Community Based Medicine - Examination of Children

Question 1

Examination of Children

Answer 1

Learning Objectives:

• To appreciate good examination techniques for examining children role-modelled by physicians on the MRCPCH programme
• To be able to take a paediatric history from parents & the child
• To be able to do a child growth & development assessment & understand the normal range of milestones

Question 2

Resources?

Answer 2

• PA Handbook for specialities – Paediatrics
• Birmingham Children’s Hospital Guidance
• Textbook: “Illustrated textbook of Paediatrics” Tom Lissauer & Graham Clayden
• McLeod’s Clinical Examination – section on examining babies & children
• Video clips via YouTube http://mrcpch.paediatrics.co.uk
• MRCPCH Clinical Revision - more videos at ‪http://mrcpch.paediatrics.co.uk

Question 3

PHYSICAL EXAMINATION 6 week baby?

Answer 3

• The main purpose of this is to detect:
• Congenital heart disease
• Developmental dysplasia of the hip (DDH)
• Congenital cataract
• Undescended testes
• The core examination is set out in National Institute for Health and Care Excellence (NICE) guidance “Routine postnatal care of women and their babies (2006).[3]

Question 4

PHYSICAL EXAMINATION 6 week baby

Answer 4

• It should comprise:
• A weight check.
• Measurement of head circumference (and opportunity to palpate sutures and fontanelles, and assess head shape).
• A general assessment of appearance: colour, behaviour, breathing, activity, and skin (colour - eg, jaundice, rashes, birthmarks).
• Assessment of tone, movements and posture.
• Assessment of head: fontanelles, face, nose, palate, symmetry.

Question 5

PHYSICAL EXAMINATION 6 week baby?

Answer 5

• It should comprise:
• Assessment of the eyes for the presence of the red reflex and visual fixing.
• Assessment of the heart: position, murmurs, rate, femoral pulses.
• Assessment of the lungs: added sounds and rate.
• Assessment of the abdomen: shape, organomegaly, herniae.
• Assessment of the genitalia: normality, testicular descent.
• Examination of the hips (by Barlow and Ortolani tests, and by looking for symmetrical skin creases in the thighs).
• Assessment of the spine.

Question 6

NHS web New-born Examination Advice for parents?

Answer 6

•http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/newborn-physical-exam.aspx

Question 7

Development of BABY?

Answer 7

•https://www.youtube.com/watch?v=8G8PRUwLd-A

Question 8

BIRTH HISTORY: APGAR Score at birth?

Answer 8

Baby Check at 6 weeks?

•http://www.patient.co.uk/pdf/2783.pdf#

Question 9

Developmental Examination INFANT?

•https://www.youtube.com/watch?v=4u4B0hs4UKU

Answer 9

Question 10