RACP DWE Paediatrics key terms

A baby in the first 28 days after birth, a period of rapid physiological transition and high vulnerability when many inherited and perinatal conditions first present.

Birth before 37 completed weeks of gestation; the earlier the birth, the greater the risk of respiratory, neurological, feeding and infective complications.

Pauses in breathing lasting 20 seconds or more, or shorter pauses with bradycardia or desaturation, occurring in immature infants because brainstem respiratory control is not yet mature.

Yellow discolouration of skin and eyes from raised bilirubin; common and usually harmless in the first days, but needing urgent assessment when early, rapid or prolonged.

Permanent brain injury from bilirubin depositing in the basal ganglia and brainstem, causing movement disorder, hearing loss and gaze abnormalities in severe untreated neonatal jaundice.

Birth weight below the tenth centile for gestational age, which may reflect constitution or intrauterine growth restriction and increases risk of hypoglycaemia and later metabolic disease.

Low blood glucose in the newborn, especially in growth-restricted, preterm or infant-of-diabetic-mother babies; may be asymptomatic or cause jitteriness, poor feeding, lethargy or seizures.

A population programme testing newborns, usually by heel-prick blood spot, for treatable conditions such as congenital hypothyroidism, cystic fibrosis and metabolic disorders before symptoms appear.

Thyroid hormone deficiency present at birth, often from an absent or ectopic gland; detected by newborn screening and treated early to prevent irreversible intellectual disability.

An inherited enzyme deficiency causing phenylalanine accumulation and brain damage unless a restricted diet is started in infancy; a classic target of newborn screening.

A genetic defect in an enzyme or transporter of intermediary metabolism, often presenting in infancy with vomiting, lethargy, encephalopathy or acidosis after feeding.

A viral lower respiratory infection of infants, usually from respiratory syncytial virus, causing wheeze, crackles and feeding difficulty; management is supportive, with oxygen and hydration.

Viral inflammation of the larynx and trachea in young children producing a barking cough, hoarse voice and inspiratory stridor, treated with corticosteroids and sometimes nebulised adrenaline.

A harsh, high-pitched sound made mainly on inspiration when airflow is turbulent through a narrowed upper airway; persistent or positional stridor needs investigation for structural causes.

The clinical picture of increased work of breathing: tachypnoea, recessions, nasal flaring, grunting and use of accessory muscles, signalling inadequate gas exchange in a child.

A non-invasive method estimating arterial oxygen saturation from light absorption through skin, widely used to grade respiratory illness and guide oxygen therapy in children.

A seizure occurring with fever in a child aged six months to five years without central nervous system infection or prior afebrile seizures; usually brief and self-limiting.

A seizure lasting five minutes or more, or repeated seizures without recovery of consciousness between them, requiring urgent airway support and staged anticonvulsant treatment.

Inflammation of the meninges, usually infective, causing fever, headache, neck stiffness and altered consciousness; in infants signs may be subtle, so urgent lumbar puncture and antibiotics are needed.

Life-threatening organ dysfunction caused by a dysregulated response to infection; in children often recognised by fever or hypothermia, tachycardia, poor perfusion and altered mental state.

Sepsis with circulatory failure, shown by hypotension, prolonged capillary refill, mottled skin and reduced urine output, requiring rapid fluid resuscitation and early antibiotics.

The seconds taken for skin colour to return after firm pressure, usually measured on the sternum or fingertip; prolonged refill suggests poor peripheral perfusion in a sick child.

A scored assessment of eye opening, verbal response and motor response used to grade and monitor consciousness; a paediatric version adjusts the verbal descriptors for young children.

Inadequate physical growth in infancy or childhood, often shown by weight crossing centile lines downward; causes include underfeeding, chronic illness, neglect and malabsorption.

A plotted reference of height, weight and head circumference against age, used to compare a child with population norms and to detect abnormal growth velocity over time.

Height well below the expected range for age and population, which may reflect familial constitution, delayed puberty, growth hormone deficiency or chronic systemic disease.

An immune-mediated reaction to dietary gluten damaging the small bowel, causing diarrhoea, poor growth and anaemia; diagnosed by serology and confirmed by duodenal biopsy.

Impaired uptake of nutrients from the gut, producing chronic diarrhoea, steatorrhoea, weight loss and deficiency of fat-soluble vitamins and iron despite adequate intake.

Telescoping of one bowel segment into the next, usually in infants, causing episodic screaming, vomiting and redcurrant-jelly stool; air or contrast enema is diagnostic and often therapeutic.

Hypertrophy of the pyloric muscle in early infancy causing forceful non-bilious projectile vomiting, visible gastric waves and hypochloraemic alkalosis, corrected before surgical division.

Vomiting of green or yellow-green fluid in a newborn or child, a red flag for intestinal obstruction such as malrotation and volvulus that demands immediate surgical assessment.

A low blood pH with reduced bicarbonate, caused by acid accumulation or bicarbonate loss; in children often signals sepsis, diabetic ketoacidosis or an inborn metabolic disorder.

A metabolic emergency of insulin deficiency with hyperglycaemia, ketosis and acidosis, presenting with vomiting, dehydration and deep breathing; managed with careful fluids and insulin.

Autoimmune destruction of pancreatic beta cells causing absolute insulin deficiency; the commonest childhood diabetes, presenting with polyuria, polydipsia, weight loss or ketoacidosis.

An acute childhood vasculitis causing prolonged fever, rash, mucositis, conjunctivitis and limb changes, with risk of coronary artery aneurysms; treated with intravenous immunoglobulin and aspirin.

The unexpected death of an infant under one year that remains unexplained after investigation; risk is reduced by back sleeping, a smoke-free home and avoiding overheating.

The multi-agency duty to recognise and respond to suspected abuse or neglect in children, including physical, emotional and sexual harm, and to safeguard their welfare.

Physical harm inflicted by a caregiver, suggested by injuries inconsistent with the history or developmental stage, delayed presentation, or characteristic patterns such as metaphyseal fractures.