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Parents often seek medical assistance for ADHD when children enter school and are having a hard time keeping up with class work.

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One of the key challenges of writing a textbook of diagnostic medicine is to balance the "bottom up" approach of constructing a differential diagnosis from individual clinical findings, and the "top down" approach of learning the key features pertaining to a particular diagnosis.

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Signs of peritonitis, such as abdominal rigidity, distention, and guarding, need to be reported immediately so that medical or surgical intervention can be initiated.

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The condition may be congenital, acquired traumatic , or esophageal.