Working with a Breastfeeding Mother | This episode describes what you need to know before your first time working with a breastfeeding parent. This will include topics such as how to ensure families feel comfortable, benefits of and contraindications to breastfeeding, how to approach conversations about breastfeeding, and the science behind lactation or milk production. Making families feel comfortable Benefits of breastfeeding for mom and baby Contraindications to breastfeeding Approaching conversations about breastfeeding with families The process of lactogenesis (milk production) Resources/Links: Bella Breastfeeding Curriculum on Open Pediatrics (free): www.openpediatrics.org Virginia Department of Health/Breastfeeding Education Consortium Online Course (free for those who live or work in Virginia): https://bfconsortium.org American Academy of Pediatrics Residency Breastfeeding Curriculum: https://www.aap.org/en/learning/breastfeeding-curriculum/ ACOG Statement on Optimizing Support for Breastfeeding: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/10/optimizing-support-for-breastfeeding-as-part-of-obstetric-practice AAP Policy Statement: Breastfeeding and the Use of Human Milk, 2022: https://publications.aap.org/journal-blogs/blog/20699/Welcome-to-the-AAP-s-2022-Policy-on-Breastfeeding?autologincheck=redirected# US Breastfeeding Guidelines for Mothers with HIV: https://clinicalinfo.hiv.gov/en/guidelines/perinatal/infant-feeding-individuals-hiv-united-states NEWT Curve: https://newbornweight.org UpToDate “Initiation of Breastfeeding”: https://www.uptodate.com/contents/initiation-of-breastfeeding Links: https://newbornweight.org/ https://bfconsortium.org https://www.aap.org/en/learning/breastfeeding-curriculum/ https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/10/optimizing-support-for-breastfeeding-as-part-of-obstetric-practice https://publications.aap.org/journal-blogs/blog/20699/Welcome-to-the-AAP-s-2022-Policy-on-Breastfeeding?autologincheck=redirected# https://clinicalinfo.hiv.gov/en/guidelines/perinatal/infant-feeding-individuals-hiv-united-states https://newbornweight.org https://www.uptodate.com/contents/initiation-of-breastfeeding About the Speaker: Host: Emily Fronk – Emily Fronk is a former UVA School of Medicine student who has published research on virtual reality in pediatrics and pain management in pediatric patients. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 8/28/23 | ![]() Before Attending Your First Delivery in Labor and Delivery | Today we will talk about what to expect before attending your first delivery as part of the pediatrics team while on the Newborn rotation. Each delivery is different and what is needed for each infant at the delivery can be different depending on the status of the infant at birth. In this episode, we will focus on the lower risk deliveries that you are most likely to attend during your newborn rotation, and what you can expect once the baby is born. Newborn deliveries: Low Risk Low-risk delivery team members What constitutes a low-risk delivery page Differences in Operating Room (OR) versus labor room deliveries Differences in attending delivery in the delivery room versus the operating room Operating room attire Importance of Apgar (timer button) on radiant warmer Delayed Cord clamping Delayed cord clamping: When this happens and the importance Why it matters if umbilical cord is clamped before 1 minute and infant brought to the radiant warmer Neonatal Resuscitation NRP guidelines from American Academy of Pediatrics Pertinent Physical Exam at delivery Importance of full, efficient exam in delivery room Need for Higher Level Intervention: Neonatal Intensive Care Reasons for calling for NICU: high-risk delivery team Resources/Links: Neonatal Resuscitation Program (NRP)/American Academy of Pediatrics Neonatal Resuscitation Program (aap.org) Links: https://www.aap.org/en/learning/neonatal-resuscitation-program/ About the Speaker: Host: Jolene "Jody" Carlton, DNP, APRN, CPNP-PC/AC, RNC-NIC, EMT-B – Jolene "Jody" Carlton, DNP, APRN is a Pediatric Nurse Practitioner affiliated with UVA Health University Medical Center in Charlottesville. She holds multiple certifications including CPNP-PC/AC and RNC-NIC. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 8/28/23 | ![]() Before Your First Patient with an Eating Disorder | Today, we’ll be discussing how to evaluate and work up a patient with a suspected eating disorder. We’ll use a general case for an adolescent with an eating disorder to examine the different aspects of care you should be thinking about, from lab work to admission criteria and what to do once the diagnosis is made. How to identify an eating disorder What to do if you suspect an eating disorder How to manage eating disorder patients in the outpatient setting or in the hospital Strategies and tips for talking to teens with eating disorders Resources/Links: The American Psychiatric Association Practice Guideline for the Treatment of Patients with Eating Disorders, 2023, https://doi.org/10.1176/appi.books.9780890424865. Laurie L. Hornberger, Margo A. Lane, THE COMMITTEE ON ADOLESCENCE, Laurie L. Hornberger, Margo Lane, Cora C. Breuner, Elizabeth M. Alderman, Laura K. Grubb, Makia Powers, Krishna Kumari Upadhya, Stephenie B. Wallace, Laurie L. Hornberger, Margo Lane, MD FRCPC, Meredith Loveless, Seema Menon, Lauren Zapata, Liwei Hua, Karen Smith, James Baumberger; Identification and Management of Eating Disorders in Children and Adolescents. Pediatrics January 2021; 147 (1): e2020040279. 10.1542/peds.2020-040279 Links: https://doi.org/10.1176/appi.books.9780890424865 About the Speaker: Host: Sam Baldazo, MD – Sam Baldazo, MD completed his pediatric residency at UVA, where he was involved with the wellness committee and process improvement initiatives. He is currently a Hospice and Palliative Care Fellow. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 8/22/23 | ![]() Before You Choose Antibiotics for a Child or Adolescent | Antibiotic selection can be complicated. In this episode, we discuss how you should approach choosing the appropriate antibiotic for your pediatric patient. There are multiple considerations, including: What organisms do you want to treat? What does anatomy have to do with antibiotic selection? You also have to think about individual circumstances, such as immunzation status, chronic disease, drug allergies, and environmental exposures. Know what organisms you want to treat Because we often treat empirically, we need to know organisms that typically case this typical infection Narrow-spectrum antibiotics if possible Anatomy of the infection For fever in first 4-6 weeks, think about organisms that infant was exposed to during pregnancy and delivery For respiratory infections, think about organisms that live in the respiratory tract Abnormal anatomy Immunization status of child may change your differential diagnosis Drug allergies Look in medical record and ask patient and family about allergies Consider cross-reactivity of antibiotics Geographic location: resistance patterns Individual circumstances Chronic diseases Environmental exposures Resources/Links: Up to date: uptodate.com American Academy of Pediatrics Red Book: https://publications.aap.org/redbook?autologincheck=redirected Sanford Guide to Antimicrobial therapy: https://www.sanfordguide.com/products/print-guides/?gad=1&gclid=CjwKCAjwtuOlBhBREiwA7agf1oWtsyBrx0OFaHxpG2ZpDTXYukd1JGs5R_ZpRWrECT_v0bqhboN15hoCijIQAvD_BwE American Academy of Pediatrics clinical practice guideline: The Diagnosis and Management of Acute Otitis Media. 2013. https://publications.aap.org/pediatrics/article/131/3/e964/30912/The-Diagnosis-and-Management-of-Acute-Otitis-Media Links: https://publications.aap.org/redbook?autologincheck=redirected https://www.sanfordguide.com/products/print-guides/?gad=1&gclid=CjwKCAjwtuOlBhBREiwA7agf1oWtsyBrx0OFaHxpG2ZpDTXYukd1JGs5R_ZpRWrECT_v0bqhboN15hoCijIQAvD_BwE https://publications.aap.org/pediatrics/article/131/3/e964/30912/The-Diagnosis-and-Management-of-Acute-Otitis-Media About the Speaker: Host: Rachel Moon, MD – Rachel Moon, MD is the Harrison Distinguished Professor of Pediatrics at UVA Health Children's. She is an internationally recognized researcher in sudden unexpected infant death and chairs the AAP Task Force on SIDS. She is also the Chief of General Pediatrics at UVA. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 8/22/23 | ![]() Before You Prescribe Medicines for a Child or Adolescent | Prescribing medicines in pediatrics is different than prescribing medicines for adults. In this episode, we discuss what you need to know before prescribing medications for the pediatric population, including calculating dose for the child’s weight, choosing IV vs PO medications, and other considerations. 1) References to look up pediatric drug doses and frequencies. 2) Calculating weight-based doses 3) Maximum daily doses 4) Different formulations of medications 5) Prescribing oral medicines Pills vs Liquid Consider taste Use the most concentrated suspension Use milliliters instead of spoonfuls 6) What if the medicine is not available in liquid form 7) Options if oral medications are not easily available in liquid form. 8) Medicine dosing frequency – use the least frequent option 9) Acetaminophen and Ibuprofen Resources/Links: Up to date: uptodate.com Harriet Lane Handbook: https://evolve.elsevier.com/cs/product/9780323876988?role=student Lexi-Comp: https://apps.apple.com/ca/app/lexicomp/id313401238 Links: https://evolve.elsevier.com/cs/product/9780323876988?role=student https://apps.apple.com/ca/app/lexicomp/id313401238 About the Speaker: Host: Rachel Moon, MD – Rachel Moon, MD is the Harrison Distinguished Professor of Pediatrics at UVA Health Children's. She is an internationally recognized researcher in sudden unexpected infant death and chairs the AAP Task Force on SIDS. She is also the Chief of General Pediatrics at UVA. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
| 8/18/23 | ![]() Before Your First Encounter Using an Interpreter | Many of our patients and their families are not proficient in English, and it's important to be able to communicate effectively with them. In this episode, you’ll learn about how to work with an interpreter during encounters with patients who are not proficient in English. We’ll discuss dos and don’ts, common challenges, and tips for interacting with interpreters and families. Definitions Interpretation vs translation Modes of interpretation When do I need an interpreter? III. Who should not serve as an interpreter? Non-certified team members Patient’s non-certified friends or community members Patient’s family members Getting started Verify preferred language Positions in the room Introductions, including of the interpreter and recording interpreter’s information Conducting the visit How long to speak before awaiting interpretation During the physical exam Teach-back method via interpreter Trouble-shooting When the patient declines interpreter services When you think the interpreter is misinterpreting When you have technical difficulties or ambient noise VII. At the end of the encounter Translating written patient materials Considering variable written and medical literacies Next steps and follow-up care VIII. After the visit Documentation of your use of interpreter services Verification of preferred language Resources: – “Addressing Low Health Literacy and Limited English Proficiency,” American Academy of Pediatrics: https://www.aap.org/en/practice-management/providing-patient--and-family-centered-care/addressing-low-health-literacy-and-limited-english-proficiency/ – “Guidelines for Use of Medical Interpreter Services,” Association of American Medical Colleges: https://www.aamc.org/media/24801/download – “Appropriate Use of Medical Interpreters,” American Academy of Family Physicians: https://www.aafp.org/pubs/afp/issues/2014/1001/p476.html – “Working effectively with an interpreter,” U.S. Department of Health and Human Services Office of Minority Health: https://thinkculturalhealth.hhs.gov/assets/pdfs/resource-library/working-effectively-with-interpreter.pdf Links: https://www.aap.org/en/practice-management/providing-patient--and-family-centered-care/addressing-low-health-literacy-and-limited-english-proficiency/ https://www.aamc.org/media/24801/download https://www.aafp.org/pubs/afp/issues/2014/1001/p476.html https://thinkculturalhealth.hhs.gov/assets/pdfs/resource-library/working-effectively-with-interpreter.pdf About the Speaker: Host: Irène Mathieu, MD, MPH, FAAP – Irène Mathieu, MD, MPH, FAAP is an Associate Professor of Pediatrics at UVA and core faculty at the Center for Health Humanities & Ethics. She is a primary care pediatrician, award-winning poet with four published collections, and a Fulbright Fellow who completed her residency at CHOP. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice. | — | ||||||
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Chart Positions
4 placements across 4 markets.
Chart Positions
4 placements across 4 markets.
