Pediatrics
Pediatrics tests growth, development, neonatal care, common infections, dehydration, asthma, seizures, and immunisation. The exam expects age-appropriate assessment and recognition of serious illness in children.
Core rules
- Neonatal jaundice: timing matters. Jaundice within 24 hours is pathological; check bilirubin and blood group incompatibility.
- Dehydration: use weight loss, mucous membranes, skin turgor, tears, and capillary refill; oral rehydration is first-line in mild-moderate cases.
- Bronchiolitis: supportive care; do not routinely give bronchodilators, steroids, or antibiotics.
- Febrile seizure: simple if generalised, under 15 minutes, once in 24 hours, with no focal signs.
- Immunisation status and red flags must be documented in every paediatric assessment.
Worked example
An 18-month-old has fever 39°C, a 2-minute generalised tonic-clonic seizure, and is drowsy then recovers. There are no meningeal signs or focal deficits. The reasoning is: this is a simple febrile seizure. Reassure, treat fever, assess hydration and source, and give safety advice. Routine EEG, neuroimaging, and lumbar puncture are not indicated without red flags.
Traps that cost marks
- Missing meningitis because postictal drowsiness is blamed on the seizure.
- Treating bronchiolitis with salbutamol or antibiotics.
- Ignoring jaundice in the first 24 hours.
- Using adult fluid boluses without weight-based calculation.
- Failing to check vaccination status.