‫بسم هللا الرحمن الرحيم‬

Examination of a Malnourished Child

Skills SCORE
Introduction and approach:
 Appropriate greeting
 Appropriate introduction of oneself, 0 1 2 3
 Asked about the mother and child names
 Asked about the child age
 Appropriate permission
 Washing hands
General Condition:
 Wellbeing (comfortable, ill, toxic)
 Nutritional status (wasted)
 The mood,
 Jaundice, 0 1 2 3 4
 Dehydration,
 Pallor
 Vital Signs: (P.R, R.R, Temperature, B.P if needed)
 Other clues: e.g. NGT
Specific examination: Findings Technique
Demonstrate Wasting: Inner aspect of thigh, axilla, buttocks, 0 1 2 0 1 2
Growth parameters: OFC, Weight, Height/ length, MAC {to plot 0 1 2 0 1 2
them in the appropriate chart}
Head and Neck:
 Hair: (Colour, Distribution, texture, pluckability)
 Fontanel’s: depressed, bulging
 Eyes: signs of vitamin A deficiency, Conjuctival Xerosis, Bitot
Spots, Corneal Xerosis, Keratomalacia 0 1 2 3 0 1 2 3
 Nose and Ears: for any discharges
 Mouth and Tongue: Angular Stomatitis, Chelosis, smooth
tongue, thrush
 Neck: for Lymph Nodes, Goitre
Skin and Lower limbs:
 Skin: Hypo/Hyper pigmentation, desquamation, petechiae 0 1 2 0 1
 Lower Limb: for Oedema
Other Areas:
 Chest: Air Entry, Breath Sound, Added Sound
 CVS: Palpate and Auscultate 0 1 2 0 1 2
 Abdomen: Distention, Organomegaly
 Anal and nappy area: (for excoriation and cutaneous
candidiasis)
Conduct of exam: 0 1 2
 Smiles and communicate with pt
 Rapport, puts child at ease
Discussion with examiner:
E.g. differential diagnosis, investigation selection, management plan,… 0 1 2
Examiner's overall assessment/comment Poor Borderline Good Excellent

Total Score: 32 Student's Score

Examiner's Signature:
 ‫بسم هللا الرحمن الرحيم‬

International University of Africa

Faculty of Medicine
Paediatric Department

Station no ( )
Examination of a Malnourished Child

Instructions to the candidate:

You are requested to perform a thorough
examination on this malnourished child

• State your findings as you proceed

• The examiner will ask you a few questions at the
end
• You have 8 minutes for this station
 Station no ( )
Examination of a Malnourished Child

Instructions to the examiner

The student should be able to perform detailed Examination
of this Malnourished Child and then to answer relevant
questions posed by the examiner
• The student should state the findings as he proceeds
• The student should be marked for proper technique,
identification and interpretation of signs, systematic
approach, and appropriate conduct
You are kindly requested to:
1. Confirm the findings on the patient before the exam
2. Observe the student only (without interaction or interference)
3. Discuss relevant areas (differential diagnosis, investigations,
management plan) with the student when he finishes examining
the patient
4. Circle the appropriate score for all items on the check list:
a. Student may not follow the sequence in the check list;
therefore, you may need to go up & down the list to record
the score
b. If the item on the checklist is not applicable, please score
the highest mark
5. Make sure to mark the box for the examiner's overall
assessment.
6. Time allowed for this station: 8 minutes