REWRITES: list[tuple[int, tuple[str, str], str]] = [
    (
        321,
        (
        'Low blood glucose in infants and childre',
        'Hypoglycaemia in infants and children is',
        ),
        'Hypoglycemia in infants and children is a blood glucose below 60 mg/dL, '
        'causing autonomic shakiness and sweating or neuroglycopenic confusion and '
        'seizures, though newborns are often silent. Ketotic fasting hypoglycemia is '
        'most common in children without diabetes, while hyperinsulinism drives '
        'persistent cases and needs glucose kept above 70 mg/dL.',
    ),
    (
        322,
        (
        '[[356|Cryptorchidism]]: epidemiology, ev',
        'Undescended testis ([[356|cryptorchidism',
        ),
        'Undescended testis ([[356|cryptorchidism]]) is the most common congenital '
        'anomaly of the male genitourinary tract, affecting 1-4% of full-term and up to '
        '45% of preterm boys, and around half descend spontaneously during the '
        'minipuberty testosterone surge. A testis still undescended at 4 months will '
        'not descend, so orchiopexy follows after 6 months to limit later subfertility '
        'and malignancy.',
    ),
    (
        324,
        (
        'Pediatric nasal fractures: recognizing s',
        'Nasal fracture is the most common facial',
        ),
        'Nasal fracture is the most common facial bone injury in children, typically '
        'from sports, falls or abuse, and presents with epistaxis, edema and ecchymosis '
        'that abundant pediatric cartilage can easily mask. Every child needs an '
        'intranasal speculum examination for septal hematoma, a true emergency, while '
        'reduction is decided on residual deformity at 2-7 days rather than on '
        'radiographs.',
    ),
    (
        327,
        (
        'Pediatric blunt splenic injury: mechanis',
        'Blunt trauma causes most paediatric sple',
        ),
        'Blunt trauma causes most pediatric splenic injury, with motor vehicle '
        'collisions accounting for about 40% and pre-existing splenomegaly raising '
        'susceptibility. Over 95% of cases are now managed nonoperatively because of '
        'postsplenectomy sepsis risk, and asplenic children need penicillin prophylaxis '
        'alongside pneumococcal, Hib and meningococcal vaccination.',
    ),
    (
        331,
        (
        'Epiglottitis/supraglottitis: the abrupt ',
        'Epiglottitis is a rapidly progressive, l',
        ),
        'Epiglottitis is a rapidly progressive, life-threatening inflammation of the '
        'supraglottis, peaking at 1-8 years and presenting abruptly with drooling, '
        'dysphagia and distress in a toxic child sitting forward. Hib vaccination has '
        'made it rare, and management is to secure the airway in a controlled setting '
        'before broad-spectrum antibiotics, avoiding any oropharyngeal manipulation.',
    ),
    (
        333,
        (
        'Metabolic syndrome as cardiometabolic ri',
        'Metabolic syndrome is a cluster of cardi',
        ),
        'Metabolic syndrome is a cluster of cardiometabolic risk factors — central '
        'obesity, raised blood pressure and triglycerides, low HDL and hyperglycemia — '
        'arising from insulin resistance and adipose dysfunction. No agreed pediatric '
        'definition exists, and the AAP advises screening and treating each risk factor '
        'with lifestyle modification rather than chasing a formal diagnosis.',
    ),
    (
        337,
        (
        'Pediatric thyroid nodules: why they carr',
        'Thyroid nodules are found in only 1-2% o',
        ),
        'Thyroid nodules are found in only 1-2% of children but carry a 20-25% '
        'malignancy risk, roughly double that in adults, and are twice as common in '
        'girls. Evaluation starts with serum TSH and neck ultrasound, with fine-needle '
        'aspiration for nodules of 1 cm or more or with suspicious sonographic '
        'features.',
    ),
    (
        338,
        (
        'The general approach to a child with a s',
        'Toxic ingestion follows a bimodal age di',
        ),
        'Toxic ingestion follows a bimodal age distribution, with accidental '
        'exploratory swallowing peaking at 1-4 years and intentional overdose in '
        'adolescents; caustic agents are the most common exposure, though '
        'pharmaceuticals cause most deaths. Because young children cannot report what '
        'they took, poisoning belongs on the differential for any symptom complex that '
        'fits no recognizable syndrome.',
    ),
    (
        339,
        (
        'Tinea capitis: T. tonsurans vs M. canis ',
        'Tinea capitis is a dermatophyte infectio',
        ),
        'Tinea capitis is a dermatophyte infection of the scalp and hair shafts, the '
        'most common cutaneous mycosis in children, with a prevalence of 3-13% and a '
        'peak age of 3-7 years. Trichophyton tonsurans causes up to 95% of US cases, '
        'and treatment must be oral griseofulvin or terbinafine because topical agents '
        'cannot penetrate the hair shaft.',
    ),
    (
        341,
        (
        'Congenital and acquired toxoplasmosis: t',
        'Congenital toxoplasmosis follows materna',
        ),
        'Congenital toxoplasmosis follows maternal Toxoplasma gondii infection in about '
        '0.1-0.5% of pregnancies and affects roughly 1 in 3,000-10,000 live births, '
        'with transmission rising toward term while severity falls. Most infected '
        'infants look normal at birth but later develop chorioretinitis or learning '
        'difficulties, so confirmed infection is treated with pyrimethamine, '
        'sulfadiazine and folinic acid.',
    ),
    (
        343,
        (
        'Pediatric visual impairment: acuity-base',
        'Severe visual impairment in children mea',
        ),
        'Severe visual impairment in children means corrected acuity poorer than 6/60, '
        'with an incidence of about 2.5 per 100,000 and a peak in the first year of '
        'life. Cerebral visual impairment is the leading cause in developed countries, '
        'so wandering nystagmus or poor visual regard by 3-6 months warrants urgent '
        'assessment.',
    ),
    (
        347,
        (
        'Pediatric acute pancreatitis: the 2-of-3',
        'Acute pancreatitis in children is diagno',
        ),
        'Acute pancreatitis in children is diagnosed on two of three criteria — '
        'epigastric pain, amylase or lipase at least three times normal, and consistent '
        'imaging — most often from gallstones, blunt trauma, multisystem disease or '
        'drugs. Conservative management carries a mortality under 0.4%, though up to '
        '10% of children have a further episode.',
    ),
    (
        353,
        (
        'Pediatric cellulitis: exposure-based pat',
        'Cellulitis is an acute infection of the ',
        ),
        'Cellulitis is an acute infection of the dermis and subcutaneous tissue '
        'producing erythema, edema, warmth and pain with poorly defined borders, most '
        'often from Staphylococcus aureus or Streptococcus pyogenes and most common on '
        'the lower extremities. Only 10-20% of children develop fever, and mild disease '
        'responds to oral cephalexin or dicloxacillin, with clindamycin when MRSA is '
        'suspected.',
    ),
    (
        355,
        (
        'Chorioamnionitis / Triple I: clinical di',
        'Chorioamnionitis, now called intrauterin',
        ),
        'Chorioamnionitis, now called intrauterine inflammation or infection at birth, '
        'follows microbial invasion of amniotic fluid after membranes rupture for 18 '
        'hours or more, and is diagnosed on maternal fever plus fetal tachycardia, '
        'leukocytosis or purulent cervical discharge. Group B Streptococcus and '
        'Escherichia coli cause most neonatal infection, so mothers receive antibiotics '
        'while the newborn is observed for sepsis.',
    ),
    (
        357,
        (
        'Pediatric chronic sinusitis: the 90-day ',
        'Chronic sinusitis is cough, nasal discha',
        ),
        'Chronic sinusitis is cough, nasal discharge or congestion persisting beyond 90 '
        'days, milder and more indolent than acute disease, with fever uncommon and '
        'examination often normal. Its microbiology favors S. aureus and anaerobes, so '
        'empirical antibiotics are given and children who fail to improve are referred '
        'to otolaryngology; nasal polyps should prompt testing for cystic fibrosis.',
    ),
    (
        360,
        (
        'Pediatric dilated cardiomyopathy: age-de',
        'Dilated cardiomyopathy is the commonest ',
        ),
        'Dilated cardiomyopathy is the most common cardiomyopathy in children, '
        'affecting about 4-8 per 100,000 each year, and 71% present in congestive heart '
        'failure — infants with tachypnea, weak pulses and failure to thrive, '
        'adolescents with adult-type exertional dyspnea. Diagnosis is '
        'echocardiographic, and treatment runs from diuretics and afterload reduction '
        'to transplantation, though over a third recover significant function.',
    ),
    (
        362,
        (
        'Exercise-induced bronchoconstriction: th',
        'Exercise-induced bronchoconstriction is ',
        ),
        'Exercise-induced bronchoconstriction is transient airway narrowing triggered '
        'by exertion, affecting an estimated 40-90% of children with asthma, with '
        'symptoms peaking 5-10 minutes after stopping and settling within 20-30 '
        'minutes. Diagnosis needs a standardized exercise challenge showing a 15% fall '
        'in FEV1, since methacholine testing cannot exclude it, and pre-exercise '
        'treatment suffices unless poor endurance signals uncontrolled asthma.',
    ),
    (
        364,
        (
        'Fetal alcohol syndrome within the FASD s',
        'Fetal alcohol syndrome is the most sever',
        ),
        'Fetal alcohol syndrome is the most severe diagnosis within fetal alcohol '
        'spectrum disorder, affecting about 0.5-2 per 1,000 live births, and requires '
        'all four of facial anomalies, growth restriction, a brain abnormality and '
        'neurobehavioral impairment. Alcohol is the leading preventable cause of birth '
        'defects with no safe dose in pregnancy, and over 80% of affected children have '
        'developmental delay.',
    ),
    (
        366,
        (
        'Fragile X syndrome: the FMR1 CGG-repeat ',
        'Fragile X syndrome is the commonest inhe',
        ),
        'Fragile X syndrome is the most common inherited cause of intellectual '
        'disability, caused by a CGG repeat expansion beyond 200 in FMR1 that silences '
        'the gene, and affects about 1 in 4,000-8,000. The long face, large ears and '
        'macro-orchidism appear only in the second decade, so any boy with '
        'developmental delay warrants molecular testing regardless of appearance.',
    ),
    (
        369,
        (
        'Pediatric glomerulonephritis: the nephri',
        'Glomerulonephritis presents as nephritic',
        ),
        'Glomerulonephritis presents as nephritic syndrome — gross hematuria, red cell '
        'casts, hypertension and edema — with acute post-streptococcal disease the most '
        'common cause worldwide, typically at 4-12 years and marked by low C3 and a '
        'raised ASO titre. Post-infectious disease is self-limiting and treated '
        'supportively, while a rapidly progressive or chronic membranoproliferative '
        'course needs biopsy and immunosuppression.',
    ),
    (
        370,
        (
        'Pediatric alopecia: distinguishing [[346',
        'Acquired localised hair loss is the comm',
        ),
        'Acquired localized hair loss is the most common pattern in childhood and is '
        'nearly always [[346|alopecia areata]], [[339|tinea capitis]] or traumatic '
        'pulling, with about 60% loss in an area needed before it becomes visible. '
        'Alopecia areata regrows completely within a year in half of children, and a '
        'negative Wood-lamp examination never excludes tinea, since T. tonsurans does '
        'not fluoresce.',
    ),
    (
        371,
        (
        'Seasonal [[298|influenza]] A infection i',
        '[[298|Influenza]] A causes seasonal wint',
        ),
        '[[298|Influenza]] A causes seasonal winter epidemics, with antigenic drift in '
        'its hemagglutinin and neuraminidase driving new strains and an annually '
        'updated vaccine, and hospitalisation is highest under 2 years. Older children '
        'get sudden fever, myalgia and headache while infants may present with '
        'diarrhea, vomiting or a sepsis-like illness, and aspirin must be avoided '
        'because of Reye syndrome.',
    ),
    (
        372,
        (
        'Pediatric HIV: transmission routes, earl',
        'Paediatric HIV is acquired mostly from a',
        ),
        'Pediatric HIV is acquired mostly from an infected mother before, during or '
        'after birth, and about 20% of untreated infants present in the first 3-6 '
        'months with an AIDS-defining illness such as Pneumocystis pneumonia. Chronic '
        'parotid swelling and lymphoid interstitial pneumonia are child-specific '
        'findings, and CD4 count guides classification, with most treated children now '
        'surviving into adulthood.',
    ),
    (
        375,
        (
        'Pediatric IIH/pseudotumor cerebri: the n',
        'Idiopathic intracranial hypertension is ',
        ),
        'Idiopathic intracranial hypertension is raised intracranial pressure with '
        'normal parenchyma, CSF and neuroimaging, affecting 1-2 per 100,000 children '
        'but around twenty times more in adolescent girls with obesity. Diagnosis needs '
        'a raised opening pressure on lateral decubitus lumbar puncture, and prompt '
        'treatment matters because the visual field loss it causes is reversible.',
    ),
    (
        377,
        (
        'Pediatric insomnia: behavioral insomnia ',
        'Insomnia is difficulty falling or stayin',
        ),
        'Insomnia is difficulty falling or staying asleep despite adequate opportunity, '
        'causing daytime fatigue and irritability, and behavioral insomnia of childhood '
        'is the most common pediatric sleep disorder, affecting 10-30% and peaking '
        'between 6 months and 2 years. It divides into sleep-onset association and '
        'limit-setting types, both treated with consistent bedtime limits and sleep '
        'hygiene rather than medication.',
    ),
    (
        379,
        (
        'Intracranial hemorrhage across the pedia',
        'Intracranial haemorrhage is the commones',
        ),
        'Intracranial hemorrhage is the most common acute CNS complication of preterm '
        'birth, arising from the subependymal germinal matrix, with risk rising as '
        'gestational age falls and infants under 1,500 g most affected. Beyond the '
        'newborn period it causes about half of childhood strokes, usually from a '
        'congenital vascular anomaly, and sudden severe headache should prompt '
        'immediate CT.',
    ),
    (
        381,
        (
        'Juvenile dermatomyositis: the Bohan-Pete',
        'Juvenile dermatomyositis is the commones',
        ),
        'Juvenile dermatomyositis is the most common pediatric inflammatory myopathy, '
        'affecting roughly 3.2 per million children, with onset at a median 7-11 years '
        'and a female predominance. It is diagnosed by a heliotrope rash or Gottron '
        'papules plus three of proximal weakness, raised muscle enzymes, EMG change and '
        'biopsy inflammation, and its underlying vasculopathy, unlike adult disease, '
        'rarely signals malignancy.',
    ),
    (
        383,
        (
        'Pediatric laceration management: hemosta',
        'Lacerations in children involve the face',
        ),
        'Lacerations in children involve the face in about 60% of cases and the upper '
        'extremities in 25%, and most are managed with direct pressure, LET topical '
        'anesthetic and simple closure. Deep-structure injury must be excluded in the '
        'neck and in laterally extending palatal wounds, and any laceration in a '
        'non-mobile infant raises concern for abuse.',
    ),
    (
        385,
        (
        'Laryngomalacia: the omega-shaped epiglot',
        'Laryngomalacia is the commonest congenit',
        ),
        'Laryngomalacia is the most common congenital laryngeal anomaly and the leading '
        'cause of infant stridor, appearing at 2-6 weeks with inspiratory stridor that '
        'worsens supine, with feeding and when crying, and eases prone. Symptoms peak '
        'around 6 months and resolve in most children by 12-18 months, so only 10-22% '
        'need supraglottoplasty, usually for airway obstruction or failure to thrive.',
    ),
    (
        387,
        (
        'Pediatric metabolic acidosis: distinguis',
        'Metabolic acidosis follows a net gain of',
        ),
        'Metabolic acidosis follows a net gain of hydrogen ions or loss of bicarbonate, '
        'acutely from diarrhea, shock or diabetic ketoacidosis and chronically from '
        'renal tubular acidosis, renal insufficiency or an inborn error of metabolism. '
        'The anion gap directs the work-up, and bicarbonate boluses are reserved for '
        'the severely unstable because they risk intracranial hemorrhage and '
        'paradoxical intracellular acidosis.',
    ),
    (
        391,
        (
        'Oligohydramnios and the Potter sequence:',
        'Oligohydramnios is a maximum vertical po',
        ),
        'Oligohydramnios is a maximum vertical pocket of amniotic fluid under 2 cm, '
        'most often from ruptured membranes but also from placental insufficiency or '
        'reduced fetal urine output in renal agenesis or bladder outlet obstruction. '
        'Because amniotic fluid drives lung development, it can produce the Potter '
        'sequence of compressed facies, joint contractures and pulmonary hypoplasia, '
        'which is almost uniformly fatal.',
    ),
    (
        393,
        (
        'Peanut allergy prevention and management',
        'Peanut allergy affects 1-3% of children ',
        ),
        'Peanut allergy affects 1-3% of children in westernized countries, has tripled '
        'in 10-15 years, and is outgrown by only about 20%, almost always before age 5. '
        'The LEAP trial showed early regular introduction cuts allergy at age 5 from '
        '17% to 3% in infants with severe [[288|eczema]] or egg allergy, and '
        'established allergy needs strict avoidance and epinephrine for '
        '[[143|anaphylaxis]].',
    ),
    (
        396,
        (
        'Pediatric pneumothorax: spontaneous (pri',
        'Pneumothorax is air in the pleural space',
        ),
        'Pneumothorax is air in the pleural space and is more common in the neonatal '
        'period than at any other age, affecting 1-2% of term and about 6% of preterm '
        'newborns. In older children it is either primary spontaneous, in tall thin '
        'adolescent boys with apical blebs, or secondary to asthma, cystic fibrosis or '
        'trauma, and tension physiology needs immediate needle decompression.',
    ),
    (
        398,
        (
        'Pediatric polytrauma: unique anatomic/ph',
        'Polytrauma is injury to several body reg',
        ),
        'Polytrauma is injury to several body regions needing multiple specialties, and '
        'trauma is the leading cause of childhood death in the developed world, with '
        'blunt mechanisms predominating. Children compensate for 25-30% blood loss with '
        'a normal blood pressure, so assessment follows ABCDE with cervical spine '
        'protection, and persistent shock should raise tamponade or cardiac contusion '
        'rather than continued bleeding.',
    ),
    (
        399,
        (
        'Posterior urethral valves: presentation ',
        'Posterior urethral valves are obstructin',
        ),
        'Posterior urethral valves are obstructing leaflets in the prostatic urethra of '
        'boys and the most common cause of lower urinary tract obstruction and of '
        'childhood renal failure from obstructive uropathy. Most are now found '
        'prenatally as bilateral hydronephrosis with a thick-walled bladder, a voiding '
        'cystourethrogram confirms them and endoscopic ablation follows, yet about 30% '
        'still progress to chronic renal failure.',
    ),
    (
        404,
        (
        'Prepubertal vulvovaginitis: why unestrog',
        'About 75% of prepubertal vulvovaginitis ',
        ),
        'About 75% of prepubertal vulvovaginitis is nonspecific, driven by thin '
        'unestrogenized alkaline mucosa, an unprotected introitus and the anus lying '
        'close by, and worsened by poor hygiene and chemical irritants. Visible '
        'discharge changes that — up to half of those girls have a specific infection — '
        'and a sexually transmitted organism should prompt evaluation for abuse.',
    ),
]