Paediatric-History taking & Physical examination of pneumonia

Paediatric-History taking & Physical examination of pneumoniaCreated OnApril 24, 2020Last Updated OnApril 26, 2020byadmin You are here: Main Clinical Examination Paediatric-History taking & Physical examination of pneumonia < All Topics Table of Contents Clinical features: Poor feeding (common presentation in newborn) Irritability Rapid breathing Use of accessory muscle Grunting Cough (most common symptom after 1 month, newborn with pneumonia rarely cough – grunting) Fever (more prominent in bacterial, viral or atypical pneumonia may be afebrile or low-grade fever) Wheezing/noisy breathing Post-tussive vomiting Adolescent – constitutional symptoms (headache, chest pain, abdominal pain, diarrhoea, otitis, pharyngitis) History taking: Ask about current symptoms Ask about character of cough and phlegm Ask about feeding history Ask about level of activity of the child Ask about travel history (fungi specific to geographic area) Ask about exposure to tuberculosis Ask about exposure to birds (psittacosis) droppings (histoplasmosis), bats and other animals (Q fever, tularemia, plague) Ask about birth history Ask about past medical history – immune deficiency, anatomic defect Ask about genetic disease (cystic fibrosis, ciliary dyskinesia) Physical examination: General examination: Wellbeing – sick/toxic/irritable Fever Coughing Cyanosis Conjunctivitis (C trachomatis) Vesicles (Herpes simplex) Adenopathy (tuberculosis, histoplasmosis, blastomycosis) Respiratory examination: Accessory muscle use – nasal flaring, chest wall retractions Tachypnea <2 months: greater than or equal to 60breaths/min 2-11 months: greater than or equal to 50 breaths/min 12 months – 6 years: greater than or equal to 40 breaths/min Crackles / rales Decreased breath sound Asymmetry of chest excursion Dull percussion – consolidation Taken from Doctrina Perpetua guides on Paediatric

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