Any acute illness
The history
When a child presents with an acute illness, it is essential to know its exact duration, and when the child was last perfectly well—and in particular whether he has had the symptoms before. One needs to know whether anyone else in the family (or school friend) has the same symptoms or whether there has been any contact with an infectious disease, what medicines (prescribed or unprescribed) the child has been given (including aspirin), whether there has been a recent immunization, and whether he has recently been abroad. One has to ask specifically about every system of the body—the nose for nasal discharge, the car for pain or discharge, the throat, the chest for a cough, the stomach for vomiting, the bowels for diarrhoea, and the urinary system for frequency, scalding, etc. One asks whether the child has pain anywhere.If the child has a pain, one needs to have answers to the following questions:
1. Where is the pain?
2. Is it always in the same place? The pain of appendicitis may begin in the periumbilical region, and then settle in the right iliac fossa. Otherwise pain which is located first in one place and then in another is less likely to be organic.
3. How severe is it? One wants to know whether it makes the child cry, doubles him up, stops him playing, keeps him awake, or takes him off his food. One asks the mother, 'Would you know that he had the pain if he did not tell you? If the answer is no, it is not likely to be severe.
4. Is it getting better or worse?
5. What brings the pain on, what relieves it? A pleural pain is worse on inspiration.
6. What sort of pain is it? A pleural or peritoneal pain is often stabbing and knife-like in nature.
7. Is it continuous or intermittent? A rhythmical pain coming and going every few minutes suggests an intestinal origin. A child too young to describe it may have episodes in which he looks pale and poorly and then recovers.
8. If the pain comes in attacks, how frequent are the attacks, how long do they last, and are they coming more or less frequently? One often finds that the recurrent pain about which the mother is worried lasts moments only, and occurs once every three or four months: it is then not likely to be serious.
9. Are there any associated symptoms, e.g. headache, bowel or urinary symptoms?
1. Where is the pain?
2. Is it always in the same place? The pain of appendicitis may begin in the periumbilical region, and then settle in the right iliac fossa. Otherwise pain which is located first in one place and then in another is less likely to be organic.
3. How severe is it? One wants to know whether it makes the child cry, doubles him up, stops him playing, keeps him awake, or takes him off his food. One asks the mother, 'Would you know that he had the pain if he did not tell you? If the answer is no, it is not likely to be severe.
4. Is it getting better or worse?
5. What brings the pain on, what relieves it? A pleural pain is worse on inspiration.
6. What sort of pain is it? A pleural or peritoneal pain is often stabbing and knife-like in nature.
7. Is it continuous or intermittent? A rhythmical pain coming and going every few minutes suggests an intestinal origin. A child too young to describe it may have episodes in which he looks pale and poorly and then recovers.
8. If the pain comes in attacks, how frequent are the attacks, how long do they last, and are they coming more or less frequently? One often finds that the recurrent pain about which the mother is worried lasts moments only, and occurs once every three or four months: it is then not likely to be serious.
9. Are there any associated symptoms, e.g. headache, bowel or urinary symptoms?
Coloured immigrant children may have diseases rarely seen in British children. It is important to know whether they were born abroad and when they were last in their country of origin. If chey have lived in these countries they may harbour a variety of worms, of which ankylostoma, amongst others, is an important cause of debility. If they have been in (heir home country recently, malaria, enteric fever and even cholera have to be considered. Dermal Leishmaniasis is common in parts of Iraq, causing ulceration and scarring on the face or elsewhere. Tuberculosis, now generally unconsidered in British children, certainly has to be considered in coloured children not born in this country.
Sickle cell anaemia occurs amongst American negroes, in parts of India, the West Indies and large parts of Africa: it has such protean manifestations that it has certainly to be remembered in the case of coloured children. Thalassacmia occurs in the Mediterranean area, India, Pakistan and Ceylon: it causes anaemia with splenomegaly. Glucose 6 phosphate dehydrogenase deficiency occurs in Greeks, Cypriots, Turks, Chinese, Indians, Saudi Arabians, Filipinos, and Jews from Iraq and Iran. Haemolysis may occur when the child is given antimalarial drugs, diphenhydramine, nitrofurantoin, salicylates, sulphonamidcs. Vitamin K or other drugs, or when he eats broad beans or acquires certain infections.
When British children arc seen because of illness following a holiday in countries abroad the possibilities to consider are the enteric, dysentery and Salmonella group, malaria and poliomyelitis. Visceral Leishmaniasis, giving PUO and hepatomegaly, can occur after a visit to Malta or other parts of the Mediterranean area from a bite by sandflies.
cihuahua
ReplyDeletePenyakit Tipes
Penyakit Menular
Gejala Penyakit Pneumonia
Gejala Mata Minus
Gejala Asam Lambung
Gejala Penyakit Maag
Cara Menggemukan Badan
Gejala Penyakit Batuk
Obat Paru Paru Basah
Obat alami paru paru basah
Pengobatan Paru Paru Basah
Tentang Kesehatan