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1MB - 3MB OSCEs > Child & Health (history + examination) > Flashcards

Child & Health (history + examination) Flashcards

1
Q

Outline general history taking for paediatrics (12)

A

Basics
(History of) Presenting complaint
Past medical history
Drugs
Allergies
Immunisations
Birth history
Feeding
Developmental history
Family history
Social history
Systemic enquiry

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2
Q

State the age group for neonates

A

0-4 weeks of age

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3
Q

State the age group for infants

A

1st year

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4
Q

State the age group for preschool children

A

2-<5 years

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5
Q

State the age group for school children

A

5-15 years

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6
Q

State the age group for ‘childhood’

A

1-15 years

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7
Q

State the age group for ‘adolescents’

A

13-19 years

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8
Q

What are the basics in paediatric history taking?

A

Full name, DOB, ideally CHI, address, GP
Date and time of history
Name of history taker and relationship of history giver to child

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9
Q

How would you take a history of presenting complaint? (7)

A

Commencement
Cessation
Constant or intermittent
Exacerbating or relieving factors
Associated symptoms
Contact with infectious disease (inc. animals)
Opinions - what do parents or referring GP think is wrong

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10
Q

What PMH is taken?

A

Past hospital admissions
Any other medical conditions
Any operations
Treatment already given

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11
Q

What drug history is taken?

A

Details of any regular medications taken
Details of any other medicines taken recently e.g. oral antibiotics, paracetamol
Form (liquid, suspension, granules etc)
Frequency
Duration of course
Other details (spacer)

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12
Q

Which allergy history is taken?

A

Medicine
Food
Previous allergic reactions (latex, soap, pets, dust etc)

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13
Q

How would you take a birth history? (7)

A

Where and when were they born, weight at birth
Term or premature
Antenatal problems (exposure, drugs)
Delivery problems (forceps, ventouse, planned/elective c-section)
Problems after birth - were they admitted to SCBU/NICU? If so how long? What treatment was received? (ventilation, CPAP, abx, O2 phototherapy)
Any other post-natal problems for mum or baby

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14
Q

What feeding history is taken?

A

Breast/bottle fed
Bottle - product, volume, frequency (overfeeding)
Older children - run through a typical day to get a better picture

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15
Q

Outline the social history taken in paediatrics?

A

Draw out a family tree - health status of siblings
Establish who else looks after the child
School/nursery - bullying
Parental occupation
Parental smoking (inside the house, during pregnancy)
Alcohol
Pets
Hobbies/sports

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16
Q

What immunisation history is taken?

A

Routine immunisations
BNFc/online green book - vaccination schedule

17
Q

T or F: Some older patients will have had all the vaccinations on the current schedule - however the schedule will have changed since they were an infant

A

True

18
Q

Outline general examination of newborns

A

Height, weight, OFC in babies, centiles
Obs: temperature, HR, RR< oxygen sats SpO2, sometimes BP
Inspection (comfortable/distressed, cyanosis/pallor, syndromic features in cranium/eyes/face/hands, signs of existing conditions (wheelchair, tracheostomy, walking aids)

19
Q

Outline the CVS examination of a newborn

A

Inspect - cyanosis, squatting, dyspnoea, oedema, finger clubbing, distension of veins
Palpate - apex beat, thrills, heaves
Pulse - radial (brachial, femoral, or carotid can be used in younger patients if difficult)
Heart rate and rhythm
Auscultate - rhythm, heart sounds, murmurs

20
Q

Outline the respiratory examination of a newborn

A

Inspect - chest expansion, deformities, finger clubbing
Listen - stridor, wheeze, cough, grunting
Palpation - tracheal deviation, cervical lymphadenopathy
Percussion - hyperresonnance, dullness
Auscultation - fine/coarse crackles, rubs

21
Q

Outline the abdominal examination of a newborn

A

Inspection - distension, peristalsis, swelling, umbilical abnormalities, hernia
Palpation - hands, tenderness, guarding, masses, liver, spleen, hernia, inguinal lymph nodes
Percussion - shifting dullness, full bladder
Auscultation - bowels sounds

22
Q

Outline the ENT examination of a newborn

A

Ears
Ear drum reflectivity - gas bubbles, erythema, wax, perforation, grommets, foreign bodies
Nose - blockage, foreign bodies, epistaxis, polyps
Throat
Tonsil erythema - size, pus, tongue, candida, ulcers

23
Q

How are ears examined in a child?

A

Keep child sitting upright on your knee, turned to one side, with one hand placed around the shoulders and the other above the ear to hold the head still

24
Q

How is a throat examined in a child?

A

Keep child facing forward and sitting upright on parent’s knee, with one hand around both shoulders, and the other on the forehead to hold the head still

1MB - 3MB OSCEs (12 decks)

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