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Phase 3A - Paediatrics > History and Examinations > Flashcards

History and Examinations Flashcards

1
Q

What are the gross motor developmental red flags

A

Not walking at 18 months

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2
Q

What are the key features in a paediatric history and examination

A

The child’s age
The nature of the problem
Observe the child - appearance, behaviour, play, gait

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3
Q

How old is a neonate?

A

Younger than 4 weeks

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4
Q

How old is an infant

A

Younger than 1 year

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5
Q

How old is a toddler

A

1-2 years old

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6
Q

How old is a preschool child?

A

2-5 years old

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7
Q

How old is a school-age child?

A

Older child

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8
Q

How old is a teenager?

A

Adolescent

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9
Q

What are the key enquiries to make?

A

General health - how active and lively? When were they last their normal self
Normal growth?
Feeding/drinking/appetite
Recent change in personality

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10
Q

When doing a respiratory systems review what should you ask?

A

Cough
Wheeze
Breathing problems

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11
Q

When doing a ear nose throat review what should you ask?

A

Earache
Throat infections
Snoring
Noisy breathing -stridor

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12
Q

When doing a CVS systems review what should you ask?

A

Cyanosis
Exercise tolerance
Faints

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13
Q

When doing a GI systems review what should you ask?

A

Vomiting
Diarrhoea
Constipation
Abdominal pain

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14
Q

When doing a GU systems review what should you ask?

A

Dysuria
frequency
Wetting
Toilet trained

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15
Q

When doing a neurological systems review what should you ask?

A 
Development 
Vision 
Hearing 
Seizures 
Headaches
Abnormal or impaired movements
Change in behaviour
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16
Q

When doing a MSK systems review what should you ask?

A

Gait
Limb pain or swelling
Functional abnormalities

17
Q

What questions should you ask about past medical history?

A

Maternal obstetric problems - antenatal scans, screening bloods, delivery
Birthweight and gestation
Perinatal problems - admitted to special care baby unit, jaundice
Immunisation
Past illnesses, hospital admissions and operations, accidents and injuries

18
Q

What medication questions do you ask?

A

Past and present medications, prescribed and over the counter
Known allergies

19
Q

Family history questions?

A

Anyone with similar problems or disorders

Any neonatal childhood deaths

20
Q

Social history questions

A

Parental occupation, economic status, housing, relationship, parental smoking, marital stresses
Is the child happy at home
What are the preferred okay or leisure activities is the child happy at nursery or school
What has been the impact of this illness on the family
Do you have a health visitor or a social worker

21
Q

Initial observations will provide information on

A

Severity of illness
Growth and nutrition
Behaviour and social responsiveness
Level of hygiene and care

22
Q

60 second rapid assessment shows

A

Airway and breathing - respiratory rate and effort, presence of stridor or wheeze, cyanosis
Circulation - heart rate, pulse volume, peripheral temperature, capillary refill time
Disability - level of consciousness

23
Q

General appearance

A

General morphological appearance
Head large or small
Palpate the fontanelle and sutures
Dehydrated, jaundiced or anaemic

24
Q

What do you check for in respiratory system

A

Cyanosis, clubbing, tachycardia, dyspnoea, chest shape, palpation, percussion, auscultation

25
Q

What is clubbing associated with?

A

Chronic suppurative lung disease, cystic fibrosis, cyanotic congenital heart disease. IBD or cirrhosis

26
Q

How to do recognise tachypnoea

A

Count the rate or determine from a monitor. Rate of respiratory is age dependent

27
Q

What is dyspnoea?

A

difficult or laboured breathing. Laboured or increased work of breathing from increased airway resistance.

28
Q

How is dyspnoea judged?

A

Nasal flaring
Expiratory grunting - to increase positive end expiratory pressure
Use of accessory muscles - especially sternomastoids
Retraction of the chest wall, from use of suprasternal, intercostal, and subcostal muscles
Difficulty speaking (or feeding)

29
Q

What chest shape do you get in hyperexpansion?

A

Barrel shape

30
Q

What chest shape do you get asthma?

A

Barrel shape

31
Q

What is pectus excavatum?

A

Hollow chest

32
Q

What is the pathophysiology of pectus excavatum?

A

Congenital deformity of the chest wall that causes several ribs and the sternum to grow in an inwards direction

33
Q

What is pectus carinatum?

A

Pigeon chest - malformation of the chest characterised by a protrusion of the sternum and ribs

Phase 3A - Paediatrics (11 decks)

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