Viral syndromes, 474 –475 Viremia, 501 t Vision, double, 1385 Visual disturbances causes, 189 t common conditions that cause, 189 t diagnostic approach to, 192 f differential diagnosis, 188 –191 emergent conditions that cause, 190 t evaluation and decision, 191 –193 pathophysiology, 188 from Pseudomonas infections, 188 sickle cell disease or trait and, 189 from Staphylococcus infections, 188 traumatic injuries and, 189 Visual loss associated with trauma, 193 mild, 193 not associated with trauma, 193 severe, 193 Vital signs, pediatric, 23 –24 , 23 t Vitamin B12 deficiency, 417 Vitamin K antagonists (VKAs), 1065 Vitamin K–deficient bleeding, 215 –216 VITAMINS mnemonic, 561 , 561 t Vitiligo, 465 Vocal cord dysfunction, 515 Vogt–Koyanagi–Harada syndrome, 189 Volvulus, malrotation of bowel, 1299 –1302 Vomiting, 119 , 148 t, 482 , 886 , 929 , 1304 appearance of vomitus, 548 association with diarrhea, 153 common causes, 550 t differential diagnosis, 551 f evaluation and decision general approach, 548 history, 548 physical examination, 548 , 550 by genitourinary symptoms, 548 by GI symptoms, 548 life-threatening causes, 550 t in neonates, 552 by neurologic symptoms, 548 in older children, 553 –554 in older infants, 552 –553 regurgitation and, 549 t signs and symptoms associated with, 550 t symptomatic relief of, 554 Von Willebrand disease, 166 , 168 , 797 –798 Vulvar bleeding, 533 –534 Vulvar inflammation, 533 Vulvar lacerations, 533 Vulvitis, 384 t Vulvovaginitis, 384 t, 533 –534 W Waardenburg syndrome, 222 , 465 Warts, 635 –636 Weakness approaches to acute onset, 563 f subacute, indolent, or chronic, 564 f sudden onset of severe, 562 f causes, 559 t common, 560 t life-threatening, 557 t definition, 556 differential diagnosis, 556 –561 , 557 t evaluation and decision, 561 –565 pathophysiology, 556 Weight loss acute, 566 assessment of, 566 causes, 570 t acutely life-threatening, 568 t by organ system, 570 t physiologic processes as, 567 t chronic, 566 differential diagnosis adolescents, 570 –571 infants, 568 –570 toddlers and preadolescents, 570 disposition, 571 evaluation and decision, 566 –567 algorithm, 569 f history, 566 , 567 f laboratory tests, 567 physical examination, 566 pathophysiology, 566 pediatric malnutrition and, 566 psychosocial factors of, 566 Werdnig–Hoffmann disease, 337 West Nile virus, 126 Wheals, 650 –651 Wheezing, 133 , 135 , 199 , 480 , 948 attributable to anaphylaxis, 573 cardiovascular abnormalities and, 573 –574 causes, 576 t clinical classification of, 573 t from congenital structural anomalies, 574 diagnostic approach, 575 f, 577 diagnostic tests, 576 –577 differential diagnosis, 572 –574 evaluation and decision history, 574 –575 physical examination, 575 –576 extrinsic tracheobronchial compression and, 574 pathophysiology, 572 persistent, 574 from pulmonary edema, 574 pulmonary hemorrhage and, 574 transient, 573 tumor and, 574 Whipple disease, 338 whole-body radiation, 703 Whole bowel irrigation (WBI), 1036 –1037 Wilms tumor, 87 , 910 , 913 f, 1308 –1309 , 1309 f Wilson disease, 897 Winter eczema, 433 Wireless capsule endoscopy, 220 Witch’s milk, 112 Wolff–Parkinson–White (WPW) syndrome, 424 World Health Organization Scale, 155 f Wound botulism, 559 Wound care, 719 , 1163 –1165 aftercare, 1164 –1165 discharge instructions, 1164 t dressing, 1163 systemic antibiotics, guidelines, 1163 –1164 tetanus, 1164 topical antibiotics, 1163 Wound closure techniques, 1158 , 1158 f, 1163 t Wound edge eversion, 1158 f Wound healing, 1154 Wound irrigation, 1157 Wound repair bones, 1155 clinical assessment, 1154 –1156 closure techniques, 1158 , 1158 f, 1163 t cosmesis, 1154 evidences, 1154 foreign body, 1155 hemostasis, 1153 infection prevention, 1153 –1154 infection rate, 1154 management, 1156 –1162 nerve damage, 1155 parental satisfaction, 1154 ... 569 f history, 566 , 567 f laboratory tests, 567 physical examination, 566 pathophysiology, 566 pediatric malnutrition and, 566 psychosocial factors of, 566 Werdnig–Hoffmann disease, 337 West