General Pediatrics and Well-Child Care
Core concepts
Well-child care is a schedule plus a set of screens. Know the visit rhythm (newborn, 1, 2, 4, 6, 9, 12, 15, 18 months, then annually), the growth-chart logic (plot, then interpret velocity rather than a single point), and the developmental surveillance milestones that trigger formal testing. Immunization schedules, lead and anemia screening, vision/hearing screening, and dental referral are high-yield. Understand the difference between screening (applied to everyone) and diagnostic testing (applied to those who screen positive).
Traps
Questions love the child who is growing along a low percentile (normal if velocity is preserved) versus one who crosses two major percentile lines (concerning). Another trap is mistaking a normal variant - genu varum in a toddler, flat feet, physiologic phimosis - for pathology. Anticipatory guidance questions test whether you counsel safety (car seats, water temperature, choking) before the age where the risk appears, not after.
Worked example
A 9-month-old has weight at the 50th percentile and length at the 10th, but at 15 months weight has fallen to the 15th and length to the 3rd. The absolute numbers are unremarkable; the crossing of centiles is the finding. That pattern mandates a feeding history, a review for chronic illness (renal, cardiac, GI), and a growth-velocity reassessment rather than reassurance.
Rule of thumb
Plot at least two points before you interpret growth; a single measurement tells you where a child is, not where the child is going.