A guide to success in MBBS study!
Self-written notes based on lecture notes and Uptodate.
The notes cover all materials medical student need to know about paediatrics before they graduate. Detailed coverage on common child diseases (signs and symptoms, investigations, treatment) with convenient t...
Others
Total protein 68 – 84 g/L
Globulin 24 – 36 g/L
CK 260 – 530 U/L
LDH 118 – 221 U/L
ESR ♂ Age / 2 mm/hr
♀ (Age + 10) / 2 mm/hr
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, Illustrate textbook of paediatrics: Normal child development
I. Basic paediatrics knowledge
1. Classification of age
Neonate: < 4 weeks
Infant: < 1 year
Toddler: 1 – 2 years
Young child: 2 – 5 years
Older child: 6 – 9 years
Adolescent: 10 – 19 years (WHO)
2. Respiratory rate in children
Tachypnea in different age groups
• Age < 2 months: > 60 breaths/min
• Age 2 – 12 months: > 50 breaths/min
• Age 1 – 5 years: > 40 breaths/min
• Age ≥ 5 years: > 20 breaths/ min
Age Normal Tachypnea
Neonates < 4 weeks 30 – 50/ min > 60/ min
Infants < 1 year 20 – 30/min > 50/ min
Young child 2 – 5 years 20 – 30/min > 40/ min
Older child 6 – 9 years 15 – 20/min > 30/ min
Age Normal (PEWS)
Infants 1 – 12 months 30 – 50/ min
Toddlers 1 – 3 years old 20 – 40/ min
Pre-school 4 – 6 years old 17 – 33/ min
School age 7 – 12 years old 15 – 30/ min
3. Pulse rate in children
Age Normal
< 1 year 110 – 160/ min
2 – 5 years 95 – 140/min
5 – 12 years 80 – 120/min
> 12 years 60 – 100/min
Age Normal (Uptodate)
0 – 6 months 110 – 180/min
6 months - 1 year 110 – 160/ min
1 – 2 years 90 – 150/min
2 – 5 years 80 – 140/min
5 – 12 years 70 – 120/min
> 12 years 60 – 100/min
4. Blood pressure in children
Age Upper limit of normal of systolic BP
< 1 year 110 mmHg
2 – 5 years 120 mmHg
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,II. Developmental milestones
1. Background
4 fields of developmental function
• Development milestones refers to acquisition of important developmental skills
• Normal pattern for acquisition of skills are
o Sequentially constant
o Varies in rate between children
Median age and limit age
• Median age
o A guide to the pattern to expect in normal development
o Refers to the age when half the population acquire the skill
• Limit age
o A guide to the necessity for further assessment and examination
o Refers to the age when a skill should have been acquired
o Calculated as “Mean + 2 SDs”
Adjustment for preterm infants
• Assessment of development age according to the expected date of delivery
• Correction is no longer required after about 2 years of age when number of weeks early
the child was born no longer a significant proportion of the child’s life
2. Developmental milestones by median age
Age Gross motor Vision and fine Hearing, speech and Social, emotional
motor language and behavioral
7 months Sits without Transfer objects from Turns to voices Puts food into mouth
support one hand to another Polysyllabic babble Fears strangers
1 year Stands Pincer grip 1st meaning word Drinks with a cup
independently Wave bye-bye
15 – 18 Walks Scribble 6 – 10 words Hold spoon and gets
months independently (18 months) food safely to mouth
(12 – 18 months)
2.5 years Runs and jumps Draws 4-word sentence Dry by day
Parallel play
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, III. Hearing
1. Hearing checklist
Time Description Example
Shortly after birth Startles and blinks at sudden noise Slamming of door
By 1 month Notices sudden prolonged sound Vacuum cleaner
By 4 months Smiles to sound of parent’s voices even when it is
out of sight
By 7 months Turns immediately to voices
By 9 months Listens attentively to familiar everyday sound
Searches for quiet sounds out of sight
Show pleasure in babbling loudly and tunefully
By 12 months Respond to own name and other familiar words
Respond when you say “no” or “bye-bye”
2. Hearing screening for newborn infants
Evoked otoacoustic emission (EOAE)
• Advantages
o Simple and quick to perform
• Disadvantages
o Affected by ambient voice
o Not a test of hearing but a test of cochlear function
o Misses auditory neuropathy since CN VIII and brain are not tested
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