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Child Healthcare Block > Paediatric Hx and Ex > Flashcards

Paediatric Hx and Ex Flashcards

(47 cards)

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1
Q

What additional sections do we need to add to a paediatric history?

A

Birth Hx
Developmental Hx
Feeding Hx
Vaccination Hx

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2
Q

What do we need to ask in the birth hx?

A
  • Gestational age
  • Weight
  • Complication of pregnancy or delivery
  • Mode of delivery
  • Mode of feeding
  • Amount of care needed after birth
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3
Q

What do we need to ask in the feeding hx?

A
  • How much and how often they eat
  • Do they appear settled after feeding
  • How is their weight progressing
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4
Q

When do infants continue to drink just milk?

A

Up to about 6 months

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5
Q

How much milk should an infant drink a day after birth?

A

150 mls/kg/day.

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6
Q

How long in a day should an infant feed for?

A

10-30 minutes per feed

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7
Q

When should a child be onto solid foods (i.e. chopped up but not mush any more)?

A

One year old

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8
Q

How many times a day should children on solid foods/older children be eating?

A

3 meals a day plus snacks

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9
Q

What, if any, vaccinations are given at birth?

A

BCG for at risk infants

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10
Q

What, if any, vaccinations are given at 2 months?

A

DTP
IPV
HIB
Pneumococcus

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11
Q

What, if any, vaccinations are given at 3 months?

A

DTP
IPV
HIB
Men C

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12
Q

What, if any, vaccinations are given at 4 months?

A

DTP
IPV
HIB
Pneumococcus

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13
Q

What, if any, vaccinations are given at 6 months?

A

None lol, gotcha

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14
Q

What, if any, vaccinations are given at 8 months?

A

None, lol, gotcha again

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15
Q

What, if any, vaccinations are given at 12 months?

A

HIB

Men C

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16
Q

What, if any, vaccinations are given at 13 months?

A

MMR

Pneumococcus

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17
Q

When are pre school boosters given?

A

Age 3/4

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18
Q

What vaccinations are given in secondary school?

A

School leaving boosters including Men C

HPV vaccination

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19
Q

What are the first milestones we look for in a developmental hx?

Study These Flashcards
A

Gross motor skills

20
Q

What are the 4 essential milestones in development?

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A

Smiling
Sitting unaided
Walking
Talking

21
Q

When should an infant smile?

22
Q

When should an infant sit unaided?

23
Q

When should a child start to walk?

Study These Flashcards
A

12 months but can be up to 18 months

24
Q

When should a child start to talk?

25
What is a good measure of fine motor skills?
The grip a child uses
26
When should a child have developed a mature pincer grip by?
10-12 months
27
Name some other things we can use to measure development.
Language Social skills Special senses
28
A child is refered to you with a cough/difficulty breathing. Form a list of differentials.
``` Bronchiolitis Viral/bacterial LRTI Croup Bacterial URTI Asthma Foreign body ```
29
A child is refered to you with a cough/difficulty breathing. What questions should you ask to narrow down the list of differentials?
- Any secretions? - Any temperature (rule infection in or out)? - Noise on inspiration or expiration? - Pattern? Exposure to new allergens?
30
A child is refered to you with a vomiting. Form a list of differentials.
Pyloric stenosis Reflux Gastroenteritis (early if no diarrhoea yet) Meningitis Anything really!
31
What is the issue with a child presenting with vomiting?
It could really be anything as children often vomit in response to any kind of illness like pain, shock etc. Need to enquire about every system.
32
Tell me about pyloric stenosis.
M>F, may have FHx Present from around 3-6 weeks after birth. Presents with spitting up food after eating progressing to projectile vomiting.
33
What do we really need to rule out with vomiting?
Meningitis :L !!!!!!!!
34
Why do we ask when the child passed its first stool (meconium) after birth? What is a significant answer?
To look for Hirschsprung's Disease. If a child has been constipated from birth, and first meconium was passed more than 24 hours after birth.
35
If a child has D+V, what system is most likely the cause?
GI Think gastroenteritis, intersusseption
36
A child presents urinating too frequently. What is the list of differentials to work through?
- T1DM - UTI - Psychogenic polydipsia - Diabetes insipidus
37
What is a normal amount for a child under the age of 1 to be drinking?
100ml/kg/day up to 10kg
38
If we suspect psychogenic polydispsia, what should we ask the parent? Why?
What does the child drink? psychogenic polydipsia usually drink loads of squash, but if restricted to water they drink a normal amount.
39
If we suspect diabetes insipidus, what should we ask the parent? Why?
What does the child drink? A child with DI will drink anything to quench the incredible thrist they feel.
40
What are the differentials if a child is not urinating enough?
``` Obstruction Dehydration (probably other signs) ```
41
A mother brings her child to you. He has not passed any urine for a long time. Form a list of differentials.
Retention | Kidney problems
42
A parent brings there child to you with "fits". Form a list of differentials for "fits". Use a surgical seive.
Vascular - Vasovagal episode Infection/Inflamm - Febrile convulsions, Meningitis Trauma - Head Trauma (Autoimmune) Metabolic - Hypoglycaemia, hypernatraemia, hypocalcaemia. Iatrogenic/Drugs - antidepressants, cocaine, ecstasy, alcohol. Neoplastic - Brain tumours Congenital - Hydrocephalus Degenerative - Neurodegenerative Endocrine - T1DM/hypoglcaemia Functional - New onset epilepsy, Pseudoseizures, Breath holding, Self-gratification, Reflux, Night terror.
43
Give me 3 tips for examining a child.
- Dont ask the child if things are ok - gain consent from the parent, then tell the child kindly what you are doing. - Auscultate first, or whenever you can. If a child is screaming, you won't be able to hear a thing. - Be on their level - crouch down, or bring them up, and don't approach too quickly. They might spook.
44
What is different when examining a child compared to an adult?
The reference ranges for basic obs.
45
Which obs do we expect to be: a) lower than in an adult? b) the same as an adult? c) higher than in an adult?
a) BP b) Temperature and O2 sats c) Resp and heart rate
46
In addition to what we do in adults for CVS examination, what do we do for a paeds cvs examination?
Feel for the liver, and feel femoral pulses.
47
What is important to note on general inspection of a child at the start of an examination?
- Behaviour and level of awareness - Appearance - Shape of head and facial features - Nature and distribution of skin lesions - Any bruising, and if so where it is and what they look like

Child Healthcare Block (17 decks)

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