Paediatrics: Development, Assessment and Common Illnesses
What is examined
Paediatric questions test growth and development milestones, nutrition, immunisation, and the recognition of common and serious childhood illness. You must know the principles of paediatric assessment, including age-appropriate vital signs and the importance of weight-based dosing. High-yield topics include bronchiolitis, croup, asthma, gastroenteritis and dehydration, febrile seizures, meningitis, and the recognition of child safeguarding concerns.
Traps and discriminations
- Normal ranges change with age. Heart and respiratory rates are higher in infants; a value normal in an adult may be abnormal in a newborn.
- Dehydration assessment. Use clinical signs such as capillary refill, skin turgor and mucous membranes rather than a single number.
- Fever without focus. Age matters greatly; a young infant with fever needs urgent investigation.
- Croup versus bronchiolitis. Stridor with a barking cough suggests croup; wheeze with distress in an infant suggests bronchiolitis.
- Safeguarding. Unexplained injury patterns, delayed presentation and inconsistent history should prompt concern and referral.
Worked example: the weight-based rule
A child needs a drug dose. Rule of thumb: always calculate from weight in kilograms and check against the maximum adult dose. A common exam trap is a stem giving an adult dose; the correct answer adjusts to weight. If the calculated dose exceeds the adult maximum, the maximum applies.
Development and prevention
Know the key milestones: social smile, head control, sitting, walking and first words, with approximate ages. Immunisation schedules and contraindications are frequently tested. Remember that developmental delay may be isolated or part of a broader picture, and referral thresholds should be applied rather than watchful waiting when red flags exist.