Health Care of Children and Common Childhood Illnesses
Health Care of Children and Common Childhood Illnesses
This domain tests recognition, home management and prompt referral for the illnesses that cause most child deaths and disability: diarrhoea, pneumonia, fever, measles, malnutrition and skin/eye infections. The exam favours applied questions on danger signs, ORS and when not to give antibiotics.
Core rules
- IMCI danger signs mean urgent referral: unable to drink or breastfeed, convulsions, lethargy/unconsciousness, chest indrawing, stridor, severe dehydration, severe malnutrition.
- Diarrhoea: give ORS and zinc. Low-osmolarity ORS is dissolved in 1 litre of clean water; give small frequent sips. Zinc: 10 mg/day under 6 months, 20 mg/day for 6 months–5 years, for 10–14 days. Continue feeding.
- Pneumonia: fast breathing thresholds are 50 breaths/min for 2–12 months and 40/min for 1–5 years; chest indrawing is severe. Count for a full minute when the child is calm.
- Fever: treat the child, not the thermometer. Paracetamol is dosed by weight; do not give aspirin to children.
- Measles: vitamin A is given; watch for complications such as pneumonia, diarrhoea and eye infection.
- Do not give antibiotics for simple viral upper respiratory infection or watery diarrhoea.
Worked example
A 10-month-old has watery stools 6 times today, is thirsty, drinks eagerly, has sunken eyes and skin pinch returning slowly. Reasoning: two or more signs indicate some dehydration. Plan B: give ORS 75 ml/kg over 4 hours, continue breastfeeding, give zinc, then reassess. If the child cannot drink or has convulsions, refer immediately.
Traps that cost marks
- Recommending antidiarrhoeals or stopping feeds.
- Counting respiratory rate for 15 seconds and multiplying - errors are common.
- Missing severe dehydration because the child is not vomiting.