How child health is examined
Child health is 12.5% of the AMC MCQ blueprint, about 19 of 150 questions. Most are set in general practice or the paediatric emergency department. The core skills are recognising serious illness, judging hydration and respiratory distress, knowing developmental norms and the immunisation schedule, and acting on child protection concerns. The Royal Children's Hospital Melbourne clinical practice guidelines are a widely used Australian reference.
The newborn
- Jaundice in the first 24 hours is pathological until proven otherwise; jaundice beyond 2 weeks with pale stools needs a split bilirubin to exclude biliary atresia.
- Newborn bloodspot screening (heel prick) at 48 to 72 hours detects conditions such as hypothyroidism, PKU and cystic fibrosis; newborn hearing screening follows.
- Neonatal sepsis: early-onset is usually group B streptococcus or E. coli; treat with benzylpenicillin and gentamicin.
- Developmental dysplasia of the hip: Ortolani and Barlow tests at birth and checks; ultrasound at about 6 weeks for babies with risk factors.
- Safe sleeping: on the back, in a safe cot, face uncovered, smoke-free (Red Nose guidance).
The febrile and unwell child
Young infants are high risk: a febrile infant under about 3 months often needs blood, urine and CSF testing and empirical antibiotics, guided by local pathways. In older children, look for the source and for red flags.
| Red flag | Concern |
|---|---|
| Non-blanching rash | Meningococcal disease: give parenteral antibiotics immediately |
| Lethargy, poor perfusion, reduced urine output | Sepsis or severe dehydration |
| Grunting, recession, hypoxia | Significant respiratory illness |
| Bulging fontanelle, neck stiffness, seizure | Meningitis or encephalitis |
| Fever for 5 days with conjunctivitis, rash, mouth and extremity changes | Kawasaki disease |
Respiratory illness
| Condition | Typical age | Management |
|---|---|---|
| Bronchiolitis | Under 12 months | Supportive care; oxygen if saturations below 90 to 92%; no salbutamol, steroids or antibiotics |
| Croup | 6 months to 6 years | Oral dexamethasone or prednisolone; nebulised adrenaline for severe croup |
| Asthma | Over 1 year (diagnosis harder in preschoolers) | Salbutamol by spacer; oral prednisolone for moderate to severe attacks; preventer if frequent symptoms |
| Pneumonia | Any | Oral amoxicillin for non-severe cases |
| Inhaled foreign body | Toddlers | Unilateral wheeze after choking: rigid bronchoscopy |
Gastroenteritis, dehydration and abdominal pain
- Assess dehydration clinically: capillary refill, skin turgor, mucous membranes, mental state and urine output.
- Use oral rehydration solution first, including by nasogastric tube; IV fluids for severe dehydration or shock.
- Ondansetron can reduce vomiting in children over 6 months.
- Bilious vomiting in a neonate is malrotation with volvulus until proven otherwise.
- Projectile non-bilious vomiting at 2 to 8 weeks suggests pyloric stenosis (hypochloraemic, hypokalaemic alkalosis).
- Episodic screaming, pallor and redcurrant jelly stool in an infant suggests intussusception.
Growth and development
| Age | Expected milestone |
|---|---|
| 6 weeks | Social smile |
| 6 to 8 months | Sits without support |
| 9 to 12 months | Pincer grip, waves, first words around 12 months |
| 12 to 18 months | Walks independently (refer if not walking by 18 months) |
| 2 years | Two-word phrases, about 50 words |
| 3 to 4 years | Speaks in sentences, understood by strangers |
Red flags include loss of skills at any age, no pointing or babbling by 12 months, and hand preference before 18 months. Check hearing in any language delay. Plot growth on charts and act on falling centiles.
Immunisation
The National Immunisation Program schedule gives vaccines at birth (hepatitis B), 2, 4 and 6 months, 12 months (including MMR), 18 months (including MMRV), and 4 years, with school-based adolescent vaccines including HPV. Know common contraindications: true anaphylaxis to a previous dose or component, and live vaccines in significant immunosuppression. Minor illness is not a reason to delay.
Check the current schedule in the Australian Immunisation Handbook, as it changes. Aboriginal and Torres Strait Islander children and some medical risk groups receive additional vaccines.
Child protection
Every state and territory requires doctors to report reasonable suspicion of child abuse or neglect, although the details differ. Exam questions test recognition and the next step.
- Suspect abuse with injuries inconsistent with the history or development (any fracture or bruise in a non-mobile infant), delayed presentation or changing stories.
- Admit the child if needed for safety and investigation, including skeletal survey in young children.
- Report to the state child protection service and document carefully; do not confront or investigate yourself.
Adolescent health
See young people alone for part of the consultation, explain confidentiality and its limits, and use the HEADSS psychosocial assessment (home, education or employment, activities, drugs, sexuality, suicide and mood). A young person who understands the treatment can consent for themselves under the mature minor principle.
Common exam themes are contraception and sexual health, eating disorders, depression and self-harm, substance use and type 1 diabetes management.
Common childhood infections
| Condition | Key features | Management |
|---|---|---|
| Acute otitis media | Ear pain, fever, bulging drum | Analgesia and watchful waiting in most children over 6 months; amoxicillin if under 6 months, severe, or high-risk (including many Aboriginal children) |
| Tonsillitis and scarlet fever | Sore throat, fever; sandpaper rash in scarlet fever | Phenoxymethylpenicillin for 10 days for strep, especially in groups at risk of rheumatic fever |
| Urinary tract infection | Fever without a source in infants | Clean catch or catheter sample; oral or IV antibiotics; imaging if atypical or recurrent |
| Measles | Cough, coryza, conjunctivitis, then rash from the hairline | Notify, isolate, and give contacts MMR or immunoglobulin |
| Chickenpox | Vesicles in crops | Avoid NSAIDs and aspirin; watch for secondary bacterial infection |
| Hand, foot and mouth disease | Mouth ulcers and vesicles on hands and feet | Supportive care |
Diabetes, growth and puberty
- Type 1 diabetes: polyuria, thirst, weight loss and bedwetting; check a finger-prick glucose the same day and refer urgently. In DKA, replace fluids slowly over 48 hours because of cerebral oedema risk.
- Short stature: plot height and parental heights; constitutional delay shows normal growth velocity with delayed bone age.
- Precocious puberty: breast development before 8 in girls or testicular enlargement before 9 in boys needs assessment.
- Obesity: family-based lifestyle change, and screening for complications in significant obesity.
Development, behaviour and learning
- Autism: early signs include no pointing by 12 months, poor eye contact, not responding to name and loss of skills; refer early for diagnosis and intervention.
- ADHD: symptoms across settings for at least 6 months; behavioural strategies, school support and stimulant medicine with growth and blood pressure monitoring.
- Speech delay: always check hearing first.
- Enuresis: common until 5 to 6 years; alarms are first-line for motivated older children; treat constipation.
- Breath-holding spells: benign; check for iron deficiency and reassure.
Paediatric emergencies
- Anaphylaxis: IM adrenaline 0.01 mg/kg into the lateral thigh (maximum 0.5 mg), repeated every 5 minutes if needed; lay the child flat or let them sit if breathless.
- Status epilepticus: benzodiazepine (buccal or intranasal midazolam, or IV) after 5 minutes of seizure, then a second-line agent.
- Ingestions: call the Poisons Information Centre (13 11 26); button batteries need urgent X-ray and removal.
- Drowning and burns: supervision and pool fencing prevent most drowning; cool burns with running water for 20 minutes.
Worked examples
Worked example 1 · Bronchiolitis
A 4-month-old has 2 days of cough and rhinorrhoea, a respiratory rate of 56, mild recession and oxygen saturation of 94% in air. She is feeding about two thirds of her usual amount. What is the most appropriate management?
- A Nebulised salbutamol and review in an hour
- B Oral prednisolone for 3 days
- C Supportive care with feeding support and safety-netting
- D Oral amoxicillin
- E Admit for IV fluids and oxygen
Show the reasoning
Answer C. This is mild to moderate bronchiolitis. Australasian guidance recommends supportive care only. Oxygen is not needed above 90 to 92%, and salbutamol, steroids and antibiotics do not help. Feeding at two thirds of normal can often be supported at home with clear safety-netting, or with nasogastric feeds if intake falls further.
Worked example 2 · Development
An 18-month-old boy is not yet walking. He sits well, pulls to stand and says three words. What is the most appropriate next step?
- A Reassure and review at 3 years
- B Check creatine kinase and refer for assessment
- C Start physiotherapy without further assessment
- D MRI brain under general anaesthetic
- E Hearing test only
Show the reasoning
Answer B. Not walking by 18 months needs assessment. In boys, a creatine kinase is recommended to screen for Duchenne muscular dystrophy, alongside a developmental review.
Common child health traps
- Prescribing salbutamol or steroids for bronchiolitis.
- Delaying antibiotics for suspected meningococcal disease to do a lumbar puncture.
- Reassuring about a non-mobile infant with a bruise.
- Accepting a bag urine sample for culture in an infant.
- Using adult antibiotic doses instead of weight-based paediatric dosing.
Free sample child health questions
Questions from our AMC MCQ bank. Choose your answer, then open the explanation.
A 6-hour-old baby born at 37 weeks has tachypnoea, temperature instability and reduced feeding. His mother had intrapartum fever and prolonged rupture of membranes. Blood culture and a full blood count are taken. Lumbar puncture is deferred because he is unstable. According to Australian guidelines, which empirical antibiotic regimen is most appropriate?
- AIV ceftriaxone as monotherapy
- BOral amoxicillin with clavulanic acid
- CIV benzylpenicillin plus gentamicin
- DIV vancomycin plus meropenem
- EIV flucloxacillin as monotherapy
Show answer and explanation
Answer C. Empirical treatment of early-onset neonatal sepsis in Australia (Therapeutic Guidelines) is IV benzylpenicillin (or amoxicillin/ampicillin) plus gentamicin. This covers group B streptococcus, Escherichia coli and other Gram-negative organisms, and the amoxicillin option covers Listeria. Gentamicin levels are monitored, and the regimen is changed if meningitis is suspected.
Learning point: Empirical therapy for early-onset neonatal sepsis is IV benzylpenicillin (or amoxicillin) plus gentamicin.
A 7-year-old boy is brought to his GP after his teacher suggested he may have ADHD. The teacher reports that he is inattentive, fidgety and disrupts other children in class. His parents say that at home he can concentrate on Lego for long periods, follows instructions and has no behavioural problems, and his sports coach has no concerns. He is otherwise healthy and his development has been normal. What is the most appropriate next step?
- AStart methylphenidate for a two-week trial
- BDiagnose ADHD based on the teacher's report
- CAdvise a change of school and classroom
- DArrange an EEG to exclude epilepsy
- ECollect rating scales from home and school
Show answer and explanation
Answer E. DSM-5 criteria for ADHD require several inattentive and/or hyperactive-impulsive symptoms present for at least 6 months, with onset before age 12, that cause impairment in two or more settings, such as home and school. When symptoms appear in only one setting, collecting standardised rating scales (for example Conners or Vanderbilt) from parents and teachers, and considering classroom factors, learning difficulties, anxiety or bullying, is essential before making a diagnosis.
Learning point: ADHD diagnosis requires impairing symptoms in at least two settings, confirmed with information from home and school.
A 22-month-old boy presents to a GP with 4 months of irritability, a distended abdomen and large, pale, offensive stools. His weight has fallen from the 50th to below the 10th centile since solids including wheat cereals were introduced. On examination he is miserable, with wasted buttocks and a protuberant abdomen. There is no history of chest infections. He is eating a normal toddler diet. What is the most appropriate initial investigation?
- AFaecal elastase and stool fat microscopy
- BSweat chloride test by iontophoresis
- CUpper gastrointestinal endoscopy with biopsy
- DTissue transglutaminase IgA with total IgA
- EHydrogen breath test after lactose load
Show answer and explanation
Answer D. This child has the classic presentation of coeliac disease: faltering growth after gluten introduction, abdominal distension, irritability, steatorrhoea and buttock wasting. The first-line test is tissue transglutaminase IgA together with total IgA, because IgA deficiency is more common in coeliac disease and causes false-negative results. Testing must be done while the child is eating gluten, and positive serology is generally followed by duodenal biopsy to confirm the diagnosis.
Learning point: Screen for coeliac disease with tTG-IgA plus total IgA while the child is still eating gluten.
Practise more child health questions free
Every child health subtopic in our bank
The bank holds 392 child health questions across 68 subtopics. You can filter by any of them, build a custom block and track your accuracy subtopic by subtopic.
- ADHD7
- Adolescent health12
- Anaphylaxis5
- Appendicitis in children5
- Asthma in children6
- Autism spectrum disorder6
- Behavioural problems6
- Birth injuries7
- Bronchiolitis6
- Cerebral palsy5
- Child protection & mandatory reporting7
- Childhood cancers5
- Coeliac disease in children5
- Congenital heart disease & murmurs5
- Congenital infections7
- Constipation5
- Croup6
- Cystic fibrosis5
- Developmental dysplasia of the hip7
- Developmental milestones & delay7
- Down syndrome & common genetic conditions5
- Enuresis & encopresis6
- Epilepsy syndromes in childhood5
- Eye problems in children1
- Failure to thrive6
- Febrile seizures5
- Fever in infants and children6
- Foreign body inhalation and ingestion5
- Gastroenteritis and dehydration5
- Hirschsprung disease5
- Hypospadias4
- Infant formula & cow's milk protein allergy6
- Infants of diabetic mothers6
- Inguinal hernia & hydrocele5
- Intussusception5
- Kawasaki disease5
- Limp in children5
- Malrotation & volvulus5
- Meningitis and sepsis6
- National Immunisation Program schedule & contraindications7
- Neonatal abstinence syndrome6
- Neonatal feeding problems6
- Neonatal hypoglycaemia7
- Neonatal jaundice7
- Neonatal resuscitation7
- Neonatal sepsis7
- Nephrotic syndrome, HSP & HUS5
- Newborn examination7
- Newborn screening7
- Non-accidental injury5
- Nutrition & breastfeeding6
- Obesity in children6
- Otitis media6
- Paediatric orthopaedics4
- Paediatric resuscitation and poisoning5
- Pneumonia in children6
- Prematurity complications6
- Puberty disorders6
- Pyloric stenosis5
- Respiratory distress in the newborn7
- Short stature6
- Speech & hearing concerns6
- Sudden unexpected infant death & safe sleeping6
- Tonsillitis and scarlet fever6
- Type 1 diabetes & DKA in children5
- Undescended testis4
- UTI in children5
- Viral exanthems6
Common questions
How many child health questions are in the AMC MCQ?
Child health is 12.5% of the blueprint, about 19 of 150 questions.
Which paediatric guidelines should I study?
Australian sources such as the Royal Children's Hospital Melbourne clinical practice guidelines, the Australian Immunisation Handbook and Therapeutic Guidelines.
When is MMR given in Australia?
At 12 months, with MMRV at 18 months, on the National Immunisation Program.
Is bronchiolitis treated with salbutamol?
No. Australasian guidance recommends supportive care only, with oxygen and hydration support when needed.
How many child health questions are in the AMC MCQ bank?
There are 392 child health questions across 68 subtopics, and the bank grows as new questions pass review.
Can I practise only child health questions?
Yes. Filter by area or by any subtopic to build a custom block, in tutor mode with explanations after each question or in timed mode.
How are child health questions explained?
Every question explains why the answer is right and why each other option is wrong, with a learning point and the Australian source behind it.
How much of the AMC MCQ mock is child health?
About 19 questions in each 150-question mock come from child health, following our mock blueprint.
Which sources is this child health page based on?
It summarises current Australian guidance, including AMC MCQ Examination Specifications (version 8, 2025); Royal Children's Hospital Melbourne Clinical Practice Guidelines; Australian Immunisation Handbook. Guidelines change, so always check the latest edition.
When was this child health guide last updated?
It was last reviewed on 9 November 2026. We update topic pages when the exam or Australian guidance changes.
Sources
Clinical content is summarised from current Australian guidance at the date above. Guidelines change, so always check the latest edition.