Community Pediatrics Committee Flashcards
What is the CPS recommendation for breastfeeding?
Exclusive breastfeeding for the first 6 months and continued breastfeeding with complementary foods for up to 2 years and beyond (no upper limit is defined)
What is the most common reason mothers give for weaning from the breast?
Perceived insufficiency in milk supply
What is the risk of delaying solid introduction beyond 6 months in infants?
Iron deficiency anemia and other macronutrient deficiencies
What are 4 simple ways to manage a nursing strike?
- Making feeding time special and quiet; minimizing distractions 2. Increasing the amount of cuddling and soothing of the baby 3. Offering the breast when the infant is very sleepy or just waking up 4. Offering the breast frequently using different nursing positions, alternating sides or nursing in different rooms
Which 3 types of drugs are absolutely contraindicated for breastfeeding?
- Antimetabolites 2. Therapeutic doses of radiopharmaceuticals 3. Drugs of abuse
Is bromocriptine recommended in the mother to facilitate the breastfeeding weaning process for an infant?
Bromocriptine (a prolactin suppressant) is not recommended Has been associated with adverse drug reactions such as seizures, strokes, and death
When should whole cow milk be introduced to an infant’s diet?
nine months, but preferably at 12 months of age
When is water introduced to an infant’s diet?
At 6 months of age along with complementary foods
When is drinking from a cup introduced to an infant?
At 6 months of age
In what situations should antibiotic prophylaxis be CONSIDERED for a child with a urinary tract infection?
Grade IV or V VUR or a significant urological anomaly (However, antibiotic resistance may negate the benefits in these cases in the future)
How long should antibiotic prophylaxis last for if it is being used in a child to prevent recurrent urinary tract infections?
No longer than 3 to 6 months
What are the usual choices for prophylaxis against recurrent UTIs?
Septra or nitrofurantoin
Should you use broad spectrum PO antibiotics for UTI prophylaxis?
No. Experience shows that prophylaxis with broad-spectrum antibiotics (e.g. cefixime or ciprofloxacin) will result in an organism that is resistant to any oral options for therapy
What are two common causes of childhood amblyopia?
Strabismus and difference in refractive error
At which age should an infant start to face follow?
Birth to 4 weeks of age
At which age should an infant start to follow visuals?
3 months of age
At which age can visual acuity be measurable?
By 42 months of age
By what age can children recognize Snellen letters and numbers?
Most children are able to by 4 years of age
Which eye are you supposed to vision test first?
The suspected better eye first
What are unreliable forms of discipline in early toddlers (1 - 2 years)?
Time outs should not be used. Verbal directions and explanations are unreliable.
Why should time outs not be used in early toddlers (1-2 years of age) as an effective form of discipline?
Early toddlers are very susceptible to fears of abandonment
How should a parent respond to a temper tantrum in a late toddler (2-3 years old)?
Emphathize and understand the meaning
Continue to supervise
Redirect to a different activity
Once the child gains control, parent should offer simple verbal explanation or reassurance
At which age can time-outs be used if a child loses control?
Timeouts can be introduced by 24 months of age
What are the most powerful motivators for good behaviours in preschoolers and kindergarten-age children? (3-5 year olds)
Approval and praise
What are acceptable means of discipline in school-age children (6 - 12 year olds)?
Withdrawal or delay of privileges, consequences, and time-outs
How long should time outs last for?
A time-out should last one minute per year of the child’s age, to a maximum of five minutes
What are “away from the moment” as a form of child discipline?
‘Away from the moment’ refers to dealing with the difficult behaviour not in the heat of the moment, but rather in advance or away from the actual misbehaviour.
In which age group is the “away from the moment” or reasoning discipline technique not effective?
This technique is not appropriate for use in children younger than three years to four years of age
With children with risk factors for hypoxemia during air travel, what measurement should be checked?
The child’s partial pressure of CO2 should be checked because hypercapnia can suggest poor pulmonary reserve which could be problematic in higher altitudes
Name three cardiovascular diseases are contraindicated for commercial airline flight?
- Uncontrolled hypertension
- Uncontrolled SVT
- Eisenmenger’s syndrome
Identify the 7 groups of patients that should be evaluated for potential hypoxemia before air travel?
- Patients with known or suspected hypoxemia
- Patients with known or suspected hypercapnia
- Patients with known COPD
- Patients who already use supplemental oxygen
- Patients with a previous history of difficulty during air travel
- Patients with recent exacerbations of chronic lung disease
- Patients with other chronic conditions that may be exacerbated by hypoxemia
Which groups (4) of children are at high risk of developing DVT when they air travel?
- Thrombophilia
- Previous thromboembolism
- Malignancy
- Major surgery within 6 weeks
What is Barotitis media?
Inflammatory change (acute or chronic) of the middle ear secondary to barotrauma
What are some alternative methods of treating air sickness aside from providing anti-emetics on flight?
- Direct cool ventilated air to the face
- Get the child to gaze at the horizon
- Select a seat that is away from the rear of the cabin
If possible, children with AOM should wait how many weeks before air travel?
2 weeks from diagnosis
If a pediatric patient presents with signs of a stroke, what complementary therapy should you ask about?
History of neck manipulation from a chiropractor
What should be the first step in treatment with respect to the management of functional constipation?
Give a brief description of the mechanism of functional constipation
What are the two transition periods when children are particularly prone to functional constipation?
- Toilet learning
- Start of school
What is the recommended amount of fiber intake for all children?
0.5 grams/kg/day
Children with constipation should be treated for at least how many months prior to the consideration of weaning maintenance therapy?
6 months and regular bowel movements need to be established
When should a child with constipation be referred to a gastroenterologist?
When adequate treatment measures fail or if there is a concern that there is an organic disease present
What is the scientific definition of SIDS?
The sudden death of an infant under one year of age which remains unexplained after thorough case investigation, including the performance of a complete autopsy, examination of the death scene, and review of the clinical history
What is the definition of bedsharing?
Bedsharing refers to a sleeping arrangement in which the baby shares the same sleeping surface with another person
What is the definition of cosleeping?
Cosleeping refers to a sleeping arrangement in which an infant is within arm’s reach of his or her mother, but not on the same sleeping surface.
What were the two big risk factors for SIDS based on case-control studies?
- Prone sleeping
- Exposure to tobacco products during and after pregnancy
What is the CPS recommendation on sleeping environments for infants?
For the first year of life, the safest place for babies to sleep is in their own crib, and in the parent’s room for the first six months.
What is the impact of co-sleeping or room sharing on SIDS?
Room-sharing is protective against SIDS and that this type of sleeping arrangement is a safer alternative to bedhsaring
What are the two most frequently encountered sleep disorders in the pediatric age group?
- Delayed sleep phase type
- Behavioural insomnia of childhood
There is no evidence to support the use of melatonin in which age group?
Less than 2 year olds
