Clinical examination skills in paediatrics : for MRCPCH candidates and other practitioners

Examining children presents unique challenges for trainees and new doctors in paediatrics. Paediatric patients vary greatly in age and development, often find it difficult to describe their symptoms, and can behave unpredictably in clinical settings. Clinical Examination Skills in Paediatrics helps MRCPCH candidates and other practitioners learn effective history taking and fundamental examination techniques. Clear and concise chapters–with contributions from a team of paediatric specialists–demonstrate the clinical examination and questioning techniques used in daily practice. Emphasis on the intellectual processes involved in decision making assists both trainees preparing for a formal examination as well as new clinicians faced with a difficult diagnostic problem. Topics include cardiovascular and respiratory examination, examining a child with a neuromuscular disorder, musculoskeletal examination, and taking history from a child with diabetes and a rheumatological condition. Includes access to a companion website containing high-quality videos that demonstrate techniques, procedures and approaches Features commentary by experienced practitioners which offer observations and deductions at each stage of the examination process Offers tips for communicating effectively with the patients using appropriate lay terms Helps translate the symptoms and signs experienced by patients into medical-speak Covers all the skills tested in the MRCPCH Clinical exam Clinical Examination Skills in Paediatrics is the perfect study and reference guide for paediatrics trainees, MRCPCH candidates, foundation doctors, allied healthcare professionals, and anyone looking to improve their clinical and communication skills in paediatrics. Editors......Page 14 Chapter authors......Page 15 How to use this book......Page 19 About the companion website......Page 22 Do......Page 23 Do not......Page 24 Enter the room......Page 26 Let the ‘parent’ ask their questions......Page 27 Highlights......Page 28 Problem 1: Pseudo‐medical‐speak......Page 29 Problem 2: Using both types of speak at once (plain English and medical)......Page 31 Top tip......Page 32 From the end of the bed......Page 33 Important signs to look for (and not miss)......Page 34 Heart sounds and murmurs......Page 35 Questions to prepare......Page 37 Top tips......Page 38 Possible scenarios......Page 39 From the end of the bed......Page 41 Important signs to look for (and not miss)......Page 42 Additional components of the respiratory examination......Page 43 Top tips......Page 44 Possible scenarios......Page 45 Positioning the child......Page 46 From the end of the bed......Page 47 Important signs to look for (and not miss)......Page 48 Additional components of the respiratory examination in a child with underlying neurological problems......Page 49 Questions to prepare......Page 50 Possible scenarios......Page 51 From the end of the bed......Page 52 Important signs to look for (and not miss)......Page 53 Abdominal examination......Page 54 How to summarise your findings......Page 55 Possible scenarios......Page 56 Positioning the child......Page 58 Important signs to look for (and not miss)......Page 59 Top tips......Page 61 From the end of the bed......Page 63 Important signs to look for (and not miss)......Page 65 What scars might you see?......Page 67 Questions to prepare......Page 68 Possible scenarios......Page 69 The Following Should Provide you with all you Need to Know about Examination of the Cranial Nerves......Page 70 From the end of the bed......Page 77 Important signs to look for (and not miss)......Page 78 Additional components of the examination of a child with possible neuromuscular problems......Page 79 Top tips......Page 80 Further reading......Page 85 Possible scenarios......Page 86 Examination......Page 87 References......Page 98 Approach to the examination of a child with short stature......Page 99 Examination of a swelling in the neck......Page 101 Examination of a child with suspected primary adrenal insufficiency (Addison disease)......Page 103 Examination of a child with suspected steroid excess (Cushing syndrome and Cushing disease)......Page 104 Important signs to look for (and not miss)......Page 106 Nervous system......Page 107 Additional components of the diabetes examination......Page 108 Key points to consider while conducting your examination......Page 109 Examination points......Page 110 How to summarise your findings......Page 111 Top tips......Page 112 Key points to consider while conducting your examination......Page 113 Important signs to look for (and not miss)......Page 114 Questions to prepare......Page 115 Top tips......Page 116 Important signs to look for (and not miss)......Page 117 Questions to prepare......Page 118 Top tips......Page 119 Questions to ask about the history of the presenting complaint......Page 120 Medications and vaccination history......Page 121 Family history......Page 122 Questions to prepare......Page 123 Top tips......Page 124 Key points to consider while taking a history......Page 125 Additional history......Page 126 Top tips......Page 127 Key points to consider while taking a history......Page 128 Background......Page 129 Respiratory status......Page 130 Exercise and lifestyle......Page 132 Top tips......Page 134 Key points to consider while taking a history......Page 136 Top tips......Page 137 Key points to consider while taking a history......Page 139 How to summarise your findings......Page 141 How did the child present initially?......Page 144 Past medical history......Page 145 Medicines/immunisations/allergy......Page 146 Social history......Page 147 Reference......Page 148 Background......Page 149 Essential components to the musculoskeletal history......Page 150 Management of rheumatological conditions......Page 155 Index......Page 157 End User License Agreement......Page 190