Week 1 - M - Taking a history in paediatrics

Question 1

When history taking in paediatrics, is it usually taken from the child?

Answer 1

often taken from a third party i.e. parents or carers which may introduce a bias based on their knowledge or beliefs

Question 2

Should you take into account what the child has to say when taking a paediatric history?

Answer 2

Yes - children as young as three can provide some useful information about their illness

Question 3

What are the five steps of the calgary cambridge guide which help when carrying out a consultation? What step is sometimes missed out? (ie if child is absent)

Answer 3

• Initiating the session
• Gathering information
• Physical examination - not always able to be carried out if child is not present
• Explanation and planning
• Closing the sessin

Question 4

There are a lot of non-specific complaints such as, fever, vomiting, breathlessness, and poor feeding What are the specific to paediatrics sections that are very important in the consultation?

Answer 4

Birth/peri-natal Development Immunisations

Question 5

What is the perinatal period defined as?

Answer 5

The perinatal period commences at 22 completed weeks (154 days) of gestation and ends seven completed days after birth

Question 6

Taking a history in paediatrics is carried out in a structured fashion What are the 10 stages of the history?

Answer 6

Presenting complaint (PC) History of presenting complaint (HPC) Past medical history (PMH) Birth/perinatal Development Family history Social history Drug history/allergies Immunisations Systemic enquiry

Question 7

When should the systemic enquiry be asked to help the history taking flow better? (Symptoms: their duration and order of appearance; affects on the child generally.)

Answer 7

Ask this when taking the history of presenting complaint

Question 8

What type of questions should be asked for the systemic enquiry? (CVS, RS, GI, CNS, Urinary, MSK)

Answer 8

CVS – infant feeding / sweating / cyanosis / pallor / SOB RS – runny nose / cough / wheeze / SOB / activity limitation / snoring GI – appetite / diet / vomiting / pain / abdominal distension / bowel habit / stools / toilet training CNS – headaches / fits / hearing / vision / weakness / rash Urinary – pain / colour / frequency / training MSK - limp / limb pain / joint swelling / pain

Question 9

What stage of the consultation should immunisations be asked? What are the now 8 stages of the structured approach?

Answer 9

Past medical history PC HPC (includes systemic enquiry) PMH (includes immunisations) Birth/peri-natal Development Family history Social history Drug history

Question 10

What questions should be asked in birth/peri-natal?

Answer 10

Enquire about gestation, mode of delivery and birth weight Weather there was any problems with birth

Question 11

In development part of history taking you ask about the milestones What are the four sections to the milestones?

Answer 11

Gross motor skills Fine motor and vision Language and hearing Social skills and play