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canuc-paeds / Foundational Knowledge

March 2012

 

Health Supervision

 

Describe the use and limitations of tools to support periodic health supervision

 

Describe the principles of screening tests

 

Describe how cultural values influence health and health care interactions

 

Take a family history to identify increased risk for inherited conditions and discuss mechanisms and patterns of inheritance.

 

Describe the nutritional requirements for growth and maintenance of health for infants, children and adolescents.

 

Compare breast and formula feeding

 

Describe the criteria for diagnosis of common mood, anxiety and behavioural disorders in children and youth.

 

Describe how vaccines work and the diseases they prevent.

 

Summarize the benefits and contraindications of immunizations.

 

Describe the epidemiology of childhood injury

 

Describe age-related measures to reduce injury in the paediatric population.

 

Describe normal visual development

 

Identify risk factors for hearing impairment

 

Describe normal dental development

 

Describe the pathophysiology of and risk factors for dental caries and gingival disease.

 

Explain the concept of reinforcement and factors that influence learning and behaviour

 

Describe sleep physiology and stages, sleep needs for different age groups, and best practices for sleep hygiene.

 

List the effects of sleep deprivation.

 

List risk factors for and strategies that decrease the risk of Sudden Infant Death

 

Describe the typical and atypical timing and progression of sexual maturation.

 

List common sexually transmitted infections, their presentation, treatment and strategies for prevention.

 

Describe the concept of developmental surveillance.

 

 

Newborn 

 

Describe basic embryology and fetal development and how alterations may lead to congenital abnormalities

 

List factors affecting fetal growth

 

Describe normal and abnormal patterns of fetal growth

 

Define pre-term, term and post-term gestation

 

Identify prenatal risk factors for adverse outcomes in a newborn

 

Describe the processes of transition and adaptation from intrauterine to extrauterine life

 

Define asphyxia and describe its biochemical and physiological effects on the newborn at birth

 

Describe common injuries that may be sustained by the newborn during delivery

 

Describe glucose homeostasis in the newborn

 

Describe the extrinsic and intrinsic factors that predispose newborns to infection

 

 

Neonatal Jaundice

 

Describe liver anatomy and the physiology of bilirubin metabolism and excretion.

 

Describe the functions of the liver and interpret the tests of liver function, hepatocellular function, and cholestasis.

 

Differentiate between conjugated and unconjugated bilirubin.

 

Describe blood group type and antigens, and explain the mechanism whereby blood group incompatibility can affect bilirubin metabolism.

 

Fever

 

Describe the pathophysiology of thermoregulation and define fever

 

List and classify common pathogens that cause fever

 

List non-infectious causes of fever

 

Describe modes of transmission of infectious agents and means of prevention.

 

Demonstrate competence in application of universal precautions

 

Describe the basic principles of pharmacology used in the management of fever and infectious and non-infectious febrile conditions

 

 

Dehydration

 

Describe the fluid composition of the body, the body water compartments and the normal movement of fluids and electrolytes between compartments

 

Describe clinical signs of dehydration                  

 

Describe the pathophysiology of fluid, electrolyte and acid-base imbalances

 

Describe principles of rehydration

 

Explain the effect of hyperglycemia on fluid, electrolyte and acid-base status

 

Describe the basic principles of pharmacology used in the management of diabetic ketoacidosis

 

 

Respiratory Distress/Cough

 

Describe the anatomy and physiology of the respiratory system and relate them to the respiratory physical exam

Describe the differences between upper and lower airway conditions and their clinical manifestations

Describe the physiology of restrictive and obstructive lung disease

Describe the pathophysiology of infectious and non-infectious respiratory conditions

Identify symptoms and signs of respiratory distress and recognize adventitious sounds

Name and classify pathogens that cause respiratory disease in children

Describe basic principles of pharmacology used in the management of common respiratory conditions

Demonstrate an approach to chest X-ray and blood gas interpretation

 

 

Developmental & Behavioural Problems

 

Define the 5 developmental domains used in describing children’s development: gross motor, fine motor, speech & language, cognitive and social-emotional.

 

List major age-related developmental milestones through age 5.

 

Describe typical patterns of social-emotional development.

 

Explain the concept of temperament and its effect on development and behaviour.

 

Explain the influence of extrinsic factors on the development and behaviour of children.

 

Recognize major deviations from the normal range of development and behaviour

 

 

Growth Problems

 

Describe the anatomy and physiology of the endocrine system.

 

Describe the physiology of pre- and post-natal growth

 

Describe the normal pattern of growth velocity in the fetus, infants, children, and adolescents.

 

Differentiate abnormal growth from normal growth variants

 

Describe the risk factors that contribute to the development of abnormal eating behaviours

 

Describe the physiological and psychological consequences of obesity and malnutrition

 

 

Inadequately Explained Injury (child abuse)

 

Define the different types of child maltreatment

 

List the risk factors for child maltreatment

 

Recognize normal and abnormal patterns of injury in children.

 

 

Abdominal Pain

 

Describe the anatomy, physiology and embryology of the gastrointestinal, genitourinary and reproductive systems

 

Relate locations and patterns of abdominal pain to basic anatomy and physiology

 

Describe normal stooling patterns and the influence of diet.

 

Describe the differences between upper and lower intestinal obstruction and their clinical manifestations.

 

Identify investigations that may be used in the evaluation of abdominal pain

 

 

Vomiting

 

Describe the physiology of gastrointestinal tone and motility.

 

Relate bilious vomiting to the anatomy of the gastrointestinal tract

 

Identify non-gastrointestinal causes of vomiting

 

Describe metabolic and electrolyte alterations that occur with vomiting.

 

Apply basic principles of pharmacology and indications for drugs used in the management of vomiting

 

 

Diarrhea

 

Describe the pathophysiology of diarrhea

 

Identify infectious and non-infectious causes of diarrhea and describe the pathophysiology of these conditions

 

Name and classify pathogens that cause bloody and non-bloody diarrhea

 

 

Altered Level of Consciousness

 

Describe the anatomy and physiology of the central and peripheral nervous systems

 

Describe in basic terms the pathophysiology of brain injury

 

Describe how the brain maintains consciousness, how unconsciousness occurs and the differences between unconsciousness and sleep

 

Name and classify the most common CNS pathogens, based on organism type and area of brain commonly affected

 

List toxic agents that can cause altered level of consciousness and describe their mechanisms of action

 

Describe common toxidromes

 

Discuss the indications for the use of the different modalities available to assess neurologic structure and function

 

Describe metabolic and electrolyte abnormalities that cause altered level of consciousness

 

 

Seizure/Paroxysmal Event (ALTE/syncope/breath-holding/seizure/)

Describe the neurophysiology of electrical and chemical signal transmission 

 

Discuss the pathophysiology of seizure activity

 

Identify neurologic and non-neurolgic causes of paroxysmal events

 

Apply basic principles of pharmacology in the management of seizure

 

 

Headache

 

Describe the anatomy and pain sensing structures of the head and neck

 

Classify headaches by etiology and explain the pathophysiology of each type

 

Outline the pathophysiology of increased Intracranial Pressure (ICP)

 

Describe the tissue origins and pathophysiology of central nervous system tumours

 

Apply basic principles of pharmacology in the management of headache

 

 

Murmur

 

Describe the anatomy of the cardiovascular system, explain the basic physiology of cardiac function, and be able to relate the anatomy and physiology to the cardiac physical exam finding.

 

Describe the basic embryology of the heart and major vessels and how abnormalities in embryological development lead to the development of congenital heart defects.

 

Describe the structural and dynamic changes that occur following birth in the cardiovascular system, including closure of the ductus arteriosus.

 

Describe the classification system of murmurs.

 

 

Rash

 

Describe the anatomy and function of the skin and related structures

 

Describe and classify rashes

 

Name and classify common pathogens that cause rashes

 

Describe the basic principles of pharmacology used in the management of common paediatric rashes.

 

 

Bruising & Bleeding

 

Describe the coagulation cascade and process of clot stabilization

 

Identify the symptoms and signs of bleeding or clotting disorders

 

Demonstrate an approach to the interpretation of coagulation studies  

Describe the indications, contraindications and complications of blood products and their administration

 

 

Pallor (anemia)

 

Describe the anatomy and physiology of the hematopoietic system, including origin, function and structure of each major blood component

 

Describe iron metabolism as it relates to heme production

 

Classify hematologic disease in terms of production, destruction and consumption.

 

Describe the physiologic consequences of anemia

 

Identify signs and symptoms of hematological diseases.

 

Demonstrate an approach to the interpretation of a CBC and differential and iron studies

 

 

 

Lymphadenopathy

 

Describe the anatomy and physiology of the lymphatic system

 

Compare and contrast the physical characteristics and distribution of normal vs abnormal lymphatic tissue

 

Distinguish between infectious and non-infectious causes of lymphadenopathy in children

 

Name and classify pathogens that cause lymphadenopathy in children

 

 

Limp/Extremity Pain

 

Identify the basic anatomy and physiology of the musculoskeletal system.

 

Describe the growth and development of bones, joints, and surrounding soft tissues.

 

Describe the components of normal gait.

 

Explain the infectious and non-infectious causes of musculoskeletal pain and inflammation.

 

Name and classify the common pathogens to affect the musculoskeletal system.

 

Define innate and humoral immunity and describe the pathophysiology of autoimmune diseases.

 

Summarize the process of repair and healing of musculoskeletal injury.

 

Describe the basic principles of pharmacology used in the management of inflammation and pain.

 

 

Urinary Complaints (polyuria / frequency / dysuria / hematuria)

 

Describe the anatomy and physiology of the genitourinary system.

 

Identify infectious and non-infectious causes of urinary complaints.

 

List and classify the common pathogens causing urinary tract infections in children.

 

Distinguish between glomerular versus non-glomerular hematuria.

 

Describe the pathophysiology of glucose homeostasis and the consequences of hyperglycemia.

 

Apply basic principles of pharmacology and indications for drugs used in the management of urinary tract infections and diabetes.

 

 

 

Edema

 

Describe the fluid composition of the body, the body water compartments and the normal movement of fluids and electrolytes between compartments.

 

Describe the anatomy and physiology of the renal system.

 

Describe non-renal causes of edema.

 

Describe the pathophysiology of glomerular disease.

 

Interpret results of a urinalysis and other tests of kidney function.

 

Distinguish between pre-renal, renal and post-renal failure.

 

Distinguish between transient, benign, and pathologic proteinuria.

 

 

Sore Ear

 

Describe the anatomy and physiology of the ear and related structures

 

Describe the pathophysiology and risk factors of common diseases affecting the ear and related structures

 

Name and classify pathogens that cause ear infections in children

 

Describe the basic principles of pharmacology for antibiotic use and analgesia in ear infections

 

 

Sore Throat / Sore Mouth

 

Describe the anatomy and physiology of the throat and oral cavity

 

Describe the pathophysiology and risk factors of common diseases affecting the throat and oral cavity

 

Name and classify pathogens that cause common diseases of the throat and oral cavity

 

Describe the basic principles of pharmacology used in the management of common throat and oral cavity infections

 

 

Sore Eye / Red Eye

 

Describe the anatomy and physiology of the eye and related structures

 

Describe the pathophysiology and risk factors of common diseases affecting the eye and related structures

 

Demonstrate assessment of extraocular movements and identify the corresponding cranial nerves

 

List and classify the pathogens causing infections of the eye and related structures

 

Describe the basic principles of pharmacology used in the management of common eye infections

 

 

 

 

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