Official Pediatrics Shelf Exam Thread

[Pox in a box]

Anyone have any advice on the pediatrics shelf exam? This exam hasn't been stickied yet so I'm still scavenging the advice and trying to get some better perspective. My plan thus far is to read all of Blueprints, FA, A&L or Pretest (not sure which one I want to do yet), and I've skimmed certain sections of Harriet Lane and Nelson's. Your advice and insight would be helpful. Thanks.

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[InHoc]

Anyone have any advice on the pediatrics shelf exam? This exam hasn't been stickied yet so I'm still scavenging the advice and trying to get some better perspective. My plan thus far is to read all of Blueprints, FA, A&L or Pretest (not sure which one I want to do yet), and I've skimmed certain sections of Harriet Lane and Nelson's. Your advice and insight would be helpful. Thanks.

People swear by Blueprints on this site, but I only could force myself to read about 15pgs out of it. I tried to read about cyanotic congenital heart defects, but discovered a persistant primitive reflex forcing me to throw the book across the room. I did PreTest twice, A&L, and CaseFiles as well as some reading in Nelsons throughout the rotation - and those served me quite well.

There are some ridiculous questions in A&L re memorizing RDAs for vitamins and orders of eruption of indiviual primary and permanent teeth. How should I put it? -- waste of time.

 

[irrka]

Pre-test was AWESOME. wish i had done it twice, but even once will get you a pretty decent shelf score

 

[daisygirl]

Scored the 95th percentile. I read blueprints once- could not read through the cardio section though since it really was awful. I did 900 questions to prepare- pretest, blueprints question book and the peds questions in NMS for step II.

 

[tufts02]

Is anyone using Illustrated textbook of pediatrics? I heard good things. I was going to use that book along w/ pretest and uptodate for my specific patients. you think that's enough for the rotation and the shelf? or do i need blueprints instead of the illustrated textbook?

thanks

 

[RonaldColeman]

I felt that the pediatrics shelf was probably the easiest of the shelf exams. (I don't know about the curve yet, however!). I thought the exam was extremely focused unlike the other shelf exams which tend to draw material from many different clerkships. I didn't believe people when they said all you need for this exam is pretest + Blueprints, so I also read First AID and the Harriet Lane handbook. What a waste. Blueprints + Pretest is all you need for this exam even if you are a serious gunner. I'm thinking about derm, and if I could do it all over again, I would only use Blueprints + Pretest.
Most of the questions are diagnosis, and the cases are much more classic than in other shelfs. I was really surprised at the number of classic buzz words used: obese with limp, cold agglutinins, cheeks that looked like they had been slapped, etc. Another question that was quite common (>15 questions) on the exam was mechanism of disease. They would give you a ridiculously obvious clinical scenario and ask you to describe the mechanism. Another important thing that I noticed is that unlike most 3rd year shelfs, there were very few next step in management questions on my exam.

Bottom Line: Blueprints + Pretest. I'm not guaranteeing that you will answer every question, but the vast majority are in these 2 books.


Topics: quite a few diabetes insipidus and SIADH questions, lots of GI, a few trauma cases, diabetes, congenital heart disease (duh!), 1 developmental milestone question (First AID actually has a pretty nice chart for these with really good mnemonics--this is the only thing I would use that book for!),
vaccinations...

Got my score back: 97.

Good Luck...

 

[UCSBMed1]

I felt that the pediatrics shelf was probably the easiest of the shelf exams. (I don't know about the curve yet, however!). I thought the exam was extremely focused unlike the other shelf exams which tend to draw material from many different clerkships. I didn't believe people when they said all you need for this exam is pretest + Blueprints, so I also read First AID and the Harriet Lane handbook. What a waste. Blueprints + Pretest is all you need for this exam even if you are a serious gunner. I'm thinking about derm, and if I could do it all over again, I would only use Blueprints + Pretest.
Most of the questions are diagnosis, and the cases are much more classic than in other shelfs. I was really surprised at the number of classic buzz words used: obese with limp, cold agglutinins, cheeks that looked like they had been slapped, etc. Another question that was quite common (>15 questions) on the exam was mechanism of disease. They would give you a ridiculously obvious clinical scenario and ask you to describe the mechanism. Another important thing that I noticed is that unlike most 3rd year shelfs, there were very few next step in management questions on my exam.

Bottom Line: Blueprints + Pretest. I'm not guaranteeing that you will answer every question, but the vast majority are in these 2 books.


Topics: quite a few diabetes insipidus and SIADH questions, lots of GI, a few trauma cases, diabetes, congenital heart disease (duh!), 1 developmental milestone question (First AID actually has a pretty nice chart for these with really good mnemonics--this is the only thing I would use that book for!),
vaccinations...

Got my score back: 97.

Good Luck...

BUMP!

Any recommendations/advice for the people just coming off of Peds this year?

 

[opus03]

BUMP!

Any recommendations/advice for the people just coming off of Peds this year?

Yeah, like they said Blueprints and PreTest are all you really need....I truly didn't believe this when I started peds but it turned out to be true. The vignettes are long so it's a good idea to look at the question before reading they whole thing. Nothing really sticks out in my mind as being over-represented on the exam... though mine had plenty of heme-onc, ID, and GI. Not too bad in all, better than the surgery shelf at least. Good luck!

 

[Mav979]

Yeah, like they said Blueprints and PreTest are all you really need....I truly didn't believe this when I started peds but it turned out to be true. The vignettes are long so it's a good idea to look at the question before reading they whole thing. Nothing really sticks out in my mind as being over-represented on the exam... though mine had plenty of heme-onc, ID, and GI. Not too bad in all, better than the surgery shelf at least. Good luck!

There's a lot of debate at my school as to whether or not Pretest is enough. Looks like a few are in agreement here that it is plenty. I also just got through A&L, but didn't think it was nearly as good as Pretest. It was a bit too picky on lots of things and didn't really add much to my prior studying with Pretest.

Thanks again! If anyone else wants to weigh in, I'd love to hear it!

 

[btmed772]

I couldn't stand Blueprints so I decided to go with FA. Does anybody have any experience with FA? I plan on using that + Pretest, and using Nelson's or Blueprints to supplement areas that I don't think are well or thoroughly explained in FA. It just seems that FA is more high yield, and I like the organization. I just hope that it is enough. From what I hear, Peds is a difficult shelf exam.

 

[Mav979]

I just took the Peds exam. Here are some thoughts:

1) I think Blueprints + PreTest is enough. They were sufficient to do better than the mean. If you want to get into the 90's on a raw score, I don't know what to tell you, but I don't think Blueprints + PreTest is enough to get you there.

2) A&L is alright, but really of no improvement over PreTest. It is useful for getting more practice questions in, but the content is at times too picky and when it isn't, it repeats much of PreTest.

3) There are plenty of questions on there that can not be answered by reading Blueprints or PreTest. Some of the ones I remembered when walking out I tried to look up answers to and couldn't find anywhere.

I'll try to reply the best I can to any questions that anyone has.

 

[letusbedocs]

I'd sort of stray away from First Aid -- it gets way too specific and detailed and you need to be thinking about patient MANAGEMENT and decision making.

The shelf was not too-too much about Pediatric unique problems per se -- that is, I can't remember too much about genetic stuff (Werdnig-Hoffmann, etc.) except for the couple -- which I thought were easier -- questions.

The tough part about it was patient management about GI, Respiratory, Cardiac, etc. disorders -- that was most difficult. Especially for my clerkship experience, we didn't have a too-too busy inpatient experience and it was my first clerkship -- I was like "What is fluoroscopy?" when asked for types of imaging for a patient. I feel more a textbook that's not like First Aid will help you on patient management stuff.

That being said, MOVE FAST -- it's been the toughest shelf exam to finish all year for me. Good luck on it.

 

[Pox in a box]

That being said, MOVE FAST -- it's been the toughest shelf exam to finish all year for me. Good luck on it.

Me too.

 

[cremasteric]

Me too.

So now that you have taken the shelf exam, do you have any advice Pox?

 

[OneStrongBro]

So now that you have taken the shelf exam, do you have any advice Pox?

You can forget it....

This guy/gal has opened a surgery thread and a pediatrics shelf thread chiefly for his benefit. Notice he hasn't given back to SDN after he has taken the exam.... What a Gunner! And to think he keeps picking on BigFrank. At least BigFrank has given back to SDN by posting his shelf exam experiences.

 

[Pox in a box]

So now that you have taken the shelf exam, do you have any advice Pox?

Hey, the exam was a lot tougher than the books like Pretest make it out to be. I found that some of the very stressed points by my course director were either minimal or absent on my exam (i.e. immunizations, milestones, etc.). Know common pediatric topics such as otitis, rashes, how to detect the most common pediatric heart defects, and STDs in adolescence. There were a good deal of a rash and a limp scenarios. It seemed to be a theme. Know the treatments, methods of diagnosis (including criteria), and how to prevent some of these. Blueprints to me was too generic, First Aid was good but somewhat of an overkill at times (especially the cardiac section), Harriet Lane was good for the wards but for the shelf was too narrow in spectrum, the Clerkship Guide for Pediatrics was good but the format was weak in my opinion and not conducive for quick studying...too much prose, and Pretest was way too easy (the question stems were much longer on the real exam and much more second- and third-order questioning).

By the way, for the previous poster, let's put the horse before the cart. I usually don't like to give a full synopsis regarding a rotation or even an exam without actually having all the grades in the book. If you missed what I had to say about the surgery shelf, it's there. I'll let you know whether the sources I used for peds were sufficient. Good luck to you in your rotations.

 

[bigfrank]

You can forget it....

This guy/gal has opened a surgery thread and a pediatrics shelf thread chiefly for his benefit. Notice he hasn't given back to SDN after he has taken the exam.... What a Gunner! And to think he keeps picking on BigFrank. At least BigFrank has given back to SDN by posting his shelf exam experiences.

Thanks for your kind words. It is so very funny (sad?) how narcissistic some people genuinely are.

 

[Cpt.Hook Hamate]

By the way, for the previous poster, let's put the horse before the cart. I usually don't like to give a full synopsis regarding a rotation or even an exam without actually having all the grades in the book. If you missed what I had to say about the surgery shelf, it's there. I'll let you know whether the sources I used for peds were sufficient. Good luck to you in your rotations.

Hey, Pox, who gave you the authority to make this thread "official." There are elected officials for this sort of thing.

 

[bigfrank]

Hey, Pox, who gave you the authority to make this thread "official." There are elected officials for this sort of thing.

See my above post.

 

[Pox in a box]

Hey, Pox, who gave you the authority to make this thread "official." There are elected officials for this sort of thing.

Dr. Mom apparently.

 

[Entei]

You can forget it....

This guy/gal has opened a surgery thread and a pediatrics shelf thread chiefly for his benefit. Notice he hasn't given back to SDN after he has taken the exam.... What a Gunner! And to think he keeps picking on BigFrank. At least BigFrank has given back to SDN by posting his shelf exam experiences.

I don't quite understand... Yes, Pox started this thread, but he/she has gotten just as much out of it as you or I have. We all have access to the same posts on the same message board. Pox just took the initiative to make the thread, which you and I were both too lazy to do. And honestly, I really couldn't care less about people's individual testing experiences when the shelf exams are different every month, but the books that people found to be informative/easy to read/understand is a much more valuable resource.

That said, I and most of my classmates in my rotation group are using Blueprints.

 

[OneStrongBro]

I don't quite understand... Yes, Pox started this thread, but he/she has gotten just as much out of it as you or I have. We all have access to the same posts on the same message board. Pox just took the initiative to make the thread, which you and I were both too lazy to do. And honestly, I really couldn't care less about people's individual testing experiences when the shelf exams are different every month, but the books that people found to be informative/easy to read/understand is a much more valuable resource.

That said, I and most of my classmates in my rotation group are using Blueprints.

Are you a 4th year medical student too? How could I "get help" when I have already taken the exam?

 

[Entei]

Are you a 4th year medical student too? How could I "get help" when I have already taken the exam?

My apologies. I guess it was silly for me to assume that since you're reading a thread about people's opinions about preparing for the peds shelf, then you must have a need to see people's opinions about preparing for the peds shelf. I should have just known that you've got a bone to pick with Pox and want to clutter up potentially useful threads with your mud slinging. I'll try to be more perceptive in the future.

 

[DrMom]

Dr. Mom apparently.

Hey, you titled the thread. Don't go implying that I'm involved in this in any way.

 

[Pox in a box]

Hey, you titled the thread. Don't go implying that I'm involved in this in any way.

It's a joke. Note the " "

 

[btmed772]

FA + pretest ended up serving me rather well. I didn't read every little detail in FA, but tried to get through most of it once. I would definitely stress getting through pretest once. My exam had ZERO questions on immunizations and milestone. Also, my exam had quite a few "classic" presentations and buzz words. It is a difficult exam, but I actually didn't find it as bad as everyone has been saying.

 

[bigfrank]

Hey, you titled the thread. Don't go implying that I'm involved in this in any way.

Pox is again busted.

 

[HtSht2BoneDoc]

pre test blueprints once each--> 94 raw. Nuff said

 

[2TIM4:7]

Anyone use Pediatrics for Medical Students? comes with a CD-ROM of questions. Just curious because this is the book i'm using and it's very good so far...but then again, i haven't taken the shelf yet.

thanks in advance.

 

[mar8d]

1

 

[mar8d]

I am so amazed that you all have time to read so many review books! I feel like I have barely enough time to get through two before the exam. I've heard Case Files is good, so I'm using that book and Pre-test...

I'll let you know how I did on the exam. Good luck

 

[abbaroodle]

I just took the Peds shelf, and thought I would add my own 2 cents.

I used blue prints, pre-test, and Case Files. I only made it through about half of CF and I really wish I had finished it - I feel like it was helpful for learning and understanding material and was very relevant to the shelf. BP - what everyone else says. It can be a place to start, but it doesnt take you far. And PT is the standard questions. And of course I read about my pts and common illnesses, attended our lectures, etc.

The shelf itself: I feel like it covered a good range of material and had a good range of questions from really obvious to what the f---? I felt like there were a lot of questions on anemia and heme and renal, but I think thats just because I think kidneys are the most boring subject and didnt really study them and just didnt think to study blood disorders. (Yeah, I know that was dumb!) Also, I have more trouble with endocrine and electrolytes so I remembered them, but I dont think they were heavily emphasized. In fact, I dont think anything was the main focus. In general I think the stuff I dont know sticks out more than the questions I answered without a lot of thought.

Definately buzz-words. A couple questions on development, but pretty straight forward. A couple on ethics\child abuse. A fair amount of ID - including some q's about recognizing, preventing spread, treating, and the lab test to confirm the diagnosis. Nothing too profound there. A couple questions on weird genetics diseases - but the more common ones that you actually see. A couple diseases came up multiple times - when one came up about 5 questions later I looked back and really questioned myself.

I had heard it was really long, but a lot of folks left pretty early, and I didnt have a problem. Maybe it depends one when you take it. (First shelf vs second semester).

Good luck and enjoy the kidlings!

 

[rockit]

Has anybody used pretest for PDA? I'd rather use that than the book but have read that some versions are really tough to navigate. Any experiences?

 

[twesting2173]

.

 

[Pianoboe01]

I just took the peds shelf today. I agree with previous posters that all systems are tested about equally. There was about every possible child with a limp question, lots of infectious disease and treatment, a little more gyn than I would have expected, very little neuro (I think I just had one question about identifying a type of seizure), more immuno than I would have liked, lots of rashes and respiratory (which is expected of course). I did have a couple developmental and anticipatory guidance questions, so don't forget to study those. Overall, I did not think the SHELF was that difficult (I'll post my score when I get it), and this is my first rotation of 3rd year.

How I studied:
*First Aid for Pediatrics - read through once in its entirety throughout the rotation, and then skimmed the side boxes and tables just before the exam
*Case Files - read through once in its entirety throughout the rotation, and reread the bold words and clinical pearls just before the exam
*PreTest - did all the questions once just before the exam
*CLIPP cases (www.clippcases.org) - my school required that we complete half of these during the clerkship, but if your school doesn't require it, I think it's only $30 for a 90 day subscription, and I highly recommend it!

Update: received my shelf score - 86th percentile (not as high as I had hoped, but I'm not complaining)

 

[fun8stuff]

i heard the question vignettes are long... like some questions were a couple paragraphs long. how'd you guys do for time?

 

[Pianoboe01]

Most of the questions are of regular SHELF length, although there were a few that were quite long, especially the last 5-10 questions or so. I did just fine on time, however -- finished about 20 minutes early. I can't speak for the rest of the class to know if there were a lot of people there til the end though. It seemed to me that this SHELF had so many glaring buzz words in it that it just wasn't necessary to read all of the question and all the superfluous labs. You just see a few key words, the disease is immediately obvious, and you just need to know the next step or whatever they're asking.

 

[redruby]

I have the 2004 editions of pre-test, blueprints, and first aid. Did anybody else use these? Do you think they'll be enough or should I get something more recent?

 

[fun8stuff]

Most of the questions are of regular SHELF length, although there were a few that were quite long, especially the last 5-10 questions or so. I did just fine on time, however -- finished about 20 minutes early. I can't speak for the rest of the class to know if there were a lot of people there til the end though. It seemed to me that this SHELF had so many glaring buzz words in it that it just wasn't necessary to read all of the question and all the superfluous labs. You just see a few key words, the disease is immediately obvious, and you just need to know the next step or whatever they're asking.

thanks.. it is my first shelf so i am not sure what regular length is... guess i will find out!

 

[Pianoboe01]

thanks.. it is my first shelf so i am not sure what regular length is... guess i will find out!

You never took shelf exams during 1st or 2nd year? Anyway, if you used PreTest to study, the questions are typically 2-3x as long as those, and almost every question includes a bunch of labs. If you don't have PreTest, here's an example of one of their longer questions (and then multiply it by 2 for length of the real thing):

A 3-year-old child presents to your office for an evaluation of constipation. The mother notes that since birth and despite frequent use of stool softeners, the child has only about one stool per week. He does not have fecal soiling or diarrhea. He was born at term and without pregnancy complications. The child stayed an extra day in the hospital at birth because he did not stool for 48 h, but has not been in the hospital since. Initial evaluation of this child should include
a. A child psychiatry evaluation for stool retention and parenting assistance
b. A barium enema and rectal manometry
c. Plain films of the abdomen
d. Dietary log and observation
e. Beginning oral antispasmotic medication

 

[fun8stuff]

You never took shelf exams during 1st or 2nd year? Anyway, if you used PreTest to study, the questions are typically 2-3x as long as those, and almost every question includes a bunch of labs. If you don't have PreTest, here's an example of one of their longer questions (and then multiply it by 2 for length of the real thing):

A 3-year-old child presents to your office for an evaluation of constipation. The mother notes that since birth and despite frequent use of stool softeners, the child has only about one stool per week. He does not have fecal soiling or diarrhea. He was born at term and without pregnancy complications. The child stayed an extra day in the hospital at birth because he did not stool for 48 h, but has not been in the hospital since. Initial evaluation of this child should include
a. A child psychiatry evaluation for stool retention and parenting assistance
b. A barium enema and rectal manometry
c. Plain films of the abdomen
d. Dietary log and observation
e. Beginning oral antispasmotic medication

ok, thanks. no, we didn't have shelf exams over first 2 years. i do have pre-test... it sounds like the shelf questions will be pretty long. prob best to scan last sentence and answer choices first?

 

[fun8stuff]

You never took shelf exams during 1st or 2nd year? Anyway, if you used PreTest to study, the questions are typically 2-3x as long as those, and almost every question includes a bunch of labs. If you don't have PreTest, here's an example of one of their longer questions (and then multiply it by 2 for length of the real thing):

A 3-year-old child presents to your office for an evaluation of constipation. The mother notes that since birth and despite frequent use of stool softeners, the child has only about one stool per week. He does not have fecal soiling or diarrhea. He was born at term and without pregnancy complications. The child stayed an extra day in the hospital at birth because he did not stool for 48 h, but has not been in the hospital since. Initial evaluation of this child should include
a. A child psychiatry evaluation for stool retention and parenting assistance
b. A barium enema and rectal manometry
c. Plain films of the abdomen
d. Dietary log and observation
e. Beginning oral antispasmotic medication

how is the difficulty of the shelf questions compared to pretest (if you don't take into account the length of the question)?

 

[Pianoboe01]

ok, thanks. no, we didn't have shelf exams over first 2 years. i do have pre-test... it sounds like the shelf questions will be pretty long. prob best to scan last sentence and answer choices first?

This is not a bad idea, but it may hurt you on time -- sometimes there are up to 12 answer choices (I think choices went up to L). Anyway, scanning the last sentence first would be a good idea though. It just depends how you do best with taking tests. I'm someone who typically just reads through the question and answers once (unless it's one that's particularly difficult or requires a lot of thinking obviously).

how is the difficulty of the shelf questions compared to pretest (if you don't take into account the length of the question)?

I'd say the questions are on the same level as pretest, but maybe a bit harder. And of course there will always be easy ones and what the *&^$ questions thrown in too.

I have a feeling that since this is your first shelf exam you will find it quite difficult. I've been taking shelf exams for practically every course since 1st year, and they've gotten much much easier with time. Good luck -- when do you take the exam?

 

[fun8stuff]

This is not a bad idea, but it may hurt you on time -- sometimes there are up to 12 answer choices (I think choices went up to L). Anyway, scanning the last sentence first would be a good idea though. It just depends how you do best with taking tests. I'm someone who typically just reads through the question and answers once (unless it's one that's particularly difficult or requires a lot of thinking obviously).



I'd say the questions are on the same level as pretest, but maybe a bit harder. And of course there will always be easy ones and what the *&^$ questions thrown in too.

I have a feeling that since this is your first shelf exam you will find it quite difficult. I've been taking shelf exams for practically every course since 1st year, and they've gotten much much easier with time. Good luck -- when do you take the exam?

thanks... end of august. i have some time left still. yeah, i kind of wish we would have had shelf exams for first couple years.

 

[GonnaBeAnMD]

Are which vaccines we give at which dates important for the shelf? And the reflexes? Is the blueprints people are talking about the textbook or the questions? thank you for all the guidance! My first shelf as well

 

[domer621]

Just took it today. I agree that the questions are pretty damn long, so be sure to do a lot of them to prepare yourself. This was my first shelf and I knew that the questions were going to be longer than on the USMLE, and they were. I think I was one of the only people that finished on time. You need to read the entire question stem, too, since there will literally be one word in there that gives away the diagnosis. I recommend reading the last sentence in q's that give you lots of lab values, since they usually gave the answer away.

As far as subject material, it's the same as all of the other shelf exams - they test you on everything. Go to the NBME website to see the breakdown by subjects. Nothing was over/underrepresented on my exam.

Overall, I didn't think the exam was too terrible. The majority of q's are based on classic presentations. Definitely not as hard as Pretest (which had the hardest questions of any question book I did), but there are some tough questions scattered throughout. In fact, I don't know why so many people around here recommend Pretest. Questions asking for the next best step or treatment are always the hardest. I was surprised that there were no questions on storage diseases, no calculations, and no immunization questions. Only 2 developmental q's that were straightforward.

Buzzwords are there, so know them!

As far as prep, I started with FA Peds but realized it was impossible for me to come home and sit down and read that 400 page monster. I ended up doing Case Files, Peds section in FA CK book, Pretest q's (tough q's that I would save for last), A&L review q's (not in shelf format, but great for nailing in the basics), Blueprints Q&A q's (good), and peds q's from Kaplan QBook (good, but verrry long explanations). I think all of those q's covered my bases well. Hopefully I did ok.

Update: Final score - 88 raw (I was disappointed at first, but the clerkship director told me that only 10 people make this high of a score per year).

 

[drfunktacular]

Case Files + Pre-Test = 97.

Just be fast... as noted above, the stems basically boil down to buzzwords, but they are long and there are 100 of them in two hours.

 

[Ypo.]

Just took it Friday. I'd say Pre-test + blue prints + reading in depth on the cases you see on the wards is good enough to honor.

All the questions were long paragraphs.

 

[optiplex]

used blueprints, FA, and pretest, blueprint q&A, Kaplan CK book, A&L (part).

- don't spread yourself too thin, I recommend FA (read it 2X) and pretest (do this 2X). if you want shelf like q's, do Kaplan CK book 150Q's. They are like the shelf exam. Also good to look at the shelf descriptors on NBME website...gives you the breakdown. I had hard time finishing on shelf, wish I did the q's backwards. Easy buzzword questions at the end (either you know it or you don't)...so do the last 10q's first and you will save sometimes. There are lab values on the exam, but you don't really need it most of time. so try not to waste time looking up values...go with buzz words. Know your rashes and infections.

People vary in opinion...some peeps are smarter than others...but if you are an average joe like me, you probably need to use less sources and go through them several times more.

 

[enanareina]

Are which vaccines we give at which dates important for the shelf? And the reflexes? Is the blueprints people are talking about the textbook or the questions? thank you for all the guidance! My first shelf as well

Vaccines: NO. Learn when a vaccination is truly contraindicated and some of the really serious vaccine reactions. In other words, "My kid has a 99 degree fever" is not a contraindication.

Reflexes: A few important ones only, like Babinski until ~walking age, moro/root/suck at birth.

Blueprints: Generally, people are referring to the review text book, not the question book. I had both Blueprints and First Aid and I found them pretty similar. I preferred Case Files.

Developmental Milestones: Really big ones only. I'd learn a few key phrases off the Denver to tell if a child is 2 versus 3. There will only be 1-2 questions on this topic (see the NBME shelf exam breakdown) so don't go berserk and try to memorize the whole Denver.

It's too late for whomever asked this question originally, but hopefully this will help someone else!