Master of Medicine

(Paediatric)
Entrance Exam
Syllabus

Edited 18/07/2019

1
Index Page

1. Acute Clinical Medicine 3

2. Cardiology 6

3. Community Paediatrics 8

4. Dermatology 10

5. Development Paediatrics 11

6. Endocrinology 12

7. Gastro-hepatology 14

8. Genetics – Inherited Errors and Metabolism 16

9. Haemato-Oncology 18

10. Immunology and Allergy 20

11. Infectious disease 22

12. Musculoskeletal 23

13. Neonatology 25

14. Neurology 28

15. Nephrology 30

16. Nutrition 32

17. Respiratory 33

2
ACUTE CLINICAL MEDICINE
Syllabus
The seriously ill child
Fluid and electrolyte
balance
Respiratory distress/ failure
(also refer to Section on
Respiratory)
Learning outcomes Content
Able to recognise a Clinical features of serious
seriously ill child illness – respiratory distress,
shock, decreased level of
consciousness
Knows symptoms and signs
of impending cardiorespiratory
arrest
Knows the pathophysiological
consequences of serious
illness
Able to discuss fluid and Knows physiology of body
electrolyte homeostasis fluids
Able to manage fluid and Fluid and electrolyte
electrolyte imbalances requirements in well and
unwell infants and children of
different ages
Knows how to assess fluid
status / dehydration
Principles of fluid and
electrolyte maintenance and
replacement
Knows content of commonly
available replacement fluids
Knows the causes, Causes of respiratory
pathophysiology and signs distress/ failure (upper airway
of respiratory failure obstruction, lower airway
obstruction, lung parenchyma
Able to discuss the use of disease, and disordered
oxygen therapy control of breathing)
Knows the pathophysiology of
respiratory failure in the above
situations
Knows the signs of respiratory
failure
Knows the indications,
methods of delivery,
monitoring and adverse
effects of oxygen therapy.
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 Knows the methods of
ventilation in children of
different ages.

Shock Able to recognise the child Definition of shock

with shock and provide
initial resuscitation Differentiation of
compensated and
hypotensive shock

Different types of shock

(hypovolaemic, cardiogenic,
distributive and obstructive)
and their pathophysiology

Knows types of fluid for

resuscitation
including advantages and
disadvantages of crystalloids
and colloids

Knows how to utilise fluid

resuscitation as initial
management

Coma Able to recognise and Knows common causes of

evaluate a comatose child coma in children

Knows how to utilise age-

related Glasgow coma score

Arrhythmias and rhythm Able to manage common Knows how to read and
disturbances rhythm disturbances interpret a normal
electrocardiogram

Knows the features of and

recognises the following
rhythm disturbances:
 Heart block
 Sinus bradycardia
 Asystole
 Pulseless electrical activity
 Supraventricular
tachycardia
 Ventricular tachycardia
 Ventricular fibrillation

Recognises the importance of

hypoxia as an important
cause of rhythm disturbances
in children

4
Poisoning/drug overdose Knows common poisonings Knows the clinical
and Envenomation and envenomation pharmacology of the common
and serious poisonings/drug
overdose:
 Paracetamol
 Kerosene

Knows the presentation of

common envenomation:
 Bee stings
 Snake bites

Transportation and use of Knows principles involved Anticipates patients in whom

retrieval services in the transportation of an ill rapid deterioration can occur
child and provide necessary
management plan

Recognises the need and

able to discuss the case with
the more senior staff if
transportation or retrieval to
another facility is required

Preparation of a patient for

transfer to another facility

5
CARDIOLOGY

Syllabus Learning Outcomes Content

 Able to describe anatomy and  Anatomy of the heart

Anatomy and physiology of normal circulation and great vessels
physiology of
circulation  Able to describe anatomy and  Understanding of
cardiac cycle
physiology of foetal circulation
 Circulatory changes
at birth in health and
disease

 Able to understand cyanosis  Cyanosis: definition/

Common cardiac & differential
signs  Able to describe different types diagnosis
of cardiac murmurs
 Cardiac murmurs:
innocent and
pathological

 Able to understand the  Basic knowledge and

Conducting conducting system of the heart interpretation of ECG
system and and its relation to  Recognize the ECG
arrythmia electrocardiogram (ECG) changes from birth to
adolescence
 ECG for sinus
rhythm, sinus
arrhythmias, heart
block &
supraventricular
tachycardia

 Able to describe the  Heart failure :

pathophysiology and clinical pathophysiology,
Heart Failure presentation and principles of clinical presentation
management of heart failure and principles of
management

 Able to describe the  Concept of left to

Acyanotic Heart pathophysiology and clinical right shunt
Defects presentation of Acyanotic Heart  Knowledge on
Defects common conditions
with similar shunting
including VSD, ASD,
PDA

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  Able to describe the
Cyanotic Heart pathophysiology and clinical
Defects presentation of cyanotic heart
conditions
 Describe common
ductal & non-ductal
dependant conditions
 Indications for
prostaglandin (PG) in
ductal dependent
heart lesions

 Able to describe the  Clinical presentation

Obstructive Heart pathophysiology and clinical including Aortic
Lesions presentation of the common Atresia/ Hypoplastic
obstructive heart lesions Left Heart Syndrome/
Coarctation of Aorta

 Able to understand the common  Diagnosis and

Acquired Heart acquired heart disease principles of
Diseases management of :
- Rheumatic heart
disease

- Kawasaki disease

- Infective

endocarditis

 Able to understand hypertension  Correct measurement

Blood Pressure and the approach to diagnosis of blood pressure
and Hypertension  Variation of blood
pressure with age
 Causes of
hypertension

 Able to describe the common  Diuretics

Pharmacotherapy medications used in cardiology  Prostaglandin

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COMMUNITY PAEDIATRICS
Syllabus
Preventive health care &
health promotion
Advocacy
Child Protection (Non-
accidental injury)
Injury Prevention
Children in disadvantaged
communities
Screening
Routine Health Surveillance
Learning outcome
Knowledge of the role of
community health services
in preventive health care &
health promotion
Knowledge of child rights as
the basis for advocacy
Knowledge of the different
forms of child abuse and an
approach to management
Knowledge of unintentional
injuries in young children
Knowledge of categories of
disadvantaged children &
their associated problems
Knowledge of screening
programmes conducted for
infants and children
Importance of health
surveillance as a preventive
health strategy
Content
Emerging and lifestyle
diseases e.g. obesity
Concepts of child rights
Categories of rights under
UN Convention on the
Rights of the Child
Clinical presentation of
different forms of child
abuse (physical, sexual &
emotional abuse, child
neglect)
Types & common causes of
unintentional injuries in
young children road,
drowning, falls, etc
Strategies for prevention
Categories: Urban
poor/slums, Rural poor,
Estates, Indigenous,
Migrants
Associated problems:
malnutrition, failure to
immunize, infectious
disease, risk of injury,
development & schooling
problems
WHO criteria for
implementing a screening
programme
Umbilical cord blood
screening for
hypothyroidism & G6PD
deficiency – rationale &
implementation
Monitoring of Growth
Normal growth patterns
Indices to measure growth
Developmental screening of
Developmental delay: types,
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 causes & indications for
referral

The child in school Knowledge of problems school bullying

encountered by children in school & examination
schools pressure
sexual health

Epidemiology Knowledge of health Indicators of child health: in

indicators for children a population (under 5
mortality, infant mortality
rate, perinatal MR, neonatal
MR)

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DERMATOLOGY

Syllabus Learning outcome Content

Anatomy and Able to describe structure and Anatomy and physiology of skin
physiology of skin function of the skin

Skin infections a. Able to recognise BACTERIAL

clinical features Impetigo
Ecthyma
b. Basic principle in the Cellulitis
management of skin Folliculitis
infection SSSS

c. Understand the FUNGAL

infective agents Tinea infection/candida

- Bacterial VIRAL
- Fungal (superficial) Molluscum
- viral Viral warts

Skin Infestations a. Able to recognise clinical Scabies

features Lice
b. Basic principle in the
management of skin
infestations

Inflammatory a. Able to recognise clinical Seborrheic dermatitis

Dermatoses features Atopic dermatitis
b. Basic principle in the
management of common
inflammatory dermatoses

Neonatal a. Able to recognize manage Milliaria

Dermatoses common physiological skin Erythema toxicum neonatorum
changes in newborn

b. Able to recognise and Port wine Stain

manage common birthmarks Infantile haemangiomas

Principle of skin Understand the common Potencies of topical steroids and

treatment topical preparations in complications of topical steroid
dermatology

Skin and systemic Able to recognize common skin Neurofibromatosis

diseases manifestations of systemic Tuberous Sclerosis
diseases Sturge Weber
Systemic Lupus erythematosus

10
DEVELOPMENT PAEDIATRICS

Syllabus Learning Outcomes Content

Child development 1. Able to -Normal development including

describe gross motor, fine motor, speech and
normal child language, emotional, cognitive
development
- Normal visual and hearing
2. Able to development
recognise
- factors influencing child
abnormal
development
developmental
milestones. Normal variation and deviation and
abnormality in developmental
assessment
Red flags in normal development

Developmental Delay a) Able to identify a Global developmental delay

and intellectual child with
-definitions
disability (ID) developmental delay
-aetiology
b) Able to discuss the
aetiology of Specific developmental delay –
developmental delay. motor, speech delay
c) Able to identify a -aetiology
child with ID
Intellectual disabilities
d) Able to discuss the
aetiology of ID Definition
Aetiology
Developmental Able to define and Developmental regression
regression identify
-definition
developmental
regression and its -aetiology
causes

Learning disability Able to define and Definition

identify learning
Learning disability
disability and its
causes Specific learning disability - dyslexia

Behavioural problems Able to identify Autism spectrum disorder

common behavioural
ADHD
problems in children
-clinical features
-comorbidities

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ENDOCRINOLOGY
Syllabus Learning Outcomes
The - Able to describe the
Hypothalamic embryology and physiology of
Pituitary Axis the hypothalamic pituitary and
target organ axis.
Growth - Understands normal growth;
physical and endocrinological
changes.
- Factors determining
physical growth ie genetic,
hormonal, environmental
(prenatal and postnatal).
- Method of correct and
accurate method of measuring
growth.
- Able to identify and diagnose
short stature.
Normal Puberty - Able to describe the physical
& Pubertal and hormonal changes of
Disorder normal puberty.
- Able to detect disorders of
precocious puberty and knows
the principles of management
Childhood - Able to describe the
diabetes homeostasis of blood sugar
and physiology of insulin.
- Understands the principles of
diagnosis and types (Type 1
vs Type 2) of diabetes.
- Pathophysiology of diabetic
ketoacidosis.
Content
Physiology of hypothalamic pituitary
thyroid, gonadal and growth axes.
Synthesis, transport, biochemical
actions and control of hormones.
Physiology of hypothalamic pituitary
growth axis.
Normal growth pattern: from prenatal
growth to puberty.
Principles of growth charts: normal
distribution, understanding of mid-
parental height, target height.
Growth monitoring: accurate auxology
measurement.
Causes and approach to short stature.
Physiology of puberty.
Assessment of puberty: Tanner
staging (boys and girls)
Precocious Puberty:
 Central vs peripheral:
characteristics and
investigations
 Variants of normal
development (premature
thelarche, premature
pubarche)
Glucose homeostasis.
Criteria to diagnose diabetes in
children.
Characteristics of diabetes in
children: Type 1 vs Type 2.
Diabetic ketoacidosis:
pathophysiology and management
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Vitamin D and - Able to describe vitamin D
Calcium and calcium homeostasis.
Metabolism
- Knowledge on disorders of
calcium metabolism and
vitamin D abnormalities.
- Able to diagnose and
manage hypocalcaemia
Congenital - Able to understand and
Hypothyroidism explain the development and
physiology of the thyroid
gland.
- Synthesis, transport,
biochemical actions and
control of thyroid hormones.
- Able to discuss aetiology and
principles of management of
congenital hypothyroidism.
Ambiguous - Understands steroid
genitalia biosynthesis and the effect of
21-hydroxylase deficiency
- Able to detect and evaluate
ambiguous genitalia
Calcium homeostasis.
Vitamin D metabolism.
Clinical features and causes of
vitamin D and calcium abnormalities.
Assessment/investigation and
principles of management of
childhood hypocalcaemia.
Physiology of hypothalamic pituitary
thyroid axis.
Cord blood TSH screening;
importance of screening,
interpretation of screening results.
Congenital hypothyroidism: clinical
presentation and investigation.
Embryology and development of
genitalia.
Approach to ambiguous genitalia and
salt-losing crisis in 21-hydroxylase
deficiency.
13
GASTRO-HEPATOLOGY

Syllabus Learning outcomes Content

General competencies Have the knowledge and

skills to be able to assess
and initiate management
of patients presenting with
gastroenterological
problems in acute and
outpatient settings

Acute presentations

Acute abdominal Know the causes of acute Causes of acute abdomen

pain abdominal pain and their (medical and surgical)
presentation
Recognise conditions which
require urgent intervention e.g.
intussusception

Acute diarrhoea Know the causes of acute Pathophysiology

and/or vomiting diarrhoea and/or vomiting
and assessment of Causes of acute diarrhoea
dehydration and/or vomiting

Know about oral and Assessment of dehydration

intravenous fluid therapy
Be familiar with local isolation
policies

Understand the scientific

principles for oral and
intravenous fluid therapy

Upper and lower Approach to upper and Causes

gastrointestinal lower gastrointestinal
bleeding bleeding Assess the severity and the
potentially life-threatening
nature of this condition

Emergency treatment

Acute liver failure Know the pathophysiology Causes of acute liver failure
and approach to acute
liver failure Pathophysiology

Complications of acute liver

failure

Congenital Know the presenting Causes

abnormalities features of congenital and presentations
abnormalities including tracheo-oesophageal
fistula, malrotation, bowel
atresias, Hirschsprung’s

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Outpatient presentations
Recurrent vomiting eg Know the presenting
Gastro-esophageal(GER) features of GER and
reflux and Gastro- GERD
oesophageal reflux
disease (GERD)
Chronic or recurrent Know the causes and
abdominal pain presentations of chronic or
recurrent abdominal pain
Chronic diarrhoea Know the causes and
presentation of chronic
diarrhoea
Constipation Approach to chronic
constipation
Jaundice Approach to prolonged
jaundice
Evaluation of childhood
jaundice
disease, abdominal wall defects,
diaphragmatic hernia
Be familiar with potential
associated abnormalities
Recognise the range of signs
and symptoms associated with
gastro-oesophageal reflux and
GERD
Know the causes and features
that suggest functional and
underlying pathological
conditions
Causes
Pathophysiology/mechanism of
chronic diarrhoea and features
eg osmotic/malabsorption
secretory, motility, inflammatory
Features that suggest functional
and underlying pathological
conditions predisposing
conditions e.g. hypothyroidism,
neurodisability, psychosocial
problems
Causes :
-Cholestatic and non-
cholestatic
Presentations
Investigations
Viral hepatitis A,B,C,D, E
Investigations
15
GENETICS – INHERITED ERRORS AND METABOLISM

Syllabus Learning Outcomes Content

Basic Genetics Understand the scientific Basic cell biology-physiology,

basis of inherited function
disorders
Chromosomes and genes

Understand basis of Constructing a pedigree

patterns of inheritance
Interpretation of modes of
inheritance

Understand the basis of Gene structure and function

molecular genetics
disorders Mutations and diseases

Birth defects and Know about birth defects Basic principles of

common chromosomal and the features of embryology
conditions some common
chromosomal conditions Birth defects – major and
minor

Multiple birth defects and

chromosomal disorders

Common chromosomal
conditions

Problems associated
with Down syndrome

Inherited metabolic Basis of inherited Genes and enzymes

diseases metabolic disease
Metabolites:
 Acidosis
 Lactate
 Ammonia
 Glucose
 Ketones
Recognition of a child at Pathogenesis
risk for inherited Clinical presentation
metabolic disease

16
Know the appropriate Newborn screening –
screening investigations principles
that should be
performed when a Basic screening for inborn
metabolic disorder is errors of metabolism
suspected

17
HAEMATO-ONCOLOGY

Syllabus Learning Outcomes Content

Haematology

Haemopoiesis To know the Development, structure and function

differentiation of the of 3 cell lines
pluripotent stem cells

Haemoglobin Changes of Normal haemoglobin types

haemoglobin chain and
peripheral blood
elements after birth to
adolescence

Haemostasis Approach to a child Physiology of normal and abnormal

with bleeding haemostasis
tendencies
Inherited & acquired haemostatic
disorders: Haemophilia A/B, von
Willebrand disease, Idiopathic
immune thrombocytopenia

Clinical and laboratory diagnosis of

bleeding disorders

Anaemia Differential diagnosis, IDA

classification and basic Megaloblastic Anaemia
investigations of Haemolytic Anaemia
childhood anaemia

Metabolism of iron Diagnosis, prevention and

management of iron deficiency
anaemia

Blood products Basic knowledge on Packed RBC

types of blood products Platelets
and side effects of FFP
blood products

Thalassaemia and other Diagnosis & Complications of chronic iron

haemoglobinopathies management: overload
--TDT
--NTDT Screening
Genetic counselling

Clinical and Technical

Skills

18
Oncology

Common childhood Characteristics : clinical Acute Leukaemias

malignancies presentation,
differential diagnosis, Lymphomas
laboratory findings of
common childhood Brain tumours: medulloblastoma
malignancies
Neuroblastoma

Wilms tumour

Oncological emergencies Diagnosis Tumour lysis syndrome

Clinical presentation Hyperleukocytosis

Interpretation of
laboratory findings Febrile neutropenia

Principles of
management

Interpretation of results White cell differential counts

of FBCs at different
ages

Recognition of common Red cell indices

abnormalities on a
blood film

Assessment of PT, APTT, DIVC

haemostasis and
interpretation of test of
haemostasis

19
IMMUNOLOGY AND ALLERGY

Syllabus Learning Content

Outcomes

Normal body Able to compare  Describe differences between innate and

defense and contrast innate adaptive immunity
mechanisms and adaptive
immunity  Describe and understand components of
innate immunity

 Describe characteristics of adaptive immunity –

specificity, diversity, discrimination between
self and non-self, memory

 Describe the 4 types of adaptive immunity

Cellular and Able to outline the  Knows the components of adaptive immunity –
humoral immunity general steps humoral immunity and cell-mediated immunity
involved in
adaptive immune  Understand the humoral and cellular immune
response responses

 Understand the primary and secondary

immune responses

Hypersensitivity Knowledge of the  Describe the Gell and Coombs classification of

different types of hypersensitivity reactions and give examples
hypersensitivity
reactions  Understand the basic mechanisms involved in
4 types of hypersensitivity

Recognise a child
with anaphylaxis  Understand pathophysiology of anaphylaxis
and initiate basic
emergency and  Clinical presentations of anaphylaxis
supportive care
 Diagnosis and management of anaphylaxis

 The indications for auto-injector epinephrine

Immunisation Able to describe  Understand the principles of immunisation and

common concept of herd immunity
immunisation
issues like vaccine  Knowledge of active and passive
hesitancy or immunisations

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 refusal, timing and
spacing of  Knowledge of live-attenuated and inactivated
immunisations vaccines

 Contraindications and precautions to routine

childhood immunisation

 Malaysian National Immunisation programme

Primary Able to outline the  Describe clinical predictors of PID (10

immunodeficiencies indications for warnings signs of PID)
(PID) investigating for
PID  Common basic screening tests in suspected
patients with PID – full blood count, humoral,
cellular, phagocytic

21
 INFECTIOUS DISEASE

Syllabus Learning outcome Content

Knowledge of the
physiological basis and Physiology of vaccination
principles of immunisation Concept of herd immunity

To be able to counsel and Active and passive immunisations

advise parents on Live attenuated and inactivated vaccines
common immunisation
Immunisation issues like vaccine Adverse events following immunisation (AEFIs)
hesitancy or refusal,
timing and spacing of Contraindications and precautions to routine
immunisations childhood immunisation

Reporting of AEFIs to Malaysian NIP and policy

relevant authorities

Definition –classical FUO, and evolving definitions

Simple classification – classical FUO and fever

Approach to a child with due to nosocomial infections, cyclical neutropenia
Fever of unknown
FUO and periodic fever syndromes, neutropenic fever,
origin
fever in HIV infections

Categorise causes of FUO and their investigations

Pathophysiology and its complications

Predisposing conditions – immunocompromised,
Recognise early features
central lines, etc
of septic shock
Sepsis and septic
shock Prevention – neutropenia, splenectomised
Initiate resuscitation and
patients
early management
Principles of management

Commonly used classes of anti-infectives –

penicillins, macrolides, cephaolsporins,
aminoglycosides, carbapenems

Basic principles in selection of an anti-microbial in

treating common infections
Rationale use of anti-
Prescribing
microbials in different
common anti- Anti-microbial stewardship – concepts
clinical settings
infectives
Understand concept of MIC and therapeutic drug
monitoring
Drug interactions

Hospital and National Antibiotics Guidelines

22
MUSCULOSKELETAL

Syllabus
Learning outcome
Development of bone Knows basic clinical anatomy
and joints and physiology of bone and
joints
Content
Types of bones & bone growth
Anatomy of joint and surrounding
structures

Basic immunology Knows basic immunology and Innate and adaptive immune
concept of autoimmunity system

Pathogenesis of autoimmunity

Musculoskeletal Interprets MSK symptoms, Causes of MSK symptoms

(MSK) symptoms, signs and investigations according to pathophysiology -
signs and Inflammatory, mechanical and
investigation psychosomatic

Red flags to suggest serious

pathology –e.g. inflammatory ,
malignancy, infection, vasculitis,
NAI

Joint swelling Knows common causes of Causes of arthritis/joint swellings

joint swelling in children

Knows clinical features, Septic arthritis

investigation and diagnosis Juvenile idiopathic arthritis

Limp Knows differential diagnosis Infections

of limping at different ages Trauma
Arthritis
Developmental problems e.g.
DDH
Orthopedic conditions e.g SUFE,
Perthes

Limp pain Knows differential diagnosis Growing pains

of limp pain Benign hypermobility

Scoliosis Knows causes of scoliosis Congenital

Neuromuscular
Idiopathic
Others (e.g. tumours, infections)

Leg alignments and Knows normal variants Bow legs

foot postures Knock knees
In-toeing and out-toeing
Flat feet

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Multisystem disease Differentiate between
inflammatory and non-
inflammatory systemic
diseases
Knows clinical presentation,
investigation and diagnosis
Clinical features and
investigations supporting an
inflammatory aetiology
Systemic lupus erythematosus,
Juvenile Dermatomyositis
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NEONATOLOGY

Syllabus Learning Outcomes Content

Basic science and  Describe the foetal The components that make
fundamentals circulation up the foetal circulation

 Describe the Contrast between the foetal

physiological changes circulation and the postnatal
after birth and transition circulation
to extra-uterine life

 Know the physiological Principles of thermoregulation

adaptation/changes in and mechanisms of heat and
postnatal life transepidermal water loss

 Know the concept of

thermoneutrality

 Describe the oxygen

dissociation curve and
factors that shift this
curve

Newborn screening  Know the principles and National programme for

and newborn care meaning of newborn universal cord blood
screening screening
(G6PD deficiency and
congenital hypothyroidism)

Other tests e.g. universal

newborn hearing screening
and critical congenital heart
disease (CCHD) screening

 Know the principles of

Vitamin K prophylaxis
against haemorrhagic
disease of the newborn

 Know about the national BCG and Hepatitis B;

programme for indications for Hepatitis B
vaccination at birth Immunoglobulin

 Know the importance of The components of the WHO

early initiation of breast Baby Friendly Hospital
feeding and kangaroo Initiative
mother care

25
  Know the importance of The principles in umbilical
umbilical cord stump cord care and recognition of
hygiene omphalitis

Neonatal resuscitation  Know the principles and The content of the current
and transitional care steps of newborn NRP guidelines
resuscitation

 Know the cause and Principles in avoiding toxicity

effects of oxygen-related with the use of
toxicity air or blended oxygen during
resuscitation and monitoring
oxygen saturation using pulse
oximetry

 Know the definition and Recommendations by the

practice of delayed WHO and NRP
umbilical cord clamping
or umbilical cord milking

Nutrition and growth  Able to describe the The basic physiology of

monitoring importance and lactation
advantages of
breastfeeding and
recognise problems in
lactation

 Know the constituents of

human breast milk and
benefits to the infant

 Able to describe small,

appropriate and large for Causes and complications of
gestational age SGA and LGA

Fluid therapy Know the principles of fluid Definitions and physiology of

balance and therapy in the insensible and transepidermal
newborn period water loss. Normal urine
output and fluid requirements.

Prematurity  Able to define the Gestational periods for

various degrees of severe, very, moderate and
prematurity late preterm

 Know the various causes

of prematurity

 Know the definitions and Commonly associated

medical conditions and
problems of low birth
weight (LBW), including

26
 very and extremely LBW complications related to
infants prematurity

 Know the physical Assessment of gestational

characteristics and age using the Ballard and
appearance of preterm Dubowitz scores
infants

Respiratory distress in  Able to describe the Silverman scoring for the

the newborn signs of respiratory various degrees of respiratory
distress distress

 Know the common The underlying causes,

respiratory disorders clinical features and
affecting the newborn principles of management of:
infant (a)Respiratory distress
syndrome,
(b)Meconium aspiration
syndrome,
(c)Transient tachypnea of the
newborn,
(d) Pneumothorax and air
leak syndrome,
(e)Persistent pulmonary
hypertension of the newborn

 Able to define and know Clinical features and

the common causes of principles of management of
pneumonia congenital, early-onset and
nosocomial pneumonia

 Know the principles and

complications of The basis of surfactant
mechanical ventilation replacement therapy for
and continuous positive respiratory distress syndrome
airway pressure therapy
The normal, abnormal and
 Know the physiology of differences between capillary,
surfactant arterial and venous blood gas

 Able to analyse and

interpret blood gas
results

27
NEUROLOGY
Syllabus
Development of the brain
Febrile seizures
Intracranial infections
Cerebral palsy
Seizures and epilepsy
Neuromuscular disorders
Raised intracranial pressure
and hydrocephalus
Learning Outcomes
Able to describe the normal
development of the central
nervous system
Able to diagnose, manage
and stratify risk of
recurrence
Able to describe the
pathophysiology, clinical
features, investigations and
management
Able to identify the
antecedents, classify and
describe clinical features
Able to describe seizure
semiology, classify, identify
aetiology and institute acute
management
Able to describe clinical
features, identify aetiology
based on a systematic
approach
Able to describe
pathophysiology, identify its
presence, aetiology and
institute acute management
Content
Congenital brain
malformations
-Aetiology
Spinal dysraphism
Acute management
Risk of recurrence
Counselling of parents
Acute bacterial meningitis
Viral encephalitides
Tuberculous meningitis
Cerebral abscess
Definition
Antecedents
Classification
Clinical features
Describe seizure semiology
Classification
Aetiology
Acute management
including status epilepticus
Floppy infant syndrome
-Classification
-Aetiology
-Investigations
Dystrophinopathy
Spinal muscular atrophy
Clinical features
Aetiology
Acute management
28
Clinical skills Able to interpret abnormal Localize site of neurological
neurological signs lesion

Differentiate between upper

and lower motor lesion

Recognize cerebellar and

extrapyramidal signs

Technical skills Knowledge of LP Lumbar puncture

Indications
Contraindications

Able to interpret Interpret CSF results

cerebrospinal fluid (CSF)
results

29
NEPHROLOGY

Syllabus Learning Content

Outcomes

1. Basic Sciences Able to describe the Anatomy – landmark, adjacent

a. Renal and basic renal and structures
Bladder bladder function Physiology –glomerular and tubular
Anatomy anatomically and function
physiologically. Bladder innervation and control
b. Embryology Able to describe renal physiological
of changes that occur from neonates to
genitourinary adult
system
To understand how renal regulate
electrolyte balances and clinical
c. Renal manifestation
physiological
changes To understand the concept of RAAS
from neonate
Appreciate the concept of acid base
to adult
disturbances and interpretation of
Understand how blood gaseous
d. Bladder
innervation normal renal and
bladder Congenital anomalies of the kidney
and controls and urinary tract (CAKUT) - PUV,
development (in
order to understand PUJO, VUJO.
pathogenesis of
CAKUT)

2. Clinical conditions Able to describe the Idiopathic vs secondary nephrotic

pathophysiology, syndrome (NS)
clinical features,
investigations and Pathogenesis of oedema (underfilled
basic management vs overfilled)
of common
condition Management of NS

Glomerulonephritis – APSGN
Henoch Schonlein Purpura

Nephrotic syndrome Principles of managing paediatric UTI

Acute kidney injury- manifestation

and basic management approach

30
 Nephritis: Causes for young hypertension and
Acute post- pharmacological management of
streptococcal GN hypertension (acute)
Henoch Schonlein
Purpura Corticosteroids-mechanism and side
effects

Urinary tract Common drugs associated with

infection nephrotoxic- antibiotic/chemo
agents/ analgesic
Acute kidney injury

Hypertension

To be aware what
are potential
steroids side effects
and toxicity

To be aware of
medication that
potentially resulted
in renal
toxicity/nephrotoxic
drugs

3. Relevant GUS Able to explain the Basis of specific test- clinical

investigations (when basis of relevant significance
to request/how to investigations, and
perform and interpret the findings a. Urinalysis
interpret) b. USS KUB
c. MCUG
d. Radionuclide
scan(DMSA/DTPA/MAG3)

31
NUTRITION

Syllabus Learning Outcomes Content

Nutrition & growth Knowledge in management - Basic nutrition

basic nutritional requirement requirement for all
paediatric age group

Infant feeding Breastfeeding - Benefits to mother

and child
Breast milk substitutes - Contraindication:
- Choices absolute and relative
- Types - Baby-friendly
- Indications initiative: the 10 steps
- Issues surrounding
breastfeeding

Complementary feeding & Able to counsel on weaning - What is weaning.

weaning and choice of - Timing of weaning.
complementary feeds - Appropriate choices
and ways in
complementary
feeds

Nutritional assessment Able to perform appropriate - Different techniques

nutritional assessment for all of measuring
age group nutritional
parameters
Able to monitor growth - Different types of
appropriately growth charts

Malnutrition & malabsorption Physiology of nutrient - Able to anticipate

digestion, absorption, potential deficiency
metabolism, and elimination of specific nutrition
group in different
clinical scenario
- Able to recognise
protein energy
malnutrition &
kwashiorkor

Obesity Able to recognize obesity - Important

and its potential parameters and
complication clinical signs during
assessment of
overweight and
obese
- Potential
complications of
obesity
-

32
RESPIRATORY

Syllabus Learning Outcomes Content

Lung development Able to describe the Different stages of lung

embryological development
development of the lung

Pulmonary physiology Able to describe Respiratory muscles

and control of breathing structure and function of Chest wall
the respiratory system Airway (upper & lower)
Lungs
Pulmonary circulation

Able to describe the Central controller

breathing mechanism Brainstem, Medulla and Pons
and its control
Effectors - Muscles of
respiration

Sensors - Central & peripheral

chemoreceptors & Lung
receptors

Able to describe the Oxygen-haemoglobin

mechanism of gas dissociation curve
exchange.
Mechanism and causes of
Hypoxia and hypoventilation

Differences between Able to describe the Upper and lower airway and
infant and adult anatomical differences lung anatomy
respiratory system between infants and
adults

Able to describe the Low lung volumes

physiological differences Limited respiratory reserve
between infants and Poor lung elastic recoil
adults High lung compliance
High airway resistance

Lung defense Able to describe the lung Cilia function and its role in
mechanism defense mechanism the defense system

Mechanical responses Cough reflex

Mucus secretion and
clearance

Non-immunologic Pulmonary macrophages

responses Airway epithelial cells
Mast cells

33
Lung function Able to describe and PEFR
interpret lung function. Bronchodilator response

Respiratory failure Able to understand and Type 1 and type 2 respiratory

explain the features and failure – pathophysiology and
development of causes
respiratory failure
Clinical signs and symptoms
of respiratory failure

Interpretation of blood gas

Common respiratory Able to explain and Wheezing

noises understand the
pathophysiology and Acute and chronic stridor.
causes of
common respiratory Grunting
noises
Snoring
Approach to wheezing, Clinical history, physical
stridor and snoring examination, differential
diagnosis, and management.

Upper respiratory tract Able to describe the Rhinitis

infections pathophysiology, clinical Pharyngitis
features, investigations Tonsillitis
and principles of Otitis media
management. Sinusitis
Epiglottitis
Croup
Bacterial tracheitis

Lower respiratory tract Able to describe the Bronchiolitis

infections pathophysiology, clinical
features, investigations Community Acquired
and management. pneumonia
- different organisms
according to age groups.

Asthma Able to describe the Acute Asthma

pathophysiology, clinical
Classification and assessment
features, investigations
of asthma severity
and management.
Pharmacology in acute
asthma.

Chronic Asthma Classification

of Intermittent & Persistent
Asthma

34
 Pharmacology in chronic
asthma and the devices used
Asthma action plan
Asthma education
* reference to Malaysian CPG
on childhood asthma 2014

Chronic suppurative Able to describe the Causes, investigations and

lung disease pathophysiology, clinical management in
features, investigations bronchiectasis
and management

35