Arab Board Pediatrics Part 1 common mistakes
Arab Board Pediatrics Part 1 · Understand the traps and how to avoid them.
On genetics questions, answering pedigree or inheritance-pattern items by pattern-matching the diagnosis (e.g., 'cystic fibrosis, so autosomal recessive') instead of deriving the genotype from the stated parental phenotypes and offspring ratios.
Candidates memorise disease-to-inheritance associations and skip the actual segregation logic, so they fail items that deliberately give an atypical pedigree or ask for carrier probability rather than the disease name.
What to do instead
For every pedigree item, write out parental genotypes first, then compute offspring probabilities (including the 2/3 carrier rule for unaffected siblings of an affected child in autosomal recessive disease) before naming any disease.
On growth items, interpreting a single plotted point (one weight or height) rather than calculating and interpreting the growth velocity or the crossing of centile lines over time.
Exams present growth charts as static data and candidates read the most recent value only; they have not practised the concept that a falling centile with a normal absolute value is the abnormal finding.
What to do instead
For any growth question, state the centile at each time point, calculate the change over the interval, and classify as normal velocity, centile crossing (red flag) or static short stature before choosing an answer.
On developmental items, judging milestone attainment by the average age alone and labelling a child delayed without applying the standard red-flag thresholds (e.g., no social smile by 2 months, no sitting without support by 9 months, no single words by 16-18 months).
Average ages are over-learned while the limit ages that define delay are under-learned, so candidates call normal variation abnormal or miss genuine delay.
What to do instead
Memorise the limit ages (not averages) for each key milestone and answer by comparing the child's age against the limit age; if the child is between average and limit age, the answer is usually 'reassure and review'.
On neonatal jaundice and sepsis items, choosing management based on the total bilirubin value alone without stratifying by postnatal age in hours and by gestation/risk factors.
Candidates memorise single treatment thresholds and do not use hour-specific nomograms or risk-factor stratification, which is how these items are designed to discriminate.
What to do instead
For every jaundice item, first state the age in hours, gestation and risk factors, then place the value on the hour-specific threshold before selecting phototherapy, exchange or investigation.
On cardiology items, diagnosing a murmur by its location alone rather than systematically describing timing, character, radiation, manoeuvres (handgrip, Valsalva, squatting) and associated pulses.
Candidates shortcut to 'ejection systolic at upper right sternal edge = aortic stenosis' and are then caught by items describing acyanotic lesions with atypical or manoeuvre-dependent findings.
What to do instead
Answer each murmur item by building a five-line description (timing, site, radiation, character, manoeuvres) and matching that description to the lesion before looking at the options.
On respiratory items, treating wheeze in a preschool child as asthma by default without first excluding foreign body, structural airway disease, cystic fibrosis and aspiration using the stated history (onset, unilateral findings, failure to thrive, clubbing).
Asthma is the most rehearsed diagnosis, and candidates under-weight the 'first episode' and 'focal or unilateral findings' clues that the exam deliberately inserts.
What to do instead
For any wheeze item, run a fixed differential checklist (onset, focal signs, growth, systemic features, response to bronchodilator) and only choose asthma when the pattern is recurrent, episodic, widespread and bronchodilator-responsive.
On fluid, electrolyte and nutrition items, calculating a fluid or electrolyte deficit without first classifying the dehydration severity and tonicity from the clinical and biochemical data given.
Candidates jump to a formula (e.g., 4-2-1 maintenance, 5% or 10% deficit) before deciding whether the scenario is isotonic, hyponatraemic or hypernatraemic, and each requires different correction rates and fluids.
What to do instead
Answer in a fixed sequence: classify severity, calculate sodium and tonicity, choose fluid type, then set the correction rate (and explicitly check the maximum sodium correction rate for hypernatraemia) before selecting the option.
On endocrinology items, interpreting a single hormone level without pairing it with the corresponding trophic hormone or the dynamic test result (e.g., low cortisol with low ACTH, or a glucose and insulin pair).
Candidates recall isolated reference values and forget that endocrine diagnosis depends on axis relationships and provocative testing, not single numbers.
What to do instead
For every endocrine item, write the axis pair (target hormone plus pituitary hormone) and state whether the pattern indicates primary, secondary or resistance; if a dynamic test is described, interpret the response rather than the baseline.
On haematology items, choosing a diagnosis from a low haemoglobin alone without integrating the red cell indices, reticulocyte count and blood film description provided in the stem.
Anaemia is treated as a single diagnosis rather than a classification problem, so candidates miss the microcytic/hypochromic versus haemolytic versus marrow-failure distinctions the item is testing.
What to do instead
For any anaemia item, classify first by MCV, then by reticulocyte response (hypoproliferative versus regenerative), then match the film findings, and only then select the diagnosis or next test.
On emergency and critical care items, selecting the definitive treatment or investigation before completing the ABCDE stabilisation step that the scenario is actually asking about.
Candidates read the diagnosis (e.g., diabetic ketoacidosis, status epilepticus, anaphylaxis) and jump to the disease-specific drug, ignoring that the question is testing the next immediate priority in a resuscitation sequence.
What to do instead
For every emergency stem, identify the exact question being asked ('next immediate step' versus 'definitive management'), then answer using the ABCDE sequence and the time-critical first-line intervention for that condition.