Iran Specialty Board - Pediatrics key terms

A rapid 0-10 assessment done at 1 and 5 minutes after birth, scoring heart rate, respiratory effort, muscle tone, reflex irritability, and color; it guides resuscitation response rather than predicting long-term neurologic outcome.

Neonatal lung disease from surfactant deficiency, causing tachypnea, grunting, retractions, and hypoxemia soon after birth, mainly in preterm infants; chest radiograph shows diffuse ground-glass opacity and air bronchograms.

Chronic lung disease of prematurity defined by ongoing oxygen or respiratory support at 36 weeks postmenstrual age, resulting from injury to an immature lung exposed to ventilation, oxygen, and inflammation.

Persistence of the fetal ductus arteriosus after birth, producing a left-to-right shunt with a machinery murmur, bounding pulses, and pulmonary overcirculation; common in preterm infants and treated with fluid restriction, cyclooxygenase inhibitors, or closure.

Yellow discoloration from unconjugated hyperbilirubinemia in the first weeks of life; must be risk-stratified by age in hours to prevent kernicterus, with phototherapy or exchange transfusion for severe cases.

Bilirubin-induced neurologic damage with bilirubin deposition in basal ganglia and brainstem nuclei, causing lethargy, hypertonia, opisthotonus, and later choreoathetoid cerebral palsy and sensorineural hearing loss.

Invasive bacterial infection in the first 28 days, classified as early-onset (within 72 hours, usually acquired perinatally) or late-onset; presents nonspecifically with temperature instability, apnea, and poor feeding, requiring blood culture and empiric antibiotics.

Structured algorithm for newborns needing support at delivery, sequencing warming, airway positioning, stimulation, positive-pressure ventilation, chest compressions, and epinephrine, with emphasis on effective ventilation as the priority.

Noninvasive respiratory support that applies distending pressure through nasal prongs or mask to keep alveoli open, reduce work of breathing, and prevent atelectasis in preterm infants and bronchiolitis.

Endotracheal instillation of exogenous surfactant to reduce alveolar surface tension in respiratory distress syndrome, improving oxygenation and reducing pneumothorax and mortality when given early.

Treatment of neonatal hyperbilirubinemia with blue-green light that converts bilirubin in skin to water-soluble isomers excreted without conjugation; intensity and exposed surface area determine efficacy.

Position of a child's measurement relative to age- and sex-matched references, expressing the percentage of peers below that value; serial percentiles reveal growth velocity better than a single point.

Inadequate weight gain or growth faltering in infancy and childhood, classified as organic or nonorganic; evaluation addresses intake, absorption, increased losses, and psychosocial factors before extensive testing.

Age-specific skills in gross motor, fine motor, language, and social domains used to screen development; loss of previously acquired skills always warrants urgent evaluation.

Neurodevelopmental condition defined by persistent deficits in social communication and restricted, repetitive behaviors, with onset in early childhood; early behavioral intervention improves outcomes.

Neurodevelopmental disorder of inattention and/or hyperactivity-impulsivity that impairs functioning across settings, with symptoms before age 12; stimulants are first-line pharmacotherapy after behavioral approaches.

Predicted adult height calculated from parents' heights (average of parents plus 6.5 cm for boys, minus 6.5 cm for girls), used to judge whether a child's short stature is familial or pathologic.

Feeding only breast milk, without water, formula, or solids, for about the first six months, followed by continued breastfeeding with complementary foods; supports immunity and reduces diarrheal and respiratory illness.

Daily oral vitamin D given to all breastfed infants (typically 400 IU) to prevent nutritional rickets and hypocalcemic seizures, because breast milk contains little vitamin D.

Autosomal recessive deficiency of phenylalanine hydroxylase causing phenylalanine accumulation and intellectual disability if untreated; detected by newborn screening and managed with a low-phenylalanine diet.

Autosomal recessive defect of galactose metabolism, classically galactose-1-phosphate uridyltransferase deficiency, presenting in the neonate with jaundice, vomiting, hepatomegaly, and cataracts; requires immediate lactose and galactose restriction.

Population program using dried blood spots to detect treatable metabolic, endocrine, hematologic, and infectious conditions before symptoms appear, enabling early treatment that prevents irreversible harm.

Defective bone mineralization in growing children, usually from vitamin D deficiency, causing bowing of legs, rachitic rosary, widened wrists, and hypophosphatemia with elevated alkaline phosphatase.

Intrapartum intravenous penicillin for women colonized with group B streptococcus or with risk factors, reducing early-onset neonatal sepsis and meningitis.

Collection of cerebrospinal fluid for cell count, chemistry, Gram stain, and culture; essential in suspected meningitis, including neonates and infants with fever and abnormal behavior.

Infection of the meninges with fever, headache, neck stiffness, and altered consciousness; empiric antibiotics plus dexamethasone are started immediately after culture, without delaying for imaging.

Small white lesions on an erythematous buccal mucosa appearing 1-2 days before the measles rash; they are pathognomonic and mark the infectious period.

Live attenuated vaccine given in two doses in early childhood; contraindicated in severe immunodeficiency and pregnancy, and associated with transient fever and rash rather than autism.

Severe systemic immediate hypersensitivity with airway swelling, bronchospasm, and hypotension after allergen exposure; intramuscular epinephrine is first-line and antihistamines are adjuncts only.

Immune-mediated reaction to milk proteins, causing eczema, vomiting, diarrhea, or blood in stool in infancy; managed with extensively hydrolyzed or amino acid formula, not soy in most cases.

Allergy test placing allergen extract on the skin and pricking through it; a wheal larger than the negative control indicates sensitization, which must be interpreted with the clinical history.

Ultrasound imaging of cardiac structure and function, including shunt direction, valve competence, and ventricular size; the primary noninvasive tool for congenital and acquired heart disease.

The most common congenital heart defect; a left-to-right shunt producing a holosystolic murmur, with large defects causing heart failure and pulmonary overcirculation in early infancy.

Reversal of a long-standing left-to-right shunt to right-to-left flow because of pulmonary vascular disease, causing cyanosis and polycythemia; closure of the defect is then contraindicated.

Viral laryngotracheitis, usually parainfluenza, causing barking cough, hoarseness, and inspiratory stridor; treated with a single dose of dexamethasone and nebulized epinephrine for severe distress.

Viral lower respiratory infection of infants, most often respiratory syncytial virus, with wheeze, crackles, and tachypnea; management is supportive, with oxygen and hydration rather than routine bronchodilators.

Acute supraglottic bacterial infection causing high fever, drooling, muffled voice, and tripod positioning; the airway must be secured by skilled staff and the throat is not examined with a tongue blade.

Autoimmune enteropathy triggered by gluten causing villous atrophy, malabsorption, diarrhea, and growth failure; diagnosis uses tissue transglutaminase IgA with total IgA and confirmatory biopsy.

Hypertrophy of the pyloric muscle causing nonbilious projectile vomiting at 3-6 weeks, with a palpable olive and hypochloremic hypokalemic metabolic alkalosis; corrected before pyloromyotomy.

Telescoping of bowel into itself causing episodic colicky pain, drawing up of legs, and currant-jelly stool; air or contrast enema is both diagnostic and therapeutic if there is no perforation.

Glomerular disease with heavy proteinuria, hypoalbuminemia, edema, and hyperlipidemia; childhood cases are mostly minimal change disease and respond to corticosteroids.

Immune-complex glomerulonephritis 1-3 weeks after streptococcal infection, presenting with hematuria, edema, hypertension, and low complement; management is supportive.

Retrograde urine flow from bladder to ureter predisposing to pyelonephritis and renal scarring; graded by voiding cystourethrography and managed with observation or antibiotic prophylaxis.

Bacterial infection of the urinary tract, in infants often presenting with fever without localizing signs; urine culture is required before treatment, and imaging is considered for young or recurrent cases.

Deficient thyroid hormone at birth, usually from thyroid dysgenesis, causing prolonged jaundice, constipation, and developmental delay if untreated; newborn screening allows early levothyroxine therapy.

Insulin deficiency with hyperglycemia, ketonemia, and acidosis causing vomiting, dehydration, and Kussmaul breathing; managed with isotonic fluids, insulin infusion, and careful monitoring for cerebral edema.

Autoimmune destruction of pancreatic beta cells causing absolute insulin deficiency; presents with polyuria, polydipsia, weight loss, and possibly ketoacidosis, requiring lifelong insulin.

Insufficient pituitary growth hormone causing slow growth velocity and short stature with normal proportions; diagnosed by provocation testing and treated with recombinant hormone.

Microcytic hypochromic anemia from inadequate iron stores, common in infants and adolescents, causing pallor, fatigue, and pica; treated with oral iron and dietary counseling.

Inherited hemoglobin chain disorders causing microcytic anemia; beta-thalassemia major needs transfusions and chelation, while trait is mild and must be distinguished from iron deficiency.

Fever with an absolute neutrophil count below 500 cells per microliter, usually after chemotherapy; requires urgent cultures and empiric broad-spectrum antibiotics because infection can progress rapidly.

The most common childhood malignancy, arising from lymphoid precursors and presenting with pallor, bruising, bone pain, and lymphadenopathy; diagnosis by bone marrow aspirate with flow cytometry.

Seizure with fever in a child aged 6 months to 5 years without intracranial infection; simple ones are generalized and brief, and most require no long-term anticonvulsant.

Continuous seizure activity or recurrent seizures without recovery lasting 5 minutes or more; treated in sequence with benzodiazepines, then second-line anticonvulsants, while airway and glucose are checked.

Nonprogressive motor impairment from early brain injury, classified by tone and limb distribution; associated with epilepsy, visual and hearing deficits, and feeding difficulty requiring multidisciplinary care.

Life-threatening organ dysfunction from dysregulated host response to infection; in children presents with fever or hypothermia, tachycardia, poor perfusion, and altered mentation, requiring fluids and antibiotics within the first hour.

Structured resuscitation sequence for critically ill children using high-quality CPR, weight-based epinephrine and defibrillation, and reversible-cause review, emphasizing early compressions and minimal interruptions.

Clinical estimation of fluid deficit from mental status, mucous membranes, tears, skin turgor, and capillary refill, guiding oral or intravenous rehydration and monitoring for hypernatremia complications.