Child Anamnesis

I write this down just trying to remember my lecture today about how do we write a good anamnesis

How Many Type?
There are two type of anamnesis based on sources
1. Heteroanamnesis or Aloanamnesis, particulary for infant or incompatible children.
2. Autoanamnesis by asking directly to sick children and give the chief complain.

What is The Concept?
Concept while doing anamnesis in patient is consist of:
- Fundamental four
- Sacred seven

Fundamental Four
We should ask the patients or their family this related information because we can make a good diagnose or refer to another specialist.

1. Present Illness
To write present illness, we have to pit chief complains in it. Chief complain is complains that made patient come to seek doctor help.
For example, we can write the chief complain such as: palpitation, headache, fever, paralyze, tinnitus, chest pain, insomnia, etc.
Make sure you write one chief complain and explore them properly by using sacred seven.

2. (related) Past Health History
- Child birth (weight, needed resusitation or not, cry or not, child bearing).
- Growth development (rough motoric development, fine motoric development, language and speech, social adaptation).
- Vaccine history.
- Past (related) illness.
- Nutrition history.
There are so many. disease that related to past health history. For example, TBC (tuberculose) in children is one kind of disease that may not reach full remission. It is caused by bacteria Mycobacterium tuberculose have a latent phase make it able to appear whenever it wants. Existence of bacteria or other infectious agent is caused by other past health history too, such as child birth, growth development, vaccine history and nutrition. They all are related to the immunity of the patient.

3. Family Health History
We should ask "Is there infectious disease spread on patient's family?" or "Is there hereditary illness do exist in patient's family?" If we've done asked them about family health history, we can consider causal factor or maybe modifying or comorbid factor of the illness.

4. Personal/Social History
We may ask about interaction of patient's family member each other. Is there any problem? Because we can consider child abuse or neglect might happen to patient.

Sacred Seven
Sacred Seven is part of present illness status. Scared seven has an important role to make a good decision in given medicine. It is consist of:
- Location
- Quality
- Quantity
- chronology
- Severity
- Onset
- Modifying factor
- Associated symptoms

For example:
Case: Ana, 3 years old baby girl has been diarrhea for 2 days ago.

How to explore sacred seven from this patient?

We should ask:
- Location: bowel.
- Onset. If It had gone for more than 14 days, it may caused by chronic diarrhea and can cause severe dehydration.
- Quality including consistency, color of feces, with or without blood or mucous.
- Quantity: how many times she's been diarrhea in a day (interval per xxx hours)
- Chronology including medication history and defect in patient (cry a lot and cyanosis)
- Modifying factor such as tenesmus
- Associated symptoms such vomit, fever etc

Okay then. That's all I can tell you. Hope this writing give you some important information!

Babinski Sign

how to check babinski sign

Related Word:
Reflex
Jospeh Babinski
Neurology
Central Nervous System (CNS)
Pediatrics


What Is It?
The test for Babinski’s sign, is running a pointed instrument up the lateral border of the foot and crossing to the medial side over the metatarsal pads. The term Babinski’s sign also refers to a reflex of the forearm and indicates a lesion of the spinal cord.


How We Do It?
It is obtained by stimulating the external portion of the sole. The examiner begins the stimulation back at the heel and goes forward to the base of the toes. There are diverse ways to elicit Babinski response. A useful way that requires no special equipment is with firm pressure from the examiner's thumb. Just stroke the sole firmly with the thumb from back to front along the outside edge.
Care must be taken not to overdo it. Too vigorous stimulation may cause withdrawal of the foot or toe, which can be mistaken as a Babinski response.
click here to see video babinski sign
click here to see video babinski sign


Is It Bad Sign or Not?
Most newborn babies are not neurologically mature and therefore show a Babinski response. Upon stimulation of the sole, they extend the great toe . Many young infants do this, too, and it is perfectly normal. However, in time during infancy the Babinski response vanishes and, under normal circumstances, should never return.
A Babinski response in an older child or adult is abnormal. It is a sign of a problem in the central nervous system, most likely in a part called the pyramidal tract.

How to Report The Sign?
It is wrong to say that the Babinski reflex is positive or negative, it must be said present or absent.


Refferences
Medlineplus Encyclopedia
Whonamedit.com
Medical Dictionary


thanks for your attention

It Starts With...

Hello, I am Ayu, I am a medical student in Udayana University. It's the first time I make blog about my profession. I hope through this media, I can share with you about medicine.

As the beginning, I'll show you about Famous Medical Stories.

Aesclapeus & Caudecus
Pronounced /æsˈkliːpiəs/; Greek Ἀσκληπιός Asklēpiós [askliːpiós]; Latin Aesculapius
Aesculapius: is a stick with the snake curled around it is the staff (the rod) of Aesculapius (also called Asklepios), the ancient god of medicine. His Greek name was Asklepios and his Roman name Aesculapius.

In reality, Asklepios is a god of medicine and healing in Greek Ancient Time who was renowned for his gentle, humane remedies and his humane treatment of the mentally ill. His followers established temples called asclepions, temples of Asklepios, temples of healing. The greatest asklepion was in a grove of trees south of Corinth, Greece where the sick had to spend a night while the proper remedies were revealed during a dream to the priests of the temple and the cured had to make a suitable sacrifice (usually a rooster) to the god.

According to mythology, Asculapius had a number of children including Hygieia, the goddess of health (from whose name comes the word "hygiene") and Panaceia, the godess of healing (from whose name comes the word "panacea" for a universal remedy).

Today, the staff of Aesculapius is a commonly used symbol of medicine. It is the symbol of the American Medical Association (AMA) and many other medical societies.

This is God Aeusculapius

This is Aeusculapius Stick

This is Caduceus, logo of Indonesian Medical Society

Hippocrates

Greek: Ἱπποκράτης;

Hippocrates of Cos or Hippokrates of Kos (ca. 460 BC – ca. 370 BC)

Hippokrátēs was an ancient Greek physician of the Age of Pericles (Classical Athens), and is considered one of the most outstanding figures in the history of medicine. He is referred to as the Western father of medicine in recognition of his lasting contributions to the field as the founder of the Hippocratic School of medicine. This intellectual school revolutionized medicine in ancient Greece, establishing it as a discipline distinct from other fields that it had traditionally been associated with (notably theurgy and philosophy), thus making medicine a profession.

This is Hippocrates, Father of Medicine


Refferences:
http://www.medterms.com/script/main/art.asp?articlekey=6985
http://en.wikipedia.org/wiki/Asclepius
http://en.wikipedia.org/wiki/hippocrates