Pediatrics and Child Health
The paediatrics domain tests growth, development, nutrition, immunisation, common infections, asthma and recognition of the sick child in primary care. The examiner expects you to use age-specific norms and to distinguish self-limiting illness from red flags.
Core rules
- Plot weight, length or height and head circumference on the correct chart; crossing centiles matters more than a single value.
- Developmental milestones are approximate; loss of skills is always significant.
- Fever in a neonate under 28 days is an emergency; young infants need lower thresholds for investigation.
- Acute gastroenteritis is managed with oral rehydration solution; do not delay fluids for fear of vomiting.
- Asthma control is assessed by symptoms, reliever use, night waking and exacerbations, not by one examination.
Worked example
A 2-year-old has 2 days of vomiting and diarrhoea, is irritable, has sunken eyes, dry mucous membranes, tachycardia and reduced urine output. The reasoning: this is some dehydration. Give ORS 75 mL/kg over 4 hours in small frequent amounts, continue breastfeeding, give zinc where policy supports it, and reassess. Do not prescribe an antidiarrhoeal or routine antibiotic. Admit if shock, lethargy, persistent vomiting or failure of ORS.
Traps
Using adult fever thresholds; missing weight loss on the chart; prescribing antibiotics for viral upper respiratory infection; and reassuring without a safety-net plan.