Presenting complaints Flashcards
Wheeze qs
1 Triggers 2 Severity 3 FHx atopy 4 Choking recently 5 Apnoea/resp distress 6 Smokers in household?
Cough qs
1 sound 2 sputum quality 3 pattern (this episode and others) 4 systemic sx 5 ±wheeze, oily stool 6 PMH of recurrent chest infection 7 Smokers in household?
Stridor qs
1 Coryza/fever preceding? 2 Barking cough? 3 Hib immunisation? 4 When is it louder? (crying?) 5 Foreign body aspiration possible? 6 Onset- from birth? (laryngomalacia) or ever been intubated? (subglottic stenosis)
Differentials for wheeze
Asthma
Bronchiolitis
Inhaled foreign body
Cardiac failure
Differentials cough
URTI pneumonia asthma inhaled fb CF
Differentials stridor
Croup Inhaled fb Epiglottitis Laryngomalacia Subglottic stenosis
How would you distinguish croup and epiglottitis?
Croup has more chest signs, a barking cough and coryzal prodrome. 6-24m
Epiglottitis- haven’t had Hib vaccine, high fever, drooling, ‘toxic.’ dysphagia, dysphonia, drooling, and distress. 2-7y
Vomiting qs
Fever Wt gain (if long term) What is the vomit like- pattern, when, colour, projectile etc Blood or bile? Feeding- appetite? If bottle fed, how much? Abdo pain? Bowel ok? Urine output In adolescents- migraine or gynae cause
Differentials vomiting
pyloric stenosis gastroenteritis GOR systemic infection migraine over feeding (>200mL/kg in 24h and well with no wt loss)
difference btw regurg, posseting and vomiting?
Regurg- bringing up small amounts during/after eating
In babies drinking milk this is called posseting- effortless, low volume ‘spills’
Vomiting- more complete emptying of stomach.
Acute diarrhoea differentials
Viral/bacterial gastroenteritis
Infxn outside GI tract
Antibiotic induced
Acute diarrhoea qs
- Blood or mucous
- Pattern
- Abdo pain
- Fever
- Other source of infection e.g. earache, dysuria, coryza
- Infective contacts
- Urine output
Chronic diarrhoea differentials
Watery: Nonspecific Toddler diarrhoea Lactose intolerance Parasite e.g. giardia CMPI Overflow diarrhoea in constipation
Fatty:
CF
Coeliac
Bloody:
UC
Crohn’s
Chronic diarrhoea qs
Stool appearance, consistency, volume etc
Blood or mucous
Onset (food, other individuals infected?)
Wt loss
Abdo pain
Systems review
Abdo pain is split into what two groups?
Acute and recurrent
