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Medical Student Curriculum Guide
Knowledge—Common Pediatric Illnesses & Problems

Rationale

A patient's illness comes to the physician's attention as a clinical problem. The problem may be a complaint (e.g. headache) or a complex of symptoms and signs (e.g. fever, rash and sore throat) that prompts the visit to the physician; or the problem may be identified as a finding on physical examination or from the results of laboratory tests or imaging studies. The physician must solve the problems posed by the patient using information obtained from the history, the physical examination and, when appropriate, laboratory tests and/or imaging studies. In the problem-solving process the physician typically develops a problem list that includes differential diagnoses for each of the problems identified. The diagnostic process demands knowledge of disease etiology, pathophysiology and epidemiology and of the patient's gender, ethnicity, environment and prior health status. When the patient is an infant, child or adolescent, the physician must also consider the effects of age, physical growth, developmental stage and family environment. Commonly occurring illnesses will be the first considered, but other, less common disorders may need to be included in the evaluation of various clinical problems.

The format of this section differs from that of the other sections of the curriculum because the Objectives and Competencies refer to all of the clinical problems listed in the tables rather than a listing of specific knowledge, skills or attitudes. Common clinical problems are presented with key conditions, physical and laboratory findings for the students to learn about. These have been adapted from the actual data from ambulatory pediatric practices.

Learning Objectives

1. Using the table of clinical presentations for each clinical problem (left hand column) develop a differential diagnosis and rationale assisted by conditions listed (middle and right hand columns).
2. Identify, in addition, for each of the Core Level Conditions on table (middle column):
   • Etiology and/or pathophysiology
   • Natural history of the disease
   • Presenting signs and symptoms
   • Initial laboratory test and/or imaging studies indicated for diagnosis
   • Plan for initial management
3. To enhance your learning you may also identify for each of the Mastery Level Conditions on the table (right hand column):
   • Etiology and/or pathophysiology
   • Presenting signs and symptoms
   • Initial laboratory test and/or imaging studies indicated for diagnosis

Competencies

1. Develop a diagnostic approach to any of the clinical problems listed in the table below.
2. Explain how the physical manifestations and the evaluation and management of many pediatric illnesses vary with the age of the patient. Give specific examples.
3. Discuss the characteristics of the patient and of the illness that must be considered when making the decision to manage the patient in the outpatient setting or to admit to hospital.

Common pediatric illnesses are categorized as presenting symptoms, findings, or laboratory values in the table below.  Core pediatric level indicates more common diagnoses that would be expected from a junior medical student.  Mastery level diagnoses would exceed expectations of junior medical students, but would be expected for a senior medical student planning a career in pediatrics. , Although rare conditions occasionally must be considered they are not usually included in these core lists. A student will need to expand the diff erential diagnosis beyond the core diagnoses when indicated with individual patients.