Childhood Screenings and Vaccinations

Question 1

What is the screening recommendation for lead toxicity?

Who is at the highest risk for lead poisoning?

Answer 1

Lead toxicity is associated with neurodevelopmental impairement and behavioral concerns. It is also a major cause of GI and hematologic disorders in children.

Many children are asymptomatic.

The current Bright Futures/AAP Periodicity Schedule recommends a risk assessment at the following well-child visits: 6 months, 9 months, 12 months, 18 months, 24 months, and at 3, 4, 5 and 6 years of age. The recommendation is to do a risk assessment, and do a blood lead level test only if the risk assessment comes back positive.

Children < 5 years due to putting everything in their mouth

Question 2

Lead toxicity can be associated with what neurodevelopmental disorder that is associated with impairement in the dopiminergic pathway?

Answer 2

ADHD

Question 3

At what visit does the AAP recommend anemia screening?

Answer 3

Iron deficiency is associated with many and sometimes subtle neurological effects, the AAP recommends iron supplementation or fortifications in infants < 12 months

Recommendation is that all infants at age 12 months be screened for anemia by determining hemoglobin concentration

Children 6 through 10 who consume a vegetarian diet should be screened

Starting in adolesence, anemia screening should occur every 5 years and more frequently in females at higher risk for iron deficiency

Question 4

At what ages should autism spectrum disorder (ASD) screening be conducted?

Answer 4

18 and 24 months

MCHAT is most commonly used

Question 5

At what visits should blood pressure be taken to screen for high blood pressure?

Answer 5

Every visit starting at age 3

For children less than 3 with risk factors for HTN should also be screened as the provider sees necessary

Risk factors include: prematurity, congenital heart disease, recurrent UTI, known kidney disease, family history

Question 6

Does the USPSTF recommend cervical dysplasia screening for females younger than 21?

Answer 6

No, they recommend against screening for cervical dysplasia

The USPSTF recommends that cervical cytology screening begin at age 21

Question 7

At what age does the USPSF recommend starting screening for major depression?

Answer 7

Age 12 with the PHQ-2

Question 8

At what visits should hearing screening be preformed?

Answer 8

Newborn, First Week, 1 and 2 month visits

4, 5, 6, 8, and 10 year visit

Then, once during the early, middle, and late adolescenct visits

Risk assessment should occur more frequently

Question 9

What are the USPSTF’s recommendation for HIV screening?

Answer 9

The USPSTF recommends screening for HIV infection in adolescents and adults ages 15 to 65 at least once; more frequently if high risk (IV drug use, sexually active, hx of STIs)

Question 10

Can children with HIV receive live vaccines?

Answer 10

Yes, they should continue to the normal vaccine schedule

Question 11

Per the vaccine schedule, what vaccines are given at 2 months?

Answer 11

• Hepatits B
• DTap (Diptheria Tetanus acellular Pertussis)
• RV (Rotavirus)
• HB (Haemophilus influenza Type B)
• IPV (Inactivated Polio Vaccine)
• PCV (Pneumococal)

Question 12

Per the vaccine schedule, what vaccines are given at 4 months?

Answer 12

• DTaP (Diptheria tetenus acellular pertussis)
• RV (Rotavirus)
• HIB (Heamophilus B)
• IPV (Inactivated Polio)
• PCV (Pneumococcal)

Question 13

Per the vaccine schedule, what vaccines are given at 6 months?

Answer 13

• Hepatitis B
• DTaP
• RV
• HIB
• IPV
• PCV
• Influenza

Question 14

Per the vaccine schedule, what vaccines are given at 1 year (12 months)?

Answer 14

• Varicella Zoster
• MMR
• Hepatitis A
• DTaP
• HIB
• IPV
• PCV

Question 15

Per the vaccine schedule, what vaccines are given between age 4-6?

Answer 15

• Varicella
• DTaP
• IPV
• MMR
• Influenza