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  <head>
    <title>070-02 History, examination, diagnostic strategy, differential diagnosis, and common disease</title>
    <ownerName>Integrated Medical Foundations</ownerName>
  </head>
  <body>
    <outline text="Paediatric history, examination, and diagnosis">
      <outline text="Observation-first strategy">
        <outline text="Observe before contact">
          <outline text="Interaction, colour, breathing, posture, cry"/>
          <outline text="Reveals severity, minimises distress"/>
        </outline>
        <outline text="Age-specific probability, serial examination"/>
        <outline text="Low escalation threshold with limited reserve"/>
      </outline>
      <outline text="Layered history">
        <outline text="Symptom, onset, intake, urine, stool, sleep"/>
        <outline text="Birth, growth, development, vaccination"/>
        <outline text="Confidential adolescent psychosocial assessment"/>
        <outline text="Caregiver concern is diagnostic">
          <outline text="Sleepy, inconsolable, not interacting"/>
          <outline text="Ask concrete comparison with baseline"/>
        </outline>
        <outline text="Feeding history">
          <outline text="Supply, technique, oral-motor, cardiac, pain"/>
          <outline text="Blame impairs accuracy and care"/>
        </outline>
      </outline>
      <outline text="Severity by age-appropriate physiology">
        <outline text="Full-interval respiratory rate, correct cuff"/>
        <outline text="Normal ranges shift with age, sleep, fever"/>
        <outline text="Trends and work of breathing over thresholds"/>
        <outline text="Respiratory distress signs">
          <outline text="Recession, flaring, grunting, head bobbing"/>
          <outline text="Quieter child, falling rate: may be worse"/>
          <outline text="Normal saturation does not assess ventilation"/>
        </outline>
        <outline text="Hydration integrates many signs">
          <outline text="Turgor unreliable in malnutrition, obesity"/>
          <outline text="Sunken fontanelle nonspecific"/>
        </outline>
      </outline>
      <outline text="Fever by age, source, appearance">
        <outline text="Very young infants: invasive bacterial risk">
          <outline text="Urine, blood, sometimes CSF, empirical treatment"/>
        </outline>
        <outline text="Older children: seek a focal source">
          <outline text="Urinary infection may be fever alone"/>
          <outline text="Bag urine contamination-prone"/>
        </outline>
        <outline text="Infant meningitis may lack neck stiffness">
          <outline text="Do not delay antibiotics for lumbar puncture"/>
          <outline text="Defer puncture if unstable or high pressure"/>
        </outline>
        <outline text="Kawasaki disease: prolonged fever, coronary risk">
          <outline text="Features evolve, not simultaneous"/>
        </outline>
        <outline text="Post-infectious multisystem inflammation"/>
      </outline>
      <outline text="Respiratory disease and failure">
        <outline text="Bronchiolitis: clinical, supportive care">
          <outline text="Routine radiography, antibiotics cause harm"/>
        </outline>
        <outline text="Croup: barking cough, inspiratory stridor">
          <outline text="Steroids reduce severity"/>
          <outline text="Adrenaline temporary, observe recurrence"/>
          <outline text="Drooling, tripod posture: other diagnoses"/>
        </outline>
        <outline text="Asthma: variable expiratory limitation">
          <outline text="Silent chest signals critical obstruction"/>
        </outline>
        <outline text="Pneumonia: radiograph cannot identify pathogen">
          <outline text="Effusion, persistent fever widen imaging"/>
        </outline>
      </outline>
      <outline text="Gastrointestinal and surgical">
        <outline text="Gastroenteritis red flags: bile, blood, peritonism">
          <outline text="Small frequent oral rehydration, keep feeding"/>
        </outline>
        <outline text="Intussusception: classic triad uncommon">
          <outline text="Ultrasound diagnoses, enema can treat"/>
        </outline>
        <outline text="Malrotation with volvulus: rapid ischaemia"/>
        <outline text="Appendicitis presents late in young children">
          <outline text="Torsion, ketoacidosis, pneumonia mimic"/>
        </outline>
        <outline text="Constipation usually functional">
          <outline text="Red flags: delayed meconium, poor growth"/>
          <outline text="Incontinence may be overflow, not misbehaviour"/>
        </outline>
      </outline>
      <outline text="Growth, anaemia, chronic symptoms">
        <outline text="Growth faltering: verify measurements">
          <outline text="Intake, losses, absorption, demand, use"/>
          <outline text="Targeted tests, systemic clues justify"/>
        </outline>
        <outline text="Iron deficiency impairs development early">
          <outline text="Ferritin rises with inflammation"/>
        </outline>
        <outline text="Coeliac: varied or no gut symptoms">
          <outline text="Serology needs adequate gluten exposure"/>
        </outline>
        <outline text="Neonatal jaundice by age in hours">
          <outline text="First-day or rapid rise needs urgent review"/>
          <outline text="Unconjugated bilirubin crosses immature barrier"/>
          <outline text="Conjugated jaundice never physiological"/>
        </outline>
      </outline>
      <outline text="Neurological and musculoskeletal danger">
        <outline text="First seizure: exclude mimics, check glucose"/>
        <outline text="Status epilepticus needs timed treatment"/>
        <outline text="Febrile seizures usually benign"/>
        <outline text="Headache red flags">
          <outline text="Abrupt onset, focal deficit, papilloedema"/>
          <outline text="Morning vomiting, positional change"/>
        </outline>
        <outline text="Limp: trauma, infection, malignancy, abuse">
          <outline text="Fever, restricted passive movement: infection"/>
        </outline>
      </outline>
      <outline text="Safe discharge and reassessment">
        <outline text="Adequate hydration and breathing"/>
        <outline text="Reliable caregivers, access to return"/>
        <outline text="Concrete warning signs"/>
        <outline text="Uncertainty lowers reassessment threshold"/>
      </outline>
    </outline>
  </body>
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