Pediatrics: Assessment, Dehydration, and Prevention
What this domain tests
Pediatrics tests neonatal adaptation, growth and development, dehydration, respiratory distress, fever, immunization, and common infections. Age-specific normal values and weight-based dosing are frequent sources of marks.
Core rules
- Use the paediatric assessment triangle: appearance, work of breathing, circulation to skin.
- For acute diarrhoea, classify dehydration and use oral rehydration solution when the child can drink; give zinc for 14 days.
- Antibiotics are not routine for watery diarrhoea; they are indicated for dysentery, cholera, and specific infections.
- Neonatal resuscitation follows warmth, position, drying, stimulation, then positive-pressure ventilation if not breathing.
- Do not use aspirin in children with viral illness because of Reye syndrome.
Worked example
A 1-year-old has watery diarrhoea, sunken eyes, a slow skin pinch, and lethargy. This is severe dehydration. Give intravenous Ringer’s lactate or normal saline at 100 mL/kg, reassess frequently, and switch to oral rehydration when stable. Add zinc for 14 days and continue feeding. The reasoning is that lethargy and slow skin pinch indicate severe dehydration, so oral therapy alone is unsafe initially.
Traps
Using adult fluid boluses; withholding feeding; giving antidiarrhoeals; missing hypoglycaemia in a lethargic child; assuming all febrile children need antibiotics; forgetting weight-based drug doses.
Exam strategy
In paediatric vignettes, check age, weight, feeding, urine output, and immunization status before choosing management.