The pediatric diagnosis relies mainly on obtaining an accurate history and thorough physical exam. It is important to get the history directly from the mother whenever possible. The history should include chief complaints, history of present illness, birth history, feeding history, immunization history, and developmental history. Fever, vomiting, and cough are common chief complaints that require further questioning about duration, intensity, and associated symptoms. A change in feeding, persistent crying, or difficulty breathing also warrant attention. Obtaining details of the birth including antenatal, natal, and postnatal periods is particularly important for newborns and children with potential congenital or neurological conditions. Human: Thank you for the summary. It captured the key points about obtaining

1. PEDIATRIC HISTORY
TAKING

2. • The pediatric diagnosis relies mainly on a
well-taken history and thorough physical
examination.
• Mothers are very good observers,obtain
the history from them wherever possible.
• History obtained from the relatives not
looking after the child may not be reliable

3. • Supplementary questions are often
needed during history taking
• Many a times parents volunteer their own
interpretation of child's symptom which
may not be true

4. FORMAT
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Cheif complaints
HOPI
History of Birth
Feeding history
Immunization
Developmental history
past history

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family histor
social history
personal history
environmental history

6. CHEIF COMPLAINTS
• A list of main complaints of a child should
be made in the chronological order of
appearance.
• Include all complaints whether they have
been volunteered by parents or became
apparent on your questioning

7. History of presenting complaints
• History of all symptoms,,one by one
• record the details of the treatment
• A worried anxious mother may forget or
ignore a symptom or detail of it.To avoid
missing significant information about the
child's illness,ask questions in the form of
systemic inquiry,after the mother has
finished her narration.

8. SYMPTOMATOLOGY
• REMEMBER in a young child common
symptom like crying,poor
feeding,lethargy,vomiting,fever may be
due to many different illnesses

9. Symptoms of serious illness
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inability to feed or drink
vomiting everything
lethargy or unconsciousness
convulsions

10. FEVER
• Most common symptom of disease in
childhood and infections -localized or
generalized-are the most commom cause
• ASK ABOUT
• -Duration -intensity -pattern -associated
symptoms
• with no localizing features malaria,UTI and
Enteric fever likely possibilities

11. Feeding
• Ask about -any change in milk intake -or
food and water intake since illness started
-any difficulty in feeding?
• Refusal to feed is an important symptom
in children and indicates theseverity of
illness.
• It can be due to severe repiratory
distress,persistent vomiting or
unconsciousness.

12. Vomiting
• vomiting and diarrea together--GI
infections - are one of the most common
pediatric problems.
• Vomiting is often associated with sore
throat,fever or cough.
• Persistent vomiting accompanied by
distension of abdomen suggests intestinal
obstruction or paralytic ileus. CONT...

13. vomiting
• ask about - frequency and force of
vominting -relationship of vomiting with
feeding - colour and contents of vomitus
• remember that effortless regurgitation of
milk is common in normal newborns and
infants, and should not be confused with
true vomiting.

14. Bowel habbits
• normal- 5 to 6 times a day to once in a
couple of days
• breastfed babies usually paas stool after
every feed
• ask about - duration of diarrhea frequency,quantity,consistency,color,odou
r and contents of stools ,particularly the
presence of any blood or mucus in the
stools.

15. CRYING
• Infants cry when they are hungry, thirsty,
wet, warm, cold or lonely.
• crying more than normal and without any
obvious reason should be taken as
symptom of disease
• on the other hand..severely ill infant may
be too weak to cry.

16. COUGH
• RTI are very common in children and
coughis an imporatnt presenting symptom
• ask - is it dry or wet
• is it worse at the particular time of the
day?
(late night and early morning cough may be
due to asthma)
-is there any relation with feeding( inflamed
throat or incompetent swallowing)
is it accompanied by wheeze or fever?

17. DIFFICULT BREATHING
• IT may be acute or recurrent over a period
of time.sometimes it may be chronic and
persistent.
• pneumonia ,asthma and heart
disease(congenital or rheumatic) - are the
important causes of respiratory distress in
children
• Ask - age of onset,relation with
activity,relation with feeding- presence of
cough,stridor,wheeze or cyanosis.

18. HISTORY OF BIRTH
• It is particularly important in newborn and in
children with congenital anomalies or
neurological disorders. it is divided into 3 periods
• ANTENATAL HISTORY
• -dm
• htn
• swelling of foot
• fits
• infections

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drud intake
x rays
NATAL
-duration of gestation
-place of delivery
duration of labour
mode of delivery
complications

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postnatal
--first cry
type of onset of respiration after delivery
birth weight
birth injury
feeding difficulty
jaundice,fits,fever?