Paediatrics
Browse 190 topics in paediatrics.
Absence Seizures (Paediatric)
Absence seizures are generalized onset non-motor seizures characterized by sudden, brief lapses in consciousness (typically 5–20 seconds) without loss of postural tone. They are the hallmark of Childhood Absence...
Achondroplasia
While patients have normal intelligence and a near-normal life expectancy, the condition is associated with significant neurological and orthopaedic complications. The most critical period is infancy, where foramen...
Acute Appendicitis
Acute appendicitis is the most common surgical emergency worldwide, with a lifetime risk of 7-8% and an incidence of app... MRCS exam preparation.
Acute Appendicitis (Paediatric)
Acute appendicitis is the most common surgical emergency in children, affecting approximately 1-8% of children presenting with acute abdominal pain to the emergency department. It has a peak incidence between 10-12...
Acute Bronchiolitis - Paediatric
Bronchiolitis is an acute viral infection of the lower respiratory tract, primarily affecting infants aged 2-12 months. ... ACEM Primary Written, ACEM Primary V
Acute Dehydration - Paediatric
Acute dehydration in children represents a deficit in total body water resulting from fluid losses exceeding intake. It ... MRCPCH exam preparation.
Acute Disseminated Encephalomyelitis (ADEM)
ADEM is predominantly a disease of childhood (median age 5–8 years). The primary clinical challenge is differentiating it from the first presentation of Multiple Sclerosis (MS) or MOG Antibody-Associated Disease...
Acute Epiglottitis
Management is defined by a fundamental safety principle: Secure the Airway First . Any intervention that disturbs the child—including throat examination, venipuncture, or radiological investigation—can precipitate...
Acute Epiglottitis
Acute epiglottitis is a life-threatening inflammatory condition of the epiglottis and supraglottic structures that can p... ACEM Primary Written, ACEM Primary V
Acute Kidney Injury in Children
Acute kidney injury (AKI) in children represents a sudden decline in kidney function characterised by rising serum creat... MRCPCH exam preparation.
Acute Nephritic Syndrome
Acute Nephritic Syndrome is a clinical constellation resulting from inflammatory injury to the glomerulus. It is charact... MRCP exam preparation.
Acute Osteomyelitis (Paediatric)
Acute Haematogenous Osteomyelitis (AHO) is a bacterial infection of the bone marrow, primarily affecting the rapidly growing metaphyses of long bones in children. It represents one of the most important paediatric...
Acute Otitis Media (Child)
Acute Otitis Media (AOM) is an acute bacterial or viral infection of the middle ear , representing one of the most common childhood infections and the leading cause of antibiotic prescriptions in children ....
Acute Respiratory Distress - Paediatric
Acute respiratory distress in children represents increased work of breathing or inadequate ventilation resulting from a... MRCPCH exam preparation.
Acute Rheumatic Fever
Key Facts Definition : Post-infectious inflammatory syndrome following Group A streptococcal pharyngitis, affecting heart, joints, brain, and skin Global Incidence : 8-51 per 100,000 in developing countries; 1-3 per...
Acute Sepsis - Paediatric
Sepsis in children is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.... MRCPCH exam preparation.
Anaesthesia for Pyloric Stenosis
Infantile hypertrophic pyloric stenosis (IHPS) is a medical emergency requiring correction of hypochloraemic hypokalaemic metabolic alkalosis BEFORE surgery - it is NOT a surgical emergency. Presentation is typically...
Anaesthesia for Tonsillectomy
Tonsillectomy presents unique anaesthetic challenges due to the shared airway with the surgeon, risk of post-tonsillectomy haemorrhage (PTH) , and frequent paediatric population. Key considerations include:
Angelman Syndrome
Angelman syndrome (AS) is a rare neurogenetic disorder caused by loss of function of the maternally inherited UBE3A gene... MRCPCH exam preparation.
Asthma - Paediatric
Acute paediatric asthma is a reversible obstructive airway disease characterised by bronchospasm, airway inflammation, a... ACEM Primary Written, ACEM Primary V
Ataxia Telangiectasia
Ataxia telangiectasia (A-T) is a rare autosomal recessive neurodegenerative disorder caused by biallelic pathogenic muta... MRCP, MRCPCH, FRACP exam preparation
Atopic Eczema
The underlying pathophysiology involves a complex interplay of epidermal barrier dysfunction (commonly associated with filaggrin mutations), type 2 immune dysregulation (Th2-predominant response with IL-4, IL-13,...
Autism Spectrum Disorder (ASD)
The global prevalence has increased substantially over recent decades to approximately 1 in 36 to 1 in 100 children , likely reflecting improved awareness, broadened diagnostic criteria (DSM-5), and enhanced...
Bacterial Meningitis - Paediatric
Never delay antibiotics for lumbar puncture - Draw blood cultures, give antibiotics, then perform LP if safe... ACEM Primary Written, ACEM Primary Viva exam
Bartter's and Gitelman's Syndromes
These conditions are distinguished by their site of tubular dysfunction: Bartter's syndrome affects the thick ascending limb of the Loop of Henle (mimics loop diuretics such as furosemide) Gitelman's syndrome affects...
Biliary Atresia
The hallmark presentation is conjugated hyperbilirubinaemia with persistent jaundice beyond the physiological neonatal period, accompanied by acholic (pale) stools and dark urine. Early diagnosis is critical because...
Both Bone Forearm Fracture (Paediatric)
Both bone forearm fractures (BBFF) represent one of the most common fracture patterns in the paediatric population, acco... FRCS Orth exam preparation.
Bronchiolitis in Children
Evidence-based diagnosis and management of acute viral bronchiolitis in infants and young children
Bronchopulmonary Dysplasia (BPD)
Bronchopulmonary Dysplasia (BPD), also known as Chronic Lung Disease of Prematurity (CLD), is the most common serious re... MRCPCH, DCH exam preparation.
Cerebral Palsy
Cerebral palsy (CP) is defined as a group of permanent disorders of movement and posture, attributed to non-progressive ... MRCPCH exam preparation.
Cervical Lymphadenopathy in Children
Cervical lymphadenopathy is one of the most common clinical presentations in paediatric practice, representing a diagnos... MRCPCH exam preparation.
Chiari Malformations
The classification encompasses four types, though Type I and Type II account for the vast majority of clinical presentations:
Chickenpox (Varicella)
Chickenpox (varicella) is a highly contagious primary infection caused by varicella-zoster virus (VZV), a member of the ... MRCPCH, RCPCH Progress Test exam pre
Childhood Asthma
Comprehensive evidence-based guide to diagnosis, acute exacerbation management, and chronic stepwise therapy in paediatric asthma
Cleft Lip and Palate
Cleft Lip and/or Palate (CLP) represents the most common congenital craniofacial anomaly, arising from failure of fusion of the facial prominences during embryogenesis between weeks 4-12 of gestation. The defect...
Clubfoot (Talipes Equinovarus)
Clubfoot, or congenital talipes equinovarus (CTEV), represents one of the most common congenital musculoskeletal deformities, affecting approximately 1-2 per 1,000 live births worldwide. The deformity comprises four...
Coarctation of the Aorta
CoA accounts for 5-8% of all congenital heart disease with an incidence of approximately 4 per 10,000 live births. The condition represents a paradigm of duct-dependent physiology in severe cases: neonates may appear...
Congenital Adrenal Hyperplasia (CAH)
21-Hydroxylase Deficiency (21-OHD) accounts for 95% of all CAH cases and is the most common cause of: Ambiguous genitalia in genetic females (46,XX) Life-threatening salt-wasting crisis in neonates Primary adrenal...
Congenital Diaphragmatic Hernia (CDH)
Congenital Diaphragmatic Hernia (CDH) is a major neonatal surgical emergency characterized by a developmental defect in ... MRCPCH exam preparation.
Congenital Diaphragmatic Hernia (CDH)
CDH is a developmental defect where abdominal contents herniate into the thorax through a defect in the diaphragm, causing pulmonary hypoplasia and pulmonary hypertension. Key anaesthetic principles:
Conjunctivitis
Conjunctivitis is the inflammation of the conjunctiva, the thin transparent mucous membrane that covers the white of the... MRCP exam preparation.
Croup (Laryngotracheobronchitis)
Comprehensive evidence-based guide to croup in children: diagnosis, Westley score, dexamethasone and nebulized epinephrine management for MRCPCH and emergency medicine
Croup (Laryngotracheobronchitis)
Answer: Croup is acute viral laryngotracheobronchitis causing subglottic airway oedema in children aged 6 months to 3 years. Classic triad: barking seal cough, inspiratory stridor, hoarseness. Severity assessed using...
Cystic Fibrosis in Children
Cystic fibrosis (CF) is the most common life-limiting autosomal recessive disorder affecting Caucasian populations, with... MRCPCH exam preparation.
Developmental Dysplasia of the Hip (Child)
Developmental Dysplasia of the Hip (DDH) represents a spectrum of abnormalities affecting the developing hip joint, ranging from mild acetabular dysplasia through subluxation to complete dislocation of the femoral...
Diabetic Emergencies in Children
Comprehensive evidence-based guide to diagnosis and management of diabetic ketoacidosis and hypoglycemia in pediatric patients
DiGeorge Syndrome (22q11.2 Deletion Syndrome)
DiGeorge Syndrome, now more accurately termed 22q11.2 Deletion Syndrome (22q11DS), is the most common chromosomal microd... MRCPCH exam preparation.
Diphtheria
The diphtheria exotoxin is absorbed systemically and causes serious complications including myocarditis (Heart failure, Arrhythmias, Complete Heart Block) and neuropathy (Cranial nerve and peripheral nerve paralysis)....
Down Syndrome (Trisomy 21)
Down Syndrome (DS) is the most common autosomal chromosomal abnormality and the leading genetic cause of intellectual di... MRCPCH, USMLE exam preparation.
Drowning
Key Facts Definition : Respiratory impairment from submersion/immersion in liquid (WHO 2002) Global burden : 236,000 deaths annually; 90% in low- and middle-income countries Primary injury mechanism : Hypoxia from...
Edwards Syndrome (Trisomy 18)
The condition carries a grave prognosis, with an estimated 50-95% of affected fetuses dying in utero, and median survival of liveborn infants ranging from 3-15 days depending on the study population. However, the...
Ehlers-Danlos Syndrome
Ehlers-Danlos Syndromes (EDS) comprise a clinically and genetically heterogeneous group of hereditary connective tissue ... MRCPCH, FRACP exam preparation.
Ewing's Sarcoma
Histologically, Ewing's sarcoma belongs to the Ewing sarcoma family of tumours (ESFT) , characterized as a "small round blue cell tumour" with a pathognomonic molecular signature: the EWSR1-FLI1 fusion gene resulting...
Exomphalos (Omphalocele)
Exomphalos (also known as omphalocele) is a congenital anterior abdominal wall defect in which abdominal contents (bowel, liver, spleen, and occasionally other organs) herniate through the umbilical ring and are...
Factitious Disorder (Munchausen Syndrome)
Factitious Disorder is a complex psychiatric condition characterized by the intentional production, feigning, or exaggeration of physical or psychological symptoms with the primary motivation being to assume the "sick...
Febrile Convulsion (Febrile Seizure) in Children
Febrile convulsions are seizures occurring in children aged 6 months to 5 years, associated with fever (temperature ≥38°... MRCPCH exam preparation.
Febrile Seizures in Children
Comprehensive evidence-based guide to diagnosis, classification, investigation, and management of febrile seizures in the paediatric population
Fetal Alcohol Spectrum Disorder (FASD)
FASD represents the leading preventable cause of intellectual disability in the developed world. There is no known safe level of alcohol consumption during pregnancy — the safest approach is complete abstinence. The...
Foreign Body Airway Obstruction - Paediatric
Immediate Action : If conscious with ineffective cough → Call for help, 5 back blows, 5 chest thrusts (infants: chest thrusts only, no abdominal thrusts). If unconscious → Start CPR, check mouth for visible object...
Foreign Body Aspiration - Acute Upper Airway Obstruction and Bronchoscopy
Foreign body aspiration is the inhalation of objects into the airway, most commonly affecting children aged 1-3 years (peak incidence). It is a life-threatening emergency requiring prompt diagnosis and intervention....
Foreign Body Nasal - Paediatric
Nasal foreign bodies are common paediatric emergencies, peaking at 2-5 years. Immediate airway assessment is critical, e... ACEM Fellowship Written, ACEM Fellow
Fragile X Syndrome (Child)
Fragile X Syndrome (FXS) is the Most Common Inherited Cause of Intellectual Disability and the Most Common Single-Gene Cause of Autism Spectrum Disorder (ASD) . It is an X-Linked Dominant Disorder caused by a CGG...
Freiberg Infraction
Key Facts The Victim : The classic patient is a 14-year-old female athlete (dancer, gymnast, or runner) presenting with insidious onset forefoot pain. The Site : Second metatarsal head in 68% of cases, third...
Gastroschisis
Gastroschisis is a congenital abdominal wall defect characterised by herniation of abdominal viscera through a full-thic... MRCPCH exam preparation.
Greenstick Fracture in Children
A greenstick fracture is an incomplete fracture of long bones unique to the paediatric skeleton, characterized by cortical breach on the tension (convex) side while the compression (concave) side remains intact. The...
Growth Failure (Short Stature)
Comprehensive evidence-based guide to evaluation and management of growth failure in children, covering auxological assessment, differential diagnosis, investigation protocols, and growth hormone therapy indications...
Haemolytic Uraemic Syndrome (HUS)
Haemolytic Uraemic Syndrome (HUS) is a thrombotic microangiopathy (TMA) characterized by the classic triad of:... MRCPCH exam preparation.
Hand, Foot and Mouth Disease (Child)
Hand, Foot and Mouth Disease (HFMD) is a highly contagious viral illness predominantly affecting children under 5 years of age , characterised by the classical triad of painful oral ulcers , vesicular rash on hands...
Head Lice (Paediatric)
Head lice infestation (Pediculosis Capitis) is caused by Pediculus humanus capitis , a small obligate ectoparasitic insect that lives exclusively on the human scalp and feeds on blood. Head lice are extremely common...
Headache in Children
Headache is one of the most common neurological complaints in childhood, affecting up to 75% of children by age 15 years. While parental anxiety frequently centres on the possibility of brain tumours, more than 90% of...
Henoch-Schönlein Purpura (IgA Vasculitis)
Henoch-Schönlein Purpura (HSP), now formally known as IgA Vasculitis (IgAV) , is the most common systemic vasculitis in children , with an incidence of 10-20 per 100,000 children per year. It is a small vessel...
Hirschsprung's Disease
A comprehensive, evidence-based guide to Hirschsprung's Disease covering molecular genetics (RET proto-oncogene), neural crest migration failure, diagnostic approaches including rectal suction biopsy and anorectal...
Hypertrophic Pyloric Stenosis
Examination demonstrating 'olive' mass and gastric peristaltic waves... ACEM Fellowship Written, ACEM Fellowship OSCE exam preparation.
Hypospadias
A comprehensive guide to Hypospadias, covering the classic triad, classification, surgical repair (TIP/Snodgrass urethroplasty), and the 'double diaper' post-operative care technique.
Hypoxic Ischaemic Encephalopathy (HIE)
HIE represents the leading cause of acquired neonatal brain injury worldwide, accounting for 23% of the estimated 2.5 million global neonatal deaths annually and affecting 1-3 per 1000 live births in high-income...
IgA Vasculitis (Henoch-Schönlein Purpura)
IgA Vasculitis (IgAV), formerly known as Henoch-Schönlein Purpura (HSP), is the most common systemic vasculitis in childhood, with an annual incidence of 10-20 per 100,000 children. It is an immune-complex mediated...
Impetigo (Child)
Impetigo is a highly contagious superficial bacterial skin infection that represents the most common bacterial skin infection in children worldwide , with peak incidence in 2-5 year olds . The condition is...
Infantile Seborrhoeic Dermatitis (Cradle Cap)
Infantile seborrhoeic dermatitis (ISD), commonly known as "cradle cap," is a benign, self-limiting inflammatory skin condition affecting infants primarily in the first 3 months of life. It presents characteristically...
Infantile Spasms (West Syndrome)
Infantile Spasms (IS), also known as West Syndrome or Infantile Epileptic Spasms Syndrome (IESS) , is a severe age-specific epileptic encephalopathy predominantly affecting infants between 3-12 months of age . It...
Intraventricular Haemorrhage (Neonatal)
Intraventricular Haemorrhage (IVH), also termed Germinal Matrix Haemorrhage-Intraventricular Haemorrhage (GMH-IVH), repr... MRCPCH exam preparation.
Intussusception - Paediatric
Lethargy as presenting feature: Not just pain—lethargy occurs in 20-30% and may be the first sign... ACEM Primary Written, ACEM Primary Viva exam preparation
Intussusception in Children
Intussusception is the invagination (telescoping) of a proximal segment of bowel (the intussusceptum) into an adjacent d... MRCS, FRCS Paediatric Surgery, MRCPC
Juvenile Idiopathic Arthritis (JIA)
JIA affects approximately 1 in 1,000 children and represents a major cause of chronic disability in the paediatric population. The condition is characterised by chronic synovial inflammation leading to joint pain,...
Kawasaki Disease
The primary concern is the development of coronary artery aneurysms (CAAs) , which occur in 15-25% of untreated cases but can be reduced to less than 5% with prompt treatment using intravenous immunoglobulin (IVIG) 2...
Klinefelter Syndrome
The syndrome results from non-disjunction during parental meiosis, leading to testicular dysgenesis and progressive loss of seminiferous tubule function. The pathognomonic triad comprises hypergonadotropic...
Koehler Disease
Koehler Disease (often spelled Kohler's Disease) is a rare, self-limiting avascular necrosis (osteochondrosis) of the ta... FRCS (Orth) exam preparation.
Laryngomalacia
A comprehensive guide to Laryngomalacia, the most common cause of stridor in infants, covering clinical features, the 'omega-shaped epiglottis', and indications for supraglottoplasty.
Laryngomalacia
Laryngomalacia accounts for 60-75% of all congenital stridor cases. Most infants (90%) have mild disease that resolves s... ACEM Primary Written, ACEM Primary V
Malrotation and Volvulus (Child)
Intestinal malrotation is a Congenital Anomaly of Midgut Rotation and Fixation occurring during embryological development, resulting in an Abnormal Position of the Small and Large Bowel within the abdominal cavity....
Marfan Syndrome (Paediatric)
Marfan Syndrome (MFS) is the most common heritable disorder of connective tissue worldwide, with profound implications for paediatric care. Caused by pathogenic variants in the FBN1 gene encoding Fibrillin-1 , this...
Measles
Clinical Pearls: One of the most contagious diseases known (R0 = 12-18) Koplik spots appear 1-2 days before rash, pathognomonic Rash starts behind ears, spreads cephalocaudally Vitamin A supplementation reduces...
Meckel's Diverticulum
Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, representing a persistent rem... MRCS, MRCPCH exam preparation.
Meconium Aspiration Syndrome
Meconium Aspiration Syndrome (MAS) is a severe respiratory disorder occurring in newborns who have inhaled meconium-stai... MRCPCH exam preparation.
Molluscum Contagiosum (Child)
Molluscum contagiosum is a Common, Benign, Self-Limiting Viral Skin Infection caused by the Molluscum Contagiosum Virus (MCV) , a member of the Poxviridae family. It is characterised by Discrete, Dome-Shaped,...
Monteggia Fracture-Dislocation
A Monteggia fracture-dislocation is a fracture of the proximal third of the ulna with an associated dislocation of the radial head at the proximal radioulnar joint (PRUJ). First described by Giovanni Battista...
Mumps (Child)
Mumps is an acute, highly contagious viral infection caused by the Mumps virus (genus Rubulavirus , family Paramyxoviridae ), characterised clinically by painful, bilateral parotid gland swelling (epidemic parotitis)....
Nappy Rash
The key clinical distinction is between Irritant Dermatitis (which characteristically affects convex surfaces and spares the flexures ) and Candidal Dermatitis (which involves the deep flexures and presents with...
Necrotising Enterocolitis
Necrotising Enterocolitis (NEC) is the most common and devastating gastrointestinal emergency affecting neonates, charac... MRCPCH exam preparation.
Necrotising Enterocolitis
Necrotising enterocolitis (NEC) is a devastating gastrointestinal emergency predominantly affecting premature and very l... MRCPCH exam preparation.
Neonatal Anaesthesia
Fetal circulation physiology - PVR SVR, PDA-dependent lesions, transition challenges Immature organ systems - Low lung compliance, immature cardiac calcium handling, impaired thermoregulation Pharmacokinetic...
Neonatal Emergencies
One-liner : Neonatal emergencies encompass critical conditions in the first 28 days of life requiring urgent ICU intervention, characterised by unique transitional physiology, immature organ systems, and different...
Neonatal Hypoglycaemia
The operational threshold for intervention varies between international guidelines, but the British Association of Perinatal Medicine (BAPM 2017) defines the intervention threshold as less than 2.6 mmol/L (47 mg/dL)...
Neonatal Jaundice
Key Facts Incidence : Visible jaundice in 60% of term and 80% of preterm infants; clinically significant hyperbilirubinaemia requiring treatment in 5-10% Physiological jaundice : Appears after 24 hours, peaks at 3-5...
Neonatal Respiratory Distress Syndrome (RDS)
Comprehensive evidence-based guide to Neonatal Respiratory Distress Syndrome (RDS), covering surfactant biology, respiratory support strategies (CPAP vs mechanical ventilation), surfactant administration techniques...
Neonatal Resuscitation
Neonatal resuscitation affects 2-10 per 1000 live births, with mortality reaching 20-30% without appropriate interventio... ACEM Primary Written, ACEM Primary V
Neonatal Sepsis
Key Facts Global Incidence : EOS affects 0.5-1.0 per 1000 live births in term infants; 10-20 per 1000 in preterm infants Mortality : Overall 10-20%; up to 50% in very low birth weight (VLBW) infants (less than 1500g)...
Neuroblastoma
The clinical spectrum is remarkably heterogeneous, ranging from spontaneous regression in low-risk infants to aggressive metastatic disease in older children. This biological diversity reflects profound differences in...
Newborn Resuscitation
85% of term newborns transition spontaneously within 10-30 seconds of birth; only 10% require any assistance; under 1... ACEM Primary Written, ACEM Primary V
Noonan Syndrome
Unlike Turner syndrome (45,X), which affects only females and predominantly causes left-sided cardiac lesions, Noonan syndrome affects both sexes equally and primarily manifests right-sided cardiac pathology. The...
Oesophageal Atresia & TOF
Gold Standard comprehensive guide to oesophageal atresia and tracheo-oesophageal fistula. Covers Gross Classification (A-E), Waterston and Spitz risk stratification, VACTERL association screening, surgical repair...
Osgood-Schlatter Disease
The pathophysiology involves repetitive microtrauma to the secondary ossification centre of the tibial tubercle, occurring predominantly during activities involving powerful quadriceps contractions such as jumping,...
Osteochondritis Dissecans in Children
Osteochondritis dissecans (OCD) is a localised disorder of subchondral bone characterised by separation of an osteochond... MRCS, FRCS Orth exam preparation.
Osteogenesis Imperfecta (Child)
Osteogenesis Imperfecta (OI) is a heritable connective tissue disorder characterised by bone fragility, resulting from quantitative or qualitative defects in type I collagen. First described by Ekman in 1788 and...
Osteomalacia & Rickets
Osteomalacia and rickets represent a spectrum of metabolic bone disorders characterised by defective mineralisation of b... MRCP exam preparation.
Osteosarcoma
Osteosarcoma is the most common primary malignant bone tumour, accounting for approximately 20% of all primary bone canc... MRCP, MRCS, FRCS Orth, FRACS Orth ex
Otitis Media (AOM and OME)
Otitis Media encompasses a spectrum of inflammatory conditions affecting the middle ear cleft, representing one of the most common reasons for paediatric consultation and antibiotic prescription worldwide. The two...
Paediatric Advanced Life Support (PALS)
Paediatric cardiac arrest differs fundamentally from adult arrest. Most paediatric arrests are asphyxial (respiratory in... ACEM Primary Written, ACEM Primary V
Paediatric Airway Anatomy & Physiology
Paediatric airway management requires understanding of profound anatomical and physiological differences from adults. Infants have a proportionally larger occiput, larger tongue, higher larynx (C3-C4), and...
Paediatric Airway Management
The paediatric airway differs fundamentally from the adult airway in anatomy, physiology, and pathology. Children are NO... ACEM Primary Written, ACEM Primary V
Paediatric Anaesthesia Principles
Paediatric anaesthesia requires understanding of age-related physiological differences . Airway : Large tongue, cephalad larynx (C3-4 vs C4-5 in adults), narrow cricoid (subglottic region), short trachea, prominent...
Paediatric Cardiac Anaesthesia
Understanding circulation patterns - Systemic vs pulmonary blood flow balance, Qp:Qs ratios Shunt physiology - Direction and magnitude affect oxygenation and cardiac output Single ventricle physiology - Series...
Paediatric Cardiac Arrest
Survival depends on early recognition of pre-arrest states (bradycardia, respiratory failure), rapid initiation of BLS w... ACEM Primary Written, ACEM Primary V
Paediatric Respiratory Failure
High-flow oxygen therapy or HFNC (humidified 2 L/kg/min)... CICM Second Part Written, CICM Second Part Hot Case exam preparation.
Paediatric Resuscitation
Evidence-based emergency resuscitation of infants and children in cardiac arrest
Paediatric Sepsis
One-liner : Paediatric sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection in children, characterised by age-specific physiological responses, "cold shock" predominance,...
Paediatric Status Epilepticus
Paediatric SE affects 17-23 per 100,000 children annually with highest incidence in infants <1 year . Febrile seiz... CICM Second Part Written, CICM Secon
Paediatric Trauma
Trauma is the leading cause of death in children 1-14 years, with TBI accounting for 70-80% of trauma-related mortali... CICM Second Part Written, CICM Secon
Paediatric Trauma
Blood volume - 80 mL/kg (neonate) to 70 mL/kg (older child); hypovolaemic shock manifests late TBI management - Age-specific GCS, higher tolerance for hypotension but avoid hypoxia at all costs Hypotensive...
Patau Syndrome (Trisomy 13)
Patau syndrome, also known as trisomy 13, is a severe chromosomal disorder caused by the presence of an additional copy ... MRCPCH exam preparation.
Pediatric Bacterial Meningitis
Comprehensive evidence-based guide to diagnosis and management of bacterial meningitis in neonates, infants, and children - emergency recognition, age-specific pathogens, CSF interpretation, empiric antibiotics, and...
Pediatric Gastroenteritis
Comprehensive evidence-based guide to diagnosis, dehydration assessment, and management of acute gastroenteritis in children
Persistent Pulmonary Hypertension of the Newborn (PPHN)
A comprehensive, evidence-based guide to persistent pulmonary hypertension of the newborn (PPHN), covering pathophysiology of failed circulatory transition, molecular mechanisms, diagnostic criteria including...
Perthes Disease (LCPD)
Legg-Calvé-Perthes Disease (LCPD) is an idiopathic Avascular Necrosis (AVN) of the developing femoral head in children, typically aged 4-8 years. The condition represents a self-limiting disorder characterized by...
Perthes Disease (Legg-Calvé-Perthes Disease)
Legg-Calvé-Perthes disease (LCPD), commonly known as Perthes disease, is an idiopathic avascular necrosis (AVN) of the c... MRCPCH exam preparation.
Pertussis
While pertussis affects all age groups, it poses the greatest threat to young infants, particularly those under 6 months of age who have not completed their primary vaccination series. In this vulnerable population,...
Phimosis and Paraphimosis
Phimosis is the inability to retract the foreskin (prepuce) over the glans penis. It exists on a spectrum from physiological (normal and expected in infants and young children) to pathological (abnormal scarring in...
Pierre Robin Sequence
The primary clinical challenges are upper airway obstruction (UAO) and feeding difficulties , both directly attributable to glossoptosis. PRS can occur as an isolated anomaly (40-50% of cases) or as part of a...
Pneumonia - Paediatric
Tachypnoea is the most sensitive clinical sign of pneumonia: greater than 60/min (below 2 months), greater than 50/mi... ACEM Fellowship Written, ACEM Fellow
Poliomyelitis (Child)
Poliomyelitis (polio) is an acute viral infection caused by poliovirus , a human enterovirus belonging to the Picornaviridae family. While the majority of poliovirus infections are asymptomatic or cause only minor...
Posterior Urethral Valves (PUV)
The condition is increasingly diagnosed antenatally via ultrasound, typically manifesting as bilateral hydronephrosis, a distended thick-walled bladder, dilated posterior urethra (the pathognomonic "keyhole sign"),...
Prader-Willi Syndrome (PWS)
Prader-Willi Syndrome (PWS) is a complex multisystem genetic disorder caused by loss of expression of paternally inherit... MRCPCH, FRACP exam preparation.
Pulled Elbow (Nursemaid's Elbow)
A Pulled Elbow (Radial Head Subluxation) is the most common upper limb injury in toddlers (1-4 years). It involves the Annular Ligament slipping proximally over the radial head and becoming entrapped in the...
Pyloric Stenosis
Infantile Hypertrophic Pyloric Stenosis (IHPS) is the most common cause of gastric outlet obstruction in infants, characterised by progressive hypertrophy and hyperplasia of the pyloric smooth muscle causing...
Pyloric Stenosis
Hypertrophic pyloric stenosis is a condition of acquired gastric outlet obstruction caused by hypertrophy of the pyloric muscle, typically presenting at 3-8 weeks of life with projectile vomiting. Key anaesthetic...
Retinoblastoma
The disease typically presents before the age of 5 years, with a median diagnosis at 18 months in bilateral cases and 24 months in unilateral disease. The critical clinical challenge lies in achieving the optimal...
Retinoblastoma - Ocular Oncology and Intra-Arterial Chemotherapy
Retinoblastoma is the most common primary intraocular malignancy in children , with an incidence of 1 in 15,000-20,000 live births (approximately 300 new cases per year in the USA, 8-10 per year in Australia). It is...
Retinopathy of Prematurity
Key Facts Definition : A disorder of retinal vessel development in preterm infants caused by the interplay of hyperoxia, hypoxia, and growth factors (VEGF/IGF-1). Prevalence : ROP affects approximately 60% of infants...
Reye's Syndrome
The pathognomonic triad consists of: Acute encephalopathy with altered consciousness Hepatic dysfunction without hyperbilirubinaemia (non-icteric hepatopathy) Elevation of serum transaminases and ammonia
Rhesus Isoimmunisation
Comprehensive evidence-based guide to Rhesus D Isoimmunisation and Haemolytic Disease of the Fetus and Newborn (HDFN), covering pathophysiology, Anti-D prophylaxis protocols, Kleihauer testing, MCA Doppler...
Rheumatic Fever
Acute Rheumatic Fever (ARF) is a delayed, non-suppurative, autoimmune sequela of Group A Streptococcus (GAS) pharyngitis. It represents a multisystem inflammatory disorder characterized by migratory polyarthritis,...
Rickets
While nutritional rickets (vitamin D deficiency) accounts for the majority of cases globally, clinicians must recognize genetic and metabolic forms including hypophosphataemic rickets, vitamin D-dependent rickets, and...
Rickets and Osteomalacia
The underlying aetiology is multifactorial but globally dominated by Vitamin D Deficiency (nutritional rickets/osteomalacia), which remains a significant public health problem despite being entirely preventable....
Roseola Infantum
HHV-6 seroprevalence reaches 95% by age 2-3 years in most populations worldwide, establishing roseola as a near-universal childhood infection with lifelong viral latency following primary infection. The infection is...
Rubella (German Measles)
Rubella, also known as German measles, is an acute viral infection caused by the rubella virus , a single-stranded RNA virus of the Togaviridae family. The clinical significance of rubella exists on two distinct...
Safeguarding (Children & Adults)
Safeguarding is the statutory duty to protect the health, well-being, and human rights of individuals (children and vuln... MRCPCH, General Practice exam prepar
Scarlet Fever
The condition manifests with pathognomonic clinical features including Strawberry Tongue (initially white-coated with erythematous papillae, later denuded and beefy-red), flushed cheeks with circumoral pallor ,...
Scoliosis (Child)
Scoliosis is a three-dimensional structural deformity of the spine characterised by:
Scrotal Lumps
The diagnostic approach relies on systematic clinical examination incorporating three cardinal questions: (1) Can you get above the swelling? (2) Is the mass separate from the testis? (3) Does it transilluminate?...
Sepsis - Paediatric
Phoenix Sepsis Score (2024) replaces SIRS: Score 2+ indicates sepsis (respiratory, cardiovascular, coagulation, neuro... ACEM Fellowship Written, ACEM Fellow
Septic Arthritis (Paediatric)
Septic arthritis in children is an orthopaedic emergency requiring immediate diagnosis and surgical intervention. It represents bacterial infection of the joint space that results in rapid, irreversible destruction of...
Shigellosis (Bacillary Dysentery)
Shigellosis is an acute invasive bacterial colitis caused by species of the genus Shigella , manifesting as inflammatory diarrhoea with blood and mucus (dysentery). Distinguished by an extraordinarily low infectious...
Slapped Cheek Syndrome (Fifth Disease/Parvovirus B19)
Slapped Cheek Syndrome (Erythema Infectiosum), historically termed "Fifth Disease" as the fifth described childhood exanthem, is a common viral infection caused by Human Parvovirus B19 (B19V). This small,...
Slipped Capital Femoral Epiphysis (SCFE)
The pathophysiology involves mechanical overload of a weakened physis during the adolescent growth spurt , strongly associated with obesity ( 80% of patients), endocrine disorders (hypothyroidism, growth hormone...
Slipped Upper Femoral Epiphysis (SUFE)
Slipped Upper Femoral Epiphysis (SUFE), also known as Slipped Capital Femoral Epiphysis (SCFE), is a displacement of the... FRCS exam preparation.
Slipped Upper Femoral Epiphysis (SUFE)
The incidence ranges from 0.33 per 100,000 in Asian populations to 50.5 per 100,000 in high-risk populations, with marked ethnic variation. The condition predominantly affects obese males aged 10-16 years, with the...
Soil Transmitted Helminths
A comprehensive, evidence-based guide to the 'Big Three' Soil Transmitted Helminths (Ascaris, Trichuris, Hookworm). Covers detailed life cycles, Loeffler's syndrome, Th2 immunology, Mass Drug Administration (MDA)...
Spina Bifida (Myelomeningocele)
Spina bifida represents a spectrum of neural tube defects (NTDs) arising from incomplete closure of the embryonic neural tube during the fourth week of gestation (days 21-28). The term encompasses a range from...
Splenic Sequestration Crisis
The pathophysiology involves acute vaso-occlusion within the splenic red pulp, trapping erythrocytes and leading to a dramatic reduction in circulating blood volume. Unlike other sickle cell crises, SSC predominantly...
Staphylococcal Scalded Skin Syndrome
Staphylococcal Scalded Skin Syndrome (SSSS) is an acute toxin-mediated exfoliative dermatosis caused by epidermolytic ex... MRCPCH, DCH exam preparation.
Strabismus Surgery - Oculocardiac Reflex, PONV, and Suxamethonium Alternatives
Strabismus surgery (squint surgery) is one of the most common paediatric surgical procedures , correcting misalignment of the eyes by tightening, loosening, or repositioning extraocular muscles. It is typically...
Sturge-Weber Syndrome (SWS)
Sturge-Weber Syndrome (SWS) is a rare, non-hereditary neurocutaneous disorder characterized by the clinical triad of:... MRCPCH, MRCP exam preparation.
Sudden Infant Death Syndrome (SIDS)
SIDS remains the leading cause of post-neonatal death in developed countries, despite dramatic reductions following public health campaigns. The condition represents a diagnostic exclusion—only after comprehensive...
Supracondylar Fracture (Child)
Supracondylar fractures of the humerus are the most common elbow fracture in children, accounting for 50-60% of all paediatric elbow injuries. They typically occur in children aged 5-7 years following a Fall On...
Supracondylar Humerus Fracture (Paediatric)
Supracondylar humerus fractures represent the most common elbow fracture in children, accounting for 50-60% of all paediatric elbow injuries and approximately 3% of all paediatric fractures. These fractures occur in...
Torticollis in Children
Torticollis (derived from Latin tortus meaning "twisted" and collum meaning "neck") is an abnormal posturing of the head and neck characterized by lateral head tilt toward the affected side and chin rotation toward...
Tourette's Syndrome
Tics are sudden, rapid, recurrent, non-rhythmic motor movements or vocalisations that are experienced as irresistible but can be suppressed temporarily. The hallmark feature distinguishing tics from other involuntary...
Tracheo-Oesophageal Fistula (TOF)
TOF is a congenital anomaly where the trachea and oesophagus fail to separate during embryological development, creating abnormal connections. Oesophageal atresia (OA) is usually present. Key anaesthetic principles:
Transient Synovitis (Irritable Hip)
Transient synovitis (TS), colloquially known as irritable hip , is a self-limiting, non-infective inflammatory condition of the hip joint. It represents the single most common cause of acute hip pain and limp in the...
Transient Synovitis (Irritable Hip)
Transient Synovitis, commonly known as "Irritable Hip" or "Observation Hip", is the most common cause of acute hip pain and limp in children aged 3-10 years, with peak incidence at 5-6 years. It represents a benign,...
Transient Tachypnoea of the Newborn (TTN)
Transient tachypnoea of the newborn (TTN) is a common, self-limiting respiratory disorder caused by delayed clearance of... MRCPCH exam preparation.
Tuberous Sclerosis Complex (TSC)
Tuberous Sclerosis Complex (TSC) is an autosomal dominant multisystem genetic disorder caused by mutations in either the... MRCP, FRACP exam preparation.
Turner Syndrome (Child)
Turner syndrome (TS) is a chromosomal disorder affecting phenotypic females, characterised by complete or partial absenc... MRCPCH exam preparation.
Type 1 Diabetes Mellitus
Comprehensive evidence-based guide to Type 1 Diabetes diagnosis, insulin management, technology, and complications
Undescended Testes (Cryptorchidism) (Child)
Undescended testis (UDT), or cryptorchidism, is the most common congenital anomaly of the male genitourinary system, aff... MRCPCH exam preparation.
Undescended Testis (Cryptorchidism)
Undescended Testis (UDT), or Cryptorchidism, is the failure of one or both testes to descend from the retroperitoneum into the scrotum by term gestation. It represents the most common genital anomaly in male neonates...
Urinary Tract Infection (Paediatrics)
Urinary Tract Infection (UTI) is the most common serious bacterial infection in children , accounting for approximately 7 million office visits and 100,000 hospitalizations annually. It ranges from benign lower tract...
Varicella Zoster Virus (Chickenpox & Shingles)
Varicella Zoster Virus (VZV), also known as Human Herpesvirus 3 (HHV-3), is a neurotropic alphaherpesvirus that causes two clinically distinct syndromes separated by decades: varicella (chickenpox) as the primary...
Vesicoureteral Reflux (VUR)
VUR arises from either primary (congenital) abnormalities of the vesicoureteral junction or secondary causes such as increased bladder pressure from posterior urethral valves or neuropathic bladder. The fundamental...
Wilms' Tumour (Nephroblastoma)
The condition has an excellent prognosis with modern multimodal therapy, achieving 5-year survival rates exceeding 90% for localised disease. Treatment involves a coordinated approach of chemotherapy, surgery, and...
Zika Virus Infection
Zika virus (ZIKV) is a mosquito-borne Flavivirus that emerged from relative obscurity to become a major public health concern following massive outbreaks in the Americas from 2015-2016. While Zika virus infection...