Pediatrics
Core concepts
Pediatric questions hinge on developmental stage and age-specific norms. Know newborn transition (APGAR, jaundice timing - physiologic after 24 hours, pathologic within 24 hours), feeding and growth expectations, and immunization schedules. Master common respiratory syndromes: bronchiolitis (RSV, wheeze, age under 2), croup (barking cough, stridor, steeple sign), epiglottitis (drooling, tripod posture, do not examine the throat), and asthma. Understand dehydration assessment, gastroenteritis with oral rehydration, and the red-flag rashes (petechiae, nonblanching) that mandate urgent evaluation. Congenital heart disease patterns - cyanotic versus acyanotic, ductal-dependent lesions - are high yield.
Traps
Examiners exploit age cutoffs: bronchiolitis is typically under 2 years, croup 6 months to 3 years, epiglottitis in unimmunized children. A trap is treating viral bronchiolitis with bronchodilators or antibiotics when supportive care is correct. Another is missing dehydration severity because the child looks alert; use weight loss, mucous membranes, tears, and capillary refill together. For murmurs, distinguish innocent (soft, systolic, position-dependent) from pathologic (diastolic, harsh, associated with failure to thrive or cyanosis). Finally, remember that a febrile infant under 3 months requires a different, more aggressive workup than an older child.
Worked rule of thumb
For any pediatric respiratory stem, localize by sound and age. Stridor means upper airway (croup, epiglottitis, foreign body); wheeze means lower airway (bronchiolitis, asthma); grunting means alveolar disease. Then apply the age filter. Example: a 14-month-old with 2 days of rhinorrhea, low-grade fever, wheeze, and retractions in winter - bronchiolitis; treatment is supportive (hydration, oxygen, suctioning), not routine albuterol or antibiotics.