History & Examination Flashcards
Components of Paediatric history
Presenting complaint History of presenting complaint Focused systems review Birth Hx Feeding Hx Developmental Hx Immunisations PMH Drug Hx + Allergies Family Hx Social Hx
What do you ask about birth history
Born at term?
Normal delivery? Mode of delivery
Baby okay at birth? (E.g. jaundice, admission SCBU)
Birth weight
What do you ask in feeding history
Breast or bottle fed?
How much + how often?
2-3hrly breast, 3-4hrly bottle
150ml/kg/ day bottle
When were they weaned? (6 months)
What are they eating now? (1yr family food)
What do you ask in developmental history?
Parents any concerns about development?
Key milestones: Smile 6 weeks Sit wo support 6 months Speak 1 year Walk 1 year
Progress at school/Teacher any concerns?
What do you ask in social history
Family structure
who lives at home with you?
Parent occupation
Parent smoking
Happy at home?
Happy at school?
Favourite leisure activities?
Do you have health visitor/social worker?
Questions about general health
Active/normal self Following weight and height centiles Irritability Feeding and drinking Fever Rash
Symptoms of different systems
Resp: cough, wheeze, breathing difficulties
CVS: cyanosis, exercise tolerance, faint
GI: DV, vomiting alone, pain, constipation, recent travel
GU: dysuria, frequency, wetting
Neuro: headaches, seizures, development, hearing, vision
Components of Paediatric examination
Observation of bed side Observation of visible treatments General observation of patient Focused observation of patient Focused examination of patient
Components of general exam
Observe for:
Well-being: comfortable, well
Colour - cyanosis, jaundice, pallor
Perfusion + hydration status
Components of Resp exam
Focused observation:
Cyanosis, Clubbing, CRT
Inspection:
Tachypnoea
Dyspnoea - recession, tracheal tug, accessory muscles, abdo muscles
Chest wall - hyperexpansion, pectus excavatum/carinatum, Harrison’s sulcus, asymmetry
Chest expansion
Palpation - trachea, apex
Percussion - not in infants
Auscultation
Lymphadenopathy
Vocal fremitus: not in infants
ENT exam
Components of CVS exam
Focused observation: Cyanosis Clubbing Pulse Chest - RR + respiratory distress, scars, precordial bulge
Palpation: Apex Heaves Thrills Hepatomegaly
Auscultation
Femoral pulse
