Pediatrics and Adolescent Medicine
What candidates must know
Paediatric primary care is dominated by growth, development, immunisation and the recognition of the sick child. Understand the immunisation schedule and catch-up logic, growth-chart interpretation (crossing centiles is more concerning than a single low point), developmental milestones by age, and the traffic-light system for febrile children (green/amber/red) that guides whether to manage at home, refer urgently, or admit. Know the common respiratory and ENT presentations (bronchiolitis, croup, otitis media, asthma), gastroenteritis with dehydration assessment, and the adolescent consultation - confidentiality, consent, and screening for mental health, substance use and sexual health.
Traps in questions
- Age-specific norms: normal respiratory and heart rates fall with age; a "normal adult" rate may be abnormal in an infant.
- Bronchiolitis vs asthma: bronchiolitis (usually <1 year, RSV) is not treated with salbutamol or steroids - supportive care is the answer.
- Dehydration grading: use clinical signs (capillary refill, skin turgor, mucous membranes, eyes, behaviour) rather than a single measure.
- Adolescent consent: a competent minor can consent to confidential care in many frameworks; questions test the principle, not a single jurisdiction.
- Over-investigation: not every fever needs bloods; the traffic-light assessment drives the decision.
Rule of thumb
"Sick or not sick?" precedes "what is the diagnosis?" If a child is lethargic, has a non-blanching rash, grunting, or poor perfusion, escalate immediately regardless of the provisional label.
Worked example
A 6-month-old with 2 days of coryza, mild wheeze, subcostal recession, feeding 75% of normal, SpO2 94%. This is bronchiolitis with mild–moderate distress: supportive care, ensure hydration, safety-net advice, and review - not routine antibiotics or bronchodilators.