Pediatrics
Core framework
Pediatric questions hinge on development, weight-based dosing, and age-specific normal values. Master neonatal transition and jaundice, breastfeeding and feeding problems, growth and development milestones, immunization schedules, acute respiratory illness (bronchiolitis, croup, pneumonia), gastroenteritis and dehydration, febrile seizures, and the recognition of child maltreatment. Know the danger signs that mandate admission in a child.
Concepts you must own
Neonatal jaundice timing (physiologic versus pathologic versus breastfeeding-related). Dehydration assessment and oral rehydration. Developmental milestones by age in the major domains. Weight-based drug and fluid calculations. The distinction between upper and lower airway obstruction by auscultation and history.
Traps
- Jaundice within 24 hours of birth is always pathologic; timing is the discriminator.
- Bronchiolitis is clinical; routine antibiotics and routine chest radiographs are not indicated.
- Croup versus epiglottitis: barking cough with stridor favors croup; drooling and toxic appearance favor epiglottitis.
- Milestones: use the lower limit of normal, not the average, when deciding if development is delayed.
Worked rule of thumb
For dehydration, estimate the deficit from the clinical picture and replace it plus maintenance, using oral rehydration where possible. A child who is alert with tears and moist mucosa is usually mild; lethargy, sunken eyes, and delayed skin fold indicate severe dehydration needing intravenous therapy. Let the clinical grade drive the route.