Pediatrics and Adolescent Medicine
Core concepts
Pediatric questions reward developmental and age-specific reasoning: weight-based dosing, normal vital sign ranges by age, and immunization schedules. Master milestone surveillance, growth chart interpretation (crossing two major percentile lines is a red flag), and the difference between physiologic and pathologic jaundice in the newborn. Recognize common pediatric infections (otitis media, group A strep pharyngitis, bronchiolitis) and their appropriate-and often supportive-management. Adolescent care emphasizes confidential screening for depression, substance use, and sexual health, plus HPV vaccination.
Traps
- Treating viral bronchiolitis with bronchodilators or antibiotics; supportive care is standard.
- Missing red flags in febrile infants: age younger than 28 days with fever warrants full sepsis evaluation and hospitalization.
- Confusing croup (barking cough, stridor, dexamethasone) with epiglottitis (drooling, tripod positioning, emergency airway).
- Overlooking non-accidental trauma patterns (injury inconsistent with developmental stage).
Worked example / rule of thumb
A 3-month-old with fever of 38.3°C: this age falls in the 29–90 day window requiring urinalysis, blood and urine cultures, and risk stratification (e.g., Rochester/Philadelphia criteria) to decide lumbar puncture and admission. Rule of thumb: younger infants get more testing, not less.
Dosing and safety
Use weight-based dosing (mg/kg) for acetaminophen and ibuprofen, avoid aspirin in children with viral illness (Reye syndrome), and remember that adolescent confidentiality obligations vary by state but generally permit confidential care for STI testing and contraception.