PAEDIATRICS

PAEDIATRICS
The course includes systematic instructions in growth and development, nutritional needs of a child,
immunization schedules and management of common diseases of infancy and childhood, scope of
Social Paediatrics and counselling.

Goal
The broad goal of teaching undergraduate students in Paediatrics is to acquire adequate knowledge and
appropriate skills for optimally dealing with major health problems of children and to ensure their optimal
growth and development.

Objectives
a) Knowledge
At the end of the course, the student should be able to:
1. Describe the normal growth and development during foetal life, neonatal period, childhood
and adolescence and outline deviations thereof.
2. Describe the common paediatric disorders and emergencies in terms of epidemiology,
etiopathogenesis, clinical manifestations, diagnosis, rational therapy and rehabilitation.
3. State age related requirements of calories, nutrients, fluids, drugs etc. in health and
disease.
4. Describe preventive strategies for common infectious disorders, malnutrition, genetic and
metabolic disorders, poisonings, accidents and child abuse.
5. Outline national programmes relating to child health including immunisation programmes.

b) Skills
At the end of the course, the student should be able to:
1. Take a detailed paediatric history, conduct an appropriate physical examination of children
including neonates, make clinical diagnosis, conduct common bedside investigative
procedures, interpret common laboratory investigation results and plan and institute
therapy.
2. Take anthropometric measurements, resuscitate newborn infants at birth, prepare oral
rehydration solution, perform tuberculin test, administer vaccines available under current
national programs, perform venesection, start an intravenous saline and provide nasogastric
feeding.
3. Witness diagnostic procedures such as lumbar puncture, liver and kidney biopsy, bone
marrow aspiration, pleural tap and ascitic tap.
4. Acquire knowledge about normal newborn care, breastfeeding and to recognise the danger
signals in newborn period.
5. Exposure to ambulatory care of all sick children. To identify indications for Specialized/
inpatient care. Identify symptoms and signs requiring timely referral of those who require
hospitalization.

c) Integration
The training in Paediatrics should prepare the student to deliver preventive, promotive, curative
and rehabilitative services for care of children both in the community and at hospital as part of
a team in an integrated form with other disciplines, eg. Anatomy, Physiology, Biochemistry,
Microbiology, Pathology, Pharmacology, Forensic Medicine, Community Medicine and Physical
Medicine and Rehabilitation.

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Syllabus
1. Growth - Principles and factors affecting growth, normal growth during infancy and childhood,
use of growth charts, causes and remediation of deviant growth.
2. Development - Principles and factors affecting, normal milestones achieved at different ages,
causes delayed development and remedial measures.
3. Immunisation - Newer vaccines - Basic principles, vaccines used in the national programme,
Indications, contraindications, Newer Vaccines.
4. Breast feeding - Physiological aspects, technique, advantages, Baby friendly Hospital
initiative.
5. Infant feeding - Principles of weaning, common foods used. Feeding problems in the first year.
6. Nutritional requirement in Paediatrics, Balanced diet, Vitamins and Minerals - requirement,
function and deficiency manifestations with treatment.
7. Malnutrition - Classification, aetiopathogenesis, clinical features complications, investigations
and treatment, preventive aspects.
8. Nutritional Anemia - Causes, Clinical features, management and prevention.
9. Tuberculosis in Children - Emphasis on Primary complex, tubercular meningitis, miliary and
abdominal tuberculosis.
10. Infectious diseases relevant to paediatrics
11. Congenital heart disease -
a) Overview of the common acyanotic and cyanotic conditions
- ASD, VSD, PDA
- TOF, TGA
- Clinical features, complications, natural history.
b) Congestive cardiac failure, clinical presentation and causes at various ages and treatment.
c) Cyanotic spells, infective endocarditis - Clinical features, treatment and prevention.
12. Acute Rheumatic fever - Carditis and management.
13. Common Respiratory problems - Croup, stridor, bronchiolitis, epiglottitis, laryngotrache-
obronchitis, bronchial asthama, lower respiratory infections, bronchiectasis - aetiology, clinical
features, diagnosis, complications and management.
14. Acute glomerulonephritis, nephrotic Syndrome, urinary tract infectin, acute renal failure -
clinical features, investigations, complications and management.
15. Acute Hepatitis - A, B, Non A & Non B, Portal hypertension - Aetiology, clinical features,
complications and management.
16. Acute Gastroenteritis - Clinical features, complications and management.
17. Childhood Malignancies - Acute Leukaemia, Hodgkin and Non Hodgkin Lymphoma, Wilms
Tumor, Neuroblastoma - clinical features and principles in management.
18. a) Common haemolytic anemias, clinical features, diagnosis and management.
b) Common disorders affecting hemostasis - Thrombocytopenia, Haemophilia, Von Willebrand
disease.
19. Cerebral palsy, Febrile convulsions, Mental retardation, Seizure disorder in children.
Hydrocephalus - Aetiology, Clinical features and principles in management.
20. Vaccine preventable diseases - Measles, Mumps, Rubella, Diphtheria, Pertussis, Tetanus,
Poliomyelitis with a note on Acute Flaccid Paralysis Surveillance.
21. Acute Pyogenic meningitis - aetiology, clinical features, complications, management.
22. HIV in children.
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23. Hypothyroidism.
24. National programmes related to child health, integrated management of neonatal & childhood
illnesses.
25. Neonatal topics - Normal newborn, Gestational age assessment, Problems of premature, Post
mature and small for gestational age babies, Neonatal Jaundice, seizures, bleeding, respiratory
distress, sepsis, birth trauma.

Details of Theory Lectures:

1. Growth
2. Development
3. Breast feeding
4. Infant feeding
5. Malnutrition
6. Nutritional anemia
7. Vitamins: Fat soluble (A, D, E & K)
8. Vitamins: Water soluble (B complex & C)
9. Immunisation - Basic principles, vaccines used in national programme.
10. Immunisation - Newer Vaccines
11. Helminthiasis in children
12. MMR
13. DPT
14. Pyogenic meningitis
15. Acute poliomyelitis
16. HIV - global problem
17. Malaria
18. Acute Gastroenteritis
19. TB in children
20. Complications of TB, TBM, Miliary, Lymphnode
21. Approach to acyanotic heart disease
22. Approach to cyanotic heart disease
23. Acute rheumatic fever
24. Nephrotic syndrome
25. Acute glomerulonephritis
26. Urinary tract infection
27. Approach to hepatosplenomegaly
28. Portal hypertension
29. Acute leukaemia
30. Lymphoma
31. Neuroblastoma/Wilm’s tumour
32. Cerebral palsy
33. Convulsions in Children
34. Croup, stridor wheeze
35. ARI control programme
36. Asthma & Chronic lung diseases
37. Short stature
38. I M N C I Programme
39. Introduction to neonatology

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40. Care of Normal newborn
41. Neonatal resuscitation
42. Perinatal asphyxia
43. Thermoregulation in NB
44. Prematurity & LBW
45. Metabolic disturbances
46. Neonatal Seizures
47. Sepsis
48. Bleeding neonate
49. Respiratory distress
50. Jaundice
51. Common neonatal problems
52. Birth injury.

Tutorials:
1. Introduction to Paediatrics/Assessment of Growth (2 hrs.)
2. Assessment of Development (2 hrs.)
3. Infant feeding (2 hrs.)
4. Immunization (2 hrs.)
5. History Taking (2 hrs.)
6. Examination (2 hrs.)
7. IMNCI (2 hrs.)
8. Instruments and Procedures (2 hrs.)
9. Vaccines (2 hrs.)
10. Commonly used drugs and emergency drugs (2 hrs.)
11. Nutritional values of various foods (2 hrs.)
12. National Programmes related to child health (2 hrs.)
13. History/examination in a child with pallor
14. History/examination in a child with cyanosis
15. History/examination in a child with edema
16. History/examination in a child with jaundice
17. History/examination in a child with fever and seizures
18. History/examination in a child with vomiting and/or diarrhoea
19. History/examination in a short child
20. History/examination/investigation in a child with develop delay
21. History/examination/investigation in a child with lymhadenopathy
22. History/examination/investigation in a child with recurrent respiratory infections
23. History/examination/investigation in a child with failure to thrive
24. Common problems of Adolescents
25. Common Paediatric Surgical Problems
26. Management of Status Epilepticus
27. Management of Status Asthmaticus
28. Management of Congestive Cardiac failure
29. Fluid and electrolytes balance
30. Exanthematous illnesses in children
31. Bleeding child
32. PUO
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33. Shock in Paediatrics
34. Dengue and Dengue like fever
35. Hypothyroidism

List of Clinical Cases: The list given is not exhaustive and is only for the purpose of highlighting the
core cases. All the cases admitted in Paediatric wards that are stable can be discussed.
1. Malnutrition, PEM
2. Short stature
3. Fever with rash
4. hepatosplenomegaly
5. Developmental delay
6. Seizures
7. Hypotonia and hypertonia
8. Meningitis and encephalitis
9. Congenital heart disease: Cyanotic & Acyanotic
10. Acquired heart disease: Rheumatic, myocarditis
11. Bronchial Asthma
12. Bronchopneumonia
13. Bronchiolitis
14. Pleural effusion, pyopneumothorax
15. Pulmonary tuberculosis
16. Ascitis
17. Jaundice
18. Wilsons disease
19. Acute gastroenteritis
20. Nephrotic syndrome
21. Acute glomerulonephritis
22. Thalassemia, Sickle cell disease, Heriditary spherocytosis and other haemolytic anemias
23. Bleeding disorders
24. Immune thrombocytopenia purpura
25. Down’s syndrome and other genetic syndromes
26. Juvenile rheumatoid arthritis

List of Instruments:
1. AMBU Bag
2. Laryngoscope - Miller and Mc Intosh Blades
3. Endotracheal tubes - Cuffed and uncuffed
4. Oral airway
5. Ryle’s tube
6. Infant feeding tube
7. Flatus tube
8. Simple rubber catheter
9. Liver biopsy needle
10. Bone marrow biopsy needle
11. Bone marrow aspiration needle
12. Lumbar puncture needle
13. Tuberculin syringe

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List of Drugs:
1. Adrenaline
2. Atropine
3. Sodabicarb
4. Calcium gluconate
5. Potassium chloride
6. 25% Dextrose
7. Hydrocortisone
8. Furosemide
9. Benzyl Penicillin
10. Ampicillin
11. Amoxycillin
12. Cloxacillin
13. Amoxycillin & clavulanic acid
14. Ampicillin & cloxacillin
15. Gentamicin
16. Cefotaxime
17. Ceftriaxone
18. Piperacillin & tazobactum
19. Dexamethasone
20. Tuberculin
21. Paracetamol
22. Diazepam
23. Digoxin
24. WHO ORS
List of Vaccines:
1. BCG
2. DPT
3. OPV
4. Hepatitis B
5. Hib
6. DT
7. Td
8. TT
9. Measles
10. MMR
11. Hepatitis A
12. Varicella
13. Typhoid
14. Pneumococcal Vaccine
Nutrition:
1. Rice - white and paraboiled
2. Pulses - Bengal gram, horse gram, black gram, green gram
3. Ragi
4. Jaggery
5. Sugar
6. Oil
7. Ground nuts
8. Egg
9. Green vegetables
10. Banana
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Details of continuous assessment:
Name:
Roll No.:
Clinical Attendance:
Date of Posting Total No. of
Semester From: To: Classes No. attended
7th Semester

8th Semester

9th Semester

Theory Attendance:
Date of Posting Total No. of
Semester From: To: Classes No. attended
6th Semester

8th Semester

9th Semester

It is mandatory to have minimum 80% attendance in non lecture teaching (Clinical Posting) and
75% attendance in theory classes. The above table is meant to be maintained by the student for self
evaluation so as to enable him/her to comply with the above expectation.
1. Record Books : A student should complete 10 cases during the posting and obtain the signature
of the faculty of Paediatrics. The record should be completed as follows :
7th Semester 5 cases
8th Semester 3 cases
9th Semester 2 cases
The case record is complete only when it includes history, clinical finding, diagnosis, differential
diagnosis, follow-up and management of the case and outcome (till discharge) and a brief discussion of
the disease process.

2. Internal Assessment Theory Evaluation :

8th - Topics covered in 7th & 8th semester 40 marks
 20 MCQs each carrying 1.5 marks with
negative marking of 0.5, final marks scaled
down to max. of 10 marks.
 15 short answers questions each carrying
2 marks.
9th - All topics pertaining to Paediatrics 40 marks
 20 MCQs each carrying 1.5 marks
with negative marking of 0.5, final marks
scaled down to max. of 10 marks.
 One long question carrying 9 marks &
7 short notes 3 marks each.
Viva (conducted at the end of the 9th 20 marks
semester clinical posting)
Total 100 marks

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 Clinical Evaluation:
Semester - Skills Assessed
7th: MCQ & short answer 20 marks
Records 05 marks

Total 25 marks
8th: Basic concept of growth,
Development, Nutrition 10 marks
Interpretation of clinical signs 10 marks
Records 05 marks

Total 25 marks

9th: Ability to arrive at a probable

diagnosis interpreting all the
symptoms & signs 25 marks
Growth & development 20 marks
Records 05 marks

Total 50 marks

Total 100 marks

Details of University Examination:

Question paper will comprise of -
a) 20 MCQs each carrying 1.5 marks with negative marking of 0.5 - Final marks scaled down
to max. of 10.
b) One long question carrying 9 marks & 7 short notes 3 marks each.
University Paediatrics Exam: Theory 40 marks
Viva 10 marks
Clinical Examination:
One short case to be examined within 30 minutes -
Growth/Development Assessment/IMNCI Management 10 marks
History, clinical examination/discussion 20 marks

Total 30 marks

Internal Assessment: Theory 10 marks

Clinicals 10 marks

Total 100 marks

Specification tables for University Examination:

Specification table for the Final Paediatric Exam
Growth\Nutrition 05 marks
Development 05 marks
Immunisation 05 marks

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 Infectious disease 05 marks
Newborn/SP 05 marks
Kidney/Genitourinary/GIT/Liver 05 marks
Respiratory/CVS/CNS 05 marks
Haematology/Endocrine/Metabolic 05 marks

40 marks

General Guidelines for Sessional and University Examinations:

Case records to be submitted during conduct of clinical evaluation.
All students need to carry ID card failing which they may be denied permission to appear for exams
clinical as well as theory.
All students are expected to learn the basic art of interaction with patients including learning the local
language.
No electronic equipment will be allowed during any exams.
In every case allotted, assessment of diet, growth and development, immunisation history is a must.

Main Books:
Essential Paediatrics, 7th Edition, O.P. Ghai, Vinod Paul, Arvind Bagga
Achar’s Text book of Paediatrics, 4th Edition, Swarna Rekha Bhat, (Editor).

Clinical Examination: Hutchison’s Clinical Methods, 23rd Edition Michael Glynn & William M. Drake

Reference Books:
1) IAP Text book of Paediatrics, 4th Edition, Partharsarthy Menon Nair (Editor).
2) Nelsons Text book of Paediatrics, 19th Edition, Robert M. Kliegman, Bonita M.D. Stanton, Joseph
St. Geme, Nina Schor & Richard E. Behrman.

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