History and Examinations Flashcards
What are the gross motor developmental red flags
Not walking at 18 months
What are the key features in a paediatric history and examination
The child’s age
The nature of the problem
Observe the child - appearance, behaviour, play, gait
How old is a neonate?
Younger than 4 weeks
How old is an infant
Younger than 1 year
How old is a toddler
1-2 years old
How old is a preschool child?
2-5 years old
How old is a school-age child?
Older child
How old is a teenager?
Adolescent
What are the key enquiries to make?
General health - how active and lively? When were they last their normal self
Normal growth?
Feeding/drinking/appetite
Recent change in personality
When doing a respiratory systems review what should you ask?
Cough
Wheeze
Breathing problems
When doing a ear nose throat review what should you ask?
Earache
Throat infections
Snoring
Noisy breathing -stridor
When doing a CVS systems review what should you ask?
Cyanosis
Exercise tolerance
Faints
When doing a GI systems review what should you ask?
Vomiting
Diarrhoea
Constipation
Abdominal pain
When doing a GU systems review what should you ask?
Dysuria
frequency
Wetting
Toilet trained
When doing a neurological systems review what should you ask?
Development Vision Hearing Seizures Headaches Abnormal or impaired movements Change in behaviour
When doing a MSK systems review what should you ask?
Gait
Limb pain or swelling
Functional abnormalities
What questions should you ask about past medical history?
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
What medication questions do you ask?
Past and present medications, prescribed and over the counter
Known allergies
Family history questions?
Anyone with similar problems or disorders
Any neonatal childhood deaths
Social history questions
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
Initial observations will provide information on
Severity of illness
Growth and nutrition
Behaviour and social responsiveness
Level of hygiene and care
60 second rapid assessment shows
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
General appearance
General morphological appearance
Head large or small
Palpate the fontanelle and sutures
Dehydrated, jaundiced or anaemic
What do you check for in respiratory system
Cyanosis, clubbing, tachycardia, dyspnoea, chest shape, palpation, percussion, auscultation
