Pediatrics Exam Review: Examination, Development & Common Pediatric Disorders for Physician Assistants

Prepare for your physician assistant certification exam with this focused review of pediatric examination, development, and common pediatric disorders from A Comprehensive Review for the Certification and Recertification Examinations for Physician Assistants by Claire Babcock O'Connell and Thea Cogan-Drew. This summary highlights key assessment techniques, developmental milestones, newborn care, metabolic and chromosomal disorders, immunization guidelines, and adolescent health.

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Examination of the Newborn

• Apgar Score: Evaluates newborn status at 1, 5, and 10 minutes on heart rate, respiratory effort, muscle tone, reflex irritability, and color.
• New Ballard Score: Assesses neuromuscular and physical maturity including skin, lanugo, plantar surface, breast, eyes/ears, and genitalia.
• Physical Examination: Includes comprehensive assessment of skin, head, eyes, ears, nose, mouth, neck, chest, heart, abdomen, genitalia, and neuro function.

Common Problems in the Term Newborn

• Hypoglycemia: Blood glucose <40 mg/dL; managed with feeding or IV glucose.
• Neonatal Jaundice: Elevated bilirubin levels; monitored closely to prevent kernicterus.
• Respiratory Distress: Includes transient tachypnea, respiratory distress syndrome, meconium aspiration syndrome.

Developmental Milestones and Disorders

• Well-Child Exams: Assess motor, language, cognitive, and social development.
• Milestones: Provided for ages birth to 5 years, 6 to 10 years, and Tanner staging for adolescents.
• Developmental Disorders: Speech/language delay, ADHD, intellectual disability, spina bifida, cerebral palsy.

Inborn Errors of Metabolism & Chromosomal Abnormalities

• Newborn Screening: Tests for PKU, congenital adrenal hyperplasia, galactosemia, hypothyroidism.
• Chromosomal Abnormalities: Down syndrome, Klinefelter, Turner syndrome, Fragile X syndrome.
• Dysmorphic Syndromes: Marfan syndrome, Ehlers-Danlos syndrome, fetal alcohol syndrome, osteogenesis imperfecta.

Growth Concerns & Nutritional Disorders

• Failure to Thrive (FTT): Weight below 5th percentile or crossing two major percentiles downward.
• Growth Delay: Differentiate familial short stature, constitutional delay, growth hormone deficiency.
• Nutritional Disorders: Vitamin deficiencies, iron deficiency anemia, obesity.

Immunization Schedules

• Recommended immunizations for ages 0 to 18, emphasizing combination vaccines where possible.

Pediatric Poisonings & Common Disorders

• Pediatric Poisonings: Majority in children under 5; common toxidromes highlighted.
• Common Disorders: Functional murmurs, infectious diseases, foreign body management.

Caring for Adolescents

• Adolescent Health: Screen hearing, vision, scoliosis, mental health; obtain social, behavioral, educational histories.

Glossary of Key Terms

• Apgar Score: Newborn health assessment tool.
• New Ballard Score: Maturity assessment of newborns.
• Failure to Thrive (FTT): Poor growth in children under 2 years.
• Developmental Milestones: Age-specific skills acquisition.
• Tanner Stages: Physical development scale during puberty.
• Hypoglycemia: Low blood sugar, critical in neonates.
• Kernicterus: Brain damage from severe jaundice.
• Mongolian Spots: Benign pigmented birthmarks.

Conclusion: Key Takeaways for Pediatric Exam Success

Master essential pediatric knowledge including newborn examination, growth and development milestones, common disorders, immunizations, and adolescent care to excel on your physician assistant certification exams and clinical practice.

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