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2ND YEAR-PEDIA > 2B : Preventive Pediatrics > Flashcards

2B : Preventive Pediatrics Flashcards

1
Q

@ the core of the field of Pediatrics

A

Preventive Pediatric Health Care

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2
Q

Tasks of preventive pediatric health care

A

Disease Detection
Disease Prevention
Health Promotion
Anticipatory Guidance

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3
Q

Screening , Surveillance

A

Disease Detection

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4
Q

○ ANEMIA
what is SURVEILLANCE
what is DETECTION

A

■ Surveillance: Dietary hx; PE
■ Screening: Hb, Hct

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5
Q

○ DEVELOPMENT
■ Surveillance:
■ Screening:

A

■ Surveillance: observation
■ Screening: structured developmental tool

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6
Q

○ Fluoridation of water
○ Tetanus immunization
○ Counselling parents about poisons and drugs

A

primary prevention

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7
Q

avoiding disease before they occur

A

primary

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8
Q

early identification and treatment before disease progression

A

SECONDARY

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9
Q

○ Screening programs for scoliosis
○ Lead levels
○ Tx of a Strep infxn w/ antibiotics

A

secondary

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10
Q

directed @ ameliorating or halting disabilities

A

tertiary

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11
Q

○ Physical therapy - Cerebral Palsy
○ Chest physiotx - Cystic Fibrosis

A

tertiary

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12
Q

● Focus on wellness , strengths of the family

A

Health Promotion & Anticipatory Guidance

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13
Q

Opportunity to help the family address relationship issues; broach on safety topics; access community services

A

Health Promotion & Anticipatory Guidance

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14
Q

Ultimate goal of immunization:

A

eradication of disease

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15
Q

Immediate goal of immunization:

A

prevention of disease

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16
Q

person w/ disease ->
Immune system -> Abs

A

● Natural active immunization

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17
Q

●part/whole microorgs are introduce–> Abs

A

Artificial active immunization

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18
Q

Transfer of humoral immunity in the form of Abs

A

passive immunization

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19
Q

maternal Abs to fetus

A

● Natural passive immunization

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20
Q

high levels of pathogen or toxin-specific Abs given to non-immune persons

A

atificial passive immunization

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21
Q

indications of active immunization

A
  • Induce protective immune responses vs. attack of the natural infection
  • Once immunized, individual less likely be a source of infection
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22
Q

indications of PASSIVE IMMUNIZATION

A

●** Congenital/ acquired B-cell defects** alone or in combination w/ other Immunodeficiencies
● When time does not allow protection w/ active immunization alone. (eg. Rabies, Hepatitis B)
● When a person is susceptible and w/ high risk of complications (eg. leukemia)
● (+) Disease : Abs may help in suppressing its toxic effects (eg. tetanus, Kawasaki)

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23
Q

● BCG
● MEASLES
● MMR

A

LIVE ATTENUATED

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24
Q

● VARICELLA
● ROTAVIRUS
● INFLUENZA (INTRANASAL)

A

LIVE ATTENUATED

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25
Q

● TYPHOID FEVER(ORAL)
● ORAL POLIO
● DENGUE TETRAVALENT

A

LIVE ATTENUATED

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26
Q

● YELOW FEVER
● JAPANESE B ENCEPHALITIS

A

LIVE ATTENUATED

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27
Q

● HEPATITIS B
● DTwP or DTaP or Tdap
● H. influenzae B

A

INACTIVATED (KILLED)

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28
Q

PNEUMOCOCCAL
HEPATITIS A
MENINGOCOCCAL

A

INACTIVATED (KILLED)

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29
Q

INFLUENZA
HUMAN PAPILLOMA VIRUS
TYPHOID FEVER
RABIES
INACTIVATED POLIO VIR

A

INACTIVATED (KILLED)

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30
Q

○ Modified, weakened virus or bacteria

A

● LIVE Attenuated vaccines

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31
Q

○ Retain the ability to replicate , produce immunity
○ Produce immunologic memory that is similar to that acquired by having the natural dse

A

LIVE ATTENUATED VACCINES

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32
Q

○ Killed microorgs or inactivated components like toxoids, subunit or subvirion products or cell wall polysaccharides

A

INACTIVTED VACCINES

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33
Q

○ LESS affected by circulating Abs
○ Produce Humoral IMMUNE RESPONSE
○ Multiple doses needed to BOOST Ab titers

A

INACTIVATED VACCINES

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34
Q

CLASSIFICATIONS OF VACCINES
* Toxoids, whole cell
* Toxoids , inactivated component
* Toxoids
* Polysaccharide Protein Conjugate

A

INACTIVATED BACTERIAL

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35
Q

DTwP

classification:
types:
route:

A
  • inactivated bacterial
  • Toxoids, whole cell
  • IM
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36
Q

DTaP, Tdap
classification:
types:
route:

A
  • inactivated bacterial
  • toxoids, inactivated component
  • IM
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37
Q

Tetanus, Td

classification:
types:
route:

A
  • inactivated bacterial
  • Toxoids
  • IM
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38
Q

Hemophilus influenza type B (HIB)
classification:
types:
route:

A
  • inactivated bacterial
  • polysaccharide protein conjugate
  • IM
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39
Q

Cholera

classification:
types:
route:

A
  • inactivated bacterial
  • inactivated whole
  • oral
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40
Q

Meningococcal
Typhoid fever

classification:
types:
route:

A
  • inactivated bacterial
  • polysaccharides
  • IM
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41
Q

Poliovirus (IPV)
Rabies
Hepatitis A

classification:
types:
route:

A
  • inactivated viral
  • inactivated virus
  • IM
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42
Q

Hepatitis B

classification:
types:
route:

A
  • INACTIVATED VIRAL
  • Recombinant subunit
  • IM
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43
Q

Influenza

classification:
types:
route:

A
  • inactivated viral
  • inactivated viral components
  • IM
44
Q

Human Papilloma Virus

classification:
types:
route:

A
  • inactivated viral
  • recombinant viral Ag
  • IM
45
Q

classification:
types:
route:

DTP-base combi:
DTaP-IPV-Hib
DTaP-IPV-Hib-HepB
DTaP-IPV
DTwP-Hib-HepB

A
  • Combination inactivated viral and bacterial
  • Toxoids, inactivated bacterial components, recombinant viral Ag, polysaccharide-protein conjugate
  • IM
46
Q

Measles
Measles-Mummps-Rubella (MMR)
Measles-Mumps-Rubella-Varicella (MMRV)
Varicella
Polio virus (OPV)

classification:
types:
route:

A
  • live viral
  • live attenuated virus
  • SQ
47
Q

classification:
types:
route:

Bacillus Calmette-Guerin (BCG)

A
  • live bacterial
  • live bacteria
  • ID
48
Q

TYPES OF ROUTE FOR INJECTION

A
  • IM - 90 degrees
  • Subcutaneous - 45 degrees
  • intravenous - 25 degrees
  • Intradermal - 10-15 degrees
49
Q

based on volume of injected material and muscle size

A

IM

50
Q

site for IM injection for less than 1 year old

A

ANTERO-LATERAL THIGH

51
Q

site for IM injection of more than 1 year old

A

deltoids

52
Q

can you inject in Upper, outer buttocks

A

: A BIG NO, NO!

53
Q

● SIMULTANEOUS ADMINISTRATION OF MULTIPLE VACCINES

A

○ Use separate syringes, sites

54
Q

○ >/ 2 inactivated vaccines or inactivated and live vaccine combinations

A

Given simultaneously or @ any interval between doses

55
Q

2 parenteral live vaccines

A

Given simultaneously or interval of 4 wks

56
Q

Cholera & Yellow Fever vaccine

A

(3 wks interval)

57
Q

● LAPSED IMMUNIZATIONS

A

○ No need to reinstitute the entire series
○ Subsequent immunizations given in the next visit

58
Q

● UNKnown/UNCERTAIN IMMUNIZATION STATUS

A

○ Initiated w/out delay on a sched commensurate with the person’s age

○ NO evidence that giving vaccines to already immune recipients are harmful

59
Q

contraindications:

Anaphylactic reaction

A

permanent

60
Q

contraindications

pregnancy

A

temporary to live vaccines

61
Q

contraindications

immunosuppressions

A

temporary to liove vaccines

62
Q

contraindications

encephalopathy within 7 days after pertussis vaccination

A

permanent

63
Q

Vaccination course given prior to an exposure

A

pre exposure prophylaxis

64
Q

Preventive med tx given after exposure to a pathogen

A

PEP
post exposure prophylaxis

(PrEP)

65
Q

Preventive med tx given after exposure to a pathogen

A

PEP
post exposure prophylaxis

66
Q

NB, w/in the 2 months of life

A

BCG

67
Q

TB Meningitis, Disseminated TB

A

BCG

68
Q

● Vaccine preparations available for BCG

A

○ Freeze Dried Glutamate BCG vaccine (Japan)
○ BCG vaccine powder and solvent for suspension for injection

69
Q

● Dosage & Sched: for BCG

A

○ Intradermal(ID)

○ < 12 months: 0.05 ml
○> 12 months: 0.10 ml

70
Q

● Purified Protein Derivative (PPD) prior to BCG vaccination in what conditions

A

in any of the following:
○ Suspected Congenital TB
○ Hx of close contact to known or suspected infectious cases of TB
○ Clinical findings suggestive of TB and/or CXR suggestive of TB

71
Q

● Adverse reactions for BCG

A

○ LAD
○ Abscess injection site

72
Q

● Normal reaction to BCG vaccination?

○ @ 3 wks

A

small area of erythema

73
Q

● Normal reaction to BCG vaccination?

@ 6-10 wks

A

: raised papule w/ redness

74
Q

● Normal reaction to BCG vaccination?

@ 14 weeks

A

shallow ulceration

75
Q

● Target popn:

○Infants , children 6 weeks and older
○ Susceptible, unvaccinated children, adolescents, adults

A

DIPHTHERIA-PERTUSSIS-TETANUS (DPT) (EPI)

76
Q

Causative agents and transmission:

Diphtheria

A
  • Corynebacterium diphtheria
  • person-to-person transmission via respiratory droplets
77
Q

Causative agents and transmission:

Pertussis

A
  • Bordetella pertussis
  • respiratory droplets
78
Q

Causative agents and transmission:

Tetanus

A
  • Clostridium tetani
  • Contaminated wounds
79
Q

general guidelines for

● 6 wks - 6 yo :

A

DTaP

● DTaP pediatric formulation (diphtheria-tetanus-acellular pertussis)

80
Q

general guidfelines for

7- 9 yo

A

Td

● Td w/out pertussis component (diphtheria-tetanus)

81
Q

general guidelines for

10-64 yo

A

Tdap (esp w/ close contact w/ infant)

● Tdap reduced Ag formulation

82
Q

general guidelines for

65 yo

A

Td ( esp if w/ close contact w/ infant)

● Td w/out pertussis component (diphtheria-tetanus)

83
Q

dpt PRIMARY 1 dose minimum age

A

6 weeks

84
Q

interval for DPT primary 2 dose

A

4 weeks

85
Q

interval for DPT primary 3 dose

A

4 weeks

86
Q

interval for DPT primary 4 dose

A

6 months

87
Q

○ Booster doses DPT

A

5th dose @ 4-6 yrs of age before school entry

88
Q

DPT SCHEDULE

Older/Adolescents:

A
  • Incomplete immunization 7-18 yo

I dose of Tdap and Td for the remaining dose

2 doses given 4 wks apart

89
Q

Unimmunized 7-18 yo

A

3 dose primary series @ 0,1,6 months w/Tdap (1st dose) ,

Td after

90
Q

ADVERSE REACTION DPT

A

○ Local reactions: erythema, tenderness
○ Abscess

91
Q

SYSTEMIC REACTION DPT

A
  • Fever (less common)
  • Arthus-type rxns: exagg rxns 2-8 hrs after injection; extensive painful swelling from shoulder to elbow
  • Less frequent: high fever, persistent crying (>3 hrs), hypotonic hypo-responsive episodes (HHE); seizures
  • Rarely: gen. Urticaria, anaphylaxis, acute encephalopathy (pertussis vaccine), peripheral neuropathy, GBS ( tetanus vaccine)
92
Q

TARGET POPULATION FOR HAEMOPHILUS INFLUENZAE TYPE B (Hib)

A

6wks-5 yo

93
Q

CHILDREN >5 yo:
FOR HIB

A

○ Functional or anatomic asplenia
○ Immunodeficiency
○ On immunosuppressants
○ HIV/AIDS
○ Transplant pxs

94
Q

● Disease prevented: H. influenzae type b infection

A

○ Acute Otitis Media,
Sinusitis
○ PNM
○ Bacteremia
○ Meningitis

95
Q

● Transmission for HiB

A

○ Direct PTP via droplets
○ Autoinoculation
○ Aspiration of AF or direct contact with genitalia during delivery

96
Q

● Vaccine preparations available for HiB

A

○ Monovalent PRP-T (Polyribosylribitol PO4-Tetanus toxoid) H. influenzae type b conjugate vaccine
○ Combination vaccine w/ DPT, IPV, Hepatitis B
○ Pentavalent w/ DPT, Hep B

97
Q

Age @ 1st dose

6 wks-6 mos

primary series?
booster?

A
  • Primary series
    3 doses, 1-2 mos apart
  • Booster
    12-15 mos
98
Q

Age @ 1st dose

7-11 mos

primary series?
booster?

A

2 doses, 1-2 months apart

booster at 18 mos

99
Q

Age @ 1st dose

12-59

primary series?
booster?

A

primary series: 1 dose
booster no

100
Q

● UNVACCINATED OLDER CHILDREN for HIB

12-14 mos

A

1 dose ffd by 1 booster dose

101
Q

● UNVACCINATED OLDER CHILDREN for HIB

15-59 mos

A

1 dose

102
Q

● UNVACCINATED OLDER CHILDREN for HIB

> 59 mos

A

NOT Reco unless w/:

  • Functional or anatomic asplenia
  • Immunodeficiency On immunosuppressants
  • HIV/AIDS
  • Transplant pxs

1 dose of Hib only vaccine

103
Q

● Adverse reactions of HiB
○ Local (MC)

A

■ Pain, swelling, erythema

104
Q

● Adverse reactions of HiB

systemic

A

Fever, irritability, severe allergic rxn (rare)

105
Q

contraindication for HiB vaccine

A
  • severe anaphylactic rxn;
  • mod-severe illness (precaution)

2ND YEAR-PEDIA (11 decks)

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