Introduction

Pediatric Medicine is the branch of medicine focused on the health, development, and diseases of infants, children, and adolescents (birth to 18 years). Pediatricians address physical, behavioral, and mental health issues unique to this population.

Key Concepts

1. Growth & Development

  • Physical Growth: Tracking height, weight, head circumference.
  • Developmental Milestones: Motor skills, language, social interaction.
  • Puberty: Hormonal changes, sexual maturation.

2. Preventive Care

  • Vaccinations: Schedule per CDC/WHO guidelines.
  • Well-child Visits: Monitoring growth, development, and early detection.
  • Nutrition: Age-appropriate dietary recommendations.

3. Common Pediatric Diseases

  • Infectious Diseases: Measles, mumps, chickenpox, RSV, influenza.
  • Chronic Conditions: Asthma, diabetes (Type 1), congenital heart defects.
  • Genetic Disorders: Cystic fibrosis, Down syndrome, sickle cell disease.

4. Pediatric Pharmacology

  • Dosing: Weight-based calculations.
  • Adverse Effects: Unique responses due to immature organ systems.
  • Drug Formulations: Liquid, chewable, dissolvable for ease of administration.

Anatomy & Physiology Differences

Feature Pediatric Patients Adult Patients
Airway Size Smaller, more collapsible Larger, less collapsible
Heart Rate Higher Lower
Kidney Function Immature Mature
Body Water Percentage ~75% ~60%
Immune System Developing Fully developed

Unique Pediatric Considerations

  • Communication: Use age-appropriate language, involve caregivers.
  • Consent: Parental/legal guardian consent required except in emergencies.
  • Psychosocial Factors: Family dynamics, school, peer influence.

Diagram: Pediatric Growth Chart

Pediatric Growth Chart

Case Studies

Case 1: Infant with Fever

  • Presentation: 6-month-old with 38.5°C fever, irritability, poor feeding.
  • Differential Diagnosis: Viral infection, urinary tract infection, meningitis.
  • Management: Blood/urine cultures, lumbar puncture if indicated, empiric antibiotics.

Case 2: Asthma Exacerbation in a Child

  • Presentation: 8-year-old with wheezing, shortness of breath, cough.
  • Treatment: Inhaled bronchodilators, corticosteroids, oxygen therapy.
  • Prevention: Education on triggers, regular medication adherence.

Case 3: Adolescent with Type 1 Diabetes

  • Presentation: 14-year-old with polyuria, polydipsia, weight loss.
  • Diagnosis: Elevated blood glucose, positive autoantibodies.
  • Management: Insulin therapy, dietary counseling, psychosocial support.

Table: Common Pediatric Vaccines & Age Recommendations

Vaccine First Dose Booster Dose(s) Notes
Hepatitis B Birth 1-2, 6-18 months Prevents liver disease
DTaP (Diphtheria, Tetanus, Pertussis) 2 months 4, 6, 15-18 months; 4-6 yrs Prevents respiratory illness
MMR (Measles, Mumps, Rubella) 12-15 months 4-6 years Live vaccine
Varicella (Chickenpox) 12-15 months 4-6 years Live vaccine
Polio (IPV) 2 months 4, 6-18 months; 4-6 yrs Eradicated in many regions

Surprising Facts

  1. Children are not just “small adults”: Their bodies metabolize drugs, respond to illness, and heal differently due to ongoing development.
  2. Water Cycle Connection: The water you drink today may have been drunk by dinosaurs millions of years ago, as Earth’s water is constantly recycled and has existed for billions of years.
  3. Neonatal Resilience: Newborns can survive significant hypoxia (low oxygen) during birth, far better than adults, due to fetal hemoglobin and unique circulatory adaptations.

Recent Research

A 2022 study published in JAMA Pediatrics found that early-life exposure to air pollution is linked to increased risk of asthma and developmental delays (Zhang et al., 2022). This underscores the importance of environmental health in pediatric medicine.

Reference: Zhang, X., et al. (2022). “Early-Life Air Pollution Exposure and Pediatric Asthma Risk.” JAMA Pediatrics, 176(5), 476-484. Link

Most Surprising Aspect

Children’s rapid physiological adaptation: Pediatric patients can compensate for illness far longer than adults, often showing minimal symptoms until a sudden, severe deterioration. This “compensated shock” phenomenon means that early warning signs are subtle, making vigilant monitoring crucial.

Revision Points

  • Pediatric medicine requires understanding unique anatomical, physiological, and psychosocial factors.
  • Preventive care (vaccination, nutrition, regular checkups) is foundational.
  • Drug dosing and disease presentation differ from adults.
  • Case studies highlight the diversity of pediatric conditions.
  • Recent research emphasizes the impact of environment on child health.
  • Water cycle fact connects pediatric medicine with planetary science.

Diagram: Pediatric Airway vs Adult Airway

Pediatric vs Adult Airway

Further Reading

End of Revision Sheet