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CMN 571 Final > Final Review > Flashcards

Final Review Flashcards

1
Q

Routine Immunizations

At Birth

A

2 B’s
Birth
hep B

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2
Q

Routine Immunizations

Age 2 months

A

2B DR HIP

hep B
DTap
Rotavirus
HiB
Inactivated Polio
Pneumococcal
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3
Q

Routine Immunizations

Age 4 months

A

4 DR HIP

DTap
Rotavirus
HiB
Inactivated Polio
Pneumococcal
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4
Q

Routine Immunizations

Age 6 months

A

B DR HIP in 6 months

hep B
DTaP
Rotavirus
HiB
Inactivated Polio
Pneumococcal

Flu shot

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5
Q

Routine Immunizations

Age 12-18 months

A

1 MAD HPV

MMR
hep A
DTaP
HiB
Pneumococcal
Varicella
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6
Q

Routine Immunizations

Age 4-6 years

A

Very DIM at 4-6

Varicella
DTaP
Inactivated Polio
MMR

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7
Q

Active Immunity

A
  • Usually Permanent
  • Naturally acquired through exposure or through immunizations
  • Onset is 2-4 weeks
  • Duration is years to lifetime
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8
Q

Passive Immunity

A
  • Short-term immunity
  • Passage of antibodies from mother to fetus during pregnancy
  • Onset within 24 hours and duration is 4-6 months
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9
Q

Community Immunity

AKA Herd Immunity

A
  • Obtained through indirect protection of those around them

- 90-95% of population needs to be vaccinated in order to have Herd immunity

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10
Q

Universal Screenings

Newborn

A
  • Hearing
  • Bilirubin
  • Blood: PKU, congenital hypothyroidism, sickle cell
  • Congenital Heart Disease
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11
Q

Universal Screenings

Age 3-5 days

A
  • Hearing (if not done already)

- Blood (verify results of previous tests)

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12
Q

Universal Screenings

Age 1 month

A
  • Hearing (if not done yet)
  • Blood (verify results and make referrals if necessary)
  • Maternal depression
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13
Q

Universal Screenings

Age 2 months

A
  • Hearing
  • Blood (follow-up if needed from birth blood tests)
  • Maternal Depression
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14
Q

Universal Screenings

Age 4 months

A
  • Maternal Depression
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15
Q

Universal Screenings

Age 6 months

A
  • Oral Health (apply fluoride varnish on first tooth eruption)
  • Maternal Depression
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16
Q

Universal Screenings

Age 9 months

A
  • Developmental Screen

- Oral Health (apply fluoride varnish on first tooth eruption)

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17
Q

Universal Screenings

Age 1 year

A
  • Anemia (Hct & HgB)
  • Lead Blood Test (high prevalence area or medicaid)
  • Oral Health (should have dental home by this time)
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18
Q

Universal Screenings

Age 15 months

A
  • Oral health (encourage to have dental home, apply fluoride varnish on first tooth eruption and every 6 months)
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19
Q

Universal Screenings

Age 18 months

A
  • ASD screening
  • Developmental screen
  • Oral Health (apply fluoride varnish on first tooth eruption and every 6 months)
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20
Q

Universal Screenings

Age 2 years

A
  • ASD screening
  • Lead Blood Test (high prevalence area or medicaid)
  • Oral Health (apply fluoride varnish on first tooth eruption and every 6 months)
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21
Q

Universal Screenings

Age 2 1/2 years

A
  • Developmental Screen

- Oral Health (apply fluoride varnish on first tooth eruption and every 6 months)

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22
Q

Universal Screenings

Age 3 years

A
  • Vision (using HOTV or LEA symbols)

- Oral Health (apply fluoride varnish on first tooth eruption and every 6 months)

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23
Q

Universal Screenings

Age 4 years

A
  • Hearing (audiometry)
  • Oral Health (apply fluoride varnish on first tooth eruption and every 6 months)
  • Vision (using HOTV or LEA symbols)
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24
Q

Contraindications to give vaccines

Allergies

A

Allergic to eggs, yeast, gelatin

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25
Q

Contraindication to giving rotavirus vaccine

A

If child has intussusception or gastroenteritis

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26
Q

What vaccine should not be given if child has allergy to yeast?

A
  • Hep B (think B for bread)
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27
Q

Vaccines contraindicated during pregnancy?

A
  • MMR
  • IPV
  • Varicella
  • Hep A
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28
Q

Immunizations routinely offered to patients over 65 years old?

A
  • Tdap
  • Influenza
  • Pneumococcal
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29
Q

If a patient has an allergy to neomycin, which vaccine should they not receive?

A
  • Measles (MMR)
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30
Q

At what age should a healthy individual receive the Tdap booster?

A

65

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31
Q

Which of all childhood vaccines has most adverse effects?

A

Pertussis

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32
Q

Labs monitored for neonatal hypothyroid screen

A

TSH and T4

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33
Q

What test can confirm sickle cell disease?

A

Hemoglobin electrophoresis

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34
Q

What immunizations should be given for children who are positive for sickle cell?

A
  • PCV

- Polysaccharide

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35
Q

Most common initial symptom of sickle cell occurring in up to 50% of children before age 3

A
  • Hand-foot syndrome (dactylitis)
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36
Q

What two vaccines, when given together, increase chance for febrile seizures?

A
  • MMR

- Varicella

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37
Q

Most common route of Hep A transmission

A
  • Contaminated food/water
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38
Q

What is ankyloglossia?

A
  • Tongue tie, when attachment is closer to tip of tongue that restricts movement
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39
Q

What lead blood level is abnormal?

A

Above 5

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40
Q

What lead blood level indicates chelation needed?

A

Greater than 45

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41
Q

What lead blood level is urgent?

A

Above 70 is URGENT

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42
Q

If a child is taking more than __mg per day of corticosteroids, they should not be given a live vaccine.

A

20mg/day for 14 days

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43
Q

When is it okay for a child with cancer to have a live vaccine?

A
  • Remission

- 90 days past chemo

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44
Q

Which immunizations are live viruses?

A
  • MMR
  • MMRV
  • Varicella
  • Rotavirus
  • Yellow Fever
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45
Q

Can live virus immunizations be given together?

A

Yes, but if you have to give them at different times it must be 4 weeks apart

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46
Q

Middle childhood

A

7-10 years old

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47
Q

Early childhood

A

5-7 years old

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48
Q

What universal screenings for 5-6 year old?

A
  • Hearing
  • Vision
  • Ocular motility
  • Malocclusion
  • Fine/Gross motor skills
  • Gait
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49
Q

What causes acanthosis nigricans?

A
  • Obesity

- Type 2 DM

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50
Q

What screening should begin at age 12?

A

Depression

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51
Q

What age do you begin screening for tobacco, alcohol, and drug use?

A

15 years old

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52
Q

HIV screening age

A

Performed once between 15-18 years old

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53
Q

Hearing/Vision Screening done at which visits?

A
  • 5 yr, 6 yr, 8 yr, 10 yr visits

- Once between 11-14, 15-17, and 18-21

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54
Q

Screening for self injury begins at what age?

A

9-10 years old

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55
Q

Breast/Testicle exams begin at what age?

A

11 years old

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56
Q

Lipid screening at what age?

A
  • 9-11 years old

- 17-21 years old

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57
Q

Initial pap smear done at what age?

A

21

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58
Q

At age 5, the brain is at __% of it’s adult weight.

A

90%

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59
Q

Age 6 milestones

A
  • Recognizes numbers, letters, words
  • Learns to write
  • Beginning of concrete operations
  • Magical thinking diminishes
60
Q

Age 6 1/2 milestone

A

Mastered length (6 1/2 is a number you see on a ruler)

61
Q

Age 7-10 is most concerned with…

A

Peers and school

62
Q

Age 7 milestones

A
  • Academia intensifies
  • Becomes more abstract
  • Language at adult proficiency
63
Q

Age 8 milestone

A

Mastered volume

64
Q

What age does rapid physical, emotional, cognitive, and social development begin?

A

11-12 years old

65
Q

What age does rapid physical, emotional, cognitive, and social development end?

A

18-21 years old

66
Q

What age is puberty complete by?

A

16-18 years old

67
Q

What is included to pass from childhood to adulthood?

A
  • Completed puberty
  • Prepare for a career
  • Developed socially and emotionally
68
Q

3 leading causes of mortality in adolescence

A
  • Unintentional injury
  • Suicide
  • Homicide
69
Q

What age do you begin addressing the patient first, rather than the parent?

A

11-12 years old

70
Q

FNP 1st priority during initial interview with adolescent?

A
  • Ask about interests and school
71
Q

What does a HEADSS tool help with?

A

Obtaining a psychosocial history from an adolescent

72
Q

What does HEADSS stand for?

A
  • Home
  • Education/Employment
  • Activities
  • Drugs
  • Sexuality
  • Suicide/Depression
73
Q

T/F: Teenager weight triples during adolescence?

A

False - doubles

74
Q

Growth spurts happen earlier for girls or boys?

A

Girls

75
Q

Peak age for puberty in girls?

A

11 1/2 - 12 years old

76
Q

Peak age for puberty in boys?

A

13 1/2 - 14 years old

77
Q

Tool used to categorize genital development?

A

SMR (sexual maturity rating)

78
Q

SMR1 vs SMR5

A
  • SMR1 is pre-puberty

- SMR5 is adult maturity

79
Q

T/F: Axillary hair will begin before pubic hair.

A

False - pubic hair begins about 1 year before axillary

80
Q

Psychosocial development characteristics present in 10-13 year olds?

A
  • Feels more comfortable with same sex

- Rapid growth and secondary sex characteristics

81
Q

Psychosocial development characteristics present in 14-16 year olds?

A
  • Formal operations and abstract thinking

- Yearn for independence and autonomy

82
Q

Psychosocial development characteristics present in >17 year olds?

A
  • Less self-centered
  • Dating becomes more intimate
  • Period of idealism
83
Q

Order for puberty in girls

A
  • Height spurt
  • Menarche
  • Breasts
  • Pubic hair
84
Q

Order for puberty in boys

A
  • Testicular growth
  • Height spurt
  • Penis growth
  • Pubic hair
85
Q

Most widely used illicit drug during HS?

A

Marijuana

86
Q

Complications associated with marijuana

A
  • Elevated B/P
  • ADHD
  • Coordination/memory issues
87
Q

What drug has recently increased?

A

Ecstasy

88
Q

Complications of ecstasy

A
  • Delayed memory
  • Insomnia
  • Pulmonary HTN
  • Increased appetite
89
Q

Most widely used prescription drug by 12th graders?

A

Vicodin

90
Q

Some clues that you may see in adolescents that abuse drugs/ETOH

A
  • Delinquincy (truancy, failing grades)
  • Chronic fatigue
  • Generalized physical complaints
91
Q

What disorders are commonly linked with substance abuse?

A

Psychiatric disorders

92
Q

What tool used for screening for substance abuse?

A

CAGE questionnaire - 4 questions

93
Q

What CAGE score indicates the patient abuses substances?

A

2 or above

94
Q

Co-morbidities associated with substance abuse in adolescents?

A
  • BAAD
  • Bipolar disorder
  • ADD/ADHD
  • Anxiety disorders
  • Depression
95
Q

Components of a comprehensive pediatric history

MISS

A
  • Meds (chronic)
  • Immunizations
  • Screening
  • Sexual/social hx
96
Q

Components of a comprehensive pediatric history

BIRD

A
  • Birth hx
  • Illness (present)
  • Reason for visit
  • Development
97
Q

Components of a comprehensive pediatric history

OLD

A
  • rOs (review of systems)
  • problem List
  • Demographic data/Diet
98
Q

Components of a comprehensive pediatric history

FAM

A
  • Family hx
  • Allergies
  • Medical hx
99
Q

Appropriate visual acuity for a 3-5 year old

A

20/40

100
Q

Appropriate visual acuity for a >6 year old

A

20/30

101
Q

Most appropriate way to assess for obesity in ages 2-18 years?

A

BMI chart

102
Q

BMI >__% for age/gender is considered obese

A

95%

103
Q

BMI >__% for age/gender is considered overweight

A

85-95%

104
Q

BMI

A

5%

105
Q

BMI >__% for age/gender is considered severe obesity

A

99%

106
Q

According to USPSTF, what age should FNP screen for obesity?

A

6 years old or older

107
Q

Requirement to diagnose HTN

A
  • 2 or more elevated B/Ps separated in time

- >95th percentile for 2 visits

108
Q

1st line medications for essential (primary) HTN

A
  • Beta blockers or ACE inhibitors
109
Q

Appropriate age to begin checking B/P during annual visits

A

3 years old

110
Q

Leading cause of death in US (process begins often in childhood)

A

Cardiovascular disease

111
Q

Risk factors for CVD

A
  • Genetics
  • Diet
  • Physical activity
112
Q

First lipid panel screening (without risk factors)

A

9-11 years old

113
Q

What age would you check fasting lipid panel in a patient with CVD risk factors

A

2-8 years old and 12-16 years old

114
Q

What constitutes severe dyslipidemia

A

LDL >190mg/dl

115
Q

What LDL level, with family hx of CVD, warrants pharmacologic intervention?

A

> 160mg/dl

116
Q

What LDL level is dependent on risk factors present to determine pharmacologic intervention?

A

> 130mg/dl

117
Q

What measurement is necessary to diagnose scoliosis?

A

COBB Angle Measurement

118
Q

Most common cancer for males age 15-34

A

Testicular cancer

119
Q

Most common type of cancer in the world

A

Skin cancer

120
Q

Assessing for skin cancer

ABCDE

A
  • Asymmetry
  • Border
  • Color
  • Diameter
  • Evolving
121
Q

Prevention of skin cancer

A
  • Stay out of sun 10am-4pm
  • Minimum SPF 30 sunscreen, reapply every 2 hours
  • Hats, sunglasses, long-sleeves
122
Q

Who should be screened for IPV?

A

Women of childbearing age

123
Q

Screening tool for IPV

A 
HITS tool (hurt, insult, threaten, scream)
- each graded on scale 1-5, anything >10 is suggestive of IPV
124
Q

How to obtain a sexual history from adolescent

5 Ps

A
  • Partners (number, men/women)
  • Prevention of pregnancy (what are they doing)
  • Protection from STIs
  • Practices (type of sex)
  • Past hx of STIs
125
Q

When to begin and how often screen for STIs with a pap smear?

A
  • 21 years old

- Screen every 3 years until age 65

126
Q

STI associated with almost all cervical cancers?

A

HPV

127
Q

Most common bacterial STIs in adolescent and young women?

A

Chlamydia/Gonorrhea

128
Q

Mild depression symptoms, short duration, specific stressor causing depressed mood

A

Adjustment disorder

129
Q

MDD characteristics

A
  • Several depressive symptoms clustered over time
  • Persistent for 2 weeks or more
  • Cause impairment
130
Q

Rate of depression highest in females at what age?

A

15 years old

131
Q

Screening tool used in primary care to eval for depression

A

PHQ-9

132
Q

Dental screening in adults, how often

A

Every 6 months

133
Q

ETOH Misuse Screening tool

A

AUDIT tool

134
Q

AUDIT Tool

A
  • Quantify ETOH consumption
  • Dependency
  • Related problems
135
Q

Vision Screenings

in 20s and 30s

A

Only once each

136
Q

Vision Screenings

age 40

A

Baseline Exam

NOTE: Pre-DM or DM require YEARLY exam

137
Q

Vision Screenings

Over 65 years old

A

Comprehensive exam yearly

138
Q

ASCVD Screening

What age to begin screening?

A

Age 20

139
Q

ASCVD Screening

Ages 20-39

A
  • Measure risk factors every 4-5 years (tobacco, dyslipidemia, fam hx of ASCVD, HTN, T2DM)
  • Estimates 10 year risk
140
Q

Blood Glucose testing

A
  • Begin age 45

- Normal test, recheck every 3 years

141
Q

Colorectal Cancer screening

A
  • Begin age 45-75
  • FOBT yearly
  • Flexible sigmoidoscopy q5 years
  • OR Colonoscopy q10 years
  • Screen until age 85
142
Q

Breast Cancer Screening

A
  • Begin at age 40

- Screen annually until age 54, then q2 years >55 years old

143
Q

Prostate Cancer Screening

A
  • Begin at age 50

- Test using DRE or PSA blood test

144
Q

Testicular exam

A
  • Begin at age 15
145
Q

Osteoporosis Screening

A
  • Begin at age 65
  • BMD = osteoporosis risk score (T-score)
  • FRAX tool = 10 year risk of fracture
146
Q

Cervical Cancer Screening

A
  • Begin at age 25-65 and test q3 years

- If over 65 years and all normal screening, no more screening needed

CMN 571 Final (1 decks)

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