Introduction to Paediatrics and Assessment

Question 1

What is the definition of a child?

Answer 1

Every human being below the age of eighteen years unless, under the law applicable to the child, majority is maintained earlier

Question 2

What are the reasons for reduced paediatric mortality?

Answer 2

Obstetric care 
Better housing 
Better nutrition 
Immunisations 
Antibiotics
Established health services

Question 3

What are the paediatric cardiovascular differences?

Answer 3

Faster pulse
Faster respiratory rate
Lower blood pressure

Question 4

What are some common diseases seen in children but not in adults?

Answer 4

Abdominal migraine
Bronchiolitis 
Bronchopulmonary dysplasia
Croup
Enuresis
Febrile convulsion
Glue ear
Intraventricular haemorrhage
Necrotising enterocolitis
Non accidental injury
Sudden unexplained death of infants
Toddler’s diarrhoea
Vesico-ureteric reflux
Viral induced wheeze

Question 5

What are some chronic conditions with childhood onset?

Answer 5

Autism
Cerebral palsy
Cystic fibrosis
Gastroschisis
Hirschsprungs disease
Spina bifida

Question 6

What are the causes of sudden and unexplained death in infant (SUDI)?

Answer 6

Infection
Cardiac cause
Infanticide
Metabolic cause

Question 7

What advice is given to parents to prevent SUDI?

Answer 7

Back to sleep 
No smoking 
Breast feeding 
Lie to bottom of cot 
Don't overwrap

Question 8

How much weight should a baby gain?

Answer 8

100-200g/ week for first 6 months

Question 9

How much feed should a baby take?

Answer 9

140-180ml/kg/day

Question 10

What questions should be asked with regards to a child’s bowel habits?

Answer 10

Nappies or independent toileters 
Frequency 
Size, shape, appearance and consistency 
Difficulties passing 
Pain on passing 
Blood or mucus seen

Question 11

What information should be included in a paediatric history?

Answer 11

Birth history 
Past medical history 
Immunisations 
Development 
Drugs and allergies 
School and nursery 
Parental social history (smoking, alcohol, drugs, occupation)

Question 12

What should be observed when doing a paediatric examination?

Answer 12

General: Appearance, play, interaction, obs
Resp: Effort, noise, rate, recession, O2, nebs
CVS: Colour, perfusion
GI: Feeding, vomit, abdo distension/ movement
Neuro: Alertness, interaction, play, posture
MSK: Mobility, limbs movements, posture, splints, mobility aids
Other: Rashes, bruises, infusions, tubes, lines
Other: Toys, pictures, cards, games, caffeine, books

Question 13

What should be examined for when looking at a child’s hands and arms?

Answer 13

Warmth 
Capillary refill 
Radial/brachial pulses
Clubbing 
Nail changes 
Hand skills 
Pen marks

Question 14

What should be examined for when looking at a child’s head and face?

Answer 14

Eyes (jaundice) 
Lips (colour, moisture) 
Tongue
Nose 
Scalp changes 
Bruises 
Rashes 
Fontanel

Question 15

What should be examined for when looking at a child’s neck?

Answer 15

Rashes and nodes
Size and shape
Mobility, position, consistency, symmetry
Tracheal tug

Question 16

What should be examined for when looking at a child’s chest and back?

Answer 16

Murmurs 
Apex beat, thrills, chest expansion 
Breath sounds 
Percussion 
Resonance and fremitus 
Rashes and skin marks 
Spine alignment, deformity, sacral dimples

Question 17

What should be examined for when looking at a child’s abdomen and groin?

Answer 17

Tenderness 
Masses and organomegaly 
Bowel sounds and bruits 
Femoral pulses 
Hernias and testis 
Genital/anal appearance

Question 18

What should be examined for when looking at a child’s legs and feet?

Answer 18

Mobility, changing posture, movements, tone
Reflexes, plantars, clonus
Power, coordination, sensory assessment
Pulses, warmth, capillary refill, colour, mottling
Rashes, bruises, marks
Deformities and gait