Pediatrics: Growth, Development, and Age-Specific Disease
Pediatrics rewards knowing normal variation. Many questions describe a finding that is physiologic at one age and pathologic at another. Anchor your knowledge in growth charts, developmental milestones, immunization schedules, and feeding/nutrition.
High-yield areas
- Neonatology: jaundice timing (physiologic vs pathologic vs breast-milk), sepsis risk factors, and respiratory distress.
- Respiratory: bronchiolitis is clinical; croup has stridor and responds to steroids; epiglottitis is an airway emergency.
- Gastroenterology: dehydration assessment and ORS; intussusception with red-currant stool and a target sign; pyloric stenosis with projectile vomiting and hypochloremic alkalosis.
- Infections: febrile infant workup depends on age; the younger the infant, the lower the threshold for full sepsis evaluation.
- Development: know red flags such as no social smile by 2 months, no sitting by 9 months, and no walking by 18 months.
Traps
Stems often describe a well-appearing child to tempt over-investigation, or an ill-appearing child to tempt reassurance. Watch for weight-based dosing errors and for questions that confuse physiologic jaundice with pathologic jaundice (appearing within 24 hours is always pathologic). Do not forget that dehydration in children is assessed clinically - capillary refill, mucous membranes, and skin turgor - more than by lab values alone.
Rule of thumb
In a febrile infant younger than 3 months, assume serious bacterial infection until proven otherwise; full evaluation and empiric antibiotics are usually indicated.
Worked example
A 6-week-old with projectile nonbilious vomiting and a palpable olive-shaped mass has pyloric stenosis. Expect hypochloremic, hypokalemic metabolic alkalosis; correct fluids and electrolytes before surgery.