The Paediatric History

Question 1

What is the age definition of a child?

Answer 1

• <18 years old (children’s act 2004)

- legal definition

Question 2

What the age definition of an infant?

Answer 2

• <1 years old

Question 3

What the age definition of an neonate?

Answer 3

• <42 days of age

Question 4

What the time definition of an term?

Answer 4

• 40 weeks gestation

- premature = <37 weeks

Question 5

What the age definition of an toddler?

Answer 5

• 1-3 years old

Question 6

What the age definition of school age?

Answer 6

• > 4years

Question 7

What the age definition of an adolescent?

Answer 7

• correlates with puberty onset

- before 14 for boys and girls

Question 8

What does the acronym CYP stand for in relation to paediatrics?

Answer 8

• children and young people

Question 9

What is meant by transition in relation to paediatrics?

Answer 9

• moving to adult care from child care services

Question 10

What is a triangular consultation?

Answer 10

• a three way consultation between you, the child and their carer

Question 11

Although not fixed, place the categories below in the order of a consultation:

Development and Growth
Patient name, date of birth (age), gender, accompanying adult’s name
Summary
Presenting Complaint
History of Presenting Complaint (relevant closed questions)
Family History
Social History
Past Medical History (including antenatal, postnatal progress)
Allergies and Drug History

Answer 11

1 - Patient name, date of birth (age), gender, accompanying adult’s name
2 - Presenting Complaint
3 - History of Presenting Complaint (relevant closed questions)
4 - Past Medical History (including antenatal, postnatal progress)
5 - Allergies and Drug History
6 - Family History
7 - Social History
8 - Development and Growth
9 - Summary

Question 12

When asking about the history of a presenting complaint, what are the 4 Ws that we should ask?

Answer 12

1 - Who? Just the child or siblings and other family?
2 - What? Organ system, symptoms (fever, cough, pain), associated?
3 - When? Onset and duration, periodicity, trigger factors, change over time?
4 - Where? Location (individual, environment, trigger)?

Question 13

When asking about the history of a presenting complaint, what do we need to consider when thinking ‘how’?

Answer 13

• how is the patient presenting with these symptoms

- how do different systems link to symptoms and then identify the cause

Question 14

When asking about the history of a presenting complaint, what do we need to consider when thinking ‘why’?

Answer 14

• why are these symptoms presenting

- is it causal or association

Question 15

Why is it so important to ask about family history and genetics in a paediatric histoty taking?

Answer 15

• most paediatric diseases are due to genetics and family history

Question 16

In children what are some of the most common medications that may be used?

Answer 16

1 - Topical (creams to nappy area or eczema / Nasal / Ocular / Joints)
2 - Inhalers (asthma)
3 - Oral (suspension / syrup / solution / dissolvable / tablet / sublingual)
4 - Buccal (cheek) (Midazolam)
5 - Rectal (Paracetamol,Paraldehyde, enema)

Question 17

In children who are taking medications, what are the 5 things we need to know about the medications?

Answer 17

1 - name of medications
2 - frequency of use
3 - dose of medication
4 - route of administration
5 - concentration of medication

Question 18

What is a genogram?

Answer 18

• picture of a person’s family relationships and history

- gives genetic information

Question 19

When we ask a child about their social history, what 3 things would we ask about?

Answer 19

1 - school (nursery / home schooling)
2 - home (environment type / family members including occupations / pets)
3 - support (carers / physiotherapy / dieticians / occupational therapy)

Question 20

When using a growth chart for a boy aged 0-1 year old, what 3 measurements should be taken?

Answer 20

1 - head circumference
2 - length of baby
3 - weight

ALL ARE GENERALLY PROPORTIONAL TO ONE ANOTHER