Examination checklist

    Paediatric history taking

    The full paediatric history as a PACSE station marks it — biodata to review of systems, including the family and social history — and how to summarise it for the next station.

    Pediatrics
    General and growth
    All colleges

    Mark sheet

    26 steps · 26 marks

    #StepWellPartlyNot
    1. 1Greets the caregiver and examiner, introduces self and states the purpose of the interview1½0
    2. 2Confirms the informant's relationship to the child, preferred language and level of education1½0
    3. 3Takes biodata: name, age, sex, address, tribe and religion1½0
    4. 4Records each presenting complaint with its duration, in the caregiver's words1½0
    5. 5Explores each complaint: onset, character, progression, timing, aggravating and relieving factors1½0
    6. 6Asks associated symptoms and relevant negatives for the system involved1½0
    7. 7Asks what treatment has been given so far, including herbal remedies and self-medication1½0
    8. 8Reviews the other systems briefly1½0
    9. 9Past medical and surgical history: admissions, operations, transfusions, similar episodes1½0
    10. 10Drug history and drug allergies1½0
    11. 11Pregnancy history: booking, antenatal illness, drugs, fever or rash, HIV and hepatitis B status1½0
    12. 12Birth history: gestation, place and mode of delivery, cry at birth, resuscitation, birth weight1½0
    13. 13Neonatal history: jaundice, seizures, infection, special care admission1½0
    14. 14Nutritional history: exclusive breastfeeding, complementary feeds, current 24-hour diet1½0
    15. 15Immunisation history, checking the child health record card1½0
    16. 16Developmental history across gross motor, fine motor, speech and social domains, and school performance1½0
    17. 17Type of accommodation and number sleeping in the room1½0
    18. 18Ventilation, water supply and toilet facility1½0
    19. 19Use of insecticide-treated nets1½0
    20. 20Parents' education and occupation, and family income1½0
    21. 21Type of family, marital setting and the child's position among siblings1½0
    22. 22Number, ages, sexes and health of siblings, including any deaths and their causes1½0
    23. 23Family history of similar illness, consanguinity, atopy, seizures, sickle cell disease or diabetes1½0
    24. 24Contact with anyone with a similar illness or tuberculosis; smoking or alcohol in the home1½0
    25. 25Summarises back to the caregiver and invites questions1½0
    26. 26Thanks the caregiver1½0

    Summary of findings

    Many PACSE circuits pair a history station with a questions station, so write as you go. The examiner at the next table will ask for a diagnosis, the evidence for it and a plan.

    Adamu is a 10-year-old boy from Lagos, brought by his mother, with a four-week cough, three weeks of leg swelling and breathlessness on lying flat. A year ago he had similar symptoms and was started on monthly injections and oral furosemide, which he stopped after three months. He received all vaccines except the nine-month dose. He is the second of four children in a monogamous family of low income, sharing one room. The history suggests heart failure from chronic rheumatic heart disease after stopping secondary prophylaxis.

    A good summary has four parts:

    1. Who the child is — age, sex, informant
    2. The main complaints and their durations
    3. The positives from the rest of the history that support one diagnosis
    4. The working diagnosis and one or two differentials

    Differential diagnoses

    Structure the history so that it tests your differentials rather than wandering through systems.

    PresentationWhat the history must separate
    Swelling and breathlessnessHeart failure (orthopnoea, murmur known), nephrotic syndrome (periorbital first, frothy urine), acute nephritis (cola urine, sore throat or skin sores), malnutrition (diet, weight loss)
    Fever and confusionCerebral malaria, meningitis, diabetic ketoacidosis (polyuria, thirst, weight loss), poisoning or substance use
    Delayed milestonesPerinatal asphyxia, neonatal jaundice, meningitis, congenital hypothyroidism, genetic syndromes, neglect
    Recurrent pallor and painSickle cell disease, malaria, leukaemia (bleeding, bone pain)

    Investigations

    The history decides the tests. Name them in the order you would request them, and give the reason — "an echocardiogram to confirm rheumatic valve disease" earns more than "echo".

    Treatment

    After a history station you may be asked for principles of management. Keep to: admit or not, stabilise, treat the cause, prevent recurrence, counsel, follow up.

    For the growth and development sections, see Growth assessment and Developmental milestones.

    Examiner questions

    References

    • Kliegman RM, St Geme JW, Blum NJ, Tasker RC, Wilson KM, et al., eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia: Elsevier; 2025.

    Updated September 18, 2026