General Pediatrics
Domain focus
General Pediatrics in OEPEDS tests well-child care, growth and development, preventive screening, and common ambulatory problems. Expect milestone interpretation, immunization timing, and recognition of red flags rather than rare syndromes.
Core rules
- Use WHO growth standards for ages 0–2 years and CDC charts for ages 2–20; plot weight, length/height, head circumference, and BMI (age ≥2).
- CDC/AAP developmental milestones are surveillance anchors, not diagnostic thresholds. Loss of skills at any age is abnormal and warrants urgent evaluation.
- AAP recommends autism-specific screening at 18 and 24 months with M-CHAT-R/F; lead screening at 12 and 24 months for Medicaid-eligible or high-risk children, with targeted testing otherwise.
- Newborn screening, hearing screening, and vision screening are preventive-care items; immunization schedules are age-based and have catch-up rules.
Worked example
A 15-month-old has 3 words, does not point, and cannot walk independently. He was saying 5 words at 12 months and has stopped. Reasoning: loss of language is a regression, not “late talking.” Check hearing, perform autism screening, examine tone and reflexes, and refer for early intervention and developmental evaluation. A child with only 3 words at 15 months but no regression still merits hearing and language evaluation; the regression makes it urgent.
Traps
- Reassuring a family that a child will “outgrow” regression or persistent asymmetry.
- Using adult BMI cutoffs in children; use age- and sex-specific percentiles.
- Missing iron-deficiency risk in exclusively breastfed infants after 4–6 months without iron supplementation.