Paediatrics
What you must understand
Paediatrics rewards age-specific normal values. Learn neonatal resuscitation in the order of warmth, positioning, drying, stimulation, then positive pressure ventilation; learn the Apgar components and their timing. Understand neonatal jaundice - physiological versus pathological by onset, rate of rise, and duration - and the indications for phototherapy and exchange transfusion. Know the danger signs in a child that mandate referral, and the integrated management of childhood illness approach.
Master growth and development milestones, and the use of growth charts to detect failure to thrive. Understand dehydration classification and the principles of oral rehydration with zinc in diarrhoea, and the management of severe acute malnutrition. Learn the presentation and management of common respiratory disease - bronchiolitis, croup, asthma - and of febrile seizures, distinguishing simple from complex. Know the immunisation schedule and the concept of herd immunity.
Traps that appear
Questions often present an adult value as normal for a child - respiratory rate, heart rate and haemoglobin all vary with age. Distinguish physiological from pathological jaundice by timing and tempo. In febrile convulsions, distinguish simple from complex by duration, focality and recurrence. Beware of options that treat the fever rather than the cause in an unwell child.
Worked rule of thumb
For any sick child, count breathing, feeding and consciousness first. A child who is not feeding, has fast breathing, or is lethargic has a danger sign and needs referral regardless of the provisional diagnosis. For jaundice, apply the rule: onset within 24 hours, rise faster than expected, or persistence beyond two weeks is pathological until proven otherwise.
Study strategy
Memorise age-banded normal ranges as a table, and rehearse danger signs until they trigger automatically.