2025 Saudi Pediatric Board Exam Part 1 Lecture Notes

FLACC scale

A pain assessment tool measuring Face, Legs, Activity, Cry, and Consolability, used for non-verbal or developmentally delayed children aged 2 months to 7 years.

Status Asthmaticus

Severe asthma that fails to improve with initial therapy (high-dose nebulized salbutamol, ipratropium, and systemic corticosteroids).

Ketamine

The preferred induction agent for Rapid Sequence Intubation (RSI) in severe asthma because it is a potent bronchodilator.

Rocuronium

A paralytic agent preferred in severe asthma RSI because it does not trigger histamine release.

Familial Short Stature

A growth variant characterized by normal growth velocity along a low percentile, normal bone age, and most commonly an autosomal dominant inheritance pattern.

Neonatal Lupus

A condition caused by the transplacental passage of maternal anti-Ro (SSA) or anti-La (SSB) antibodies; manifestations include an annular erythematous rash and possible congenital complete heart block.

Neonatal Alloimmune Thrombocytopenia (NAIT)

A condition analogous to Rh disease but affecting platelets, where maternal antibodies (often against HPA-1a) destroy fetal platelets, requiring washed, irradiated maternal platelet transfusion if severe.

Kawasaki Disease

An acute medium-vessel vasculitis characterized by "CRASH & Burn": Conjunctivitis, Rash, Adenopathy, Strawberry tongue, Hand/foot swelling, and Fever $\geq 5$ days.

Gastroschisis

A right paraumbilical abdominal wall defect with herniation of bowel content not covered by a peritoneal sac.

Omphalocele

Herniation of abdominal contents through the umbilicus that is covered by a peritoneal sac.

Otitis Externa

Severe ear pain with tragal or pinna manipulation, often associated with edematous canal and purulent debris ("swimmer's ear").

Congenital Varicella Syndrome

A condition resulting from maternal infection in the first or early second trimester ($<20$ weeks), featuring cicatricial skin scarring, limb hypoplasia, and chorioretinitis.

Congenital Rubella Syndrome Triad

The classic combination of cataracts, cochlear defect (sensorineural hearing loss), and cardiac defect (Patent Ductus Arteriosus).

Diabetic Ketoacidosis (DKA)

A metabolic emergency defined by blood glucose $>200\,mg/dL$, ketones in blood or urine, and the presence of metabolic acidosis ($pH < 7.3$ or $HCO_3 < 15\,mEq/L$).

Cerebral Edema

The most serious complication of DKA treatment, typically presenting 4–12 hours after starting therapy with headache, lethargy, and altered mental status.

Enterobius vermicularis

Also known as pinworm; it causes nocturnal perianal pruritus and is diagnosed using the "tape test" in the early morning.

Nocturnal Enuresis

Involuntary urination during sleep in a child $\geq 5$ years of age; it has a strong genetic component with up to a $77\%$ chance if both parents were affected.

Myasthenia Gravis (MG)

An autoimmune disorder caused by autoantibodies against acetylcholine receptors at the neuromuscular junction, leading to fluctuating muscle weakness and ptosis.

Essential Fatty Acid Deficiency (EFAD)

A deficiency that can develop within 1–2 weeks in infants on parenteral nutrition without lipids, presenting with dry, scaly dermatitis ("crazy-paving").

Brainstem Glioma

A tumor often presenting with "crossed findings," such as cranial nerve VI and VII palsies with contralateral hemiplegia.

Turner Syndrome

A chromosomal disorder ($45,XO$) featuring short stature, primary amenorrhea, and common cardiac anomalies like coarctation of the aorta.

Congenital Diaphragmatic Hernia (CDH)

A defect involving immediate respiratory distress at birth and a scaphoid abdomen; the first step is immediate intubation to avoid bag-mask ventilation.

Congenital Muscular Torticollis

A firm SCM "pseudotumor" present in the first few weeks of life, becoming more prominent when the head is rotated to the opposite side.

Congenital Glaucoma

An ocular emergency characterized by a triad of epiphora, photophobia, and blepharospasm, often presenting with an enlarged, hazy cornea (buphthalmos).

Abetalipoproteinemia

An autosomal recessive disorder of the MTP protein causing severe fat malabsorption, acanthocytosis on peripheral smear, and progressive ataxia.

Bronchiolitis Obliterans

Chronic fibrotic obstruction of small airways following severe viral infection; Chest CT characteristically shows mosaic attenuation (air-trapping).

Cystic Fibrosis (CF)

An autosomal recessive mutation in the CFTR gene leading to thick secretions; it is the most common cause of meconium ileus in newborns.

Infectious Mononucleosis

An EBV-mediated infection presenting with fever, pharyngitis, lymphadenopathy, and atypical lymphocytosis ($>10\%$).

Erythema Multiforme (EM)

A delayed-type hypersensitivity reaction presenting with target lesions, most commonly triggered by HSV or Mycoplasma pneumoniae in children.

Serum Sickness-Like Reaction (SSLR)

A Type III hypersensitivity triggered by beta-lactams (e.g., cefaclor) presenting with fever, urticarial rash, and arthralgia 1–2 weeks after drug exposure.

Duchenne Muscular Dystrophy (DMD)

An X-linked recessive disorder due to absent dystrophin; signs include proximal weakness, Gowers sign, and calf pseudohypertrophy.

Hemolytic Uremic Syndrome (HUS)

A triad of microangiopathic hemolytic anemia (schistocytes), thrombocytopenia, and acute kidney injury, usually following STEC bloody diarrhea.

Sudden Infant Death Syndrome (SIDS)

Sudden death of an infant $<1$ year; prevention includes supine sleeping ("Back to Sleep"), avoiding loose bedding, and breastfeeding.

Epiglottitis

Acute inflammation classically caused by Hib, presenting with the "4 Ds": Drooling, Dysphagia, Dysphasia, and Distress (tripod positioning).

Isovaleric Acidemia

An organic acidemia caused by isovaleryl-CoA dehydrogenase deficiency, classically presenting with an odor of "sweaty feet."

Disseminated Intravascular Coagulation (DIC)

A consumptive coagulopathy characterized by low fibrinogen, thrombocytopenia, and elevated PT, aPTT, and D-dimer.

Osteopetrosis

"Marble bone disease" caused by defective osteoclasts, leading to abnormally dense but fragile bones and marrow failure (anemia, hepatosplenomegaly).

Anorexia Nervosa

An eating disorder characterized by low BMI, intense fear of weight gain, and physical signs of starvation such as bradycardia and lanugo hair.

Acanthosis Nigricans

A velvety, hyperpigmented thickening of the skin in neck or axillary folds, serving as a classic marker for insulin resistance.

Posterior Urethral Valves (PUV)

The most common cause of lower urinary tract obstruction in male infants; VCUG shows a dilated posterior urethra and bladder trabeculation.

Toxic Megacolon

A life-threatening complication of ulcerative colitis featuring colonic dilation ($>6\,cm$), high fever, and systemic toxicity.

Hypertrophic Pyloric Stenosis

Non-bilious projectile vomiting in infants 2–8 weeks old, leading to hypochloremic hypokalemic metabolic alkalosis.

Coarctation of the aorta

A narrowing of the aorta causing upper limb hypertension and weak/delayed femoral pulses; rib notching may be seen on X-ray.

Meckel Diverticulum

The most common congenital GI anomaly, classically presenting with painless maroon-colored lower GI bleeding in children under 2.

Shwachman-Diamond Syndrome

A triad of exocrine pancreatic insufficiency, bone marrow dysfunction (neutropenia), and skeletal abnormalities (metaphyseal dysostosis).

Rabies

An encephalitic virus presenting with hydrophobia, aerophobia, and pharyngeal spasms following an animal bite.

Classic Galactosemia

A GALT enzyme deficiency; infants present with jaundice, hepatomegaly, cataracts, and a high risk of E. coli sepsis upon starting milk feeds.

Rett Syndrome

An X-linked dominant disorder in girls; the earliest objective sign is usually the deceleration or regression of head growth between 3–6 months.

Absence Seizures

Brief episodes