History & PE

Question 0

What do you assess for on physical exam for suspected stridor?

Answer 0

• vitals: hr, rr, pulse ox
• respiratory distress present?
• stridor? (at rest or only with agitation?)
• retractions
• decreased breath sounds?
• normal skin coloring?
• normal or altered mental status?

Question 1

What questions should you ask when evaluating for stridor/ suspected croup? What do you assess for on physical exam?

Answer 1

History

• preceding URI
• fever?
• onset of stridor abrupt?
• stridor at rest or only with agitation?
• any sick contacts?
• other sx: vomiting, diarrhea, rash
• is the child feeding normally
• is the child drooling?

Question 2

What questions should be asked when evaluating a dysmorphic child?

Answer 2

1. Prenatal Hx
   - length of pregnancy, meds, drugs, fetal activity, infections other complications
2. Birth Hx
   - delivery type, wt and length, complications
3. Subsequent medical Hx
4. Developmental Hx
5. Family Hx
   - are parents related, parental ages, Hx of fetal or infant deaths, Hx of birth defects, Hx of MR, draw a family pedigree

Question 3

What are 3 situations where we worry about a baby spitting up after feeds?

Answer 3

1. If there’s pain (crying, arching back)
2. If they’re not gaining weight
3. If with feeds they are choking or turning blue around the mouth