Paediatrics for PLAB 1: The Febrile Child, Neonates and the UK Vaccine Schedule

Scope and time budget

About fourteen questions is fourteen minutes. Paediatrics is a domain where candidates from adult-focused training can lose marks, because normal values, doses and presentations differ with age. The exam leans on common conditions and safe first steps: the child who is unwell, the infant who feeds poorly, the child with a rash, and the child who may be at risk.

What is tested

• Neonates. Neonatal jaundice and resuscitation, neonatal sepsis, hypoglycaemia and feeding problems.
• Growth and development. Milestones and delay, growth, failure to thrive and obesity, cerebral palsy, autism spectrum disorder and learning disability.
• Illness in children. The febrile child with traffic-light assessment, bronchiolitis, croup and asthma, febrile convulsions and epilepsy, meningitis and sepsis, gastroenteritis and dehydration, urinary tract infection and vesicoureteric reflux, Kawasaki disease, Henoch-Schonlein purpura, rheumatic fever and exanthems, type 1 diabetes and DKA, cystic fibrosis, coeliac disease and food allergy.
• Surgical and cardiac. Intussusception, pyloric stenosis, malrotation, appendicitis, congenital heart disease and murmurs.
• Prevention and protection. The immunisation schedule and adolescent health, safeguarding including non-accidental injury, neglect and FGM, and paediatric prescribing.
• Emergencies. Choking, anaphylaxis and paediatric life support.

UK points to anchor your answers

The NHS routine immunisation schedule on 21 October 2026 is shown below. MMRV entered the routine offer from 1 January 2026, and Menitorix (Hib/MenC) is no longer in the schedule. The UKHSA Green Book is the authority for contraindications.

• Newborn screening: physical examination, hearing test and blood spot test.
• Diabetic eye screening: from age 12, relevant for young people with type 1 diabetes.
• GMC 0-18 years guidance: capacity and consent, confidentiality, access to records, child protection, and the care of under-16s who seek contraception, abortion or STI care without parental knowledge or consent.

The mandatory duty to report known female genital mutilation in girls under 18 and the Children Acts framework are examinable. We could not read those sources for this page, so learn them from GOV.UK and the legislation, and check the date.

How the questions are framed

Child health stems start with the age, which sets everything else. A fever means one thing at six weeks and another at six years. A stem may give weight, heart rate, respiratory rate and capillary refill, and ask for a classification, such as the traffic-light risk of a febrile child, or for the immediate action. Dehydration questions ask for the route and type of fluid. Immunisation items give an age and ask what is due, or give a history and ask whether a vaccine is safe. Safeguarding items describe an injury, a history that does not fit, or a delay in presentation, and ask for the right process.

What examiners ask about each group

• Fever and sepsis. Risk-stratify, recognise red flags, treat early and know when to admit.
• Respiratory illness. Distinguish bronchiolitis, croup and asthma by age, sound and response to treatment, and know which treatments help and which do not.
• Neonatal problems. Interpret jaundice by timing, recognise sepsis and hypoglycaemia, and know feeding and resuscitation basics.
• Surgical emergencies. Recognise the classic features of intussusception, pyloric stenosis and malrotation, and act on bile-stained vomiting.
• Safeguarding. Follow the escalation path: document, discuss with the senior and the safeguarding lead, and refer.
• Development. Link a missed milestone to the correct referral.

Time and common mistakes under pressure

Paediatric stems are usually short, which makes them quick if your knowledge is secure and costly if it is not. Because normal ranges move with age, do not guess from adult values. If you cannot recall the range, reason from the story: is the child feeding, alert, well perfused and playing? Those features often separate a safe answer from an urgent one.

Under time pressure, candidates often select a test (a lumbar puncture, a scan, a blood culture) when the question asks for the immediate treatment. In a sick child, the order is assess, treat, escalate, then investigate. Reading the last sentence of the stem first keeps you on the right task.

Three typical traps

1. Applying adult values and doses. Check the child's age and weight in the stem. Calculation items use weight-based dosing that must be done by hand.
2. Getting the vaccine timeline wrong. Eligibility for MMRV depends on birth date. Menitorix is out of the schedule. Read the age and birth date carefully.
3. Treating a safeguarding concern as a diagnosis to be proved. The correct step is to raise the concern through the proper channel, not to wait for certainty.

How to revise it

1. Make an age-based table of vital sign ranges, milestones and vaccines, from a trusted source.
2. Learn the three respiratory conditions side by side: bronchiolitis, croup and asthma.
3. Build one-page cards for the febrile child, neonatal jaundice, dehydration and the vomiting infant.
4. Read the GMC 0-18 guidance and practise applying it to consent and confidentiality scenarios.
5. Do 20-question timed blocks and log errors by age group.

Link this domain to acute and emergency care, respiratory and the professional domain for safeguarding.