Pediatrics
Pediatrics tests growth and development, dehydration, respiratory distress, neonatal care, immunization, and fever in children. The exam expects weight-based assessment and family-centered communication.
Core rules
- Dehydration: use WHO signs. Severe dehydration includes lethargy, sunken eyes, very slow skin pinch, and inability to drink; treat with Plan C intravenous fluids.
- Acute diarrhea: zinc and oral rehydration salts; antibiotics only for dysentery, cholera-like illness, or specific infections.
- Respiratory distress: count respiratory rate, assess retractions, grunting, and oxygen saturation; give oxygen and treat bronchiolitis or pneumonia appropriately.
- Neonatal jaundice: assess age, bilirubin level, risk factors, and need for phototherapy.
Worked example
A 10-month-old has watery diarrhea, lethargy, sunken eyes, and a very slow skin pinch. This is severe dehydration. Give Ringer's lactate 100 mL/kg: 30 mL/kg in the first hour, then 70 mL/kg over 5 hours for infants under 12 months. Reassess frequently. Reasoning: shock and severe dehydration require intravenous rehydration, not oral fluids alone.
Traps
- Treating severe dehydration with oral rehydration only.
- Giving antibiotics for routine viral diarrhea.
- Using aspirin in febrile children because of Reye syndrome risk.
- Missing sepsis in a neonate with poor feeding and temperature instability.