Pediatrics
Pediatrics tests the integrated management of sick children: respiratory rate, dehydration, neonatal jaundice, malnutrition, and immunization. The exam expects age-specific normal values and rapid recognition of danger signs.
Core rules
- Count respiratory rate for a full minute; thresholds are age-specific (for example, ≥50/min in infants 2–11 months).
- Lower chest indrawing with cough or difficult breathing classifies severe pneumonia; give oxygen and antibiotics and refer.
- Assess dehydration and give oral rehydration solution unless shock or severe dehydration requires IV fluids.
- Newborn jaundice appearing in the first 24 hours is always pathological.
Worked example
An 18-month-old has cough for 2 days, respiratory rate 58/min, lower chest indrawing, and no stridor. This is severe pneumonia. Give oxygen, start ampicillin plus gentamicin, check blood glucose, and refer. Do not send home on an oral antibiotic; the child needs inpatient care. Reassess after 48 hours if admitted.
Traps
- Counting respiratory rate for 15 seconds and multiplying, which overestimates or underestimates.
- Giving cough suppressants or antihistamines to young children.
- Missing hypoglycemia in a lethargic child with malnutrition.
- Using adult BP or respiratory thresholds for children.