Exploring symptoms - Paediatric Symptoms

Question 1

What would you ask when exploring symptoms diarrhoea and vomiting in a child?

Answer 1

• How much/how often/any at night
• Colour, consistency, contents
• Blood
• Weight loss
• Appetite
• Hydration - wet nappies, fluid intake, drowsiness
• Other GI symptoms

Question 2

What would you ask about when exploring symptoms of soiling/eneuresis?

Answer 2

• Primary or secondary
• Full account of toilet training
• SChool toilet behaviour
• Protest behaviour - difficult/chaotic life
• If soiling - faeces consistency
• If eneuresis - have they had a dry night
• If secondary - UTI symptoms, spinal cord compression symtpoms

Question 3

What would you ask when exploring failure to thrive/weight loss?

Answer 3

• Ask to see growth chart
• Input - diet, feeding, hunger
• Use - energy, activity levels
• Output - wet nappies, stools
• Other diseases - CF, recurrent infections, sweating, breathlessness, behaviour, happiness
• Associated GI symptoms

Question 4

What would you ask when exploring weight gain in a child?

Answer 4

• Ask to see growth chart
• Input - feeding, diet, hunger
• Use - energy, activity levels
• Output - wet nappies, stools
• Hypothyroid symptoms
• Cushing’s symptoms
• Syndromic features

Question 5

What are symptoms of hypothyroidism in children that you would want to ask about in a child with weight gain?

Answer 5

• Growth impairment
• Delayed puberty
• Mental slowness
• Constipation
• Cold intolerance

Question 6

What are features of cushing’s syndrome that you would ask about in a child with weight gain?

Answer 6

• Growth impairment
• Proximal weakness
• Central obesity

Question 7

What would you ask about when exploring symptoms of walking/sitting delay?

Answer 7

• Age of milestones
• Mobility
• Hand dominance
• Balance problems
• Behavioural problems
• Associated neuro symptoms

Question 8

What would you ask when exploring speech delay?

Answer 8

• Age of milestones
• Senses - vocal, hearing, vision
• Communication - comprehension, non-verbal communication, social responses

Question 9

When asking about comprehention as part of speech delay questioning, what would you ask about?

Answer 9

• Follows commands
• Responds to voice

Question 10

What questioning would you ask if a child presented with Early/late puberty/primary amenorrhoea/short stature (i.e hormonal features)?

Answer 10

• Pubertal development review
• Intracranial symptoms - visual problems, headache
• Family pubertal/stature history
• Symptoms of other systemic disease - CF, thyroid, anorexia, Crohn’s

Question 11

WHat questions would you ask when exploring allergies in a child?

Answer 11

• Pattern, Frequency, duration, persistent
• Reaction - wheeze, sneezing/itchy eyes, rash, diarrhoea/vomiting
• Anaphylaxis symptoms
• Triggers
• History of atopy - family and child
• Home and social setting