ABP General Pediatrics cheat sheet

WHO growth standards apply from birth to 2 years; CDC growth charts apply from 2 to 20 years, using weight-for-length before age 2 and BMI-for-age after age 2.

Term birth weight averages 2.5–4.0 kg; weight doubles by about 5 months, triples by 12 months, and length increases about 50% by 12 months.

Average head circumference is about 35 cm at birth, 40 cm at 3 months, and 47 cm at 12 months.

Key milestones: social smile 6–8 weeks, head control 3–4 months, sitting unsupported 6–8 months, independent walking 12–15 months, two-word phrases by 24 months.

Red flags: no social smile at 2 months, no head control at 4 months, no sitting at 9 months, no walking at 18 months, no single words at 16 months, no two-word phrases at 24 months.

Tanner staging: breast budding in girls typically begins at 8–13 years; testicular enlargement in boys typically begins at 9–14 years; menarche follows thelarche by about 2–3 years.

Mid-parental height: boys = (father's height + mother's height + 13 cm)/2; girls = (father's height + mother's height − 13 cm)/2; target range is ±8.5 cm.

Stranger anxiety appears at 6–9 months, separation anxiety at 9–18 months, parallel play in toddlers, and cooperative play in school-age children.

Routine schedule: hepatitis B at birth, 1–2 months, and 6–18 months; DTaP at 2, 4, 6, and 15–18 months, then 4–6 years; Tdap at 11–12 years.

MMR and varicella: first dose at 12–15 months, second dose at 4–6 years; IPV at 2, 4, and 6–18 months, then 4–6 years.

Meningococcal conjugate vaccine at 11–12 years with booster at 16 years; HPV series at 11–12 years, may start at 9 years; influenza vaccine annually from 6 months.

Newborn screening blood is collected 24–72 hours after birth; if collected before 24 hours or before adequate feeding, repeat at 1–2 weeks.

Lead screening is risk-based at 9–12 and 24 months and universal for Medicaid-enrolled children; the CDC blood lead reference value is 3.5 mcg/dL, confirmed by venous sample.

Hemoglobin screening for anemia is universal at about 12 months; hearing screening occurs before newborn discharge, and vision screening begins at 3–5 years.

Fluoride supplement dosing when water fluoride is below 0.3 ppm: 0.25 mg/day from 6 months to 3 years; 0.5 mg/day from 3 to 6 years; 1 mg/day from 6 to 16 years.

Injury prevention: rear-facing car seats until age 2 or seat limit; booster seats until 4 ft 9 in and 8–12 years; water heater temperature at or below 120°F; working smoke alarms.

ADHD requires at least six symptoms of inattention or hyperactivity-impulsivity for children under 17, at least five for ages 17 and older, for at least 6 months, in at least two settings, with onset before age 12.

Autism-specific screening occurs at 18 and 24 months; a positive M-CHAT or any loss of language or social skills warrants prompt referral for evaluation.

Depression screening is annual from age 12 years; a positive screen requires direct assessment of suicidal ideation, plan, intent, and access to lethal means.

Mild to moderate pediatric anxiety is treated first with cognitive behavioral therapy; moderate to severe anxiety may require an SSRI such as fluoxetine or sertraline.

Anorexia nervosa medical instability signs include heart rate below 50 beats/min, orthostatic hypotension, temperature below 96°F, dehydration, and rapid weight loss.

Primary nocturnal enuresis is common through age 5; behavioral alarm therapy is first-line for older children, and desmopressin is an alternative.

Encopresis usually involves chronic constipation and overflow incontinence; treatment begins with disimpaction followed by maintenance laxatives and toilet routines.

Autism red flags: no babbling by 12 months, no pointing or gestures by 12 months, no words by 16 months, no two-word phrases by 24 months, or regression at any age.

The pediatric assessment triangle evaluates appearance, work of breathing, and circulation to skin; an abnormal triangle signals immediate need for resuscitation or emergency intervention.

Anaphylaxis: intramuscular epinephrine 0.01 mg/kg of 1 mg/mL concentration, maximum 0.5 mg, in the lateral thigh; repeat every 5–15 minutes if symptoms persist.

Convulsive status epilepticus: lorazepam 0.1 mg/kg IV (maximum 4 mg) or midazolam 0.2 mg/kg IM (maximum 10 mg), then a second benzodiazepine dose if seizures continue.

Septic shock: obtain blood cultures and give broad-spectrum antibiotics within 1 hour; give isotonic fluid boluses of 10–20 mL/kg and reassess for fluid overload.

Croup: dexamethasone 0.15–0.6 mg/kg as a single dose; nebulized epinephrine 0.5 mL of 2.25% or 5 mL of 1:1000 for moderate or severe stridor at rest.

Bronchiolitis management is supportive: suction, hydration, and oxygen for hypoxemia; routine albuterol, corticosteroids, and antibiotics are not recommended.

Diabetic ketoacidosis: give an initial isotonic bolus of 10–20 mL/kg, then start insulin infusion at 0.05–0.1 units/kg/hour; monitor closely for cerebral edema.

Foreign-body airway obstruction: infants under 1 year receive back blows and chest thrusts; children over 1 year receive abdominal thrusts; unconscious children receive CPR.

PECARN head injury rules guide CT use: for children under 2 years, assess altered mental status, skull fracture signs, and severe mechanism; for older children, also assess vomiting and loss of consciousness.

Asthma care is stepwise: short-acting beta agonist for rescue, daily inhaled corticosteroid for persistent asthma, and a written action plan based on green, yellow, and red zones.

Pediatric diabetes target HbA1c is generally below 7%; check HbA1c every 3 months, monitor for hypoglycemia, and test ketones during illness or hyperglycemia.

Cystic fibrosis diagnosis: sweat chloride 60 mmol/L or greater is diagnostic; 30–59 mmol/L is intermediate; newborn screening positive requires diagnostic sweat testing.

Sickle cell disease: penicillin prophylaxis until age 5 years, hydroxyurea for many children, annual transcranial Doppler screening, and urgent evaluation for fever above 38.5°C.

Health care transition planning starts at 12–14 years and includes self-management skills, insurance, adult providers, and updated emergency and guardianship plans.

Children with medical complexity benefit from a medical home, care coordination, emergency care plans, and planned transitions across hospital, home, and community services.

Chronic pain management is biopsychosocial: physical therapy, cognitive behavioral therapy, sleep and school support, and cautious medication use rather than long-term opioids.

Pediatric palliative care addresses symptom burden and goals of care alongside curative treatment; it is appropriate at diagnosis of a serious illness, not only at end of life.

Innocent murmurs are soft systolic murmurs without radiation, have a normal S2, and vary with position; diastolic murmurs, holosystolic murmurs, loud murmurs, or abnormal S2 suggest pathology.

Kawasaki disease: fever for at least 5 days plus at least four of five criteria; treat with IVIG 2 g/kg and aspirin, and obtain echocardiography for coronary artery assessment.

Nephrotic syndrome: heavy proteinuria, hypoalbuminemia, and edema, often with hyperlipidemia; minimal change disease is most common, and corticosteroids are first-line.

Febrile infants younger than 2 months need a full sepsis evaluation including urine, blood, and cerebrospinal fluid studies before antibiotics; urinary tract infection is common.

Ductal-dependent congenital heart lesions often present at 2–3 weeks as cyanosis or shock when the ductus closes; prostaglandin E1 keeps the ductus open.

Simple febrile seizures occur in children 6 months to 5 years, last under 15 minutes, are generalized, and occur once in 24 hours; complex features increase evaluation needs.

Intussusception: intermittent colicky pain, vomiting, currant-jelly stools, and a sausage-shaped mass; air enema is both diagnostic and therapeutic in stable children.

Pyloric stenosis: nonbilious projectile vomiting at 3–6 weeks, hypochloremic metabolic alkalosis, and an olive-shaped mass; ultrasound confirms the diagnosis.

Cerebral edema in diabetic ketoacidosis presents with headache, altered mental status, bradycardia, and hypertension; treat urgently with hypertonic saline or mannitol.

Febrile infant younger than 28 days: full sepsis evaluation with blood, urine, and cerebrospinal fluid cultures, hospital admission, and intravenous antibiotics.

Acute otitis media: high-dose amoxicillin 80–90 mg/kg/day is first-line; observation is appropriate for selected children 6 months and older with nonsevere illness.

Group A streptococcal pharyngitis: penicillin or amoxicillin is first-line; routine testing and treatment are not recommended for children younger than 3 years.

Bacterial meningitis: empiric ceftriaxone plus vancomycin; add ampicillin for neonates and young infants to cover Listeria; dexamethasone with or before the first antibiotic dose for pneumococcal meningitis.

Tuberculosis: latent infection has a positive tuberculin skin test or interferon-gamma release assay without symptoms; active disease requires multidrug therapy and source investigation.

Lyme disease: erythema migrans is diagnosed clinically without serology; doxycycline is effective and short courses are acceptable in young children.

Respiratory syncytial virus bronchiolitis is managed supportively; palivizumab is reserved for high-risk infants such as those with prematurity or congenital heart disease.

Hand-foot-mouth disease is caused by coxsackievirus and enterovirus; treatment is supportive, and children should be excluded only while fever or uncontrolled drooling prevents participation.

HIV screening is recommended at least once for ages 13–64; post-exposure prophylaxis should start within 72 hours of a high-risk exposure.

Informed consent for minors generally comes from parents or guardians; children provide developmentally appropriate assent; emancipated minors may consent for themselves.

Adolescent confidentiality commonly covers sexually transmitted infection care, contraception, and mental health; confidentiality may be limited by danger to self or others, abuse, or statutory reporting.

Mandatory reporting of suspected child abuse or neglect requires reasonable suspicion, not proof; clinicians report to child protective services and document the concern.

Vaccine policy balances individual parental autonomy with herd immunity and child welfare; medical exemptions require a valid contraindication, while nonmedical exemptions vary by jurisdiction.

Social determinants of health include food insecurity, housing instability, transportation barriers, and poverty; screening and referral to community resources are core advocacy functions.

The medical home model provides accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective care.

Resource allocation during shortages uses transparent criteria such as likelihood of benefit, urgency, and life-years saved, while avoiding discrimination based on disability or social worth.

Research involving children requires institutional review board approval, parental permission, and child assent when developmentally appropriate; minimal-risk standards apply.