Paediatric-History taking & Physical examination of acute hepatic failure in children

Paediatric-History taking & Physical examination of acute hepatic failure in childrenCreated OnApril 23, 2020Last Updated OnApril 23, 2020byadmin You are here: Main Clinical Examination Paediatric-History taking & Physical examination of acute hepatic failure in children < All Topics Table of Contents History taking: Time of onset of symptoms such as jaundice, change in mental status, easy bruising, vomiting, and fever. Exposure to contacts with infectious hepatitis. History of blood transfusions. In teenagers, a history of depression, suicide attempts, and risk-taking behaviors. A list of prescription and over-the-counter medications in the home, including complementary and alternative medicines, and whether these medications might have been ingested intentionally or accidentally. Use of intravenous drugs or other recreational drugs that are hepatotoxins, including ecstasy, cocaine, or solvent-sniffing. Any exposure to hepatotoxic drugs or chemicals should be considered possibly related to the liver injury. However, a history of exposure to a drug or toxin should not preclude a thorough search for other causes of liver injury. Family history of Wilson disease (WD), infectious hepatitis, infant deaths or autoimmune conditions In neonates, review of maternal records for risks and tests for congenital infections, including syphilis and herpes simplex. Evidence of developmental delay and/or seizures, which should prompt a careful assessment for metabolic disease. Pruritus, ascites, splenomegaly, or growth failure. Physical examination: Skin: jaundice, bruising Eyes: scleral icterus Abdomen: hepatomegaly, ascites with dullness to percussion or fluid wave, (Secondary to hypoalbuminemia and disordered regulation of fluid and electrolyte homeostasis.) splenomegaly Neurologic Sequential mental status exams to monitor for changes in mental status with age-appropriate questions. Assess for presence of encephalopathy: Grade I: confused, altered sleep; reflexes normal, may have tremor or apraxia Grade II: drowsy, inappropriate...

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