taking a paediatric history

Question 1

what must you ask when taking a paediatric history?

Answer 1

• drugs- what form (liquids, tablet, granules etc.) & dose, all details about drugs
• allergies - ask carer to explain reactions their child has had
• immunisation history
• account of pregnancy and birth
• feeding - were they breast or bottle fed? what is their diet like now?
• developmental history
• as well as the normal history taking questions - when asking about smoking ask the parents if they smoke

Question 2

what do you ask about for social history in a paediatric consultation?

Answer 2

family tree, who lives with & looks after them
school or nursery? - how are they getting on there
parental occupation
parental smoking history- do they smoke around the children/ while pregnant
if appropriate- parental alcohol & illicit drugs
pets
hobbies

Question 3

how do you do an ENT examination in children?

Answer 3

• Ears – “keep child sitting upright on your knee, turned to one side, with one hand placed around the shoulders and the other above the ear to hold the head still”
  Look for ear drum reflectivity, gas bubbles, erythema, wax, perforation, grommets, foreign bodies
• Nose – look for blockage, foreign bodies, epistaxis, polyps
• Throat – “keep child facing forward and sitting upright on parent’s knee, with one hand around both shoulders, and the other on the forehead to hold the head still”
  Look for tonsil erythema, size, pus, tongue, candida, ulcers

Question 4

what is the treatment for overweight children

Answer 4

if they are still growing encourage weight maintenance rather than weight loss so they can ‘grow into their weight’