Paediatric-History taking & Physical examination of a tall stature

Paediatric-History taking & Physical examination of a tall statureCreated OnApril 28, 2020Last Updated OnApril 28, 2020byadmin You are here: Main Clinical Examination Paediatric-History taking & Physical examination of a tall stature < All Topics Table of Contents History taking: Ask about patient’s details: name, age, gender Ask about the chief complaint and history of presenting illness Symptoms of precocious puberty Girls: breast development <8yo, age of menarche? Boys: testicular enlargement < 9yo Symptoms of delayed puberty – Klinefelter syndrome Boys have tall stature, small and firm testis, eunochoid body proportions (decreased upper segment), gynecomastia Symptoms of hyperthyroidism Heat intolerance, excessive sweating Weight loss despite good appetite Palpitations Tremors Increased frequency of bowel movements Menstrual abnormalities Irritable, poor concentration Intellectual disability, developmental delay – Homocystinuria, Sotos syndrome Ask about antenatal history Parental consanguinity Maternal diabetes mellitus/obesity Ask about birth history Birth weight History of ambiguous genitalia – if yes, treatment given, gender assigned History of prolonged neonatal jaundice Ask about past medical history History of endocrine diseases History of gender surgery Ask about drug history Intake of medication/ supplements with sex steroid Ask about family history Family history of tall stature, early puberty, ‘early bloomers’ Family history of endocrine diseases Physical examination: Vital signs: pulse, BP, temp, RR Resting tachycardia, bounding pulse, AF, systolic hypertension à hyperthyroidism Height, weight, BMI, upper segment/ lower segment ratio, arm span Stigmata to look for Marfan syndrome: tall and thin stature, long narrow face, high arched palate, overgrowth of long bones and digits, chest wall deformity, joint hypermobility, positive thumb and wrist sign Homocystinuria: Marfanoid habitus, high arched palate, overgrowth of long bones and digits, chest wall deformity Klinefelter syndrome: tall stature, frontal baldness, gynecomastia, testicular atrophy, female type pubic hair pattern Sotos syndrome: prominent forehead, epicanthic folds, flat nose bridge, telecanthus, prominent pointed chin Beckwith-Wiedemann syndrome: macroglossia, omphalocele, ear creases/ pits, facial nevus flammeus Weaver...

Continue reading

Please Login/Register to read full article.