1. History and examination 1
Paediatric history taking 1
Adolescent history 2
Neonatal history 3
Paediatric examination 4
The neonatal examination 7
Medical sample clerking 8

2. Investigations 13
Urine tests 13
Blood tests 13
Cerebrospinal fluid 20
Imaging 21

3. Cardiology 25
Congenital heart disease 25
Rheumatic fever 32
Cardiac infections 32
Cardiac arrhythmias 33

4. Respiratory and ENT 35
Presentation of paediatric respiratory disease 35
Upper respiratory tract infections 37
Lower respiratory tract infections 40
Asthma 41
Cystic fibrosis 45
Ears, nose and throat (ENT) 48

5. Gastroenterology, hepatology and surgery 53
Presentation of gastrointestinal disease 53
Important gastrointestinal conditions 58
Liver disease 64

6. Renal and genitourinary conditions 67
Haematuria 67
Proteinuria 68
Urinary tract anomalies 69
Urinary tract infection 71
Acute nephritis 73
Nephrotic syndrome 73
Acute kidney injury 74
Chronic kidney disease 75
Urinary incontinence 75
Genital conditions 75

7. Endocrinology and growth 81
Hypothalamus and the pituitary gland 81
Growth 82
Puberty 84
Adrenal disorders 86
Thyroid disorders 88
Diabetes mellitus 89

8. Oncology 97
Childhood cancer 97
Brain tumours 99
Medulloblastoma (20%) 100
Craniopharyngioma (4%) 100
Neuroblastoma 100
Wilms tumour (Nephroblastoma) 101
Soft-tissue sarcomas 102
Bone tumours 102
Retinoblastoma 102
Langerhans cell histiocytosis 102

9. Haematology 105
The leukaemias 105
Lymphomas 106
Haematopoiesis 107
Anaemia 107
Haemolytic anaemia 111
Splenomegaly 113
Bleeding disorders 114
Coagulation disorders 116
Thrombotic disorders in childhood 118

10. Infectious diseases and immunology 119
Fever 119
Viral infections 123
Bacterial infections 130
Parasitic infections 135
Immunodeficiency 136

11. Allergy and anaphylaxis 139
Epidemiology 139
Pathophysiology 139
Aetiology 140
Clinical aspects of allergy 140
Anaphylaxis 142

12. Dermatology 145
The child with a rash 145
Acute rashes 146
Skin infections 149
Infestations 150

13. Neurology 153
Introduction 153
Fits, faints and funny turns 153
The unconscious child 155
Epilepsy 155
Febrile convulsions 158
Headache 159
Infections of the central nervous system 160
Malformations of the central nervous system 162
Cerebral palsy 163
Neurocutaneous syndromes 165
Abnormal involuntary movements 165
Intracranial haemorrhage 166
Neurodegenerative disorders of childhood 166
Neuromuscular disorders 167
Peripheral nerve palsies in children 168
Visual field deficits 168
Squint and amblyopia 169

14. Musculoskeletal system 171
Introduction 171
Limp 171
Disorders of the hip and knee 172
Disorders of the spine 174
Disorders of the upper limbs 175
Disorders of the skull 175
Fractures 176
Bone and joint infections 176
Rheumatic disorders 177
Genetic skeletal dysplasias 179

15. Neonates 181
Maternal and foetal health 181
Foetal assessment and antenatal diagnosis 181
Maternal conditions affecting the foetus 181
Normal neonatal anatomy and physiology 184
Birth 186
Birth injury 188
The newborn 188
Disorders of the term infant 192
The preterm infant 196
Disorders of the preterm infant 198
Congenital malformations 200

16. Genetics 205
Basic genetics 205
Single-gene (monogenic) disorders 205
Autosomal dominant disorders 205
Autosomal recessive disorders 207
X-linked disorders 207
Multifactorial disorders 208
Chromosomal disorders 208
Mitochondrial inheritance 212
Genetic counselling 212

17. Development 215
History 215
Examination 215
Signs of abnormal development 217

18. Child and adolescent mental health 221
Attachment 221
Problems of early childhood 221
Autism spectrum disorders 222
Attention deficit hyperactivity disorder 223
Behavioural problems 224
Continence problems 225
Affective disorders 225
Anxiety 226
Psychosis 226
Eating disorders 226
Medically unexplained symptoms 228

19. Community paediatrics, public health and child protection 231
Prevention in child health 231
Children with disabilities 235
Child protection 236
Children and the law 238

20. Accidents and emergencies 241
Emergencies 241
Unintentional injuries 252

21. Nutrition, fluids and prescribing 259
Nutrition 259
Fluids and electrolytes 263
Paediatric pharmacology and prescribing 265

Self-Assessment 267
UKMLA High Yield Association Table 269
UKMLA Single Best Answer (SBA) Questions 271
UKMLA SBA Answers 291
OSCEs and Short Clinical Cases 303