Pediatrics

Growth Assessment

Growth Charts (WHO/CDC)

Growth Parameters

class GrowthAssessment:
    """Pediatric growth assessment tools"""
    
    # WHO Growth Standards (0-5 years)
    Z_SCORE_CUTOFFS = {
        "severe_malnutrition": -3,
        "moderate_malnutrition": -2,
        "overweight": 1,
        "obesity": 2
    }
    
    # Mid-parental height calculation
    def mid_parental_height(self, father_cm, mother_cm, sex):
        """
        Calculate target height
        Boys: (Father + Mother + 13) / 2
        Girls: (Father + Mother - 13) / 2
        """
        if sex.lower() == 'male':
            return (father_cm + mother_cm + 13) / 2
        else:
            return (father_cm + mother_cm - 13) / 2
    
    # Growth velocity calculation
    def height_velocity(self, height1, height2, months_between):
        """cm/year"""
        if months_between == 0:
            return 0
        return ((height2 - height1) / months_between) * 12
    
    # BMI calculation and interpretation
    def bmi_percentile(self, weight_kg, height_m, age_years, sex):
        """Calculate BMI and interpret percentile"""
        bmi = weight_kg / (height_m ** 2)
        # In practice, use CDC growth chart lookup
        # Simplified interpretation:
        if bmi < 14:
            return "underweight"
        elif bmi < 23:
            return "healthy weight"
        elif bmi < 28:
            return "overweight"
        else:
            return "obese"

Normal Vital Signs by Age

Developmental Milestones

Gross Motor Development

Fine Motor Development

Language Development

Neonatology

APGAR Score

Neonatal Resuscitation

Initial Steps (first 30 seconds):
┌─────────────────────────────────────────┐
│ 1. Warm, dry, stimulate               │
│ 2. Clear airway if needed              │
│ 3. Assess breathing/cry               │
│ 4. Provide tactile stimulation         │
└────────────────────────────────────────┘
                    ↓
If not breathing:
┌─────────────────────────────────────────┐
│  Positive pressure ventilation        │
│  (PPV with mask or ETT)               │
│  40-60 breaths/min                      │
│  PEEP 5 cmH₂O                          │
└────────────────────────────────────────┘
                    ↓
If HR < 60 after 30 sec PPV:
┌─────────────────────────────────────────┐
│  Chest compressions                    │
│  90 compressions + 30 breaths/min     │
│  Depth: 1/3 chest diameter            │
│  Consider epinephrine                  │
└────────────────────────────────────────┘

Pediatric Diseases

Febrile Neonate Management

Common Pediatric Infections

Asthma Exacerbation Severity

Vaccination

Recommended Immunization Schedule (0-18 months)

Vaccine Abbreviations

Nutrition

Breastfeeding

• Exclusive breastfeeding: Recommended 0-6 months
• Continued breastfeeding: Up to 2 years or beyond
• Vitamin D: 400 IU daily for all breastfed infants
• Iron: Fortified cereal at 6 months

Formula Feeding

• Standard formulas: 20 kcal/oz, cow's milk protein
• Hypoallergenic: Extensively hydrolyzed for CMPA
• Soy: For lactose intolerance
• Premature: Higher protein, higher calorie (22-24 kcal/oz)

Complementary Feeding

Adolescent Health

Tanner Staging

Sexual Health Screening

Common Errors to Avoid

1. Missing critical congenital heart disease — Pulse oximetry screening before discharge
2. Underdosing medications — Always use pediatric dosing, not adult scaled
3. Ignoring growth parameters — Plot all visits on growth chart
4. Missing developmental delays — Use standardized screening tools (M-CHAT, ASQ)
5. Treating viral infections with antibiotics — Most URIs are viral
6. Not considering abuse — Unexplained injuries warrant investigation
7. Ignoring vaccination status — Check at every visit
8. Missing neonatal hypoglycemia — Screen at-risk infants
9. Inadequate fever workup — Age-based approach is critical
10. Not involving adolescents privately — Confidential care improves disclosure