Pediatrics: Growth, Development and Common Illness
Core concepts
Focus on growth monitoring, developmental milestones, immunisation schedules, and the high-frequency paediatric presentations: fever, respiratory illness (bronchiolitis, croup, asthma), gastroenteritis and dehydration, otitis media, and neonatal jaundice. Also know red flags for serious illness in a febrile child and the approach to failure to thrive.
Question traps
- Milestones. Questions test the upper limit of normal: social smile by 6–8 weeks, sitting without support by 8–9 months, walking by 18 months, first words by 12–18 months, two-word phrases by 24 months. Delayed walking at 15 months is normal; at 20 months it warrants assessment.
- Dehydration assessment. Clinical signs (capillary refill, skin turgor, mucous membranes, sunken eyes, reduced urine output) drive the classification; weight loss percentage is the objective measure.
- Bronchiolitis vs asthma. Bronchiolitis in infants under 12 months is usually viral (RSV); routine bronchodilators and steroids are not indicated. Asthma diagnosis in children requires reversible obstruction and response to therapy.
- Fever without source. Age matters: a febrile neonate under 28 days needs full sepsis workup and admission regardless of appearance; older infants can be stratified.
- Jaundice timing. Jaundice within 24 hours of birth is always pathological; physiological jaundice peaks days 3–5.
Worked rule of thumb
For any paediatric question, first determine the child's age band (neonate, infant, toddler, school-age). Age band alone often eliminates distractors because normal ranges and management pathways differ sharply.
Communication
Always include parental reassurance and safety-netting advice in the correct answer option; examiners reward holistic options over purely pharmacological ones.