Jaypee Brothers
In Current Chapter
In All Chapters
X
Clear
X
GO
Normal
Sepia
Dark
Default Style
Font Style 1
Font Style 2
Font Style 3
Less
Normal
More
Clinical Methods in Paediatrics
ML Kulkarni
SECTION 1: PAEDIATRIC HISTORY TAKING
CHAPTER 1:
History Taking
HISTORY TAKING
INTERVIEWING SKILLS
Dress Code
Communication with Children—A Few Guidelines
Communication with Adolescents
Build a Foundation
Communicate Effectively
MEDICAL TERMS
New but Essential Terms and their Definitions
Symptoms
Signs
Diagnosis
Prognosis
Genogram/pedigree
Activites of Daily Life (ADL)
Abbreviation
Sensitivity of Words
CHAPTER 2:
Eliciting History
HISTORY ELICITATION AND ITS RECORD: AN OUTLINE
Types of History
Comprehensive History
Problem Oriented or Focussed Medical History
Follow-up History
A DETAIL HISTORY ELICITATION
Informant
Basic Data
Name
Age
Sex
Postal Address
Chief Complaint
History of Presenting Illness (HoPI)
Components of History of Presenting Illness
General Guidelines for Analysing a Symptom
onset
Characteristics
Course since onset
Review of Systems
General
Integument
Head
Eyes
Respiratory
CVS
GIT
Genitourinary
Nose
Ears
Mouth
Throat
Neck
Chest
Gynaecologic
Musculoskeletal
CNS
Endocrine
Habits
Modern Trends in History Recording
Problem oriented Chart
Flow Sheet Analysis
Diagrammatic Summary
Some Special Techniques Important for Eliciting History and Examination
Past Medical History
CHAPTER 3:
Family History
INTRODUCTION
Family Pedigree
Consanguinous Marriage
Degree of Relationship
Guidelines for Construction of Pedigree
Important Elicitations during Family History
GENETIC DISORDERS
Autosomal Dominant (AD) Disorders (Fig. 3.2)
Autosomal Recessive (AR) Disorders
X-linked Recessive (XLR) Disorders
Genetic Disorders (Table 3.1)
Genetic Susceptibility
Contact in Family
CHAPTER 4:
Antenatal History
HYDROPS FOETALIS
Antenatal History
Age
Exposure to Drugs
Diabetes Mellitus
Oligohydramnios
Effects of oligohydramnios (Fig. 4.4)
Polyhydramnios
Breech Presentation
Effects of breech on newborns: Summary
Syndromes associated with breech presentation
Face Presentation (Fig. 4.7)
Predisposing factors Effects on newborn
Toxaemia of Pregnancy
Toxaemia of Pregnancy—A Summary
Anaemia
Maternal Hypertension
Twins (Fig. 4.8)
Unbooked Pregnancy
Immunisation
Other Maternal Disorders
Radiation
Source
Common Radiological Procedures and Amount of Radiation Received by the Patient
TORCH Manifestations
Toxoplasmosis
Rubella
CMV
Herpes Simplex
CHAPTER 5:
Natal History
CHAPTER 6:
Postnatal and Neonatal History
APGAR SCORE
Factors Effecting Apgar Score
False-positive (No Foetal Hypoxia—Low Apgar)
False-negative (Acidosis—Normal Apgar)
Resuscitation Manoeuvres
Prelacteal Feeds
Breast-feeding
Convulsions
Crying
Types of cry
Jaundice
Feeding Behaviour
Postnatal Abnormalities
Prematurity
High Risk Infant
Lower Segment Caesarean Section (LSCS)
CHAPTER 7:
Developmental History
INTRODUCTION
Factors Affecting Child Development
DEVELOPMENTAL MILESTONES
GROWTH
Development
Principles of Development
Principles of Growth
Variation in the General Pattern of Development
Differential Development
Behavioural Patterns in the Fields of Development
Developmental Handicap
Developmental Delay (Warning Signs)
DEVELOPMENTAL ASSESSMENT
ASSESSMENT OF INTELLIGENCE
Tests of General Intelligence
NORMAL DEVELOPMENTAL MILESTONES FROM BIRTH TO ADOLESCENCE
Growth and Development during Preschool Years
Sexual Maturity Rating (SMR) (Table 7.6)
COMPARISONS IN ADOLESCENCE — EARLY, MIDDLE AND LATE
Early
Middle
Late
DENTAL DEVELOPMENT
Dental Maturity
Skeletal Maturity
CHAPTER 8:
Immunisation History
UIP SCHEDULE
IAP IMMUNISATION TIME TABLE
Optional Vaccines
NEWER VACCINES
ADVERSE EFFECTS FOLLOWING IMMUNISATION (AEFI)—GENERAL
COLD CHAIN FOR VACCINES
STORAGE RECOMMENDATION FOR VACCINES IN CLINICAL SET-UP (Fig. 8.1)
TOWARDS 21st CENTURY
VACCINE INDUCED DISEASE
GENERAL COMMENTS
ADVERSE EVENTS FOLLOWING IMMUNISATION
CHAPTER 9:
Feeding and Dietetic History
RECOMMENDED DIETARY ALLOWANCES (RDA)
Indian Council of Medical Research (ICMR) Recommendations
Coefficient of Calorie Requirement
Bedside Calculation of Calorie Requirement
Holliday and Segar Formula
Holliday and Segar Formula
RDA of Vitamins and Minerals
Ten Commandments in Nutrition
Classification of Foods
Proteins
Sources of proteins
Quality of Proteins
Protein Requirement
Essential Amino Acids
Limiting Amino Acids
Carbohydrates
Fibre Content of Different Foods (Table 9.11)
Fats
Types of Fats
Sources
Daily Requirement
Excess Fat in the Diet
Calories
Vitamins and Minerals
Vitamins
Vitamin A (Retinol)
Dietary sources
Vitamin D
Dietary Sources of Vitamin ‘D’
Requirements
Vitamin E
Vitamin K
Dietary Sources of Vitamin K
Water Soluble Vitamins—Vitamin ‘B’ Complex
Thiamine (Vitamin B1)
Riboflavin (Vitamin B2)
Niacin (Vitamin B3)
Pyridoxin (Vitamin B6)
Cyanocobalamin (Vitamin B12)
Folic Acid
Vitamin C
Sources
Macroelements/Macrominerals
Calcium
Phosphorus
Trace Elements/Microelements
Iron
Iodine
Sources
Prevention
Zinc
Copper
Sources
Fluorine
Sodium
MAIN CATEGORIES OF FOODS
Cereals and Millets
Tubers and Starchy Roots
Legumes
Oil-seeds and Nuts
VegeTables
Fruits
Fats and Oils
Sugar and Jaggery
Foods of Animal Origin
Meats
Fish
Egg
Milk and Milk Products
Human Milk
Mature Milk
Animal Milk
Milk Products
Processing of Food
Cooking
Cutting and Trimming
Sprouting
Malting
Fermentation
Drying
Milling
Parboiling
Hyderabad Mix
Davangere Mix
Healthy Feeding Habit for Infants
Breast Feeds
Weaning
Breast Feeding Recommendations
House Hold Measures and Volumes
Recommended Dietary Allowances for Indians (Tables 9.36 to 9.38)
NATIONAL GUIDELINES OF INFANT FEEDING
APPROPRIATE INFANT FEEDING PRACTICES
Breast Feeding
Advantages of Breast Feeding
Preparation for Breast Feeding during Pregnancy
Starting Breast Feeds
Exclusive Breast Feeding
Diet of the Lactating Mother
Important Special Situations
Addition of Semi-solid and Solid Foods
Importance of Appropriate Addition
Timing of Introduction of Semi-solids
Continuation of Breast feeding
Feeding Guidelines
Preparation and Storage of Weaning Foods
Feeding During and After Common Illnesses
GUIDELINES FOR PROMOTING INFANT FEEDING
Promoting Child Survival and Safe Motherhood (CSSM)
Institutional Promotion of Appropriate Breast Feeding
CHAPTER 10:
Personal History of the Patient
SOCIOECONOMIC HISTORY
BEHAVIOUR AND EMOTIONAL HISTORY
SUMMARY
CHAPTER 11:
Important Tips for a Competitive Clinician
CHAPTER 12:
Cultural Beliefs and Traditions in Child Rearing
CHARMS IN CLINICAL MEDICINE
Use of Various Charms
SECTION 2: SYMPTOMATOLOGY
CHAPTER 13:
Classification of Important Symptoms in Children
DEFINITION
CLASSIFICATION OF SYMPTOMS
Respiratory
Cardiovascular
Gastrointestinal
Genitourinary System
Neurological
Endocrine
General
CHAPTER 14:
Respiratory and Cardiac Symptoms
COUGH
Definition
Mechanism
METHOD OF INQUIRY
Onset (Sudden or Insidious)
Type of Cough
Dry or Productive
Stimuli causing cough
Causes of Cough
Acute Cough
Chronic Cough
Common to All Age Groups
DYSPNOEA
Definition
Grades of Dyspnoea
Slight
Moderate
Considerable
Gross
Grading of Dyspnoea
Various Clinical Types of Dyspnoea
Causes of Dyspnoea on Exertion (Respiratory)
Causes of Dyspnoea at Rest (Respiratory)
Orthopnoea
Mechanism
Paroxysmal Nocturnal Dyspnoea (PND)
Mechanism
Trepopnoea
Platypnoea
Causes of Acute Dyspnoea
Chronic Dyspnoea
Other Conditions Associated with Dyspnoea
Conditions Causing Dyspnoea on Exertion
WHEEZING
Aetiology
Aspiration Syndrome Producing Wheezing
Conditions Producing Wheeze in Relation to Age
All that Wheezes is not Asthma
Evaluation of Wheezing
STRIDOR
Aetiologic Classification of Stridor
Intrinsic Obstruction of Airways
Extrinsic Airway Obstruction
Periods of Crying in Normal Babies
Causes of Acute Stridor
Main Causes
Main Causes of Chronic Stridor
Causes of Recurrent Stridor
CHEST PAIN IN CHILDREN
HAEMOPTYSIS
Causes of Haemoptysis in Newborn
Causes of Haemoptysis after the Newborn Period
Anatomical type of Causes
HOARSENESS OF VOICE
Definition
Causes of Hoarseness of Voice
In Newborn
In Newborn or Later
Infection
Methods of Inquiry
SYNCOPE
Definition
Aetiological Classification
Causes and Mechanisms
CYANOSIS (BLUISH DISCOLOURATION OF SKIN AND MUCOUS MEMBRANE)
Cyanosis in the Newborn
Pulmonary
Cardiovascular
Central Nervous System
Haematological
Metabolic
Cyanosis in the Older Child
Pulmonary
Cardiac
Neurological
Haematological
Peripheral or Localised Cyanosis
CHAPTER 15:
Symptoms of General and Central Nervous System
PALE CHILD
CRYING CHILD
Crying in CNS Disorders
Cry in Genetic Disorders
Crying in Respiratory Disorders
Crying in CVS Disorders
Crying in Abdominal Conditions
Crying in Endocrinal Conditions
OTHER SOUNDS PRODUCED BY CHILDREN
Common Causes of Crying
ALTERED MENTAL STATUS
Intracranial Processes
Metabolic Causes
Systemic Illnesses
HEADACHE
Headache Classification According to the International Headache Society
Evaluating Headaches by History
Diagnostic Criteria for Classification of Headache by International Headache Soceity
Episodic Tension-Type Headache
Diagnostic Criteria
Chronic Tension-Type Headache
Diagnostic Criteria
Revised Classification of Migraine
Diagnostic Criteria of Migraine without Aura
Diagnostic Criteria of Migraine with Aura
Diagnostic Criteria of Migraine with Typical Aura
FEVER
Causes of Fever
Mechanisms of Heat Regulation
To Raise Body Temperature
To Lower Body Temperature
Fever Patterns
RASH WITH FEVER
Fever and Lymphadenopathy
RASHES
CONVULSIONS (SEIZURES/FITS)
EPILEPTIC SEIZURES AND SYNDROMES
Classification
Seizure mimics
FAILURE TO THRIVE
Definition
Pathological Conditions Causing Failure to Thrive
Infants and Newborn
Growth Lag in School Age Children
Inorganic
Organic
CHAPTER 16:
Abdominal Symptoms
SYMPTOMS OF IMPORTANCE (Abdominal and extra-abdominal) (Illingworth's Baker's Dozen)
Abdominal Pain
Ryle's Ten Questions
Causes of Pain in Newborn
Causes of Pain in Infancy
Causes of Pain in Older Children
Extra-abdominal Causes
Common Causes of Recurrent Abdominal Pain
Common Causes of Chronic Abdominal Pain
Few Facts about Abdominal Pain
Causes of Abdominal Pain—Regionwise (Quadrant Wise)
Excessive Thirst in Children
History
Common Causes
Rare Causes
Infantile Colic
Definition
Acute Abdomen
Abdominal Mass
Localised Oedema as a Sign of Systemic Disease*
Scrotal Swelling in Children
Vomiting
Common Causes of Vomiting in Newborn
Extra-abdominal
Common Causes of Vomiting During Infancy
Extra-abdominal
After Infancy
Adolescents
Jaundice
Data Collection Sheet for Diagnosis of Neonatal Jaundice (see Table 16.3)
Data Collection Sheet for the Evaluation of the Jaundised Infant
Common Causes of Jaundice in Newborns
Causes of Jaundice by Mechanism in Young Infants
Other Children
CONSTIPATION
Older Children and Adolescents
Common
Rare
HAEMATEMESIS
Causes of Haematemesis in Newborn
Rare Causes
Infants and Young Children
Common
Rare
Older Children and Adolescents
Common
Rare
BLACK STOOLS
SUMMARY—GIT BLEEDING IN CHILDREN
Common Causes of GI Bleeding in Different Age Groups (Summary)
Common Causes of GI Bleeding in Neonates
Rare
Infants and Young Children
Common
Rare
Older Child and Adolescent
Common
Rare
Difficulty in Swallowing (Dysphagia)
Oropharyngeal
Common Causes of Difficulty in Swallowing in Newborn
Rare
Neuromuscular Causes
Common
Rare
Oesophageal Causes
Infancy
Common
Rare
Neuromuscular Causes
Common Causes
Oesophageal Causes
Older Children and Adolescents
Oropharyngeal Causes (Common)
Rare Causes
Neuromuscular Causes (Common)
Rare
Oesophageal Causes (Common)
Rare Causes
Extrinsic Causes
Gastric Causes
HAEMATURIA
Newborn
Common Causes
Infants
Common Causes
Older Children
Immunological Injury
Infectious Diseases (Common)
Familial and Congenital (Common)
Bleeding or Vascular Disorders
Neoplastic Diseases
Urinary Tract Trauma
Drug Induced Injury
Miscellaneous
Mimics of Haematuria
Changes in Urine Colour
Enuresis
Definition
Common Causes of Enuresis
ENCOPRESIS
Definition
Potentiation of Risk Factors for Encopresis
Stage-I Infancy and Toddler Years
Stage-II Training and Autonomy (2–5 Years)
Stage-III Extramural Function (Early School Years)
Difficulty in Sucking
Common Causes
Appetite
Common Causes of Increased Appetite in Children
Common Causes of Loss of Appetite in Children
Common Causes of Sore Tongue in Children
Newborn
Infants
Older Children and Adolescents
Causes of Oral Ulceration in Children (Summary)
Common
Uncommon
Causes of Gingivostomatis
Common Causes
Causes of Abdominal Distension in Children
Common Causes of Abdominal Distension in Newborn
Rare Causes
Infants
Common Causes
Rare
Older Children (Preschool group)
Common Causes
Rare
Older Children (School Groups) and Adolescents
Common Causes
Rare Causes
EXCESSIVE CRYING
Without Disease
With Disease
Older Children
Causes of Crying and irritability in Infant (Summary)
Infection
Gastrointestinal and Intra-abdominal Conditions
Inflammatory Disorders
Metabolic and Endocrine Disorders
Cardiac Causes
Intracranial Causes
Toxic Causes
Other Causes
DIARRHOEA
Assessment of a Child with Acute Diarrhoea
Acute Diarrhoea—An Evaluation
Assessment of Electrolyte Disturbances
Aetiology of Diarrhoea (Colonic or Intestinal): Differentiating Features
Assess for Lactose or Glucose Intolerance
Assess Aetiological Diagnosis
Other Causes of Acute Diarrhoea
Assess Clinical Complications
Complications of Acute Diarrhoea
Abdominal Distension (Causes in diarrhoea)
Convulsions in Diarrhoea
Causes of Diarrhoea in Different Age Groups
Causes of Diarrhoea in Newborn (Common)
Infants and Children
Acute
Extra-abdominal Causes
Chronic
Remember Small Clinical Traps in Assessment of Dehydration
CHRONIC DIARRHOEA
Definition
Synonyms
Aetiology
Pathophysiology
Differential Diagnosis of Secretory Diarrhoea
Osmotic Diarrhoea—Presentation
Investigations—Stool
Investigation—Blood
Investigations—Others
Chronic Diarrhoea Work up
Specific Clues
Clues for Diagnosis from Symptoms in Chronic Diarrhoea
By Colour of Stools
Arthritis with Diarrhoea
Fever with Diarrhoea
Symptoms of Liver Disease with Diarrhoea
Marked Weight Loss with Diarrhoea
Eosinophilia with Diarrhoea
Lymphadenopathy with Diarrhoea
Neuropathy with Diarrhoea
Postural Hypotension with Diarrhoea
Flushing with Diarrhoea
Erythema with Diarrhoea
Proteinuria with Diarrhoea
Anaemia with Diarrhoea
Chronic Lung Disease and Diarrhoea
Collagen Vascular Disease with Diarrhoea
Delayed Puberty with Diarrhoea
Growth Failure with Diarrhoea
Neutropenia and Diarrhoea
Recurrent Severe Abdominal Pain with Diarrhoea
CHAPTER 17:
Renal Symptoms
SYMPTOMS AND SIGNS OF RENAL DISEASE
OEDEMA
Examination for Oedema
Mechanism of Oedema in Various Conditions
Type and Distribution of Oedema
FAILURE TO PASS URINE
Neonatal Delayed Urine Passage after 72 Hours
Causes
OLIGURIA (DECREASED URINARY OUTPUT)
POLYURIA (INCREASED URINARY OUTPUT)
DYSURIA (PAINFUL MICTURITION)
ENURESIS
PYURIA (PUS IN URINE)
HYPERTENSION
PROTEINURIA
HAEMATURIA
Coloured Urine
Drugs and Colour Change
URINARY ODOUR
RENAL MASSES
SCROTAL SWELLING
URETHRAL DISCHARGE
VULVAL IRRITATION
VULVAL SWELLING
VULVOVAGINAL DISCHARGE
DELAYED MENSTRUATION
BACK PAIN:
OBSTRUCTIVE UROPATHY
Taking History in Glomerular Disease
Main Groups of Inherited Kidney Disorders
ACUTE GLOMERULONEPHRITIS
Clinical Syndrome
Aetiology
Immunologic
Drugs and Toxins
Examination in Increased Blood Pressure
Examination in Renal Disease
Summary of Examination in a Renal Case
Chronic Renal Failure
Features
Evidence of Treatment for CRF
Disorders Causing CRF
Causes of Increased BP—Secondary
Uraemic Symptoms
Kulkarni's Aphorisms
INDEX
TOC
Index
×
Chapter Notes
Save
Clear