FEBRILE INFANT:

Rochester Criteria for Febrile Infants Age 28-90 Days Old
- Non-toxic looking
- Previously well (>37 wks. gestational age, home with mother, no hyperbilirubinemia, no prior antibiotics or hospitalizations, no chronic/underlying illness)
- No skin, soft tissue, bone, joint, or ear infection on physical exam
- WBC 5000-15,000, bands <1500, urine <10 WBC/HPF, stool <5 WBC/HPF

FOETAL ALCOHOL SPECTRUM DISORDER

Criteria for diagnosis of FAS
- Growth deficiency: low birth weight and/or decelerating weight over time not due to nutrition
- Characteristic pattern of facial anomalies: short palpebral fissures (<2 SD below mean), flattened philtrum, thin upper lip (having all 3 features is highly specific for alcohol exposure, don’t need maternal history to confirm)
- CNS dysfunction (need ≥3): motor skills; neuroanatomy/neurophysiology; cognition; language; academic achievement; memory; attention; executive function (impulse control and hyperactivity); affect regulation; adaptive behaviour, social skills or social communication OR microcephaly in infant and young children
Criteria for diagnosis of ARBD
- Congenital anomalies, including malformations and dysplasias of the cardiac, skeletal, renal, ocular, and auditory systems
Criteria for diagnosis of ARND
- CNS dysfunction (similar to FAS)
- Complex pattern of behavioural or cognitive abnormalities inconsistent with developmental level that cannot be explained by familial background or environment alone

FUNCTIONAL CONSTIPATION:

Rome III criteria
- ≥2 of the following for at least 1 month:
  1. ≤2 defecations/wks.
  2. History of excessive stool retention
  3. History of large-diameter stools
  4. History of painful or hard bowel movements
- In toilet trained children, the following additional criteria may be used:
  1. At least one episode/wks. of incontinence after the acquisition of toileting skills
  2. History of large-diameter stools that may obstruct toilet

FIBROMYALGIA:

Criteria

Comments

Widespread Pain Index = number of areas in which the patient had pain over the last week (max score = 19):
L and R: shoulder girdle, upper arm, lower arm, hip, upper leg, lower leg, jaw
One Area: chest, abdomen, upper back, lower back, neck
Symptom Severity Score = sum of:

1. severity of fatigue
2. waking unrefreshed
3. cognitive symptoms over the past week
4. extent of somatic symptoms (IBS, H/A, abdominal pain/cramps, dry mouth, fever, hives, ringing in ears, vomiting, heartburn, dry eyes, SOB, loss of appetite, rash, hair loss, easy bruising, etc.)

all (a-d) rated on 0-3 scale: 0 = no problem, 1 = mild, 2 = moderate, 3 = severe

A patient satisfies diagnostic criteria for fibromyalgia if the following 3 conditions are met:

1. Widespread Pain Index (WPI) ≥7 and Symptom Severity (SS) scale score ≥5 or WPI 3–6 and SS scale score ≥9

2. Symptoms have been present at a similar level for at least 3 months

3. The patient does not have a disorder that would otherwise explain
the pain

Medical Criteria – F

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