DDx KP and Qs

Question 1

URTI Qs

Answer 1

Fever Qs - Temp? Chills? Meds? Effect?

ENT Qs - Obvious Sx
- Sore throat, Runny nose, Ear Pain/ Pulling ears
- L&B’s in neck

ENT Qs (Non-Obvious)
- Drooling? Difficulty Swallowing?
- Change in voice/sound in crying?
- Rash***

GI Qs - N/V/D Abd Pain

Question 2

Acute Cough DDx Qs

Answer 2

URTI Qs
Pneumonia Qs - Travel Hx? Sick People Contact?

Croup

FBA - Recent Chocking Epi?

Bronchiolitis – (if <12 m/o)

Asthma Q
- Cough worse at night?
- Cough worse at Exercise?
- FHx of Asthma, Eczema, Hay fever?

Pertussis Qs
- Vomiting after a series of cough?
- Any child younger at 6m at home?

Question 3

Chronic Cough DDx Qs

Answer 3

Asthma Qs

Post Viral Cough
- Any recent flu-like symptoms

Allergic Rhinitis/PND - Recurrent runny nose? Sneezing? Rash?

Pertussis Qs(?)
- Vomiting after a series of cough?
- Any child younger at 6m at home?

Tuberculosis
- Travel? LOW or not gaining weight
- Night Sweats?

Cardiac Qs

Psychogenic Cough - Social hx

Environmental Irritants
- Smoking at home?
- Exposure to dust, pets, and carpets?

Cystic Fibrosis
- Previous hx of recurrent infections?

Question 4

Cardiac Cough Qs

Answer 4

Cardiac (Young Child (<18m)) (Feed)
- Cough on feeding
- Turn blue on feeding

Cardiac (Older) (Activity)
- Cough on Running and Playing?
- Turn Blue on exercise?
- Exercise tolerance? - Able to run & play normally or gets tired quickly

Question 5

Psychogenic Cough Qs (Social Hx)

Answer 5

Home
– How is the home situation?
- Relation with the parents and siblings
- Stressors at home
- Any Recent changes or events in the family

School
- How are things going at school?
- Bullying

Does it happen only at certain places?
Cough at night or at the weekends?

Question 6

Travel Qs

Answer 6

Where?
How long did you stay? – Few months
Bush Walking? Insect Bites?
Street food or unbottled water?
Contact to animals (Q Fever)
Contact with sick people?
Did you see your GP for travel advice and vaccination?

Question 7

Travel Related Fever and Cough Qs

Answer 7

ENT Qs
GI Qs
MSK Qs - Joint Pain, Body Aches, Rash
Meningitis Qs
Hepatitis Qs

Question 8

Asthma KP PMHx Qs

Answer 8

Since?
Treatment? Compliant?
Follow ups?
Complication (Uncontrolled Asthma Qs)
- Night time Symptoms
- Days per week with symptoms?
- Limitations to activity/exercise
- # of Ventolin use per day

RF for Asthma Attack
- Smoking at home?
- Pets, Carpets or exposure to dust?

RF for Asthma Exacerbation
- Hospitalization
- Flare ups

Foreign Body Aspiration
- Recent choking episodes

Question 9

Fever DDx Qs

Answer 9

ENT Qs
Respi Qs - Cough, DOB, NB
GI Qs - N/V, Abd P
UTI Qs - Dysuria, Hematuria,
Menigitis Qs - HA/Sore Neck, Rash, Sensitive to light
Septic Arthritis - Joint Swelling and redness, Limping
Kawasaki Dx
Travel Hx

Question 10

Kawasaki Dx Qs

Answer 10

• Rash?
• Swelling and Peeling of skin on palm and feet?
• Dry, Cracked lips?
• Red Eye?

Question 11

Allergic Rhinitis/ Hay fever Qs

Answer 11

Nose (Allergic Rhinitis) - Itchy Nose, Sneezing
Eyes (Allergic Conjuctivities) - Red Watery Eyes, Itchy Eyes
Lung (Asthma) - Cough and noisy breathing
Skin (Eczema)- Itchy rashes?
Signs
- Dark Shadows Around the eyes?
- Breathing thru the mouth?
Complication (OSA and OM)
- Snoring or gasping during sleep? (OSA)
- Daytime sleepiness?
- Recurrent ear infection? (OM)
- Concern with speech and hearing? (Recurrent OM)
- Concerns with his development?
RF - Smoking at home, Pets, Carpet, exposure to dust,
FHx of asthma, eczema, hay fever

Question 12

Immunodeficiency Qs

Answer 12

Birth Hx - Any infection during pregnancy? (HIV) Term or Preterm?
Immunization up to date?
CF - Heel prick test done
Celiac D - Chronic Diarrhea? Greasy stools?
Leukemia
Is he gaining weight normally on his growth chart?
L&B in Body
Any admission in hospital due to infection
Family Hx of a suppressed immune system

Question 13

Recurrent Flu Symptoms Qs

Answer 13

of Flu in a year? How long does it last?
Describe the symptoms? (ENT Qs)
Hx of Admission in the hospital due to the infection?
Antibiotics for any of the infections.

Question 14

Neonate Cough DDx Qs

Answer 14

URTI Qs
Pneumonia Qs
FBA Qs
Laryngomalacia Qs
- Noisy Breathing worse when you put him down?
Cardiac Conditions
- Cough or Noisy Breathing worse during feeding?
- Turn Blue during feeding?
Birth Hx-KP
- Infection, Heel Prick Test Done, Problem after delivery?

Question 15

OSA KP (Pedia) Qs

Answer 15

Apnea
- Gasping during sleep?
- Stop breathing for a few second in sleep?
Daytime Symptoms - Daytime Sleepiness? Headache?
Other Features***
Mouth breather?
- Behavioral problems - Hyperactive, Aggre, or low conc and attention?
- Enuresis?
- Prob - Growth and Weight? (FTT)
Associated Sx - Recurrent Runny nose or colds? Hearing Problems?

Question 16

Poor Attention in School DDx Qs

Answer 16

OSA
Absence Seizure - Episodes of Staring, FHx of Seizures
ADHD Qs
Autism Qs
Oppositional Defiant Disorder
- Anger Outburst?
- Refuse to follow instructions?
Hearing and Vision Problems
Psychological d/o
- Mood? Hx of self harm?
Head Injuries

Question 17

ADHD KP Qs

Answer 17

SHx - Does it also happen at home/scool?
BHx - Extra kicking during pregnancy

Attention
- Any trouble concentrating?
- Does he remember instructions?

Hyperactive
- Talkative?
- High in energy and hard to slow down?

Impulsive
- Impatient?
- Act without thinking of the consequence

Question 18

Autism KP Qs

Answer 18

Social
- Lack emotion and empathy?
- How is his interest with his peers? Have any friends?

Communication
- Speech Problem?
- Repeat words frequently?

Repetitive Behavior
- Insists on a routine and gets upset if you change it?
- Repetitive movements?
- Extremely Attached to an object?

Question 19

Lump DDx Qs (Pedia)

Answer 19

Thyroid Qs
- Weather Preference?
- Like intolerant to cold or hot weather?
- Long term constipation and diarrhea?
- Lump move with swallowing?***

Lymph Node Qs
Reactive/ Infection
- Fever or chills?
- ENT Qs
- Rashes on skin lesion on head and neck?
- Tooth ache
Malignant
- LOW? Growth Chart
- LOA, L&B
- Night sweats?
- Tiredness?
BHx - Prob/inf Preg, Lumps when was born?

Question 20

Headache DDx Qs

Answer 20

Brain CA Qs
Benign ICP HTN Qs - Medications
Migraine Qs
Tension HA Qs
Vision Problem
Infections Qs
- Fever and Chills?
- Sinusitis – Facial pain? Congested Nose
- Dental Infections – Toothache while eating?
- Meningitis – Sore neck? Rash
- URTI Qs - Sore throat, Ear pain, L&B in the neck

Question 21

Brain CA Qs

Answer 21

LOW, LOA, L&B?
Growth and weight gain
Pain wake her up at night?
Early morning HA and Vomiting?
Increased ICP
Worse on coughing, sneezing or bending?
Noticed any drops in the school performance?
Neurologic Deficits
BOV, Problem in speech and talking?
Concern regarding development?
Weakness and numbness in the body?

Question 22

Migraine HA Qs

Answer 22

Nausea or Vomiting?
Photophobia or phonophobia
Aura - Flashing or sparkling lights before the HA
Family Hx of Migraine
Trigger - Specific foods? Missing Meals? Lack of sleep?

Question 23

Tension HA Qs (Social Hx)

Answer 23

Home
- How is everything going at home?
- Relationship with the parents and siblings?
- Any recent changes or events at home?
- Stressors at home?
School
- Stressors at school?
- Bullying?
- Changes in school performance?
- Mood? Sleep? Anhedonia?

Question 24

Neonatal Jaundice DDx Qs

Answer 24

Sepsis - Fever? Rash?**, UTI, Cough Runny nose
Thyroid - Heel Prick Test, Hoarse Crying, Dry skin, Large Tongue,
FHx - Jaundice, Anemia or Blood Problems, Thyroid Dx

Question 25

Incident and Head Injury Qs

Answer 25

During (Head and Others Injury Qs)
- Describe the injury for me?
– Direct blow or strike to the head?
– Jump and land on his neck or head?
- Other injuries? Any other pain or swelling in the body?

After (LOC & Seizure Qs)
- LOC or Aware of his Surroundings?
– How long?
-Jerky Movements? (Seizure Qs)
– Upward Rolling of the Eye?
– Tongue bite? Frothy Secretions in mouth?
– Wet or Soil Him self?

Red Flags Qs (Head Trauma)
(LOC & Seizure)
Headache?
Nausea or vomiting?
Confused and drowsy now?
BOV?
Weakness or Numbness in the body? Walking problem?
Memory Problems?
Noticed any runny nose or ear discharge, after the injury?
Is he on blood thinners or Hx of bleeding d/o?

Question 26

Seizure Qs

Answer 26

During Seizure Qs
- How long was he unconscious?**
- Jerky Movement?
- All 4 limbs or was it just 1 or 2 limbs? (GTC)
- Upward rolling of the eye?
- Tongue Bite?
- Frothy secretion around the mouth?
- Wet or Soil him self?
Before Seizure Qs (Seizure)
- Head Trauma?
- Fever? (if + Check Source) - UTI, URTI, Pneu, Mening, SA, GI
- Missed Meals?
- Warning signs before it happened?
- Triggers - Severe Pain? Lack Sleep? Stress? Flashing Lights?
After the Incident
- Was he confused and drowsy after? (Post ictal phase)
- Amnesia when he woke up?
Before and After the incident S/Sx Qs
- Neuro - HA? BOV? Weakness or Numbness
- CVS - Racing of Heart or chest pain?
- GI - N/V/D?
Psychogenic Seizure
- Breathing fast before the incident?
- Stressors at home or at school?
Brain Tumor Qs

Question 27

Unresponsive Qs (Incident)

Answer 27

Timing Qs - When, How long, First time, Grad or Sudden
Incident
- Unresponsive
– Blue? Pale?
– Floppy or stiff?
– Change in breathing?
– Choke on anything?
- Seizure Event Qs
Before Incident Qs
After Incident Qs

Question 28

Rash DDx Qs Format

Answer 28

Infection Sx
Autoimmune Qs
Allergic Condition Qs
Purpuric Rash Qs

Question 29

Rash DDx Qs - Infectious

Answer 29

Infection Sx- Fever Qs, Immunization, Sick Contacts, Travel Hx
URTI & LRTI – Runny nose, Sore throat, cough
EBV – Rash appear after antibiotics
GI – V/D (E. coli)
MC and Meningitis – Drowsy? Sore Neck? HA? Photophobia?

Question 30

Rash DDx Qs - Autoimmune

Answer 30

Celiac Dx (Herpetiform Dermatitis) - Chronic Diarrhea? Greasy Stool
IBD (Erythema Nodosum) - Bloody Diarrhea? J. Pain? BOV? Mouth Ulcer
Psoriasis - J. Pain

Question 31

Rash DDx Qs - Allergic Condition

Answer 31

Eczema - Family Hx of Atopic – Eczema, Hay fever, and Asthma
Urticaria (Hives) - Any new food? Medicine? Or Insect bites?
Anaphylaxis -Swelling of the lips and tounge? Noisy Breathing? Nausea?
Contact Dermatitis - Contact with chemicals? Hand Sanitizers?

Question 32

Rash DDx Qs - Purpuric Rash

Answer 32

HSP - Recent viral infection or flu like symptoms? Joint Pains? Abdominal Pain? Blood in the Urine?
HUS - Diarrhea
ITP (r/o Malig) - LOW, LOA, L&B and Night Sweats
NAI - Social Hx
Family of Bleeding Dx