NExT Pediatrics including Neonatology Syllabus

Pediatrics including Neonatology syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Pediatrics including Neonatology in NExT, not a summary of it.

1. 1

   Growth, Development and Nutrition

   4 topics

   • Normal Growth and Anthropometry
     • Growth charts, milestones, developmental delay
   • Protein Energy Malnutrition
     • SAM/MAM, marasmus, kwashiorkor, WHO management
   • Micronutrient Deficiencies
     • Vitamin A, D, iron deficiency
   • Infant and Young Child Feeding
2. 2

   Neonatology

   5 topics

   • Care of the Normal Newborn
     • Essential newborn care, breastfeeding
   • Neonatal Resuscitation
   • Low Birth Weight and Prematurity
     • RDS, apnea, retinopathy of prematurity
   • Neonatal Jaundice and Sepsis
     • Physiological vs pathological jaundice, phototherapy
   • Birth Asphyxia and HIE
3. 3

   Infectious Diseases and Immunization

   4 topics

   • Universal Immunization Program
     • National immunization schedule, Mission Indradhanush
   • Common Childhood Infections
     • Measles, diphtheria, pertussis, tetanus
   • Acute Respiratory Infections and Pneumonia
   • Diarrheal Diseases and ORT
     • Dehydration assessment, IMNCI protocols
4. 4

   Systemic Pediatric Disorders

   5 topics

   • Pediatric Cardiology
     • Congenital heart disease: cyanotic vs acyanotic
   • Pediatric Nephrology
     • Nephrotic syndrome, UTI, AKI
   • Pediatric Hematology and Oncology
     • Anemias, leukemia, lymphoma
   • Pediatric Neurology
     • Seizures, meningitis, cerebral palsy
   • Pediatric Endocrinology and Inborn Errors
5. 5

   Genetics, Emergencies and Adolescent Health

   3 topics

   • Chromosomal and Genetic Disorders
     • Down syndrome, Turner, thalassemia
   • Pediatric Emergencies
     • Shock, status epilepticus, poisoning
   • Adolescent Health and RKSK

Pediatrics including Neonatology flashcards for NExT

25 of 52 cards from the Pediatrics including Neonatology deck — real questions with worked answers.

1. In normal infant growth, by what age does birth weight typically double, triple, and quadruple?

   Doubles by 5 months, triples by 1 year, and quadruples by 2 years.

2. What is the Weech formula to estimate expected weight (in kg) for a child aged 1-6 years?

   Weight (kg) = (Age in years x 2) + 8.

3. At birth the average head circumference is ~35 cm. What is it expected to be at 1 year?

   About 45 cm (increases ~12 cm in the first year: 2 cm/month for 3 months, then ~0.5 cm/month).

4. What anthropometric index defines wasting, and what defines stunting?

   Wasting = low weight-for-height (acute malnutrition); Stunting = low height-for-age (chronic malnutrition).

5. By the IAP classification, what percentage of expected weight-for-age defines Grade III protein energy malnutrition?

   Grade III PEM = 50-60% of expected weight-for-age (Grade IV is <50%).

6. What are the key clinical distinguishing features of kwashiorkor versus marasmus?

   Kwashiorkor: edema, normal/reduced weight, fatty liver, skin/hair changes, apathy. Marasmus: severe wasting, no edema, marked weight loss (<60%), 'old man' facies, alert but irritable.

7. What WHO criteria define Severe Acute Malnutrition (SAM) in children 6-59 months?

   Weight-for-height/length < -3 SD, OR MUAC < 11.5 cm, OR bilateral pitting pedal edema.

8. What are the characteristic eye signs of vitamin A deficiency in order of progression?

   Night blindness -> conjunctival xerosis -> Bitot's spots -> corneal xerosis -> keratomalacia (corneal ulceration/perforation).

9. What is the WHO vitamin A supplementation dose for a child over 1 year with measles or xerophthalmia?

   200,000 IU orally on day 1, day 2, and again after 2-4 weeks (children 6-12 months get 100,000 IU; <6 months 50,000 IU).

10. What are the classic clinical features of vitamin D-deficiency rickets?

    Craniotabes, frontal bossing, rachitic rosary, Harrison's sulcus, widened wrists, bowing of legs (genu varum), delayed dentition/fontanelle closure, hypotonia.

11. Which micronutrient deficiency causes goiter and cretinism, and what is the national prevention strategy?

    Iodine deficiency; prevented by universal salt iodization (iodized salt with min 15 ppm iodine at consumer level).

12. What does WHO recommend regarding initiation and exclusivity of breastfeeding?

    Initiate breastfeeding within 1 hour of birth; exclusive breastfeeding for the first 6 months; continue breastfeeding up to 2 years with complementary feeding from 6 months.

13. What is the difference between colostrum and mature breast milk?

    Colostrum (first 3-4 days) is yellow, rich in immunoglobulins (IgA), protein, vitamin A, and low in fat/lactose. Mature milk is thinner, higher in fat and lactose for energy.

14. At what age should complementary feeding begin and what is the feeding frequency at 6-8 months?

    Begin at 6 months (180 days); 2-3 meals/day at 6-8 months, increasing to 3-4 meals/day at 9-23 months plus snacks.

15. What immediate care steps are given to every normal newborn at birth?

    Dry and provide warmth, ensure clear airway, assess breathing, delayed cord clamping (1-3 min), skin-to-skin contact, initiate breastfeeding within 1 hour, vitamin K injection, eye care.

16. What are the five components of the APGAR score and the score range?

    Appearance (color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), Respiration; each scored 0-2, total 0-10, assessed at 1 and 5 minutes.

17. What dose of vitamin K is given to a term newborn and why?

    1 mg IM at birth (0.5 mg for preterm/LBW) to prevent vitamin K deficiency bleeding (hemorrhagic disease of the newborn).

18. In neonatal resuscitation, within how many seconds should initial steps be completed and the decision to ventilate made?

    The 'Golden Minute' - initial steps, evaluation, and start of ventilation (if needed) should occur within the first 60 seconds.

19. What heart rate threshold indicates the need to start positive pressure ventilation in a newborn, and what rate of PPV is given?

    Start PPV if HR < 100/min or apnea/gasping; ventilate at 40-60 breaths per minute.

20. In neonatal resuscitation, at what heart rate do you start chest compressions, and what is the compression-to-ventilation ratio?

    Start chest compressions if HR < 60/min despite 30 sec of effective PPV; ratio is 3:1 (90 compressions and 30 breaths per minute).

21. Define low birth weight, very low birth weight, and extremely low birth weight.

    LBW < 2500 g; VLBW < 1500 g; ELBW < 1000 g.

22. How is prematurity defined and what are its subcategories by gestational age?

    Preterm = born before 37 completed weeks. Extremely preterm <28 wk, very preterm 28-32 wk, moderate-to-late preterm 32-37 wk.

23. What is the most common cause of respiratory distress in a preterm newborn, and what is its pathophysiology?

    Respiratory Distress Syndrome (hyaline membrane disease) due to surfactant deficiency causing alveolar collapse; treated with antenatal steroids and exogenous surfactant.

24. What bilirubin level/zone of physiological jaundice differentiates it from pathological jaundice in a term newborn?

    Physiological: appears after 24 hr, peaks day 3-5, <15 mg/dL, resolves by 1-2 weeks. Pathological: appears <24 hr, rises >5 mg/dL/day, total >15 mg/dL, conjugated >2 mg/dL, or persists >2 weeks.

25. What is the most common cause of jaundice appearing within the first 24 hours of life?

    Hemolysis - especially Rh isoimmunization, ABO incompatibility, or G6PD deficiency.

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