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An approach to assessing children Flashcards

1
Q

What is a childs weight measured in?

A

Kilograms (Kg) and grams (g)

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2
Q

How much weight should a baby gain per week in the first 6 months?

A

150(100)-200g / week

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3
Q

What are childs feed volumes measured in?

A

Millilitres (ml)

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4
Q

How much feed should a baby take?

A

140-180ml/kg/day (100ml/kg/day if ill)

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5
Q

Questions to ask about faeces

A 
Nappies vs independent toileting 
Frequency (per day, week or even month) 
size, shape, appearance and consistency 
Difficulties passing
Blood or mucus seen 
Bristol stool chart
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6
Q

What parts of a parents life can impact on a childs health?

A 
smoking
alcohol 
drugs
occupation 
stress
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7
Q

What do you have to be in examining children/babies?

A

Opportunistic

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8
Q

Features of examining babies / children

A

Observe first
be friendly and smile
speak to the child (even if they are weeks old)
be careful moving them - keep parents close and try best to examine them when they are there
Gentle handling and gradual exposure
show interest in their toys and play

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9
Q

What general features are you looking for?

A

Appearance
Play
Interaction
Obs

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10
Q

What resp features are you looking for?

A 
effort
noise
rate
recession 
O2
nebs
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11
Q

What CVS features are you looking for?

A

Colour

Perfusion

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12
Q

What GI features are you looking for?

A

Feeding
vomit
abdo distention / movement

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13
Q

What neuro features are you looking for?

A

Alertness
interaction
play
posture

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14
Q

What MSK features are you looking for?

A 
Mobility
limb movements
posture
splints 
mobility aids
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15
Q

What are you looking at on the childs hands and arms?

A 
Warmth 
cap refill 
radial / brachial pulses (rate / rhythm)
clubbing
nail changes 
hand skills
pen marks
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16
Q

What are you looking at on the childs head and face?

A 
Eyes (jaundice)
lips (colour, moisture)
tongue
nose
scalp changes
bruises
rashes
fontanel
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17
Q

What are you looking for on a childs neck?

A

Rashes and nodes

Tracheal tug

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18
Q

What are you looking for on a childs chest and back?

A 
Murmurs
apex beat
thrills 
chest expansion 
breath sounds
percussion 
resonance and fremitus 
rashes and skin marks 
spine alignment, deformity, sacral dimples
19
Q

What are you looking for on a childs abdomen and groin?

A 
Tenderness
masses (esp stool)
organomegaly 
bowel sounds and bruits (v rare)
femoral pulses (essential in infants)
hernias and testis 
genital / anal appearance
20
Q

What are you looking for on legs and feet on children?

A 
Mobility
changing posture
tone 
reflexes, plantars, clonus 
power
coordination 
sensory assessment if older 
pulses
warmth
cap refill 
colour 
mottling 
rashes, bruises, marks
deformity and gait
21
Q

Differentials for fever and cough

A

LRTI/URTI
Bronchiolitis
Viral induced wheeze
Viral croup

22
Q

Causes of fever with rigors

A

UTI

Pyelonephritis

23
Q

What should be asked in the antenatal history?

A 
Rheus status
Screening
- syphilis
- HIV
- Hep B
- varicella
- measles
Scans
- 12 weeks
- 20 weeks
24
Q

How many weeks on is the anomaly scan done?

25
Q

Examples of congenital infections

A

CMV
HIV
Herpes
Hepatitis

26
Q

What does PET lead to in infants?

A

Placental insufficiency which leads to growth restriction

27
Q

What should be asked in the birth history?

A 
Mode of delivery 
How was the labour?
- IOL
- Hormones
Gestation 
Complications
28
Q

What are the risk factors for sepsis after labour?

A

GBS
Prolonged ROM
Intrapartum pyrexia

29
Q

What post natal history should be taken?

A 
Birth weight 
Feeding
- how much 
- what method 
Passage of meconium
30
Q

When should meconium be passed by?

A

Within 24 hours

31
Q

Causes of unpassed meconium

A

CF
No formed anus
Hersprungs disease

32
Q

What is hirspringus disease?

A

Absence of ganglionic cells in rectum/sigmoid

33
Q

What age are solids introduced?

34
Q

What age do you get the MMR vaccine?

35
Q

What is the first vaccine babies receive, at what age and how many doses are given?

A

5 in 1
2 months old
3 doses at 1 month intervals

36
Q

What are the 4 forms of abuse?

A

Physical
Neglect
Sexual
Emotional

37
Q

Causes of rashes in children

A 
Molluscum contagiousum 
Slap cheek 
HFM disease
Eczema
Chicken pox
Non blanching rash (meningococcus)
Viral
38
Q

What is the 1st milestone?

A

Holding head

39
Q

What metabolic changes occur in vomiting?

A

Metabolic alkalosis
Hypocholaraemia
Hypokalaemia

40
Q

What is the treatment of pyloric stenosis?

A

Ramsteds pyloromyotomy

41
Q

What is used to look at a childs growth?

A

Percentiles

42
Q

What does FTT stand for?

A

Failure to thrive

43
Q

Definition of FTT

A

Failure to be on an expected weight/height trajectory

44
Q

What centiles are found on a percentile growth chart?

A 
50 
25 / 75 
99.6 / 0,4
9 / 91
98 / 2

Paeds (28 decks)

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