Exam of the Preschool Child & Common Pediatric Complaints

Question 1

List 6 key components of a well child check up

Answer 1

Pregnancy, birth, and neonatal history

Developmental history

Daycare/preschool/school performance (if applicable)

Growth curve assessment

Childhood immunization history/childhood vaccines

Anticipatory guidance

Question 2

What is anticipatory guidance?

Answer 2

Guidance given by healthcare provider to assist parents or guardians in the understanding of the expected growth and development of their children

Question 3

Head circumference is part of the vital signs assessment if the child is less than ______ of age

Answer 3

24 months

Question 4

When assessing pediatric vital signs, the BP cuff should cover about 2/3 of the upper arm. If the cuff is too small, the BP will be artificially _____. If the cuff is too big, the BP will be artificially _____

Answer 4

High; low

Question 5

What are some techniques that might make it easier to examine a child?

Answer 5

Be gentle, approach slowly, don’t be “BIG”

Ask the parents how they usually do best

Lap exams are your friend

Enlist parents’ help

Question 6

What are the age cut-offs for the 2 CDC growth curves used for well child exams?

Answer 6

Birth to 36 months (length and weight)

2 years to 20 years (height aka stature and weight)

Question 7

How is head circumference measured?

Answer 7

At largest circumference of the head - which is above eyebrows around to base of the occiput

Question 8

What is an illness script?

Answer 8

Structured mental summary of a provider’s knowledge about a specific disease

Question 9

What are the 4 components of an illness script?

Answer 9

Epidemiology

Temporal course

Pathophysiology

Clinical presentation

Question 10

The 4 components of an illness script are epidemiology, temporal course, pathophysiology, and clinical presentation.

What content is included in the epidemiology component?

Answer 10

Demographics

Risk factors: other conditions

Exposers

Question 11

The 4 components of an illness script are epidemiology, temporal course, pathophysiology, and clinical presentation.

What content is included in the temporal course component?

Answer 11

Duration of profrome or symptoms: hyperacute, acute, subacute, chronic

Pattern of prodrome or symptoms: constant (stable or worsening), episodic (waxing and waning, biphasic or interment)

Question 12

The 4 components of an illness script are epidemiology, temporal course, pathophysiology, and clinical presentation.

What content is included in the pathophysiology component?

Answer 12

Known derangements in anatomy, physiology, immunology, biochemical pathways, genetics, and metabolics

Known environmental contributors — microbiology, toxins, pharmacology

Question 13

The 4 components of an illness script are epidemiology, temporal course, pathophysiology, and clinical presentation.

What content is included in the clinical presentation component?

Answer 13

Key and differentiating features +/- MUST HAVE and REJECTING features

Question 14

Illness scripts are primarily used to enhance which of the following skills first learned by providers in training and fine-tuned throughout their medical careers?

A. Rx writing
B. Clinical reasoning
C. Patient billing
D. Electronic charting
E. Patient counseling

Answer 14

B. Clinical reasoning

Question 15

A disease included in the DDx of a recently admitted pt is known to occur more commonly in Caucasian male smokers over age 50. Which component of an illness script includes this information?

A. Epidemiology
B. Temporal course
C. Pathophysiology
D. Clinical presentation

Answer 15

A. Epidemiology

Question 16

Asthma is known to be an obstructive respiratory condition involving both airway inflammation and hyperresponsiveness/smooth muscle constriction. This info should be included in which of the following components of an illness script for asthma?

A. Epidemiology
B. Temporal course
C. Pathophysiology
D. Clinical presentation

Answer 16

C. Pathophysiology

Question 17

Which of the following best defines an illness script?

A. Structured mental summary of a provider’s knowledge about a specific disease
B. Written summary of a patient’s disease, treatment, and outcome
C. Summary of the historical aspects of a disease and its impact on society
D. Patient log of past illnesses and surgeries
E. Provider’s mental plan for treatment

Answer 17

A. Structured mental summary of a provider’s knowledge about a specific disease

Question 18

The clinical presentation component of an illness script developed for a specific disease always includes the classic signs and symptoms of the disease. The clinical presentation component must also include which of the following?

A. Demographics
B. Usual duration
C. Acuteness of onset
D. Rejecting features
E. Known environmental factors

Answer 18

D. Rejecting features