PAEDIATRICS
4TH YEAR MEDICINE
Indeera Shankla
, Table of Contents
Table of Contents ................................................................................................................................... 0
Learning Objectives ................................................................................................................................ 5
History Taking & Communication ...................................................................................................................... 5
Examination ..................................................................................................................................................... 6
Recognition and management of the sick child - pRRAPID ............................................................................... 7
Common and/or serious presentations .......................................................................................................... 8
Prescribing ....................................................................................................................................................... 9
Practical Procedures/Investigations ................................................................................................................ 10
Normal Events, Growth & Development ......................................................................................................... 11
Safeguarding .................................................................................................................................................. 12
Legal & Ethical Basis of Child Health ............................................................................................................. 13
Public health/Global health ......................................................................................................................... 14
Governance, patient safety & best practice .................................................................................................. 15
Core Conditions .................................................................................................................................... 16
1. Neonatal & Newborn .................................................................................................................................. 16
Neonatal Jaundice ................................................................................................................................................... 16
Birth Asphyxia/ Hypoxic Ischaemic Encephalopathy .............................................................................................. 17
Birthmarks ............................................................................................................................................................... 18
Cephalhaematoma .................................................................................................................................................. 20
Haemolytic Disease ................................................................................................................................................. 21
Prematurity ............................................................................................................................................................. 22
Respiratory Distress Syndrome ............................................................................................................................... 23
Small baby/ IUGR .................................................................................................................................................... 24
Talipes ..................................................................................................................................................................... 25
2. Infections & Immunity ................................................................................................................................ 26
Immunisation .......................................................................................................................................................... 26
Meningitis ........................................................................................................................................................... 28
Purpura ................................................................................................................................................................ 30
Chicken pox ............................................................................................................................................................. 31
Conjunctivitis ....................................................................................................................................................... 32
Food allergy ......................................................................................................................................................... 33
Infectious mononucleosis ....................................................................................................................................... 34
Kawasaki Disease .................................................................................................................................................... 35
Measles ................................................................................................................................................................... 36
Periorbital Cellulitis ................................................................................................................................................. 37
HIV ........................................................................................................................................................................... 38
Rubella .................................................................................................................................................................... 39
3. Haematology / Oncology ............................................................................................................................ 40
Iron deficiency anaemia .......................................................................................................................................... 40
Brain Tumours .................................................................................................................................................... 41
Haemophilia A .................................................................................................................................................... 43
Haemophilia B ......................................................................................................................................................... 44
Henoch Schönlein purpura ................................................................................................................................. 45
Leukaemia ............................................................................................................................................................... 46
Lymphoma .............................................................................................................................................................. 47
1
, Sickle Cell Anaemia ............................................................................................................................................. 48
Neuroblastoma ................................................................................................................................................... 50
Thalassaemia ........................................................................................................................................................... 51
Wilms tumour ..................................................................................................................................................... 52
4. Cardiovascular System ................................................................................................................................ 53
Innocent murmur .................................................................................................................................................... 53
Congenital Heart Disease ........................................................................................................................................ 54
5. Respiratory System / ENT ........................................................................................................................... 59
Asthma ............................................................................................................................................................... 59
Bronchiolitis ............................................................................................................................................................ 61
Croup .................................................................................................................................................................. 62
Pneumonia ......................................................................................................................................................... 63
Upper Respiratory Tract Infection .......................................................................................................................... 64
Wheeze .............................................................................................................................................................. 65
Cystic Fibrosis ..................................................................................................................................................... 66
Cough ................................................................................................................................................................. 68
Inhaled Foreign Body ......................................................................................................................................... 69
Otitis Media............................................................................................................................................................. 70
Shortness of breath ............................................................................................................................................ 71
Stridor ................................................................................................................................................................. 72
Tuberculosis ....................................................................................................................................................... 73
Whooping cough ................................................................................................................................................ 74
6. Gastrointestinal / Liver ............................................................................................................................... 75
Constipation ........................................................................................................................................................ 75
Gastroenteritis ................................................................................................................................................... 77
Gastro-Oesophageal Reflux Disease ....................................................................................................................... 78
Vomiting ............................................................................................................................................................. 79
Acute Abdominal Pain ............................................................................................................................................. 81
Recurrent Abdominal Pain ...................................................................................................................................... 82
Appendicitis ........................................................................................................................................................ 83
Coeliac Disease ................................................................................................................................................... 84
Feeding problems ............................................................................................................................................... 85
Inguinal hernia ................................................................................................................................................... 86
Intussusception .................................................................................................................................................. 87
Jaundice .............................................................................................................................................................. 88
Mesenteric Adenitis ........................................................................................................................................... 89
Pyloric stenosis ................................................................................................................................................... 90
Torsion of Testicle .............................................................................................................................................. 91
Undescended Testicles ....................................................................................................................................... 92
Biliary Atresia ..................................................................................................................................................... 93
Hepatitis ............................................................................................................................................................. 94
Hirschprung’s Disease ............................................................................................................................................. 95
Inflammatory Bowel Disease ............................................................................................................................. 96
Toddler’s diarrhoea ............................................................................................................................................ 97
2
, Volvulus .............................................................................................................................................................. 98
7. Growth / Endocrine / Metabolic ................................................................................................................. 99
Growth .................................................................................................................................................................... 99
Diabetes Mellitus ............................................................................................................................................. 100
Failure to Thrive ............................................................................................................................................... 103
Disorders of Sexual Development......................................................................................................................... 104
Hypothyroidism ................................................................................................................................................ 105
Obesity ............................................................................................................................................................. 106
Phenylketonuria ............................................................................................................................................... 107
Short Stature .................................................................................................................................................... 108
8. Nervous System........................................................................................................................................ 110
Cerebral palsy ................................................................................................................................................... 110
Febrile Fit .......................................................................................................................................................... 112
Breath holding attacks ..................................................................................................................................... 114
Epilepsies .......................................................................................................................................................... 115
Fits .................................................................................................................................................................... 117
Headache ......................................................................................................................................................... 118
Head Injury ....................................................................................................................................................... 119
Hydrocephalus ................................................................................................................................................. 120
Migraine ................................................................................................................................................................ 121
Plagiocephaly ................................................................................................................................................... 122
Tics ........................................................................................................................................................................ 123
Muscular Dystrophy .............................................................................................................................................. 124
Spina Bifida............................................................................................................................................................ 125
9. Renal / Urinary System ............................................................................................................................. 126
Enuresis and Wetting ........................................................................................................................................ 126
Urinary Tract Infection ...................................................................................................................................... 127
Haematuria ....................................................................................................................................................... 128
Haemolytic Uraemic Syndrome ............................................................................................................................ 129
Nephrotic syndrome ............................................................................................................................................. 130
Glomerulonephritis ............................................................................................................................................... 131
Hypospadias .......................................................................................................................................................... 132
Vulvovaginitis ........................................................................................................................................................ 133
10. Dermatology .......................................................................................................................................... 134
Eczema ............................................................................................................................................................. 134
Impetigo ........................................................................................................................................................... 135
Nappy Rash ....................................................................................................................................................... 136
Stevens Johnsons ............................................................................................................................................. 137
Erythema Nodosum ......................................................................................................................................... 138
Scabies .............................................................................................................................................................. 139
11. Locomotor System .................................................................................................................................. 140
Septic Arthritis....................................................................................................................................................... 140
Developmental Dysplasia of the Hip ................................................................................................................ 141
Irritable hip / reactive arthritis ......................................................................................................................... 142
Juvenile Idiopathic Arthritis ............................................................................................................................. 143
3
4TH YEAR MEDICINE
Indeera Shankla
, Table of Contents
Table of Contents ................................................................................................................................... 0
Learning Objectives ................................................................................................................................ 5
History Taking & Communication ...................................................................................................................... 5
Examination ..................................................................................................................................................... 6
Recognition and management of the sick child - pRRAPID ............................................................................... 7
Common and/or serious presentations .......................................................................................................... 8
Prescribing ....................................................................................................................................................... 9
Practical Procedures/Investigations ................................................................................................................ 10
Normal Events, Growth & Development ......................................................................................................... 11
Safeguarding .................................................................................................................................................. 12
Legal & Ethical Basis of Child Health ............................................................................................................. 13
Public health/Global health ......................................................................................................................... 14
Governance, patient safety & best practice .................................................................................................. 15
Core Conditions .................................................................................................................................... 16
1. Neonatal & Newborn .................................................................................................................................. 16
Neonatal Jaundice ................................................................................................................................................... 16
Birth Asphyxia/ Hypoxic Ischaemic Encephalopathy .............................................................................................. 17
Birthmarks ............................................................................................................................................................... 18
Cephalhaematoma .................................................................................................................................................. 20
Haemolytic Disease ................................................................................................................................................. 21
Prematurity ............................................................................................................................................................. 22
Respiratory Distress Syndrome ............................................................................................................................... 23
Small baby/ IUGR .................................................................................................................................................... 24
Talipes ..................................................................................................................................................................... 25
2. Infections & Immunity ................................................................................................................................ 26
Immunisation .......................................................................................................................................................... 26
Meningitis ........................................................................................................................................................... 28
Purpura ................................................................................................................................................................ 30
Chicken pox ............................................................................................................................................................. 31
Conjunctivitis ....................................................................................................................................................... 32
Food allergy ......................................................................................................................................................... 33
Infectious mononucleosis ....................................................................................................................................... 34
Kawasaki Disease .................................................................................................................................................... 35
Measles ................................................................................................................................................................... 36
Periorbital Cellulitis ................................................................................................................................................. 37
HIV ........................................................................................................................................................................... 38
Rubella .................................................................................................................................................................... 39
3. Haematology / Oncology ............................................................................................................................ 40
Iron deficiency anaemia .......................................................................................................................................... 40
Brain Tumours .................................................................................................................................................... 41
Haemophilia A .................................................................................................................................................... 43
Haemophilia B ......................................................................................................................................................... 44
Henoch Schönlein purpura ................................................................................................................................. 45
Leukaemia ............................................................................................................................................................... 46
Lymphoma .............................................................................................................................................................. 47
1
, Sickle Cell Anaemia ............................................................................................................................................. 48
Neuroblastoma ................................................................................................................................................... 50
Thalassaemia ........................................................................................................................................................... 51
Wilms tumour ..................................................................................................................................................... 52
4. Cardiovascular System ................................................................................................................................ 53
Innocent murmur .................................................................................................................................................... 53
Congenital Heart Disease ........................................................................................................................................ 54
5. Respiratory System / ENT ........................................................................................................................... 59
Asthma ............................................................................................................................................................... 59
Bronchiolitis ............................................................................................................................................................ 61
Croup .................................................................................................................................................................. 62
Pneumonia ......................................................................................................................................................... 63
Upper Respiratory Tract Infection .......................................................................................................................... 64
Wheeze .............................................................................................................................................................. 65
Cystic Fibrosis ..................................................................................................................................................... 66
Cough ................................................................................................................................................................. 68
Inhaled Foreign Body ......................................................................................................................................... 69
Otitis Media............................................................................................................................................................. 70
Shortness of breath ............................................................................................................................................ 71
Stridor ................................................................................................................................................................. 72
Tuberculosis ....................................................................................................................................................... 73
Whooping cough ................................................................................................................................................ 74
6. Gastrointestinal / Liver ............................................................................................................................... 75
Constipation ........................................................................................................................................................ 75
Gastroenteritis ................................................................................................................................................... 77
Gastro-Oesophageal Reflux Disease ....................................................................................................................... 78
Vomiting ............................................................................................................................................................. 79
Acute Abdominal Pain ............................................................................................................................................. 81
Recurrent Abdominal Pain ...................................................................................................................................... 82
Appendicitis ........................................................................................................................................................ 83
Coeliac Disease ................................................................................................................................................... 84
Feeding problems ............................................................................................................................................... 85
Inguinal hernia ................................................................................................................................................... 86
Intussusception .................................................................................................................................................. 87
Jaundice .............................................................................................................................................................. 88
Mesenteric Adenitis ........................................................................................................................................... 89
Pyloric stenosis ................................................................................................................................................... 90
Torsion of Testicle .............................................................................................................................................. 91
Undescended Testicles ....................................................................................................................................... 92
Biliary Atresia ..................................................................................................................................................... 93
Hepatitis ............................................................................................................................................................. 94
Hirschprung’s Disease ............................................................................................................................................. 95
Inflammatory Bowel Disease ............................................................................................................................. 96
Toddler’s diarrhoea ............................................................................................................................................ 97
2
, Volvulus .............................................................................................................................................................. 98
7. Growth / Endocrine / Metabolic ................................................................................................................. 99
Growth .................................................................................................................................................................... 99
Diabetes Mellitus ............................................................................................................................................. 100
Failure to Thrive ............................................................................................................................................... 103
Disorders of Sexual Development......................................................................................................................... 104
Hypothyroidism ................................................................................................................................................ 105
Obesity ............................................................................................................................................................. 106
Phenylketonuria ............................................................................................................................................... 107
Short Stature .................................................................................................................................................... 108
8. Nervous System........................................................................................................................................ 110
Cerebral palsy ................................................................................................................................................... 110
Febrile Fit .......................................................................................................................................................... 112
Breath holding attacks ..................................................................................................................................... 114
Epilepsies .......................................................................................................................................................... 115
Fits .................................................................................................................................................................... 117
Headache ......................................................................................................................................................... 118
Head Injury ....................................................................................................................................................... 119
Hydrocephalus ................................................................................................................................................. 120
Migraine ................................................................................................................................................................ 121
Plagiocephaly ................................................................................................................................................... 122
Tics ........................................................................................................................................................................ 123
Muscular Dystrophy .............................................................................................................................................. 124
Spina Bifida............................................................................................................................................................ 125
9. Renal / Urinary System ............................................................................................................................. 126
Enuresis and Wetting ........................................................................................................................................ 126
Urinary Tract Infection ...................................................................................................................................... 127
Haematuria ....................................................................................................................................................... 128
Haemolytic Uraemic Syndrome ............................................................................................................................ 129
Nephrotic syndrome ............................................................................................................................................. 130
Glomerulonephritis ............................................................................................................................................... 131
Hypospadias .......................................................................................................................................................... 132
Vulvovaginitis ........................................................................................................................................................ 133
10. Dermatology .......................................................................................................................................... 134
Eczema ............................................................................................................................................................. 134
Impetigo ........................................................................................................................................................... 135
Nappy Rash ....................................................................................................................................................... 136
Stevens Johnsons ............................................................................................................................................. 137
Erythema Nodosum ......................................................................................................................................... 138
Scabies .............................................................................................................................................................. 139
11. Locomotor System .................................................................................................................................. 140
Septic Arthritis....................................................................................................................................................... 140
Developmental Dysplasia of the Hip ................................................................................................................ 141
Irritable hip / reactive arthritis ......................................................................................................................... 142
Juvenile Idiopathic Arthritis ............................................................................................................................. 143
3
