Paediatric history Flashcards
History taking
Introduce yourself
Gain trust and cooperation
Explain what will happen
Observe child as take history
What to look for in history
Behaviour
If look unwell
Safeguarding - signs of neglect
Milestones
History taking
Presenting complaint
HPC
Birth and development history eg feeding
Immunisation
PMH
FH
SH
Drugs and allergy
Review of systems
Ask - what made you come in today
Summarise back to parents and check havent missed naything
What to ask around long term conditions eg asthma?
Hopsital admissions
admission to ITU previously
Questions to ask about birth
Neonatal admission
Premature
Vaginal or C section
Traumatic birth
Problems ith mum after birth
Weigth at birth
When does asking about birth become irrelevant?
Always ask about birth for exams - might seem silly but any problems when you were born
Older a child is less relevant it is - after age of 10 fairly irrelevant
Immunisations what to ask
Up to date
All received - anything missed
Nutrition questions
Bottle or breast - need to know normal - if breast then how long, if bottle then how many bottles of how much
Moving onto solids at 6 months
Varied diet
Appetite
What is projectile vomitting?
Reaches a distance
Can be forceful and not be projectile
How much will a helathy baby take of milk?
150ml/kg/day of milk
How much will a helathy baby take of milk?
150ml/kg/day of milk
Breast feeding timings
first 5-10 minutes - sweet fore milk
after that - high fat protein content milk that doesnt taste sweet
Normal feed is 20 minutes, ideally on one side
Chronic contipation how ling can go on for
4,5,6, weeks
Why issues with compliance ith constipation meds
Overflow diarrhoea - smell at school
Why issues with compliance ith constipation meds
Overflow diarrhoea - smell at school
Development Qs
Height and weight percentiles
Milestones
Social
Whos looking after child
Pets
Travel
Social services input
Sex and relationships
Hobbies etc
Systems review
General activity, tiredness
Sleep
School absence
Weight loss
Appetite
Resp systems
Resp questions
Cough
Wheeze - noisy breathing
Colour change
SOB
Asthma
Prematurity
Night cough
Asthma
Causes of stridor
Foreign object
Croup
Anaphylaxis
etc
Resp signs in paeds
Sternal/subcostal recession
Supraclavicular recession - tripod
Intercostal recession
Barrel chust
Grunting
Nasal flaring
Head bobbing
Tracheal tug
What is a red flag sign for babies resp?
Grunting
Creating own positive respiratory pressure
What be careful of when lsitening to babies chest?
Coryzal symptoms - snot and secretions etc sounds like in lungs because have no neck - sound spreads to lungs
Listen to crackles - shows acc chest infection problems
Cardiovascular systems review
Faints
Cyanosis
Murmus
Oedema
Urine output
Gi systems review
Diet
Vomitting, diarrhoea
Constipation
Abdo pain
Stool
Comitting diarrhoea qs
Timeline
Frequency
What looks like - blood, mucus
Contacts
Travel
Genitoruinary systems review
Enuresis
Dysuria
Frequency
Urine outout
Age of menarche
Dysmenorrhea
Neuro
Fits, faints, funny turns
Headahces, weakness, hearing and vision
What is an irritable baby a sign of?
inconsolabel - meningitis, encephalitis etc
ENT
Earache
Hearing impairment
Recurrent sore throat
Enlarged glands
When do you do an ENT exam?
End of any examination as often upsets child
Skin
Lesions, rashes
Itchy
Eczema, dyr skin
MSK qs
Joint pain, swelling
Limp
Restriction of movement
Paediatric gals
Development
Gross motor
etc
Growth charts consider
Height/length
weight
Head circumference
What do first if child is quiet
Auscultate/listen to chest first
TO DO
Spotting a sick child
