Paediatric History

Question 1

Order of hx

Answer 1

PC + HPC
Birth 
Feeding
Growth 
Development 
PMH, DH, FH, SH, ICE

Question 2

Paeds SE

Answer 2

General - fever, behaviour, activity, rashes, growth/height

ENT - sore throat, earache, snoring, noisy breathing

Chest - cough, stridor/croup/wheeze, SOB, cyanosis

GI - vomiting, abdo pain, diarrhoea/constipation

GU - wet nappies/toilet trained, dysuria, frequency

NeuroMSK - seizures, headache, abnormal movements

Question 3

Birth

Answer 3

Pregnancy

1. Scan results - dating and anomaly
2. Problems - maternal illness, alcohol/drug use

Birth

1. Location
2. Mode of delivery
3. Gestation
4. Birth weight (n=2.5-4.5kg)
5. Birth complications i.e. rhesus, maternal/foetal compromise, sepsis RF (group B strep, maternal fever, PROM), meconium
6. Neonatal problems i.e. jaundice, fits, fevers, feeding, SCBU/NICU

Question 4

Feeding

Answer 4

Diet and appetite

1. Breast/bottle milk (<12m) - type, volume and frequency, feeding difficulties (latching, reflux, SOB)
2. Weaning (~6m)
3. Solid meals and cows milk (~ >12m)

Toileting

1. Training - ~2-4y, dry by day ~2y, dry by night ~4y
2. Frequency - wet nappies (~5 wet by day and ~3 yellow stools)

Question 5

Growth

Answer 5

Weight - red book

Puberty - ~11 girls, ~12 boys

Question 6

Development

Answer 6

Concerns
School progress and attendance

Development screen

1. Smile by 6 weeks
2. Turn to sound by 6m
3. Sitting by 9m
4. First words by 18m
5. Walking by 18m
6. Short sentences by 3y

Question 7

Developmental red flags

Answer 7

1. loss of skills
2. not fixing/following objects
3. hearing loss
4. low muscle tone /floppy
5. can’t hold objects by 5 months
6. can’t sit unsupported by 12 months
7. can’t walk by 24 months
8. persistent toe walking
9. no speech by 18 months

Question 8

Immunisation schedule

Answer 8

2m - 6in1, rotavirus, men B
3m - 6in1, rotavirus, pneumococcal 
4m - 6in1, men B
1y - MMR, men B, pneumococcal, h. influenza B/hep C
3-4y - MMR, 4in1 
12-13 - HPV
Teens - 3in1, men ACWY

6in1 - diphtheria, tetanus, polio, pertussis, h. influenza B, hep B
4in1 - diphtheria, tetanus, polio, pertussis
3in1 - diphtheria, tetanus, polio

Annual nasal influenza vaccine offered to 2-7 year olds