Common paeds history - failure to thrive Flashcards
What would you want to ask about failure to thrive?
- Growth chart
- Input - Detailed diet history, feeding/weaning, hunger
- Use - energy, activity, exercise, anorexia?
- Output - WEt nappies, stools, GI symptoms
- Other - behaviour, general heatlh, ahppiness, parents health
What general features would you want to ask about a child who is failing to thrive?
- Fever
- Behaviour
- Activity/apathy/alertness
- Cough
What GI symptoms would you want to ask about in a child with failure to thrive?
Work down body
- Dysphagia
- Reflux/vomting
- Abdo pain/colic
- Diarrhoea/constipation
- Stools - blood/mucus/pale
What features associated with failure to thrive would suggest coeliac disease as a cause?
- Any time after weaning
- DIarrhoea - pale stools
- Bloating
- Abdo pain
What features assoacited with failure to thrive would suggest Dietary protein intolerance as a cause?
- Cow’s milk - after weaning first few months
- Diarrhoea after being fed with forumla milk for first few months
- Reflux
What features associated with failure to thrive in a child would suggest carbohydrate intolerance (e.g. lactose intolerance)?
Within a few hours of consumptions
- Flatulence
- Diarrhoea
- Bloating
- Cramps
What features assocaited with failure to thrive would suggest Pyloric stenosis as a cause?
- Projectile non-bilious vomiting after eating
- Starts around 3-6 weeks of age
What features associated with failure to thrive in a child would suggest GORD/Oesophagitis as a cause?
- Effortless regurgitation
- Crying during feeding
- COugh/hoarseness
What features assoaicted with failure to thrive in a child would suggest CF as a cause?
- Recurrent chest infections
- Steatorrhoea
What features associated with failure to thrive would suggest IBD as the cause?
- Older child
- Abdominal pain
- Diarrhoea with blood/mucus
What features associated with failure to thrive would suggest inadequate dietary intake?
- Commonest cause
- Consider neglect
What featurs associated with failure to thrive suggest nutritional neglect?
- Not offered enough food
- Hungry, food seeking/hoarding
What features associated with failure to thrive would suggest emotional neglect as a cause?
- Poor interaction between child and parents
- Withdrawn, fearful, anxious
What features associated with failure to thrive would suggest eating disorder?
- Adolescent girls
- FEar of weight gain
- Feel fat when thin
- Efforts to lose weight
- Consequential symptoms
What would you ask about when asking a child about efforts to lose weight if you suspected an eating disorder?
- Diuretics/laxatives
- Vomiting
- Excessive exercise
