Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Child Health > Paediatric History And Examination > Flashcards

Paediatric History And Examination Flashcards

1
Q

What things are important to consider when starting the consultation?

A

Most history will come from parent

Know who is accompanying the child

Clarify name, Date Of Birth gender etc.

Be aware of child protection concerns and know who to contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What typical questions do you need to ask in the history of presenting complaint? (Same as adult)

A 
Onset
Duration
Course
Severity
Precipitating/relieving factors
Previous episodes
Secondary symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some key aspects to ask about in a paediatric history?

A 
Feeding
Vomiting
Fever
Wet nappies - urine output
Stools
Rash
Behaviour
Rhinorrhoea
Cough
Weight gain/loss
Sleeping pattern
Unwell contacts
Localising symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What do you want to know about a child’s feeding habits?

A

Volume of intake

Frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What do you want to know about if a child is vomiting?

A 
Frequency and volume
Timing
Projectile? 
Bilious?
Blood?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do you want to know about a patients stools?

A

Consistency
How often they go
Steatorrhoea? - biliary obstruction
Red currant jelly - intussusception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What localising symptoms may a child show?

A

Tugging ear

Holding tummy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do you want to know about in a child’s past medical history?

A 
Immunisations up to date
Past hospital admissions
Birth
Neonatal period for mother
Accidents and injuries
Any medical conditions - congenital
Antenatal period
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do you want to know about in the developmental history?

A

Age at reaching milestones

Concerns about vision and hearing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What categories can a neonatal history be split into?

A

Pregnancy
Maternal infections
Birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do you want to find out about the pregnancy?

A 
Maternal medical history
Medications
Alcohol and smoking
Complications of pregnancy
Results of any amniocentesis, chorionic villus biopsy and ultrasound reports
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What infections are mothers in the UK tested for in the antenatal period?

A

HIV
Hepatitis B
Syphilis
Rubella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are important facts to know about a child’s birth?

A 
Duration or rupture of membranes
Gestational age at delivery
Mode of delivery
Resuscitation (if req)
Birth weight
Any problems encountered after birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do you assess in a general examination of a child?

A 
Weight and height - plot on growth chart with head circumference
Temperature
Colour
Posture, movements and conscious level
Rashes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What should you examine in a child?

A 
Respiratory system
Cardiovascular system
Abdomen
Nervous system
ENT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What respiratory rate do you expect for different ages of children?

A

Neonate <60
Infant <40
Young child <30
Older child <20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What do you listen for when examining a child’s respiratory system?

A

Strider or wheeze

Cough and its nature

18
Q

What does a barking cough indicate?

A

Croup

19
Q

What do you look for on a respiratory examination?

A

Nasal flaring
Use of accessory muscles
Intercostal and subcostal recession
Chest shape abnormalities

20
Q

When is percussion useful?

A

In children >5 years old

21
Q

What pulse is mandatory to palpate in neonates and why?

A

Femoral pulse to detect coarctation of the aorta

22
Q

What signs of cardiac failure are different in children to adults?

A

Hepatomegaly is seen

Sacral oedema and lung crepitations aren’t seen

23
Q

For each age range, what heart rate is normal?

A

<1 year - 120-160
2 - 5 years - 90 - 140
5 - 12 years - 80 - 120
>12 years - 60 - 100

24
Q

What should you observe about a a child’s abdomen?

A

Abdominal distension - alone this is not pathological

Jaundice

25
Q

What do you palpate for on abdominal examination?

A 
Abdominal masses
Peristalsis
Inguinal hernia
Umbilical hernia
Tenderness
26
Q

What can give a good indication of a child’s mental status and nervous system function?

A

The way a child plays and interacts with their surroundings

27
Q

What should be observed to assess a child’s nervous system?

A

Gait
Posture at rest
Alertness or conscious level

28
Q

What is important to do in a child’s nervous system exam?

A

Measure head circumference
Palpate head sutures and fontanelles
Test primitive reflexes

29
Q

What reflexes should be present in a newborn?

A 
Rooting reflex
Suck reflex
Moro reflex
Tonic neck reflex
Grasp reflex
Stepping reflex
Babinski’s reflex
30
Q

What is rooting reflex and how long does it last?

A

Baby turn head and open mouth when corner of mouth stroked

Last for 4 months

31
Q

What is the suck reflex and when does it start?

A

If roof of babies mouth is touched, baby will begin to suck

Start 32nd week pregnancy (fully developed 36th)
Premature babies have weak suck reflex

32
Q

What is the Moro reflex and how long does it last?

A

If baby is startled, they will throw head back and extend arms and legs before pulling them back in

It lasts for 2 months

33
Q

How is Moro reflex tested and what can it be used to test for?

A

Hold baby a little above bed and allow to free fall backwards

Can be used to test for symmetrical response - asymmetry could be due to nerve injury

34
Q

What is the tonic neck reflex and how long does it last?

A

If a baby’s head is turned to one side, the arm on that side stretches out and the opposite arm bends at the elbow

Last 5-7 months

35
Q

What is the grasp reflex and how long does it last?

A

Stroking the palm of a baby’s hand causes them to close fingers in a grasp

Hand - 5-6 months
Toes - 9-12 months

36
Q

What is a stepping reflex and how long does it last?

A

Baby appear to take steps when their feet touches a solid surface

Last 2 months

37
Q

What is babinski’s reflex and how long does it last?

A

When the sole of the foot is firmly stroked, the baby will extend their Hallucis

Normal for upto 2 years

38
Q

What is done when examining the ear nose and throat of a child?

A

Neck palpated for lymphadenopathy

Then ears examined

Finally look into throat

39
Q

Why is the throat examined last?

A

Most intrusive - may need wooden spatula for tongue

40
Q

When should the throat not be examined?

A

Upper airway obstruction suspected - severe croup or epiglottitis

41
Q

What features indicate a heart murmur is innocent?

A 
Change with posture
Localised
Asymptomatic
Normal cardiac examination
Systolic only
No thrill

Child Health (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions