common problems in paediatric outpatients

Question 1

what are the red flags in a child presenting with a headache?

Answer 1

Rapidly expanding headsize in infants
Effortless vomiting in the morning
preschool
Waking at night/early morning headache
Worse on coughing/sneezing/ straining/ bending over
Change in behaviour, sleepy,
Change in cognitive ability/ handwriting/balance difficulties
New squint or cranial nerve palsies
Diplopia/visual change

Question 2

what are red flags in infants presenting with a heart murmur?

Answer 2

other dysmorphic signs
blue discolouration
signs of heart failure
absent pulses

in children fatigue and SOB are also red flags

Question 3

what are red flags in children presenting with a cough?

Answer 3

Night time waking with cough, wheeze, SOB or obstructive symptoms
Failure to thrive
Other recurrent infections

Question 4

what are red flags in children presenting with abdominal pain?

Answer 4

Failure to thrive
Bilious or bloody vomiting
Bloody stools or symptoms of IBD

Question 5

what are the most common causes of abdominal pain in children?

Answer 5

functional abdominal pain
food intolerances
rarer- appendicits, IBD

Question 6

what are red flags in children with constipation?

Answer 6

Symptoms present from birth
Abnormal lower limb neurology

Question 7

what are red flags in children presenting with diarrhoea?

Answer 7

Weight loss
Blood in stools
Stooling at night
Other systemic symptoms fatigue, rashes, mouth ulcers, joints, eyes

Question 8

what can be found in children presenting with UTIs?

Answer 8

renal abnormalities

Question 9

what are red flags for growth in children?

Answer 9

• Other systemic illness in FTT (failure to thrive)
• Children who are short and obese (most obese children are tall)
• signs of puberty < 8yo girl <9yo boy
  Or later than 14yo boy or 13yo girl (or no menarche at age 15)