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Jamidul (Presenting difficulties (Poor concentration, Poor friendships,…
Jamidul
Presenting difficulties
Poor concentration
Poor friendships
Limited interests
Refusing to eat with family
Irritability and aggression
?Low mood
Mental health diagnoses
ADHD
Learning disability
ASD
Attachment difficulties
Anxiety disorder
Mood disorder
Initial management
Arrange to see family for a longer appointment with interpreter
Establish consent to contact school
Conduct full physical examination
Immediate concerns
Physical health
Underlying diagnoses
Acute physical problems resulting in aggression
Safeguarding
Lack of knowledge of history
Newly registered patient
Abuse: neglect, physical, emotional
History of aggression to mother
Other people/children in house
Maternal mental health
Clinical impressions
Underlying diagnosis
Cutaneous presentation
Adenoma sebaceum
Tuberous sclerosis
Further examination
Ash leaf macules
Shagreen patches (connective tissue hamartoma)