History and Examination Flashcards
1
Q
Key features of paediatric history
A
Name Age PC HPC Birth hx Feeding hx Immunisation hx Developmental hx PMH DH and allergies SE SFH
2
Q
Features of birth history
A
Relevant antenatal hx Mode of delivery Was full term Birth weight Any resuscitation Admission to neonatal unit
3
Q
Featuers of a feeding history
A
Enteral/parenteral How much How often - bottle fed baby needs 150ml/kg per day When weaned Any problems during feeding
4
Q
Fluid needs
A
Paediatrics - first 10kg - 100ml/kg/day - 10 -20kg = 50ml/kg/day - >20kg - 20ml/kg/day Term neonates - Day 1 - 50ml/kg/day - Day 2 - 75ml/kg/day - Day 3 - 100ml/kg/day - Day 4 - 120ml/kg/day - Day 5+ - 150ml/kg/day
5
Q
Key features of developmental history
A
Gross motor
- red flag = no independent walking/steps by 18 months
- cerebral palsy = persistent moro’s reflex beyond 2-3 months, tip-toe walking
- muscular disorders - poor tone, excessive headlag, frog like posture
Fine motor
Vision
Hearing
Social skills/interactions
6
Q
NIPE examination
A
Head - fontanelles - sutures - red pupil reflex - facial dysmorphism - hard and soft palate - tongue/lip cyanosis - sucking reflex - rooting reflex Shoulders/arms - clavicle fracture - arms movements - Erbs palsy - brachial and radial pulses - palmar creases - check number and shape of digits - sats probe Chest - observe breathing - heart sounds - breath sounds Abdo - shape - umbilical stump - discharge, infection, periumbilical hernia - palpate for organomegaly Genitals - observe sex - palpate testes and scrotum - present and descended, hernias and hydroceles - penis for hypospadias, epispadias and urination - anus patent - ask about meconium Legs - equal movements, skin creases, tone and talipes - barlows and ortolani manoeuvres - count toes Back - inspect and palpate spine Reflexes - Moro reflex: when rapidly tipped backwards the arms and legs will extend - Suckling reflex: placing a finger in the mouth will prompt them to suck - Rooting reflex: tickling the cheek will cause them to turn towards the stimulus - Grasp reflex: placing a finger in the palm will cause them to grasp - Stepping reflex: when held upright and the feet touch a surface they will make a stepping motion
