BRS- Health Supervision Flashcards
What screening tests are done at 4 years of age?
BP
Hearing & Vision
Until what age should height/weight/head circumference be measures?
2 years
When is FTT a major health concern?
When crossing 2 major percentile isobars on NHS charts
What measurement is most effected by FTT?
Weight more than height/ head circumference
When should babies regain, double, and triple birth weights?
regain: by two weeks
double: 4-6 months
triple: 12 months
How much weight per year should kids gain from age 2 through adolescence?
2.3 kg/year ~ 5 pounds
When should babies increase birth height by 50%, double, and triple?
50%: 12 months
double: 4 years
triple: 13 years
MCC failure to thrive?
inorganic: disturbed parent child bond –> poor caloric intake
When is head/ brain growth complete?
75% by age 1, complete by age 2
*Brain growth 90% by age 2, 100% by age 5
Define cephalohematoma
subperiosteal hemorrhage after traumatic delivery
Expected head growth during first two months of life?
0.5 cm per week
Expected head growth between 2-6 months of life:
0.25 cm per week
Expected head growth by 12 months of age
12 cm since birth
When is “acquired” microcephaly acquired?
third trimester, perinatal period, year 1 of life
therefore third trimester infection does not = CONGENITAL microcephaly cause, would be “acquired”.
What are potential effects of microcephaly?
- CP
- seziures
What are risk factors for craniosynostosis?
intrauterine crowding
hyperthyroid
hypothyroid
GI causes of FTT: (8)
- craniofacial
- TE fistula
- GERD
- obstruction
- diarrhea
- IBD
- Celiac
- CF
2 Pulmonary related causes of FTT?
2 Heme Onc?
- CF, BPD
- malignancy, anemia
4 renal related causes of FTT?
- recurrent UTI
- RTA
- Chronic RF
- Fanconi
Congenital causes of FTT?
FAS
Metabolic Syndromes
3 Neuro Causes of FTT
-Tumors, hydrocephalus, decreased tone/ weakness
Immune/ ID Causes of FTT (4):
TB, HIV, Hepatitis, Immunocompromised states
2 Endocrine Causes of FTT:
1 Toxin related Cause of FTT:
- Hypothyroid, Ricketts
- Lead
What head shape is assc with premature closure of each of the following sutures?
- sagittal
- coronal
- metopic
- saggital: scaphocepahly
- coronal: brachycehpaly
- metopic: trigonocephaly
Management of craniosynostosis
surgical
Define plagiocehpaly:
+ possible assc condition
abnormal head shape not caused by premature suture closure
-may be assc with torticollis
Potential causes of macrocephaly (6):
- familial
- overgrowth syndromes
- metabolic d/o
- NF
- achondroplasia
- hydrocephalus/ tumors
List (live) vaccines that may be given to children
Live MOVIs
- MMR
- OPV
- Varicella
- Influenza
List three examples of passive immunization
-preformed antibodies
VZIG, HBIG, HAIG
Hep B:
- vaccine type
- when given
- recombinant
- three shots in first year of life
DTaP:
- vaccine type
- when given
-purified, acellular
-2,4,6 months, boosters at 12-18 mo’s and 4-6 years
(5 total vaccines)
dT:
- vaccine type
- when given
-toxoid, 1/10th dose in DTaP
11-12 then every 10 years
Advantage to live OPV vaccine
induces secondary immunity, by can cause vaccine related polio
*Not given in US
When is IPV given? (inactivated polio vaccine)
2, 4 months plus 2 boosters at 6-18 mos and 4-6 mos
4 total vaccines
HiB vaccine type + timing
-conjugate ( to diphtheria or tetanus toxoid)
-2,4,6/12 months + 12-15 mo booster if at 6 months
(3-4 total vaccine)
MMR:
- vaccine type
- timing
live
-12-15 months plus booster at 4-6 or 11-12 years
Measles, Mumps, Rubella sequelae:
measles: pneumonia
mumps: parotitis, meningoencephalitis, orchitis
rubella: birth defects
Varicella:
- vaccine type
- timing
- live
- one at 12-18 months
Hep A vaccine type + timing
inactivated
2+ years of age if at risk
Contrast Pneumovax and Prevnar
Pneumoax: 23 subtypes, not safe before 2 years
Prevnar: 7 subtypes, sage before 2 years
When is prevnar given to babies?
2,4,6 months + booster at 12-5 (4)
Which vaccines are given a total of:
- 1 time
- 2 times
- 3-4 times
- 4 times
- 5 times
- 1: varicella
- 2: MMR
- 3-4: HiB
- 4: prevnar, IPV
- 5: DTaP
Which vaccine has been noted to cause seizures in case of severe reaction?
DTaP
What two tests are used to screen newborn hearing?
BAER: brainstem auditory evoked response
EOE: Evoked otoacoustic emission
What metabolic conditions are tested for in most states?
PKU, hypothyroid, galactosemia
What is peak timing of IDA?
What specific dietary risk is assc with IDA?
9-15 months, high risk with introduction of cows milk before 12 months
When is Hb screened, universally?
9-15 months, 4-6 years
What age group is most susceptible to lead poisoning?
less than 6 years
In what areas should all children be screened for lead poisoning?
In areas where prevalence is 12+%
What term describes inability to retract foreskin? Return foreskin?
phimosis, paraphimosis
Define balantitis? What bugs are commonly indicated?
infection of glans
candidiasis, gram negative
Range of time for initial tooth eruption + most commonly seen first tooth?
3-16 months (average 6)
lower central incisor
Causes of delayed tooth eruption beyond 16 months
familial
hypothyroid/ pituitary
downs
ectodermal dysplasia
Effects of excess fluoride?
cosmetic, white streaks/ grey staining esp between ages 2-4
Management of natal/ neonatal teeth
only remove if hypermobile to decrease aspiration risk
1 risk for dental caries in babies/ toddler + most common assc bug
sleeping with nipple in mouth
strep mutans q
How to preserve avulsed tooth
store in milk
How many x/day should newborns be fed?
8-12
When is honey safe for baby?
after age 1, same for whole milk
When do babies usually sleep through night + become able to eat solids?
6 months
What foods should be avoided before age 1?
egg whites fish citrus chocolate nuts wheat
When should baby drink from cup?
9 months
When should separation anxiety begin?
9 months
When should toilet training begin?
18 months
When are night terrors common?
18-24 months
When are the following expected?
- sharing
- parallel play
- imagination
- gender roles
- sharing: 3
- parallel: 2 years
- imagination, gender: 4
How much sleep is needed by a 5 year old?
10-12 hours
