Paediatric-History taking & physical examination of obesity in childhood

Paediatric-History taking & physical examination of obesity in childhoodCreated OnApril 22, 2020Last Updated OnApril 22, 2020byadmin You are here: Main Clinical Examination Paediatric-History taking & physical examination of obesity in childhood < All Topics Table of Contents History taking: Ask about patient’s information – name, age, gender and etc Ask about chief complaint and history of presenting illness including focuses system review to identify complications and underlying aetiologies of obesity: Age of onset of obesity syndromic obesity often occurs before 2 years old abrupt onset of obesity with rapid weight gain – medication-induced weight gain, a major psychosocial trigger, and neuroendocrine causes of obesity history of hypotonia and feeding problems during infancy followed by rapid weight gain and developmental delay – Prader-Willi syndrome Depression/anxiety/bullying – nervousness, school avoidance, social inhibitions Vitamin D deficiency – fatigue, muscle ache Type 2 diabetes mellitus – polyuria, polydipsia, fatigue, nocturia Psudotumour cerebri – headaches, facil numbness Insulin resistance – skin pigmenting, skin tags Obstructive sleep apnea – daytime somnolence, loud snoring, witnessed apnea GERD/gallbladder disease/constipation – abdominal pain, indigestion Slipped capital femoral epiphysis (SCFE)/early osteoarthritis – hip or knee pain Blount’s disease – in-toeing, leg bowing, mild knee pain Polycystic ovarian syndrome – hirsutism, irregular menses Skin disorders – heat rash, intertrigo, monilial dermatitis Ask about antenatal and birth histories Ask about nutrition history Identify the caretakers who feed the child Identify of foods high in calories and low in nutritional value that can be reduced, eliminated, or replaced Assessment of eating patterns Timing Content location of meals and snacks Ask about activity history Identify any barriers to walking or riding a bike to school Evaluate the time spent in play Evaluate school recess and physical education (frequency, duration, and intensity) Assess after-school and weekend activities Assess screen time (television, videotapes and DVDs, and video games) Ask about past medical/surgical history Ask about drug history Review all medications that are known to promote weight gain Use of corticosteroids and neuropsychiatric medications (rule out drug cause) Ask about developmental history Ask about immunization history Ask about family history History of early cardiovascular disease (to assess cardiac risk) High cholesterol and blood pressure level (to assess cardiac risk) Diabetes mellitus Liver or gallbladder disease Respiratory insufficiency History of obesity in first-degree relatives Ask about social history Cigarette smoking Information about school and social issues Physical examination: The examination of the overweight child or adolescent assess the presence of comorbidities and underlying etiologies. Vital signs assessment Measure the blood pressure Hypertension if systolic or diastolic blood pressure >95th percentile for age, gender, and height on ≥3 occasions...

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