Specialty Area: Pediatrics and Pediatric Allergy

Description of Specialty: This specialty consists of the usual childhood diseases, allergy and immunology. An effort is made to form a partnership with the family and the referring physician. It is important to diagnose and treat the whole child.

1. Diagnosis: Asthma (persistent from infancy through adolescence)

Questions that should be asked:

  1. What causes this disease?
  2. How can I gauge the severity of this illness?
  3. Will skin testing help and if positive skin tests are found, what can be done?
  4. What treatment should the child have?
  5. Should we see an allergist?

2. Diagnosis: Otitis Media (birth to seven years of age)

Questions that should be asked:

  1. Why does this happen and how can I prevent this?
  2. If viruses play a role, how can this be averted?
  3. Does allergy play a role?
  4. Will antibiotics always be needed?
  5. Is it possible there is a hearing loss and will tubes be needed?
  6. Should a referral be made to an Ear, Nose and Throat (ENT) specialist?

3. Diagnosis: Urticaria (persistent with a greater than two month duration),"Hives"

Questions that should be asked:

  1. Why does my child have this and can it be serious?
  2. What treatment should be instituted?
  3. If further tests are necessary, should we be referred to an allergist?

4. Diagnosis: Persistent cough (persistent over seven months)

Questions that should be asked:

  1. What is the cause of this cough and what tests should be done ?
  2. What treatment would be in order for the diagnosis?
  3. Should a specialist be seen, such as an allergist, an ENT or a pulmologist?

5. Diagnosis: Vomiting (during first year of life)

Questions that should be asked:

  1. Is this serious and should I be concerned?
  2. Does the frequency mean its serious?
  3. How is the growth and development of the child?
  4. What tests and treatments should be done?
  5. Is a consultation with a specialist in order?

6. Diagnosis: Tonsilitis (strep)(occuring greater than three times per year for two years)

Questions that should be asked:

  1. What treatment is necessary?
  2. Is a consultation with an ENT necessary?
  3. How long will recovery take?

7. Diagnosis: Headaches (recurring every three to four months)

Questions that should be asked:

  1. Is this serious and what are the potential diagnosis?
  2. What tests are necessary?
  3. Are the child's physical and neurological examinations normal?
  4. Should we see a neurologist?

8. Diagnosis: Rhinitis/Conjunctivitis (intermittent and chronic)

Questions that should be asked:

  1. Why is this occuring and what tests and treatment are available?
  2. Should we see an allergist or an ENT doctor?

9. Diagnosis: Chest Pain

Questions that should be asked:

  1. Is this serious?
  2. Is the diagnosis obvious or are other test necessary?
  3. Do the heart and lung appear normal?
  4. Are visits to other specialists cardiac or pulmonary recommended?

10. Diagnosis: Exercise induced bronchospasm

Questions that should be asked:

  1. The coach says the child is a "wimp" but I don't believe this and need you to confirm for me that this isn't true.
  2. What are the results of the physical examination?
  3. Does the child need a special pulmonary function test to make a diagnosis?
  4. Are treatments necessary before the child runs or exerts physical activity?
  5. Should we see a specialist?

11. Diagnosis: Infectious Mononucleosis

Questions that should be asked:

  1. How does one get "mono" and how is it spread?
  2. How sick will the child get and for how long will he/she be contagious?
  3. What is the treatment for "mono" and how long should it last?
  4. Should activity be curtailed for a period of time?
  5. How easily can "mono" reoccur?

12. Diagnosis: Osgood-Schlatter Disease

Questions that should be asked:

  1. What causes this disease and what is the treatment?
  2. When will it heal and can it reoccur?
  3. What activities are permissible while the disease is being treated?

13. Diagnosis: Cold and Ear Infections

Questions that should be asked:

  1. Does my child need an antibiotic?
  2. When is an antibiotic needed?
  3. Is there a risk waiting for throat cultures to return before starting an antibiotic?
  4. Is a humidifier of value?
  5. How much fluid should be taken and are throat lozenges of value?
  6. Are antibiotics always needed for ear infections and are nasal decongestants of value?

Robert H. Friedman, M.D. Clinical Associate Professor of Pediatric Medicine Washington University School of Medicine St. Louis, MO

                                                                                               

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