DDx KP and Qs

Question 1

GI DDx Qs (Vomiting)

Answer 1

Hernia Qs - Lump or swelling in groin?
Intussusception Qs
GORD Qs
Hypertrophic pyloric Stenosis Qs
(2-6 weeks, <12 weeks)
IBD - (Older child) Joint pain, BOV Mouth ulcers? Rashes?

Question 2

Infection DDx Qs (Vomiting)

Answer 2

General Qs - Fever Qs

GE
Sick Contacts?
Home? Childcare/school?
Travel?

URTI (Phyryngitis)- Runny Nose? Sore throat? (Young) Drooling?
Pneumonia - Cough?
Pertussis - Vomit after coughing

UTI
Irritability and crying on changing nappies or passing urine?
Foul smelling urine?

Sepsis and Meningitis
Rash? Drowsy?

Question 3

Neurological DDx Qs (Vomiting)

Answer 3

Trauma
Any recent head injury or falls?
Trauma to Abdomen?
Migraine or Brain Tumor (Old) - Headaches?

Question 4

Others DDx Qs (Vomiting)

Answer 4

Food Allergies
Vomiting related to any specific food?
Recently Started any solids?
Rash around his mouth after feeds?

DKA
Polydipsia – Have you noticed an increase in his thirst?
Polyuria – Is he passing more urine lately?
PMhx or FHx of Diabates

Testicular Tortion
Pain, Swelling and redness in the private parts?

Question 5

Neonate GI DDx Qs (Vomiting)

Answer 5

General Qs - First Bowels? Gas? Distension? Breast Milk or Formula?

Intestinal Obstruction - Lumps or seen any movement on the stomach?

TEF - Any cough on feeding? Drooling, Breathing difficulty? Noisy Breathing?

GORD Qs
HPS Qs

Question 6

Crying DDx Qs

Answer 6

Infection Qs - Fever, OM, GE, SA, UTI, URTI
GI Qs - Hernia, Intussuception, GORD, Constipation
Injuries Qs
Child Abuse Q
Corneal Abrasion Qs - Red eyes? Discharge from the eyes?
Hunger and Food Allergies Qs
- Can you describe his current intake?
- Breast fed or Formula fed?
- How Frequent do you feed him?
- Any solids?
- Rashes around his mouth after giving him solids?

Question 7

Injuries Qs (Accidental/NAI)

Answer 7

• Recent falls or head injuries?
• Bruises or swelling on the body?
• Coping with the crying? (Shaken Baby Syndrome)
• How are things are going at home?
• Partner Supportive?
• Mood? Financial Issues?
• Alcohol or drugs?
• Frustrated and hurt the baby

Question 8

Anemia (Pedia) DDx Qs

Answer 8

IDA (Intake) - Red Meat, Too Much Milk
Thalassemia - Family Hx, Ethnicity
Blood Loss - Surgery, PUD
Absorption
- IBD - BOV, Painful Rash, Mouth ulcres, Chronic D/C
- Celiac - Greasy Stools, Hard flush, Stick to the pan
- Cow protein Allergy - Diarrhea after drinking cow milk, Rashes around the mouth, Abdominal Pain
Hemolytic Anemia (Liver, G6PD) - Yellowish of the Skin, Dark urine and Pale Stools, Broad Bean Use
Malignancy (Leukemia) - LOW, LOA, L&B’s, Night Sweats

Question 9

Limping DDx Qs

Answer 9

Infections - Septic Arthritis/OM, Cellulitis
- Fever and Chills?
- Rash? Scratches or Insect Bites
- Swelling in Joints
Mechanical and Traumatic
- Recent Falls or injuries
- Play any sports? Excessive time playing?
Transient Synovitis and Myositis
- Any recent flu like symptoms?
Malignancies - Leukemia
- LOW, LOA, L&B
- Tiredness night sweats
Rheumatologic Group –
- HSP - Abdominal Pain, Blood in the Urine
- JRA – Family Hx of Arthritis, Pain in any other joint
- IBD – Bloody Diarrhea, Mouth Ulcers
Abdominal and Scrotal (Referred Pain)
- Acute Abd - Abdominal Pain
- Hernia – Swelling and Lump in the Groin
- Pain or Swelling and redness in Scrotum

Question 10

Inc. Weight DDx Qs

Answer 10

Causes - Diet Qs
Medications - Steroids
Thyroid Qs
Cushing Qs - Red Cheks, Red Striae, Easily Bruise
Compications of Weight Gain - MSK, OSA, DM
Psychosocial - Home, School, Child, Bulimia Nervosa

Question 11

Dec. Weight Qs

Answer 11

Timing
Describe - Losing Weight? Not Gaining weight? Feel that his weight is low for his age?
Growth Chart? Specific Concern?
Diet Qs
Malabsorption Qs
Inc Calorie Use Qs

Question 12

Eye Swelling DDx Qs

Answer 12

Eye Problem Qs - Fever, Redness eyelids or eye, discharge, itchiness, BOV, Pain on movement
Allergy/Anaphylaxis Qs
Kidney Problems - CKD, Nephrotic Sx
Liver Failure Qs
Heart Failure Qs
Hypothyroid Qs
Autoimmune Qs

Question 13

Allergic Reaction KP Qs

Answer 13

Explore Rash - Timing, Character

Severe Signs (Anaphylaxis)
- Swelling tongue and Lips
- Drooling
- Noisy Breathing
- Nausea and Vomiting
- Drowsy, LOC

Explore Trigger
- Food
- Medications
- Insect Bite
- Flu Like symptoms
- Changes to Soaps

FHx and PHx - Asthma, Eczema, Hay Fever, Food Allergies

Question 14

GORD Qs

Answer 14

Vomit happen after feeding?
Lie the child down immediately after feeding?
Burp him after feeding?
Refuse feeds?
Arching of his back?
Sleep well?

Question 15

Intussusception Qs

Answer 15

Intermittent screaming?
Become pale before screaming or vomiting?
Red jelly like stools?
Pulling his leg to the chest?
Recent Viral infection or vaccination?

Question 16

Hypertrophic pyloric Stenosis

Answer 16

Vomits extremely forceful?
Feel a lump or see any movement on the tummy after feeding?
Child still hungry after vomiting? (Hungry Vomitous)

Birth Hx - Jaundice, Bowels, Fever, Antibiotics
Family Hx

Question 17

Intestinal Obstruction Qs

Answer 17

Previous Hx of Obstruction
Previous Hx of Surgery
RF - Recent Change in Feeds, Enough Fluids

Cystic Fibrosis - Recurrent Infections
Adhesions - Surgery
Hernia - Lumps in the Groin
Intussusception - Red Jelly Like stools, Irritable, Pulling legs to the chest

Question 18

Neonate Vomiting Qs

Answer 18

Pregnancy Qs
- Antenatal Test done?
- Scans Done? - Polyhydramnios?
- Swab Test Done? Ulcer or Rash down below?
- TORCH infection?
- Pre-eclampsia, GDM?
- Drugs, Alcohol, Medications?

Birth Qs
- Term, Pre-Term
- CS/ NVD
- Long Birth? Instruments?

Question 19

Type 1 DM Qs

Answer 19

Since?
Treatment? Compliant?
- Change in dose? Missed Dose? SE
Reg Ff up, Blood test
Complications
- Uncontrolled DM - Polyuria and Polydipsia
- DKA** - Abdominal Pain, Change in diet? Fever? Medications

Question 20

Diet Qs

Answer 20

Can you tell me more about his diet?
Fruits? Vegetables?
Junk Foods? Lollies?
Milk?
# Times he eats?
How long is one meal?
Recent Antibiotic Use?

Question 21

Developmental Delay Qs (15 m/o)

Answer 21

Gross Motor
- Walking w/out Support? (Stand w/out, Crawl)
- Able to hold Neck

Fine Motor
- Able to Scribble with crayons? (Hold things, Reaching out)
- Hands always clenched?

Communication
- Speak Clearly (Babble, Sounds)

Social
- Able to play with other kids? (Peakaboo, Eye Contact, Smile)

Question 22

Developmental Delay Qs

Answer 22

Explore Delay - Timing Qs, Describe and Compare both sides, A&A
Explore Domain - Gross Motor, Fine Motor, Communication, Social
BINDSMA - Pregnancy, Birth, Delivery
Cause
- Brain - Seizures, Trauma, Infection, Kernicterus?
- Thyroid Qs - Coarse Cry, Large Tongue, Dry skin and Constipation
- Neuromuscular Qs - Floppy, Size of muscle, Deformities, Scissoring of legs
General Qs - Hearing Vision, Sleep, Family Hx, Social Hx

Question 23

Rash Down Below Qs (Vulvovaginitis)

Answer 23

Vulvovaginitis Qs
- Dysuria
- Wear tight fitted clothing?
- Use of strong soap? Bubble Baths?
- Playing in sand?
- Waddling in water?

Allergic Dermatitis - Fhx
Pinworms
Constipation

Psychologic Assessment of Child
- How is she behaving? Anything Unusual?
- Look Sad? Sleeping well?
- Aggression?
- Look forward to seeing her dad?

Question 24

Constipation Qs (Soiling Context)

Answer 24

Timing Qs
CCVO Qs

General Abdomen Qs
- N/V
- Abdominal Pain
- Distension/ Pass wind
- Fever/ Dizziness
- Diarrhea/Constipation

Bowel Motions
- How Often? Blood or Mucus?
- Refuse to go to toilet, Withhold his bowels?
- Painful bowels?

Constipation Rf
- Diet - Vegetables, Fruits, Junk Food, Water Intake, Excercise

Question 25

Enuresis Qs

Answer 25

Timing Qs - Dry for 6 months, On/Off, Worse
A&A, Triggers

LUTS Qs - FUNWISE
Constipation Qs
DM Qs
OSA Qs
Hernia Qs
Nutrition (Caffeine)

HEADS
BINDSMA

Question 26

Trauma Qs (Hand)

Answer 26

Describe the Incident? Land on his hand? Bent his hand?
Pain - SIQORAA
General Trauma Qs
- Swelling, Redness, Bruises
- Other Injuries - Anywhere else? Head? LOC? Vomit?
Complications
Vascular - Color change pale or blue?
MSK - Deformities? Asymmetry? Difficulty Moving?
Neuro - Pins and Needles, Numbness?

NAI Qs