Pediatrics – MCCQE1 High-Yield Notes

Pediatrics is a core MCCQE1 specialty covering neonatal emergencies, developmental milestones, vaccination schedules, and common childhood illnesses essential for Canadian medical practice.

🔑 Key Topics for MCCQE1

Developmental milestones: motor, language, social (2-4-6-9-12-18-24 months)
Immunization schedule in Canada: DTaP, IPV, Hib, MMR, varicella, pneumococcal
Neonatal jaundice: physiological vs pathological, phototherapy thresholds
Respiratory distress syndrome (RDS): prematurity, surfactant deficiency, treatment
Bronchiolitis: RSV, clinical diagnosis, supportive management (no antibiotics)
Croup (laryngotracheobronchitis): steeple sign, epinephrine, dexamethasone
Epiglottitis: Hib, thumbprint sign, do NOT examine throat, urgent airway
Febrile seizures: simple vs complex, reassurance, recurrence risk
Meningitis in children: LP findings, empiric antibiotics (ceftriaxone + vancomycin)
Child abuse: fractures at different stages, retinal hemorrhage, mandated reporting
Failure to thrive: organic vs non-organic causes, caloric intake assessment
Kawasaki disease: fever >5 days + 4 criteria, IVIG + aspirin treatment
Intussusception: colicky pain, currant jelly stools, air enema reduction
Pyloric stenosis: projectile vomiting, olive mass, hypochloremic alkalosis
ADHD: diagnosis criteria (DSM-5), methylphenidate first-line, behavioral therapy

⚠️ High-Yield Clinical Pearls

Kawasaki: Give IVIG within 10 days to prevent coronary artery aneurysm
Epiglottitis: Never do throat exam – risk of total airway obstruction
Pyloric stenosis: Hypochloremic hypokalemic metabolic alkalosis → fix electrolytes BEFORE surgery
Febrile seizure: Simple (<15 min, generalized, once in 24h) → reassure parents
Bronchiolitis: No benefit from albuterol, antibiotics, or steroids – supportive only
Child abuse: Posterior rib fractures = highly specific for non-accidental trauma

📊 Quick Reference Table

Condition	Key Finding	Management
Croup	Steeple sign on X-ray	Dexamethasone ± Epinephrine
Epiglottitis	Thumbprint sign	Secure airway, Ceftriaxone
Kawasaki	Fever >5d + rash + conjunctivitis	IVIG + Aspirin
Intussusception	Currant jelly stool	Air/barium enema
Pyloric stenosis	Projectile vomiting, olive mass	IV fluids then pyloromyotomy

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