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Pediatric Shelf Exam Preparation Notes

Jan 27, 2025

Lecture Notes: Pediatric Shelf and Step 2 CK Preview Session

Introduction

  • Presenter welcomes a global audience, highlighting participants from various locations.
  • The session is a preview for a comprehensive pediatrics rapid review webinar.
  • Focus on NBME shelf concepts for pediatrics, particularly for M3 clerkship exams, USMLE Step 2 CK, and comp exams.
  • Presenter: Rahul, a practicing pediatric critical care physician passionate about medical education.

HiGuru Approach

  • Strategic active learning for USMLE Step 2 CK.
  • Pillars of content:
    • Active recall and vignette-focused learning.
    • Integration among different organ systems.
    • Test-taking strategy.
    • Safe learning environment promoting peak test-taking psychology.

Differences Between Step 1 and Step 2 CK

  • Step 1: Focus on disease mechanisms, diagnosis, and pathophysiology.
  • Step 2 CK: Clinical focus — most likely diagnosis, next management steps, understanding risk factors.
  • Integration from symptomatology to basic science mechanisms.

Key Pediatric Concepts

Multi-Organ Involvement in Vignettes

  • Syndromic conditions and systemic conditions (e.g., hematologic, infectious, autoimmune).
  • Importance of growth percentiles in vignettes.

Cyanotic Newborns

  • Two primary considerations: congenital heart disease and respiratory causes.
  • Important conditions: Tetralogy of Fallot, transposition of great vessels, tricuspid atresia, etc.
  • Right-to-left shunts typically unresponsive to oxygen.

Test Example: Tetralogy of Fallot

  • Episodic cyanosis, particularly during feeding or irritability.
  • Key interventions: Increased systemic vascular resistance through knee-to-chest position.
  • Characteristic features: Right ventricular hypertrophy, boot-shaped heart on X-ray.

Bronchiolitis

  • Typical patient: Infant <2 years, winter presentation, wheezing, runny nose.
  • Common cause: RSV, treated/prevented with palivizumab.

Asthma Management

  • Persistent asthma not responding to albuterol: Use inhaled corticosteroids.
  • Acute exacerbation management mnemonic: ASTHMA.

Foreign Body Ingestion

  • Button battery ingestion requires urgent endoscopic removal.

Stridor and Upper Airway Obstruction

  • Congenital and acquired causes.
  • Conditions like laryngomalacia, subglottic stenosis, croup, epiglottitis.
  • Management varies based on cause.

Neonatal Jaundice

  • Different causes based on timing post-birth.
  • Importance of differentiating: Breastfeeding jaundice vs. breast milk jaundice.

Hematuria in Pediatrics

  • Differentiating glomerular vs. non-glomerular causes.
  • Conditions such as PSGN, IgA nephropathy, renal vein thrombosis.

Sickle Cell Disease Complications

  • Systemic approach to complications (e.g., CNS, respiratory, renal, infectious).
  • Management often involves exchange transfusions.

Developmental Milestones

  • Gross and fine motor skill progression from early months to kindergarten age.
  • Timeline approach aids in memorization and understanding.

Conclusion

  • Encouragement for active learning and participation.
  • Announcements for future sessions and opportunities for engagement with HiGuru.

Engagement and Feedback

  • Invitation to provide feedback and join comprehensive webinar sessions.
  • Promotion of community learning and growth through sharing resources.

These notes provide a comprehensive summary of the key points and topics covered in the pediatric lecture session. Use these notes for review and preparation for pediatric exams like the shelf and Step 2 CK.

Full transcript