Paediatric (2-5yrs)

Question 1

What are some important aspects of examination in this age group?

Answer 1

Illness and, increasingly, accidents will prompt attendance

Genu valgus is physiological in this age group

Question 2

How do you assess growth and development?

Answer 2

Growth is decelerating at this stage
Centile charts should be used and checked

The most marked advances are in communication skills and use of language
A brief assessment of language skills should be made in all children

Question 3

What is important in general examination?

Answer 3

Most often achieved on a parent’s lap or standing close to the parent

Explain and commentate on procedures as they progress - answer questions - they are usually very inquisitive at this age

Question 4

What is important in a CV examination?

Answer 4

Innocent murmurs are common

Heart sounds are more easily identified with slower heart rates

Question 5

What is important in a resp examination?

Answer 5

Peak flow measurement is not reliable until about age 5 years

Question 6

What is important in a GI examination?

Answer 6

Often best to examine kneeling down alongside the patient

Children may prefer palpation to be done with their hand underneath the examiner’s

Question 7

What is important in hip and knee examination?

Answer 7

Irritable hip and other hip conditions can occur at this age and require assessment

Normal genu varus (physiological in the toddler) and valgus

(physiological in the pre-school child) often require reassurance at this age

Question 8

What is important in neurological examination?

Answer 8

This increasingly approaches what is possible in adults

Vision can be checked by shape or letter matching at 3 years of age

A circle will be copied by 3 years, a cross by 4 years, a square by 4.5 years and triangles by about 5 years