Medical issue questioning

Question 1

Template

Answer 1

CausePIMS-TFs
Cause
Presentation - age and type
Investigations - then and most recent
Management - then and now (and side effects)
Severity (and sequelae) and baseline
Trajectory
Future and safety plan

Checklist

• cause/s, triggers
• when: first episode
• what: symptoms (first episode, last episode, others)
• investigations: diagnosis, most recent, others - frequency
• severity: baseline, hospital admissions, PICU admissions, intubations
• treatment (nonpharm, pharm, surg): first treatment, current treatment, others; side effects
• safety plan:
• sequelae/other organ involvement:

Question 2

Seizures

AED

Answer 2

Checklist

• cause/s (for epilepsy)
• when: first seizure
• what: semiology
• investigations (EEG, MRI brain): diagnosis, most recent, others
• treatment: first treatment, current treatment, others; side effects
• severity: baseline status (frequency, semiology, triggers, TRAJECTORY), hospital admissions, PICU admissions, intubations, status, IMPACT
• safety plan: midaz, ambulance
• sequelae/other organ involvement: neurodev

Question 3

Cerebral palsy

Answer 3

Checklist

• cause/s
• when: first diagnosed
• what: symptoms
• investigations: diagnosis, most recent, others
• severity: GMFCS, ADLs, hospital admissions, PICU admissions, intubations
• treatment: first treatment, current treatment, others; side effects
• safety plan:
• sequelae/other organ involvement: aspiration/dysphagia/secretions, OSA, spasticity/dystonia, menstruation, scoliosis, hip dysplasia, mobility

Question 4

Aspiration, dysphagia

Answer 4

Checklist

• cause/s, triggers: secretions, dysphagia, reflux
• when: first episode
• what: symptoms (first, last, in between)
• investigations: diagnosis, most recent, others
• severity: baseline, hospital admissions, PICU admissions, intubations
• treatment (acute and chronic; nonpharm, pharm, surg): first treatment, current treatment, others; side effects
• safety plan:
• sequelae: chronic lung disease

Question 5

Secretions

Answer 5

Checklist

• cause/s
• when: first noted
• what: symptoms (first, current (baseline), in between)
• investigations: diagnosis, most recent, others
• severity: baseline, hospital admissions, PICU admissions, intubations
• treatment: first treatment, current treatment, others; side effects
• safety plan:
• sequelae: aspiration, ADLs, caregiving

Question 6

Spasticity/dystonia

Answer 6

Checklist

• cause/s: CP, anything else
• triggers: of dystonia
• when: first noted
• what: affected limbs/joints, restriction (first episode, last episode, others)
• investigations: diagnosis, most recent, others
• severity: baseline, ADLs, hospital admissions, PICU admissions, intubations
• treatment (nonpharm, pharm, surg): first treatment, current treatment, others; side effects
• safety plan:
• sequelae/other organ involvement: pain, ADLs, caregiving, hygiene, mobility

Question 7

Scoliosis

Answer 7

Checklist

• cause/s
• when: first noted
• what: symptoms
• investigations (xray/MRI): diagnosis, most recent, others
• severity: cobb angle, ADLs
• treatment (nonpharm, pharm, surg): first treatment, current treatment, others; side effects
• safety plan:
• sequelae/other organ involvement: pain, neuro sx, restrictive lung disease, mental health

Question 8

Hip dysplasia

Answer 8

Checklist

• cause/s
• when: first noted
• what: symptoms
• investigations: diagnosis, most recent, others
• severity: ADLs, caregiving
• treatment (nonpharm, pharm, surg): first treatment, current treatment, others; side effects
• safety plan:
• sequelae/other organ involvement: development

Question 9

Developmental delay

Answer 9

Checklist

• cause/s
• when: first noted
• what: symptoms
• TESTS: diagnosis, most recent, others
• treatment (nonpharm, pharm, surg): OT/PT/SP/other and what they do
• severity: GM, FM, SOC, LANG dev age
• safety plan:
• sequelae/other organ involvement: hearing, vision

Question 10

DMD/similar

Answer 10

Checklist

• cause/s
• when: first noted
• what: symptoms (first, now)
• investigations (MRI brain, genetics, NCS, biopsy): diagnosis, most recent, others
• severity: baseline - mobility, ADLs, caregiving
• treatment (nonpharm, pharm, surg): first treatment, current treatment, others; side effects
• safety plan:
• sequelae/other organ involvement: neuro, swallowing/speech, heart, development, ?anything else

Question 11

Congenital heart disease

Answer 11

Checklist

• cause/s
• when: first noted
• what: symptoms (first, now)
• investigations (echo, CXR, ECG): diagnosis, most recent, others - frequency
• severity: baseline (sats, ex tol), hospital admissions, PICU admissions
• treatment (nonpharm, pharm, surg): operations, current pharm, previous pharm (incl inotropes)
• safety plan: heart failure, infective endocarditis
• sequelae/other organ involvement: RHD/IE, ischaemic injury to brain/kidneys/gut, genetic involvement of brain/eyes/ears/VACTERL

Question 12

CF

Answer 12

Checklist

• cause/s: gene, inheritance
• when: first noted
• what: symptoms (first episode, last episode, others)
• investigations: diagnosis, most recent, others - frequency
• severity: baseline (ex tol, infection frequency), tune ups, Brasfield score, hospital admissions, PICU admissions, intubations
• treatment (nonpharm, pharm, surg): first treatment, current treatment, others - frequency; side effects
• safety plan:
• sequelae/other organ involvement: resp, pancreas, DIOS, diabetes

Question 13

Pancreatic insufficiency

Answer 13

Checklist

• cause/s, triggers
• when: first episode
• what: symptoms (first episode, last episode, others)
• investigations: diagnosis, most recent, others
• severity: baseline, hospital admissions, PICU admissions, intubations
• treatment (nonpharm, pharm, surg): first treatment, current treatment, others; side effects
• safety plan:
• sequelae/other organ involvement:

Question 14

Diabetes

Answer 14

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Question 15

Chronic lung disease (BPD)

Answer 15

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Question 16

Asthma

Answer 16

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Question 17

Recurrent pneumonia

Answer 17

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Question 18

IBD

Answer 18

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Question 19

Coeliac

Answer 19

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Question 20

Short gut

Answer 20

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Question 21

Biliary atresia

Answer 21

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Question 22

Liver transplant

Answer 22

Checklist

• cause/s
• when: TRANSPLANT HAPPENED
• what:
• TESTS: recent liver function - transaminases, synthetic function (NH4, coags)
• treatment (nonpharm, pharm, surg): meds, side effects
• severity:
• safety plan: FAILURE, INFECTION, ADRENAL SUPPRESSION
• sequelae/other organ involvement:

Question 23

Chronic liver disease

Answer 23

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Question 24

Small molecule metabolic condition

Answer 24

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Question 25

Storage metabolic condition

Answer 25

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Question 26

CKD

Answer 26

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Question 27

Kidney transplant

Answer 27

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Question 28

Nephrotic syndrome

Answer 28

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Question 29

Other kidney

Answer 29

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Question 30

Thalassaemia

Answer 30

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Question 31

Sickle cell

Answer 31

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Question 32

Other haem

Answer 32

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Question 33

Leukaemia

Answer 33

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Question 34

Solid organ cancer

Answer 34

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Question 35

Bone marrow transplant

Answer 35

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Question 36

Immunodeficiency

Answer 36

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Question 37

Steroids | Immunosuppressants

Answer 37

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Question 38

Eczema

Answer 38

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Question 39

Food allergy

Answer 39

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Question 40

Allergic rhinitis

Answer 40

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Question 41

Acne

Answer 41

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Question 42

JIA etc

Answer 42

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Question 43

T21

Answer 43

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Question 44

NF1

Answer 44

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Question 45

Upper airway abnormalities

Answer 45

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Question 46

OSA

Answer 46

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