Medicine Notes Paediatrics Notes
An overview of the common paediatric conditions - from neonates to developmental delay and all the common childhood-specific illnesses organised by body system. Includes tips on history taking and examination along with investigations and management. Concise yet thorough enough for finals examinations. Colour coded including diagrams...
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Failure to thrive
Concern about growth is usually raised when
Weight is below 2nd centile
Height is below 2nd centile
Or weight/height cross down two centiles
Failure to thrive implies growth failure and also failure of emotional and developmental progress
Weight faltering
Always consider psychosocial problems
Eating disorders, home issues disturbed attachment
Often result of caring parents who create stressful earing environment
Causes of failure to thrive
Classified into organic and non-organic
Organic | Non-Organic |
---|---|
Inadequate intake
Inadequate retention
Malabsorption
Failure to utilize nutrients
Increased requirements
| Inadequate intake
Psychosocial deprivation
Neglect or child abuse
|
Need to study the growth chart in combination with a history and examination of the child
History
Detailed dietary history
A food diary is useful
Feeding, including details of exactly what happens during mealtimes
Is the child well? Do they have lots of energy?
Any other symptoms such as
Lethargy, D+V, cough
Was the child premature or did they have IUGR or other problems at birth?
Growth of family members and any illnesses in the family
Child’s development
The home situation
Extended history
Information about the family from
Health visitor
GP
Any other professionals involved with the family
Examination
Focus is on identifying whether there is any evidence of organic disease
Dysmorphic features
Distended abdomen, thin buttocks, irritability – coeliac disease
Respiratory signs and malabsorption – cystic fibrosis
Evidence of chronic illness
Investigations
Should be focused after a thorough examination
Investigation | Significance of abnormality |
---|---|
FBC U+E LFT TFT CRP Ferritin Immunoglobulins Anti-gliadin antibodies Urine dip and MC+S Stool microscopy and culture Karyotype in girls Chest xray and sweat test | Anaemia, infection, inflammation, immune deficiency Renal failure,... |
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An overview of the common paediatric conditions - from neonates to developmental delay and all the common childhood-specific illnesses organised by body system. Includes tips on history taking and examination along with investigations and management. Concise yet thorough enough for finals examinations. Colour coded including diagrams...
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