Manual Examination Paediatrics

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Examination Paediatrics, 4th Edition contains ample information on history-taking, examination procedure, relevant investigations, memory aids, lists and mnemonics, and management for the majority of chronic paediatric clinical problems seen in hospital-based practice.
Table of contents

Some of the oldest traces of pediatrics can be discovered in Ancient India where children's doctors were called kumara bhrtya. A second century AD manuscript by the Greek physician and gynecologist Soranus of Ephesus dealt with neonatal pediatrics. The Persian philosopher and physician al-Razi — published a monograph on pediatrics titled Diseases in Children as well as the first definite description of smallpox as a clinical entity. The body size differences are paralleled by maturation changes.

The smaller body of an infant or neonate is substantially different physiologically from that of an adult.

Examination Paediatrics: A guide to Paediatric Training

Congenital defects, genetic variance, and developmental issues are of greater concern to pediatricians than they often are to adult physicians. A common adage is that children are not simply "little adults". Pediatric physiology directly impacts the pharmacokinetic properties of drugs that enter the body. The absorption , distribution , metabolism , and elimination of medications differ between developing children and grown adults. Many drug absorption differences between pediatric and adult populations revolve around the stomach. Neonates and young infants have increased stomach pH due to decreased acid secretion, thereby creating a more basic environment for drugs that are taken by mouth.

Therefore, the absorption of these drugs in children is greater than in adults due to decreased breakdown and increased preservation in a less acidic gastric space. Children also have an extended rate of gastric emptying, which slows the rate of drug absorption.

Macleod's Physical Examination Pediatric Head to Toe Assessment OSCE Guide 2016

Drug absorption also depends on specific enzymes that come in contact with the oral drug as it travels through the body. Supply of these enzymes increase as children continue to develop their gastrointestinal tract. However, prodrugs experience the opposite effect because enzymes are necessary in allowing their active form to enter systemic circulation.

Percentage of total body water and extracellular fluid volume both decrease as children grow and develop with time. Pediatric patients thus have a larger volume of distribution than adults, which directly affects the dosing of hydrophilic drugs such as beta-lactam antibiotics like ampicillin. Infants and neonates also have less plasma proteins.

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Thus, highly protein-bound drugs have less opportunities for protein binding and leads to increased distribution. Drug metabolism primarily occurs via enzymes in the liver and can vary according to which specific enzymes are affected in a specific stage of development.


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Enzyme capacity, clearance , and half-life are all factors that contribute to metabolism differences between children and adults. Drug elimination is primarily facilitated via the liver and kidneys. This can cause unwanted drug build-up, which is why it is important to consider lower doses and greater dosing intervals for this population. A major difference between the practice of pediatric and adult medicine is that children, in most jurisdictions and with certain exceptions, cannot make decisions for themselves. The issues of guardianship , privacy, legal responsibility and informed consent must always be considered in every pediatric procedure.

Pediatricians often have to treat the parents and sometimes, the family, rather than just the child. Adolescents are in their own legal class, having rights to their own health care decisions in certain circumstances. Aspiring medical students will need 4 years of undergraduate courses at a college or university, which will get them a BS, BA or other bachelor's degree.

Examination Paediatrics - 5th Edition

In high school future pediatricians are required to take basic science classes such as, biology, chemistry, physics, algebra, geometry, and calculus and also foreign language class, preferably Spanish in the United States , and get involved in high school organizations and extracurricular activities. After high school, college students simply need to fulfill the basic science course requirements that most medical schools recommend and will need to prepare to take the MCAT Medical College Admission Test in their junior or early senior year in college.


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Once attending medical school, student courses will focus on basic medical sciences like human anatomy, physiology, chemistry, etc. The training of pediatricians varies considerably across the world. Depending on jurisdiction and university, a medical degree course may be either undergraduate-entry or graduate-entry. The former commonly takes five or six years, and has been usual in the Commonwealth. Entrants to graduate-entry courses as in the US , usually lasting four or five years, have previously completed a three- or four-year university degree, commonly but by no means always in sciences.

Medical graduates hold a degree specific to the country and university in and from which they graduated. This degree qualifies that medical practitioner to become licensed or registered under the laws of that particular country, and sometimes of several countries, subject to requirements for " internship " or "conditional registration".

Pediatricians must undertake further training in their chosen field. This may take from four to eleven or more years, depending on jurisdiction and the degree of specialization. In the United States, a medical school graduate wishing to specialize in pediatrics must undergo a three-year residency composed of outpatient, inpatient, and critical care rotations.

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Specialties within pediatrics require further training in the form of 3-year fellowships. In most jurisdictions, entry-level degrees are common to all branches of the medical profession, but in some jurisdictions, specialization in pediatrics may begin before completion of this degree. In some jurisdictions, pediatric training is begun immediately following completion of entry-level training. In other jurisdictions, junior medical doctors must undertake generalist unstreamed training for a number of years before commencing pediatric or any other specialization.


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Specialist training is often largely under the control of pediatric organizations see below rather than universities, and depend on jurisdiction. From Wikipedia, the free encyclopedia. This article is about the branch of medicine. For the journal, see Pediatrics journal. For the branch of dentistry, see Pedodontics.

Examinations

The examples and perspective in this section deal primarily with United States and do not represent a worldwide view of the subject. You may improve this section , discuss the issue on the talk page , or create a new article , as appropriate. September Learn how and when to remove this template message. May Retrieved 18 April January Airway diseases, asthma and COPD 6.

MRCPI in Paediatrics

Epidemiology and Environment 7. Paediatrics 8. Thoracic Surgery and Transplantation 9. Allied Respiratory Professionals Respiratory Infections Thoracic Oncology Interstitial Lung Diseases Pulmonary Vascular Diseases Preparation: paediatric exam. Examination Committee: paediatric exam. Diplomates: paediatric exam. Eligibility, registration and fees: paediatric exam. Find out more Reduced fees apply to candidates who are sent by their national societies to sit the examination as part of the final-year national exit examination.

Registration steps Check your eligibility and prepare all necessary documentation for your examination category. Your registration process is successfully finished once you receive a confirmation of received payment. Note: we advise you to start the registration process well in advance of the deadline, in case we encounter any issues with your application, and to prevent longer processing time before the registration deadline.