Ped Gen Reg Ex-24-25 Flashcards
What are the fundamentals of diagnosis?
-Skillful history-taking.
-Careful, complete physical exam with keen observation.
-Good clinical judgment.
-Wise selection of additional exams (e.g., x-rays, labs).
List traits of a good pediatrics student.
Observer.
Social and confident.
Listener.
Likes challenges.
Dedicated.
Empathetic.
What are some general tips for pediatric examination?
-Ensure the child is undressed appropriately.
-Use warm, clean hands.
-Begin with an initial assessment of developmental skills.
-Be orderly and systematic; use a head-to-toe approach where suitable.
What are the components of a general examination?
-General appearance.
-Vital signs.
-Anthropometric measurements (growth).
What are the components of regional examination?
-HEENNT (Head, Eye, Ear, Nose, Neck, Throat).
-Extremities.
-Back.
-Skin, hair, nails, joints, bones, and lymph nodes based on region.
What should be assessed during general appearance examination?
Face, head, neck, and hands are examined.
– Conscious level (ARRU)
– Facial expression, Complexion (pallor, jaundice, cyanosis).
– Posture - Movement.
– Observe hygiene, cry, behavior, social interaction.
– Interpret the general appearance of the child (Looking well or ill).
The general morphological appearance may suggest a
chromosomal syndrome.
What vital signs should be measured in children?
Temperature.
Heart rate (pulse).
Respiratory rate.
Blood pressure.
Oxygen saturation (if available and indicated).
What are anthropometric measurements?
Weight.
Height.
Head circumference.
Chest circumference.
Mid-arm circumference.
Skin fold thickness.
What should be examined in the head?
Fontanels: Check size and closure.
Sutures: Check for abnormalities.
Symmetry and shape of the face and skull.
Signs of increased intracranial pressure (bulging fontanel).
What should be examined in the neck?
Thyroid swelling.
Tracheal deviation.
Torticollis.
Signs of hypo/hyperthyroidism.
What should be examined in the throat/mouth?
Lips: Color and moisture.
Teeth: Sequence of eruption, caries.
Tongue: Color and ulceration.
Tonsils and oropharynx: Inflammation, exudates.
What are the normal ranges for heart rate, respiratory rate, and systolic/diastolic BP? (Neonate)
Neonate:
HR (beats/min) 80-180
RR (breaths/min) 30-50
Systolic BP (mmHg) 65-85
Diastolic BP (mmHg) 45-55
What are the normal ranges for heart rate, respiratory rate, and systolic/diastolic BP? (Infant)
Infant:
HR (beats/min) 80-160
RR (breaths/min) 25-40
Systolic BP (mmHg) 80-100
Diastolic BP (mmHg) 55-65
What are the normal ranges for heart rate, respiratory rate, and systolic/diastolic BP? (Toddler)
Toddler:
HR (beats/min) 80-120
RR (breaths/min) 25-35
Systolic BP (mmHg) 90-105
Diastolic BP (mmHg) 55-70
What are the normal ranges for heart rate, respiratory rate, and systolic/diastolic BP? (School-age)
School-age:
HR (beats/min) 75-110
RR (breaths/min) 15-20
Systolic BP (mmHg) 100-120
Diastolic BP (mmHg) 60-75
What are the normal ranges for heart rate, respiratory rate, and systolic/diastolic BP? (Adolescent)
Adolescent:
HR (beats/min) 60-100
RR (breaths/min) 12-18
Systolic BP (mmHg) 110-135
Diastolic BP (mmHg) 65-85
What is the most common cause of diagnostic errors in pediatrics?
Inadequate history-taking and superficial exams.
List the equipment needed for a pediatric examination.
Stethoscope & sphygmomanometer.
Thermometer.
Weight scale.
Length measuring table/stadiometer.
Measuring tape.
Penlight.
Hammer.
Otoscope.
Ophthalmoscope.
What are the three main components of a pediatric examination?
General examination (appearance, vital signs, growth).
Regional examination (HEENNT, extremities, back).
Systemic examination (neurological, respiratory, cardiovascular, gastrointestinal).
What is the gold standard for measuring temperature?
Rectal temperature, although axillary temperature is preferred by parents and patients.
What are key considerations for pulse examination in infants?
Best measured apically or from the femoral artery in infants under 1 year.
Count for a full minute.
Increased pulse rate may indicate crying, anxiety, fever, or pain.
What should be assessed in an ear examination?
External ear structure.
Tympanic membrane using an otoscope.
What should be examined in the nose?
Mucosa color and condition.
Symmetry and deformity.
Presence of septal deviation or foreign bodies.
When is the best time to assess respiratory rate in an infant?
When the infant is sleeping or resting quietly.
Case Studies
Case 1: A doctor examines a child without taking weight or reading the referral letter.
Q: What key examination step was missed?
Measuring and plotting weight on a weight-for-age chart.
Case 2: A doctor examines a child with fever and rash without full examination.
Q1: What was wrong with this examination?
The doctor only performed general inspection and did not examine each organ system.
Case 2: A doctor examines a child with fever and rash without full examination.
Q2: What additional information should have been recorded?
The child’s weight and temperature.
Case 3: A nurse uses cold hands and misses heart sounds during examination.
Q: What are the correct examination steps?
Warm hands.
Perform inspection, palpation, and auscultation in sequence.
What are the components of a systemic (local) examination in pediatrics?
- Neurologic CNS
- Respiratory System (Chest)
- CVS (Heart & Vessels)
- GIT (Abdominal) Exam
