Cardiovascular system history and examination

Look around the room to see if any accessories/ instruments like wheelchairs/ inhalers/ Sputum sample Once the child is seated, ask if you could expose the upper body. For lower body, you may need to ask permission from the examiner also General examination Level of consciousness- Alert/ Oriented/ cooperativeDecubitus (position in bed)GaitBuilt- Average/ small or […]

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History taking scheme

Most history taking follows the below format Details of the patient History Physical examination Summary Diagnosis Differential diagnosis Investigations Management History of presenting complaints 1) Details of the patient Name Sex Age Occupation Address Accompanying person and the relation 2) History Chief presenting complaints Past medical history Family history Treatment history Psychological history Obstetric history […]

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CRANIAL NERVES AND THEIR FUNCTIONS

There are 12 Cranial nerves. All of them arising from the brain and running down various pathways and performing the following functions.           

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Oxygen

Oxygen is a common practice in sick children. It is very important to remember that oxygen is now considered as a drug and it needs to be prescribed by a doctor before it is administered Like any Drug, excess of this can cause side effects to the patient and hence it needs to be used […]

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Nasopharyngeal aspirate

Taking aspirate samples from nasopharyngeal region is important for investigation purposes The normal procedure is as below Method This procedure should be done before feeding so to reduce false organisms It is very important to make sure that there are resuscitation items like oxygen and bag and mask in case the child goes into apnea […]

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Pulse oximetry

This is an non invasive method to monitor the capillary oxygen levels from the periphery of body This is always expressed as percentage. These are arbitrary numbers which should always be used in conjunction of the clinical presentation of the child Sites used Finger tips Toe Earlobe Method Pulse oximetry sensor consists of a red […]

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Healthy eating in pregnancy

Many of expectant mothers wonder about the ‘dos’ and don’ts’ in pregnancy regarding eating. The aim is to take adequate calories with variety of vitamins and minerals naturally. There are various phases in pregnancy where the requirements vary. For example in early  pregnancy certain vitamins are important and in later pregnancy, calories and protein become […]

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Examination of tongue

E The tongue has both motor and sensory functions. You can always ask the child about taste sensations. For the motor function, Ask the child to open the mouth and protrude the tongue. You can also ask the child to move the tongue from side to side to see the motor component If you are […]

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Variations in shape of the spine

There are 2 main variations that can be seen. Kyphosis and scoliosis Kyphosis is backward bending of the vertebral column Scoliosis is lateral bending of the vertebral column Common Causes Congenital Ankylosing spondylitis Rheumatoid arthritis Rickets Neurofibromatosis Friedrich’s ataxia Cerebral palsy Marfan syndrome Turners syndrome Method to diagnose scoliosis Request the child to remove their […]

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Common variations to look out for in the head and face

Causes of Delayed closure of Anterior Fontanelle Rickets Congenital hypothyroidism Achondroplasia Hydrocephalus Downs syndrome Causes of bulging anterior fontanelle Increase intracranial pressure Hydrocephalus Crying infant Galactosemia Causes of high arched palate Downs syndrome Marfan syndrome Crouzon syndrome Apert syndrome Turners syndrome Causes of Frontal bone bossing Thalassemia major Rickets Congenital syphilis Hydrocephalus Acromegaly Causes of […]

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Spinal tracts

Sensations carried by Spinal tracts. There are three major sensory tracts The posterior column tract The spinothalamic tract The spinocerebellar tract The spinothalamic tract This is also called the ‘Lateral Tract’. These carry the following sensations Pain Temperature Crude touch The Posterior tract It carries the following sensations Vibration Position Pressure Proprioception Fine touch The […]

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Hypotonia in Infancy approach

A hypotonic infant can be a typical case in neurology station. It is also likely to see one in your clinic The following points are mandatory Points to remember in Prenatal History: History of TORCH infections History of antenatal Drugs or alcohol Any Maternal illness Fetal movements- normal or hypoactive? Points in Neonatal History: Complications […]

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Marfans syndrome – examination

Features of Marfan syndrome It is a very common condition that can be presented in the musculoskeletal station You may be given the patient and asked to examine Look for the following clinical features Examination Kyphoscoliosis Anterior chest wall deformity- pectus excavation/ carinatum High arched palate Long slender fingers (Arachnodactyly) Cardiac findings- Mitral valve prolapse, […]

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