Lecture Week Learning objectives: History taking + Study guide

Question 1

History and examination in paediatrics:

So important: Read paediatric consultation: 41-44 (paed at a glance)

Answer 1

Remember to listen to the parents!!!!!!!

History usually taken from parents

You must include child in hx taking, (dependant on development age)

RECORD who provides the history:

(development, childhood, at home)

Question 2

First component of history: Is general observation of child:

A- Alertness/airway B-breathing C- Colour/ rashes cyanosis, circulation (cold peripheries, poor cap refill)

Outline other important features of history that can be taken just on observation:

Answer 2

Question 3

Outline the standard catergories of a paediatric history:

Answer 3

Question 4

Again outline Thorough paed hx: Explaining each catergory (from Paeds at a galnce)

Note Always start with exact age!

Answer 4

Question 5

Always give exact age on note in History- (e.g 2 years 2 months)

Also always record prematurity and correction of age: (if premature substract amount of time premature to age)

Answer 5

Question 6

Also always record prematurity and correction of age: (if premature substract amount of time premature to age)

Read example:

Answer 6

Question 7

Presenting complaint: What to include?

Answer 7

Question 8

Presenting complaint : Example:

Answer 8

Question 9

HOPC:

What detail needs to be in paed HOPC: remember importance of chronological order, what previous treatments etc

What made the pts present now?

Trace each symptom!

Answer 9

Question 10

Importance of clarifying symptoms from pts and parents: examples:

Answer 10

Question 11

Examples: 2 children different with cough and breathing difficulty:

Answer 11

Bronchiolotits, infection, foriegn body

Question 12

Systems review: What questions to ask about certain systems?

Respiratory? Outline system review of resp system on hx

Answer 12

Question 13

System examination and important hx question: PAG

Read:

Answer 13

Question 14

More Questions needed to asked in system review of resp:

list

Answer 14

Question 15

System review: ENT outline:

What questions to ask? List 6

Answer 15

Question 16

System review: Cardiovascular system:

What questions to ask?

SOB? Excercise limit? Color? Growth?

Answer 16

Question 17

System review: CVS - History and exam_ read - PAG

Answer 17

Question 18

Systems review: Family hx: What to ask all patients? (CVS)

Associated conditions to ask about in paeds? (CVS)

Answer 18

Question 19

Gastrointestinal system review: History:

What questions to ask?

Hydration and nutrition? Input? output? (vomit, bowel motions). Abdo pain? FH?

Answer 19

Question 20

Outline key system review questions GI:

Outline Gi assessment paeds:

Specific questions related to GI in paeds: outline

PAG

Answer 20

Question 21

Neurological system review: Questions outline:

Answer 21

Question 22

Neurological assessment: System review+ Hx and examination:

PAG read

Answer 22

Question 23

Past obstetric history: 3 components:

Pre

During

Post delivery:

Answer 23

Question 24

Past obstetric history: Paed continued:

Read: NAy problems with pregnancy, how many, information about all, did you attend antenatal appoints, did drs, nurses have concerns?

Were you able to attend all your visits? Were drs nurses concerned?

Answer 24

Question 25

Past obstetric hisotry (environment) - E.g child exposed to? (what does the utero environment look like)

]Medications?

Non prescribed?

Cigarettes? Trauma? Did mum have a rash during the pregnancy?

Answer 25

Question 26

Past obstetric hx: continued: Asking the hard questions: When did you find out? Was it planned? Did you stop meds? Drugs etoh? etc?

Answer 26

Question 27

Past obstetric history:

Duration of pregnancy?

Method of delivery?

Answer 27

Question 28

Past obstetric hx:

what you need to measure or know from birth? (e.g weight, height, apgar, any neonatal concers?

Answer 28

Question 29

What is the apgar score? Explain the criteria: And the scoring system and when these scores are taken

Answer 29

Question 30

Example of how to take notes on all the previous history:

Answer 30

Question 31

Past medical history:

(paeds) - Ask more about previous illness, and record in chronological orders

For hospitilizations detail: Diagnosis? Treatment? age? hospital?

Answer 31

Question 32

PMH: Paeds: Example:

Answer 32

Question 33

PSHx: Paed: What to record?

Answer 33

Question 34

Developmental History:

Outline the components of developmental hx?

Answer 34

Question 35

Immunisations:

Record, applaud family, make a plan, mention the importance, - look at current guidelines:

Answer 35

Question 36

Allergies: PAediatrics: What to ask?

Answer 36

Question 37

Medication history: Important in paeds (dose)

Ask about, name, route, dose, frequency, indication, duration of treatment

Answer 37

Question 38

Family, school and social history:

What do you need to ask about? What are the family dynamics? Parental occupation?

Answer 38

Question 39

Ask also: (family/school/social) - continued: Who lives at home? Think about crowding conditions/hygeine

Answer 39

Question 40

family/social/school:

Ask about pets? Who lives at home?

Answer 40

Question 41

For school aged child: What should you ask about? Family/school/social history:

Are you bullied?

List qs

Answer 41

Question 42

School/home/social:

What are they good at? What is their favourite part of the day? (always try find oout what pt is good at)

Answer 42

Ask what patient is good at!

Ask patient what they like to do!

Question 43

Family history of illness: Paeds:

What qs to ask?

Answer 43

Question 44

Problems list:

What to be included?

Answer 44

Question 45

Summary of everything: History part 1 : what needs to be covered

Answer 45

Question 46

PArt 2: Paed history everything that needs to be covered

Answer 46