Vital Signs and Common Illnesses
This domain tests measurement technique, normal ranges and recognition of common illnesses that must be referred. Expect one numbers question and one interpretation question.
Normal adult values
- Temperature 36.5 to 37.5 degrees Celsius (98.6 Fahrenheit); pulse 60 to 100 per minute; respiration 12 to 20 per minute; blood pressure under 120/80 mmHg; SpO2 95 percent or more.
- Count pulse and respiration for a full minute, not 15 seconds multiplied by four.
- Count an infant's respiration while the child is calm; fast-breathing thresholds are 50 per minute for 2 to 12 months and 40 per minute for 1 to 5 years.
Common illnesses and red flags
- Fever: malaria with periodic chills, dengue with rash and pain behind the eyes, typhoid with step-ladder fever.
- Tuberculosis: cough for more than two weeks, evening fever, weight loss; sputum test, six months of NTEP treatment, notify on Ni-kshay.
- Pneumonia: cough with fast breathing; chest indrawing means severe pneumonia and requires referral with a first dose of antibiotic.
- Diabetes: fasting plasma glucose 126 mg/dL or more on two occasions.
Worked example
An 8-month-old with cough breathes 58 times a minute with chest indrawing. Reasoning: the threshold for this age is 50, so breathing is fast, and indrawing makes it severe pneumonia rather than a simple cold. The correct action is referral to hospital with a first dose of oral amoxicillin before sending, not cough syrup at home.
Traps that cost marks
- Estimating respiration from a 15-second count.
- Taking blood pressure over clothing or with a wrongly sized cuff.
- Treating chest indrawing as a minor symptom.
- Missing the two-week cough rule for tuberculosis.