History and PE Flashcards
Part of history with basic info
General Data
Part of history with informant’s name, relationship and reliability
General data
Part of history with initial impression and DDx
HPI
Part of history where must not use medical term
Chief Complaint
Part of history that helps uncover related symptoms in other organ system
ROS
Part of history that further elicit relevant data
ROS
included in Past Personal History if <2yo
gestational, birth and neonatal history
where to write APGAR in history?
Neonatal History, under Past Personal History
Hx Parts in Sequence
General Data Chief Complaint HPI ROS Past Personal Hx Immunization Hx Family Medical Hx Socioeconomic Hx Environmental Hx
Contents of Immunization Hx
vaccines and tuberculin test
growth chart that measures whether underweight or not
wt for age
growth chart that measures whether stunted or not
ht for age
growth chart that measures whether wasted or not
wt for ht
wt for age measures…
whether underweight or not
ht for age measures…
whether stunted or not
wt for ht measures…
whether wasted or not
growth chart used for CHRONIC malnutrition
ht for age
growth chart used for ACUTE malnutrition
wt for ht
growth chart used for ACUTE or CHRONIC malnutrition
wt for age
normal RR of newborn
30-60/min
normal RR of 2-12 months old
50/min
normal RR of 1-5 y.o.
40/min
most reliable parameter for growth
Growth Chart
when to compute for BMI
if wt for ht is +1 or +2
-2 wt for age
underweight
-3 for ht for age
severely stunted
-3 for wt for ht
severely wasted
BMI formula
kg/m2
APGAR components
heart rate resp effort muscle tone reflex irritability color
APGAR heart rate scoring
0 = absent 1 = <100 2 = >100
APGAR resp effort scoring
0 = absent 1 = slow and irreg 2= good and strong
APGAR muscle tone scoring
0 = flaccid 1 = some flexion of arms and legs 2= active movement
APGAR reflex irritability scoring
0 = no response 1 = grimace 2 = crying vigorously, sneeze, or cough
APGAR color scoring
0 = blue, pale 1 = pink body, blue extremities, 2 = pink all over
how to measure reflex irritability
reaction to suction of nares with bulb syringe
1 min APGAR scoring
8-10 normal
5-7 some nervous depression
0-4 severe depression, requiring immediate resuscitation
5 min APGAR scoring
8-10 normal
0-7 high risk for subsequent CNS and other organ system dysfunction
Skin color. yung kamay at paa bluish. hypothermia.
acrocyanosis
skin color. yung half of the body with diff color secondary to hypothalamic immaturity
Harlequin sign
skin color. lattice-like appearance
mottling
skin color. bluish mottled appearance
cutis marmorata
skin color. icteric
jaundice
loss of elasticity, hydration, skin pinch
turgor
which fontanel closes first? when do they close.
posterior fontanel closes by 2 mos.
anterior fontanel 4-26 mos, (90%) closes by 7-19 mos.
20/20 visual acuity by when?
5-6 y.o.
wheezes
musical. during expiration.
stridor
musical. inspiratory wheeze.
upper airway obstruction
rhonchi
sonorous wheeze; snoring,gurgling quietly; low-pitched moan; dull.
obstruction of larger main airways.
crackles (rales)
fine (hair rubbing) or coarse (velcro/pouring water from bottle)
Hoover sign
abdomen out and chest in; inward movement of the rib; COPD
“purring” vibratory sensations felt by the palm of the hand over the precordium
thrills
sign of LVH (feels like an abnormally large beating heart)
heaves
location of valves
A 2R
P 2L
T 4L
M 5L (apex beat)
thrills are associated with
murmurs
murmur grading that is associated with murmurs
Grade 4 above
valves that open on systolic and
close on diastolic
aortic and pulmonic
valves that close on systolic and
open on diastolic
mitral, tricuspid
mitral stenosis., systolic or diastolic?
diastolic (dun sya bukas e)
mitral regurgitation. systolic or diastolic?
systolic (dun sya close e)
stenosis
narrowing. naririnig kung bukas valve
regurgitation
turbulence. naririnig kung sarado valve
uneven shoulders, uneven hips, S-curved spine
Scoliosis
nakaLiyad
Lordosis
Kuba
Kyphosis
to test dislocation of hip. paabduct
Ortolani test
to test dislocation of hip. paadduct
Barlow test
nasa ilalim butas ng bird
hypospadia
di maretract balat ng bird
phimosis
undescended testes
cryptochidism
may tubig sa balls. (water in tunica vaginalis)
hydrocoele
bulge in inguinal area; failure of obliteration of the processus vaginalis (7 mos) M>F
hernia
CN I
Olfactory
difficult to test
CN II
Visual acuity
have baby regard your face. and look for facial response and tracking
CN II, III
Response to light
darken room, raise baby to sitting position to open eyes.
use light and test for optic blink reflex (blinking inresponse to light.
use otoscope (no speculum) to assess papillary responses
CN III, IV, VI
extraocular movements
observe how well baby tracks your smiling face.
CN V
Motor.
Test rooting reflex.
Test sucking reflex (watch baby suck breast, bottle, or pacifier)
CN VII
Facial.
Observe baby crying and smiling: note symmetry of face and forehead.
CN VIII
Acoustic
Test acoustic blink reflex (blinking of both eyes in response to loud noise)
CN IX, X
Swallow
observe coordination during swallow.
Gag
Test for gag reflex
CN XI
SPinal accessory.
Observe symmetry of shoulders
CN XII
Hypoglossal
observe coordination of sucking, swallowing, and tongue thrusting.
Tanner Stage 1
preadolescent. elevation of nipples
tanner stage 2
breast bud forms below areola
tanner stage 3
further enlargement and elevation of both breast and areola
tanner stage 4
areola forms a secondary mound above the contour of the breast
tanner stage 5
breast is fully mature, with recession of the secondary mound and a smooth breast contour
male genitalia stage 1
prepubertal genitalia. with vellus hair.
male genitalia stage 2
enlargement of testes and scrotum, with reddening and thinning of scrotum, no enlargement of penis
male genitalia stage 3
penis began to enlarge, first in length, then in diameter, testes and scrotum continue to enlarge
male genitalia stage 4
testes and scrotum continue to enlarge with continued lengthening of penis and enlargement of the glans
male genitalia stage 5
genitalia of adult size and proportion
pubic hair stage 1
fine vellus hair
pubic hair stage 2
growth of sparse straight hair. base of penis. along the labia.
pubic hair stage 3
hair increases in quantity and is darker and curlier
pubic hair stage 4
resembles adult pubic hair although the escutcheon covers a smaller area than seen in adults
pubic hair stage 5
increased volume. spread onto medial thighs and taken on the characteristic male or female configuration.
attempt to dislocate femoral head from acetabulum
Barlow’s test
nutrition, hydration, which part of hx
general survey
oral temp vs axillary temp
oral temp is 0.5C higher than axillary temp
interval hx which part of hx
HPI
manner of delivery, which part of hx?
birth hx, under personal past hx
useful when child’s age is unknown
wt for ht
flat, short head with Down syndrome
brachycephaly
checking tympanic membrane in Neonates- 3 yrs:
tympanic downward - pull auricle down and back
checking tympanic membrane in > 3 yrs. old
pull auricle up and back
