Pediatric and Adolescent Health
Core concepts
Well-child care is dominated by growth, development, and immunization. Know the immunization schedule milestones: hepatitis B at birth, DTaP/IPV/Hib series in infancy, MMR/Varicella at 12–15 months, Tdap and HPV at 11–12, and meningococcal at 11–12 with boosters. Catch-up schedules and contraindications (live vaccines in immunocompromise, severe egg allergy nuances) are high-yield.
Development: track gross motor, fine motor, language, and social milestones; refer early for delays. Autism screening at 18 and 24 months (M-CHAT). Newborn screening, hearing screening, and lead screening at 12 and 24 months (or per risk) are expected. Adolescent care includes depression screening, substance use, sexual health, and anticipatory guidance.
Common high-yield clinical topics: fever in the infant <3 months (full sepsis workup), bronchiolitis (supportive care; no routine bronchodilators or steroids), otitis media (watchful waiting in selected older children), croup (dexamethasone), Kawasaki disease (prolonged fever, conjunctivitis, mucositis, rash, extremity changes - IVIG + aspirin), and intussusception (currant-jelly stool, sausage-shaped mass, ultrasound).
Traps
- Missing serious bacterial illness in a febrile young infant.
- Treating viral bronchiolitis with unnecessary medications.
- Misattributing developmental delay to prematurity without adjusting.
- Forgetting adolescent confidentiality and consent laws.
Rule of thumb
In a febrile infant under 3 months, the answer is a full sepsis evaluation - do not be lulled by a well appearance. In bronchiolitis, supportive care is the answer.