PEDS

Question 1

BINDE

Answer 1

1. Birth/Pregnancy:
   
   • Pregnancy
     
     • Planned?
     • Follow-up visits?
     • Illnesses? Complications?
     • Medications? / SAD?
     • Screening for HepB, HIV?
     • Blood group?
   • Birth
     
     • Full term?
     • Method of delivery?
     • Cry immediately? APGAR?
     • Bruises or swelling?
     • Special features?
     • After delivery, fever or discharge?
2. Immunizations
   
   • Up-to-date?
3. Nutrition
   
   • Weight today
   • Weight at birth
   • Access to growth charts?
4. Development
   
   • Gross motor
     
     • 3 years: Ride a tricycle; copy circle
     • 4 years: Down the stairs; draws a square
   • Speech&language
     
     • 2 years: 2-word phrase
     • 3 years: 3-word phrase
   • Social skills
     
     • Stranger anxiety: 6 months
     • Separation anxiety: 9 months
5. Environmental (Home/pre-school/school)
   
   • Mom’s emotional wellbeing?
   • Whom do you live with?
   • Relationship between partner-child
   • Financial support?
   • Anyone at home seeing a psych or with mental ilness?

Question 2

HEADSSS

Answer 2

H - Home
E - Education
A - Activity
      -In epilepsy: Do you operate machines/drive/go hiking?
D - Diet
S - Suicide
S - Sexual history
      -Are you dating? Are you in a relationship?
S - SAD

Question 3

Cough: DDx

Answer 3

1. Asthma/Hyperactive airway disease
2. Cystic Fibrosis
3. Infections (Bacterial/Viral)
4. GERD
5. Pertussis
6. Foreign body
7. Psychogenic

Question 4

Fever: DDx

Answer 4

1. CNS: Meningitis
2. ENT: Otitis media
3. Chest - bacterial /viral
4. GIT
5. Bone/joint infection
6. Teething
7. Malignancies

Question 5

What to ask/mention at the start with pediatric patients?

Answer 5

1. What is the name of your baby?
2. How old is ….. now?
3. Where is ….. right now?

Question 6

Jaundice: DDx

Answer 6

1. Within 24 hours
   
   • Rh and ABO incompatibility
   • Sepsis (GBS, Torch)
2. 24-72 hrs
   
   • Physiological
   • Polycythemia
   • Dehydration
   • Breastfeeding jaundice
   • Hemolysis / bruising / spherocytosis / hematoma
3. More than one week
   
   • Breast milk jaundice
   • Jaundice in pre-term
   • Hypothyroidism
   • Hepatitis
   • Galactosemia
   • Biliary Atresia

Question 7

Delayed speech: DDx

Answer 7

• Ear infections
• Cleft lip pallet
• Autism
• Meningitis/Seizures
• TORCH infections
• Hypothyroidism
• Cerebral palsy
• URTI
• Kernicterus

Question 8

Seizures: DDx

Answer 8

1. DISM
   * Drugs
   * Infections
   * Metabolic
   * Structural
2. Febrile

Question 9

ADHD: DDx

Answer 9

1. ODD
2. Conduct disorder (or anti-social)
3. Learning disability
4. Petit-mal epilepsy
5. Depression
6. Autism
7. Adjustment disorder !!!!

Question 10

ADHD: Diagnosis

Answer 10

1. Two settings (school and home)
2. > 6-month duration
3. Less than 12 years old

Hyperactive? Can he stand still?
Inattentive? focus >30 min
Impulsive?

Question 11

Anemia: DDx

Answer 11

1. Iron def. anemia
2. Thalasemia
3. Hemolitic disorder
4. Bleeding disorder (gum, nose, bruises)
5. Chronic disease
6. Lead intoxication
7. Leukemia (constitutional symptoms, bone pain, tender points)