(
        3,
        (
            'Common lower respiratory infection of in',
        ),
        'Bronchiolitis is the most common lower respiratory tract infection in infants, '
        'usually caused by respiratory syncytial virus, and follows 1-3 days of coryza '
        'with cough, tachypnea, wheeze and crackles that peak on day 3-5. The diagnosis '
        'is clinical, and care is supportive with suctioning, hydration and oxygen, '
        'since bronchodilators, corticosteroids and antibiotics are not routinely '
        'indicated.',
    ),
    (
        4,
        (
            'Middle-ear infection — one of the common',
        ),
        'Acute otitis media is a middle-ear effusion with acute signs of inflammation, '
        'diagnosed by a bulging tympanic membrane or new otorrhea together with acute '
        'onset of symptoms. Every child needs analgesia, while antibiotics are reserved '
        'for young infants, severe symptoms or bilateral disease in the very young, '
        'with observation and follow-up otherwise.',
    ),
    (
        5,
        (
            'Medium-vessel vasculitis of childhood wi',
        ),
        'Kawasaki disease is an acute, self-limited vasculitis of young children '
        'presenting with at least five days of fever plus bilateral non-exudative '
        'conjunctivitis, oral mucosal changes, polymorphous rash, extremity changes or '
        'cervical lymphadenopathy. Inflammatory markers are raised and echocardiography '
        'assesses the coronary arteries, since early intravenous immunoglobulin with '
        'aspirin reduces the risk of aneurysms.',
    ),
    (
        6,
        (
            'Recognising new-onset diabetes and [[241',
        ),
        'Type 1 diabetes results from autoimmune destruction of pancreatic beta cells '
        'and presents over days to weeks with polyuria, polydipsia and weight loss, '
        'with new nocturnal enuresis in a previously dry child a useful clue. '
        '[[241|Diabetic ketoacidosis]] adds Kussmaul breathing, vomiting and abdominal '
        'pain, and is treated by restoring circulation and correcting deficits '
        'gradually before starting insulin.',
    ),
    (
        9,
        (
            'Chronic airway inflammation with reversi',
        ),
        'Childhood asthma presents with recurrent, variable wheeze, cough and '
        'breathlessness that respond to bronchodilators, confirmed by spirometry '
        'showing reversible airflow obstruction where the child can perform it, usually '
        'from about age 5. Acute attacks need inhaled short-acting beta agonists, '
        'systemic corticosteroids and oxygen, while chronic control uses step therapy '
        'with inhaler technique reviewed at every visit.',
    ),
    (
        10,
        (
            'A practical framework for surveillance a',
        ),
        'Developmental surveillance at every health visit, with standardized screening '
        'at set ages, underpins early identification, and gross motor, fine motor, '
        'language and social development are tracked separately because delay in one '
        'domain need not mean global delay. Loss of previously acquired skills is a red '
        'flag, warranting prompt evaluation, hearing and vision checks and referral to '
        'early intervention.',
    ),
    (
        248,
        (
            'Classification, screening, and evaluatio',
        ),
        'Congenital hearing loss affects about 1-3 per 1,000 births and is roughly half '
        'genetic and half acquired, with 80% of genetic cases autosomal recessive. '
        'Universal newborn screening by otoacoustic emissions or auditory brainstem '
        'response replaced risk-based screening because only about half of affected '
        'infants have a risk factor, and the critical window for speech is birth to 3 '
        'years.',
    ),
    (
        258,
        (
            'Distinguishing OME from [[4|acute otitis',
        ),
        'Otitis media with effusion is middle-ear fluid without signs of acute '
        'infection, which distinguishes it from [[4|acute otitis media]], and it causes '
        'mild hearing loss or aural fullness rather than pain or fever. It usually '
        'resolves within 3 months, antibiotics have no role, and trials found no '
        'advantage to early tympanostomy tubes in otherwise healthy children.',
    ),
    (
        259,
        (
            'Physiology, risk factors, and stepwise m',
        ),
        'Patent ductus arteriosus is failure of the ductus to close after birth, and '
        'its incidence rises as gestational age falls, affecting about 45% of infants '
        'under 1,750 g and 80% of those under 1,000 g. Clinical signs are unreliable so '
        'echocardiography confirms it, and indomethacin closes about two-thirds of '
        'significant shunts before catheter or surgical closure is considered.',
    ),
    (
        266,
        (
            'Clostridium tetani pathophysiology and t',
        ),
        'Tetanus follows wound contamination by Clostridium tetani, whose toxin blocks '
        'inhibitory spinal synapses to cause uncontrolled spasms, typically 4-14 days '
        'after injury and almost exclusively in unvaccinated children. Trismus is the '
        'presenting sign in about half, and treatment is tetanus immune globulin plus '
        'metronidazole, with prophylaxis guided by immunization history and wound type.',
    ),
    (
        267,
        (
            'Burn depth classification, the Parkland ',
        ),
        'Burns are classified by depth into first-degree, partial-thickness and '
        'full-thickness injury, and resuscitation uses the Parkland formula of 4 mL/kg '
        'per percent body surface area burned, half in the first 8 hours. Because a '
        'child withdraws from water above 120°F within seconds, a full-thickness '
        'immersion burn is rarely accidental and should prompt evaluation for abuse.',
    ),
    (
        274,
        (
            'The expected course of a typical pediatr',
        ),
        'Children average 5-10 upper respiratory infections a year, especially under '
        'age 2, with clear nasal discharge, cough and early fever that usually settle '
        'within 10-14 days, though about 10% still have symptoms at day 14. New fever '
        'and worsening cough around day 9 suggest secondary bacterial sinusitis, and an '
        'active infection raises the risk of laryngospasm under anesthesia.',
    ),
    (
        276,
        (
            'Distinguishing viral from GAS pharyngiti',
        ),
        'Acute pharyngitis peaks between ages 4 and 7 and is rare under 1, and over 90% '
        'of febrile sore throat in children is viral, with group A Streptococcus '
        'causing only 15-30%. Clinical criteria are too nonspecific to diagnose it, so '
        'culture or a rapid antigen test is required, and confirming GAS matters '
        'because untreated infection can lead to rheumatic fever.',
    ),
    (
        278,
        (
            'Rates and causative organisms of serious',
        ),
        'Serious bacterial infection occurs in 7-13% of febrile neonates and young '
        'infants, of which urinary tract infection accounts for 5-13%, bacteremia 1-2% '
        'and meningitis 0.2-0.5%, with risk highest in the youngest and the clinically '
        'unwell. Escherichia coli is the most common organism overall, and separating '
        'invasive infection from UTI matters because UTI is often treated orally.',
    ),
    (
        282,
        (
            'DSM-5 criteria for cannabis use disorder',
        ),
        'Cannabis is the most commonly used illicit drug among US adolescents, with '
        'about half having tried it by 12th grade, and earlier onset predicts later '
        'substance use and psychiatric comorbidity. DSM-5 grades use disorder on 11 '
        'criteria rather than separating abuse from dependence, and chronic heavy use '
        'can produce a withdrawal syndrome and cannabinoid hyperemesis relieved by hot '
        'showers.',
    ),
    (
        283,
        (
            'How to recognize a newborn cephalohemato',
        ),
        'Cephalohematoma is a subperiosteal hemorrhage confined to a single cranial '
        'bone that never crosses suture lines, distinguishing it from caput '
        'succedaneum, and complicates about 1-2.5% of births, far more often after '
        'vacuum or forceps delivery. Swelling appears hours to days later and resolves '
        'over 2-6 weeks, needing only monitoring of hematocrit and bilirubin.',
    ),
    (
        285,
        (
            'Age-specific presentation of pediatric C',
        ),
        "Congestive heart failure is the heart's inability to meet metabolic demand, "
        'most often from congenital heart disease or cardiomyopathy, and presents in '
        'infants with tachypnea, sweating with feeds and poor weight gain but in older '
        'children with exertional breathlessness and edema. Treatment escalates from '
        'diuretics and ACE inhibitors to mechanical support, though structural causes '
        'are usually reversible with surgery.',
    ),
    (
        291,
        (
            'Modern drowning terminology and the inst',
        ),
        'Drowning is respiratory impairment from submersion or immersion, classified '
        'only as fatal or nonfatal, and is the leading cause of injury-related death in '
        'children under 5, who most often drown in swimming pools during brief lapses '
        'in supervision. Immediate on-scene resuscitation is the single most important '
        'step, and pool fencing, life jackets and touch supervision prevent it.',
    ),
    (
        293,
        (
            'How generalized-onset seizures differ fr',
        ),
        'Generalized [[206|epilepsy]] is the most common childhood epilepsy, accounting '
        'for about half of pediatric cases, and involves diffuse bilateral discharges '
        'from seizure onset with abrupt loss of awareness and no preceding aura. '
        'Absence seizures peak at 3-8 years in otherwise normal children and are '
        'usually outgrown, though 40-60% eventually have a generalized tonic-clonic '
        'seizure.',
    ),
    (
        301,
        (
            'Recognizing infantile spasms and West sy',
        ),
        'Infantile spasms are brief, stereotyped clusters of neck, trunk and limb '
        'contractions beginning between 3 and 12 months, peaking at 4-6 months, and are '
        'often mistaken for colic or reflux because they cluster around falling asleep '
        'and waking. With hypsarrhythmia and developmental regression they form West '
        'syndrome, and urgent MRI and EEG matter because prompt treatment improves '
        'developmental outcome.',
    ),
    (
        303,
        (
            'ILAR classification of JIA into 7 subtyp',
        ),
        'Juvenile idiopathic arthritis is arthritis of unknown cause lasting at least 6 '
        'weeks with onset before age 16, affecting about 1 in 1,000 children and more '
        'girls than boys. ILAR divides it into seven categories by joint pattern in the '
        'first 6 months, and because chronic anterior uveitis is usually silent, '
        'scheduled ophthalmologic screening is required.',
    ),
    (
        309,
        (
            'Distinguishing simple muscle contusion f',
        ),
        'Muscle contusion is a crush injury to soft tissue with hematoma formation, the '
        'familiar charley horse, and together with sprains and strains accounts for '
        'most pediatric musculoskeletal injury. Immediate swelling, deformity, a '
        'painful pop or joint locking points instead to fracture or internal '
        'derangement, while treatment is ice, compression and rest with pain-free '
        'movement started the same day.',
    ),
    (
        311,
        (
            'Recognizing pediatric OSAS from history ',
        ),
        'Obstructive sleep apnea syndrome is recurrent upper airway obstruction during '
        'sleep, affecting 1-5% of children and peaking at 2-8 years when tonsils and '
        'adenoids are largest relative to the airway. Over 95% of cases are structural, '
        'polysomnography confirms the diagnosis and severity, and adenotonsillectomy is '
        'first-line with CPAP for those it does not help.',
    ),
    (
        317,
        (
            'How pediatric peptic ulcer disease prese',
        ),
        'Peptic ulcer disease is a mucosal break through the muscularis mucosa of the '
        'stomach or duodenum, uncommon in children at 0.5-4.4 per 100,000, and its '
        'presentation shifts with age from neonatal stress ulcers bleeding or '
        'perforating to adult-type epigastric pain in adolescents. Two-thirds of '
        'confirmed cases carry H. pylori, treated with 7-14 days of triple therapy.',
    ),
    (
        318,
        (
            'Why early detection and dietary treatmen',
        ),
        'Phenylketonuria is autosomal recessive deficiency of phenylalanine hydroxylase '
        'affecting about 1 in 10,000-15,000 births, and infants appear normal before '
        'developing vomiting, irritability and a musty odor. Brain damage becomes '
        'irreversible by around 8 weeks, so newborn screening detects nearly all cases '
        'and a lifelong phenylalanine-restricted diet started within weeks preserves '
        'neuropsychological outcome.',
    ),
    (
        319,
        (
            'Managing the classic pediatric foot punc',
        ),
        'Most pediatric puncture wounds occur when a child steps on a nail, and the '
        'majority heal after thorough irrigation and a tetanus booster if indicated. '
        'Punctures through a sneaker risk Pseudomonas alongside Staphylococcus, wounds '
        'over the metatarsophalangeal joints risk osteomyelitis, and radiographs are '
        'needed for a retained foreign body, though wood is radiolucent and needs '
        'ultrasound or MRI.',
    ),
    (
        320,
        (
            'Distinguishing school refusal from truan',
        ),
        'School refusal is missing school 2-3 days a week for at least 2 weeks out of '
        'fear of leaving home or of school, with the parent aware and somatic morning '
        'symptoms that resolve by midday. It peaks at ages 4-6 and 11-12, and prompt '
        'return to school matters because untreated refusal leaves 45% not completing '
        'high school.',
    ),
    (
        325,
        (
            'Defective mineralization of growing bone',
        ),
        'Rickets is defective mineralization of growing bone, most often from '
        '[[326|vitamin D deficiency]] but also from calcium or phosphorus deficiency '
        'and distal renal tubular acidosis. It produces craniotabes, frontal bossing, '
        'rachitic rosary, widened wrists and bowed legs with metaphyseal cupping and '
        'fraying on radiographs, which is why the AAP advises 400 IU of vitamin D daily '
        'for breastfed infants.',
    ),
    (
        326,
        (
            'Low 25-hydroxyvitamin D from limited sun',
        ),
        'Vitamin D deficiency is a serum 25-hydroxyvitamin D below 15 ng/mL, and the '
        'main at-risk groups are exclusively breastfed infants without supplementation, '
        'dark-skinned and premature children, and those with fat malabsorption. It '
        'causes hypocalcemia, hypophosphatemia and rickets, presenting in young infants '
        'as hypocalcemic seizures, and resolves within months of treatment, though '
        'prolonged deficiency can leave permanent deformity.',
    ),
    (
        328,
        (
            'A limb-threatening rise in pressure with',
        ),
        'Compartment syndrome develops when pressure inside a closed fascial '
        'compartment exceeds capillary perfusion pressure, obstructing flow and causing '
        'muscle and neurovascular ischemia, and lower leg fractures cause about 60% of '
        'pediatric cases. Children are recognized by the 3 As of anxiety, agitation and '
        'rising analgesia need rather than the adult 5 Ps, and treatment is urgent '
        'fasciotomy.',
    ),
    (
        329,
        (
            'Definitions and forms of child maltreatm',
        ),
        'Child abuse covers physical and sexual abuse, emotional and physical neglect '
        'and medical child abuse, and the caregiver is responsible in about 90% of '
        'cases. Neglect is the most common form, while physical abuse is the leading '
        'cause of serious [[139|head trauma]] in the first year of life, and an '
        'implausible or evolving history should raise concern.',
    ),
    (
        330,
        (
            'Reactivation of latent varicella-zoster ',
        ),
        'Herpes zoster is reactivation of varicella-zoster virus latent in a sensory '
        'ganglion since primary infection, and is uncommon in healthy children under 10 '
        'except those infected in utero or during the first year of life. It causes '
        'grouped vesicles across one to three dermatomes, is milder than in adults with '
        'postherpetic neuralgia rare, and V1 involvement needs ophthalmologic '
        'examination.',
    ),
    (
        332,
        (
            'Traumatic and nontraumatic spinal cord i',
        ),
        'Spinal cord injury is rare in children, who account for about a quarter of all '
        'traumatic cases, and motor vehicle collisions remain the leading cause. '
        'Children under 5 injure the upper cervical spine while adolescents resemble '
        'adults, and because spinal cord injury without radiologic abnormality is '
        'common, a normal radiograph never excludes it; neurologic status at '
        'presentation best predicts outcome.',
    ),
    (
        335,
        (
            'Sunburn pathophysiology (UVB erythema), ',
        ),
        'Sunburn is the most common photosensitive reaction in children, a UVB-induced '
        'thermal injury whose redness, edema and blistering appear 6-12 hours after '
        'exposure and peak at about 24 hours. Treatment is cool compresses, analgesia '
        'and a bland emollient, and because most people receive over half their '
        'lifetime UV dose by age 20, blistering childhood sunburn raises later melanoma '
        'risk.',
    ),
    (
        336,
        (
            'The major tick-transmitted infections an',
        ),
        'Ticks transmit Lyme disease, spotted fever rickettsioses, ehrlichiosis, '
        'babesiosis, anaplasmosis, tularemia and relapsing fever to children exposed '
        'through pets or grass and brush. Attachment of 6 hours or more allows '
        'transmission, so frequent checks and prompt removal are the mainstay of '
        'prevention, while tick paralysis causes an ascending flaccid weakness that '
        'resolves rapidly once the tick is removed.',
    ),
    (
        340,
        (
            'Primary varicella-zoster virus infection',
        ),
        'Varicella-zoster virus causes chickenpox, a pruritic exanthem appearing in '
        'crops that spreads centrifugally from trunk and scalp, with papules, vesicles, '
        'pustules and crusts present simultaneously after a 10-21 day incubation. '
        'Children stay infectious until every lesion crusts, and acyclovir is reserved '
        'for adolescents and those with chronic skin or lung disease or '
        'immunocompromise.',
    ),
    (
        344,
        (
            'Benign bluish discoloration of the hands',
        ),
        'Acrocyanosis is bluish discoloration confined to the hands, feet and perioral '
        'area with trunk and mucous membranes staying pink, reflecting benign '
        'peripheral vasoconstriction rather than hypoxia. It is normal in the first 24 '
        'to 48 hours of life and resolves with warming, so cyanosis beyond that '
        'distribution, or central cyanosis persisting after the first minutes, needs '
        'prompt evaluation.',
    ),
    (
        345,
        (
            'Acne across the pediatric age spectrum -',
        ),
        'Acne vulgaris is chronic inflammation of the pilosebaceous unit affecting '
        'about 85% of people aged 12-24, typically starting at 12-14 years and earlier '
        'in girls, and driven by sebum production, abnormal keratinization, '
        'Cutibacterium acnes and inflammation. First-line treatment is topical '
        'retinoids, benzoyl peroxide and antibiotics, with isotretinoin reserved for '
        'the most severe disease.',
    ),
    (
        350,
        (
            'Bacteria in the bloodstream in children,',
        ),
        'Bacteremia complicates 3-5% of children with fever without a source, '
        'particularly under 2 years and with temperatures above 39°C, and Streptococcus '
        'pneumoniae, Staphylococcus and Haemophilus influenzae predominate at that age. '
        'Occult bacteremia often resolves spontaneously but 3-5% of pneumococcal cases '
        'progress to meningitis, and asplenic, neutropenic or catheterized children are '
        'at highest risk.',
    ),
    (
        351,
        (
            'The stepwise P/Cr-ratio pathway for asym',
        ),
        'Isolated proteinuria is found in 5-15% of children, and about 80% of it is '
        'transient while orthostatic proteinuria, which is benign and peaks in '
        'adolescence, accounts for roughly 60% of asymptomatic cases. A positive '
        'dipstick is confirmed with a first-morning protein-to-creatinine ratio, and a '
        'value of 1.0 or higher on repeat testing warrants full evaluation and '
        'nephrology referral.',
    ),
    (
        352,
        (
            'Inflammation of the cervix in the postpu',
        ),
        'Cervicitis is inflammation of the cervix in the postpubertal adolescent, most '
        'often from Neisseria gonorrhoeae or Chlamydia trachomatis, and is frequently '
        'asymptomatic or causes only purulent discharge, postcoital bleeding or '
        'dyspareunia. Sexually active patients are treated empirically for both '
        'organisms, because untreated infection ascends to cause [[106|pelvic '
        'inflammatory disease]], infertility and ectopic pregnancy.',
    ),
    (
        356,
        (
            'Failure of a testis to descend into the ',
        ),
        'Cryptorchidism is failure of a testis to descend into the scrotum, affecting '
        '2-4.6% of full-term and up to a third of premature boys, with a third to a '
        'half descending spontaneously by about 3 months. Bilateral nonpalpable testes '
        'must prompt exclusion of congenital adrenal hyperplasia, and orchiopexy '
        'between 6 and 18 months best preserves fertility and lowers cancer risk.',
    ),
    (
        363,
        (
            'The line between normal infant spitting ',
        ),
        'Gastroesophageal reflux is physiologic and near-universal in infants, becoming '
        'gastroesophageal reflux disease only when it causes troublesome symptoms or '
        'complications, which affects 10-20% of infants and 5-8% of older children. '
        'Regurgitation peaks at 3-4 months and resolves in over 80% by 18 months, so '
        'treatment starts with smaller thickened feeds and positioning before acid '
        'suppression.',
    ),
    (
        365,
        (
            'Streptococcus agalactiae infection in ne',
        ),
        'Group B Streptococcus colonizes the genital tract of 15-35% of pregnant women '
        'and is the source of most infant infection, causing early-onset disease within '
        'the first 24 hours with respiratory distress and shock, or late-onset disease '
        'at 3-4 weeks with bacteremia and meningitis. Intrapartum prophylaxis has cut '
        'early-onset disease by 85% but has not reduced late-onset disease.',
    ),
    (
        367,
        (
            'The moderate stage of the pediatric heat',
        ),
        'Heat exhaustion is the moderate stage of the heat illness continuum, with a '
        'core temperature of 37.7-40°C and weakness, headache, nausea and orthostasis '
        'but little CNS dysfunction, arising from water depletion, salt depletion or '
        'both. Children are more vulnerable than adults, and treatment is rest in a '
        'cool place with cooling and electrolyte rehydration before it progresses to '
        '[[295|heat stroke]].',
    ),
    (
        373,
        (
            'From common obesity-associated insulin r',
        ),
        'Insulin resistance is reduced tissue responsiveness to insulin, most often '
        'from obesity in children, with acanthosis nigricans present in over 60% of '
        'those whose BMI exceeds the 98th percentile and about half of severely obese '
        'children affected. Rare INSR mutations cause severe syndromes such as Donohue '
        'and Rabson-Mendenhall, while treatment remains lifestyle change since '
        'metformin is not yet recommended.',
    ),
    (
        374,
        (
            'A functional gut-brain disorder causing ',
        ),
        'Irritable bowel syndrome is a disorder of gut-brain interaction affecting up '
        'to 3% of school-aged children, causing recurrent crampy abdominal pain with '
        'altered bowel habits but no structural damage. Rome IV requires pain at least '
        '4 days a month for 2 months without alarm features, and affected children stay '
        'well, which distinguishes it from inflammatory bowel disease and celiac '
        'disease.',
    ),
    (
        382,
        (
            'The most severe form of spina bifida — a',
        ),
        'Myelomeningocele is the most severe form of spina bifida, an open neural tube '
        'defect from failed caudal closure in the third gestational week, most often '
        'lumbar, and recurrence risk is 3-4% after one affected child. Nearly all cases '
        'have a Chiari II malformation causing hydrocephalus in 80-85%, and deficits '
        'follow the neurologic level, needing lifelong multidisciplinary care.',
    ),
    (
        384,
        (
            'Involuntary nighttime bedwetting past th',
        ),
        'Nocturnal enuresis is involuntary bedwetting at least twice a week for 3 '
        'months in girls over 5 and boys over 6, affecting about 15% of 5-year-olds and '
        'resolving spontaneously at roughly 15% a year. Fewer than 5% have an organic '
        'cause, family history predicts strongly, and behavioral measures with alarm '
        'therapy are first-line before medication.',
    ),
    (
        388,
        (
            'The classic gene-environment metabolic d',
        ),
        'Phenylketonuria is the classic gene-environment disease, in which '
        'phenylalanine hydroxylase deficiency causes irreversible brain damage by 8 '
        'weeks only when dietary phenylalanine is present, so a child identified early '
        'and kept on a restricted diet develops normally. Newborn screening detects '
        'nearly all of the roughly 1 in 10,000-20,000 affected infants, and untreated '
        'disease causes microcephaly, seizures and severe intellectual disability.',
    ),
    (
        389,
        (
            'NF1: the 2-of-7 clinical diagnostic crit',
        ),
        'Neurofibromatosis type 1 is the most common neurocutaneous disorder, affecting '
        'about 1 in 3,000, caused by loss-of-function NF1 mutations, half inherited and '
        'half sporadic. Diagnosis needs two of seven criteria led by six or more '
        'cafe-au-lait macules, most children qualify by 8-10 years, and complications '
        'include optic pathway glioma in 15-20% and [[114|learning disability]] in '
        '30-60%.',
    ),
    (
        390,
        (
            'The most common endocrine disorder of re',
        ),
        'Polycystic ovary syndrome is the most common endocrine disorder of '
        'reproductive-age women, affecting about 10% of adolescent females and often '
        'first presenting in adolescence with menstrual irregularity and '
        'hyperandrogenism. Ovarian ultrasound criteria do not apply to teenagers '
        'because normal adolescent ovaries look polycystic, and management centers on '
        'lifestyle change, since 5-10% weight loss meaningfully improves symptoms.',
    ),
    (
        392,
        (
            'The minority of concussed children whose',
        ),
        'Persistent postconcussion symptoms affect the minority of concussed children '
        'whose somatic, cognitive, emotional and sleep symptoms last beyond 28 days, '
        'when most sport-related concussions resolve within 7-10 days. Initial symptom '
        'burden is the strongest predictor, and management is graduated return to '
        'school and sport, since a second impact before full recovery risks permanent '
        'disability or death.',
    ),
    (
        397,
        (
            'From toddlers who accidentally swallow h',
        ),
        'Substance intoxication is accidental in about 97% of pediatric cases, peaking '
        'in the second year of life with 85% occurring under age 5, while ingestions in '
        'adolescents are largely intentional. Alcohol is the substance most often '
        'abused by young people, and management is airway, breathing and circulation '
        'first, then identifying the agent and giving an antidote if one exists.',
    ),