General Pediatrics Flashcards
Which growth charts should be used for children between 0 and 2years?
World Health Organization (WHO) chart
Which growth charts should be used for children >2years?
CDC growth charts
Birth weight of newborn usually regained at what age?
10–14days
Birth weight doubles at what age?
5–6months
Birth weight triples at what age?
1year
Normal weight gain after 2years of age per year
2–3kg/year approximately
Body mass index (BMI) should be used starting at what age?
2years
How is BMI calculated?
Weight (kg)/[height (m)]2
What is the most common cause of failure to thrive?
Inadequate caloric intake
How much is birth length increased by 1year of age?
50%
Birth length doubles at what age?
3–4years
What is the average growth length (growth velocity) per year after 2years of age (later childhood)?
5cm/year approximately
What is the approximate range of pubertal peak growth velocities in boys and girls?
7–12cm/year in boys 6–10.5cm/year in girls
How much does the head circumference increase per month in the 1st year?
1cm/month
When does the head grow the fastest?
First 60days of life (0.5cm/week)
Head circumference should be measured routinely in each well visit until what age?
2years
What is the risk for a premature infant with an enlarged head circumference?
Hydrocephalus
What is the study of choice for an infant who presents with macrocephaly?
Head ultrasound (US)
What is the study of choice for an infant who presents with absolute microcephaly?
Brain MRI
Child with enlarged head >98th percentile, similar to the father, no symptoms and normal cognitive function, head imaging study showed prominent subarachnoid space especially in the frontal region
Benign familial macrocephaly
Anterior displacement of the occiput on one side and the frontal region on the ipsilateral side and the ear is more anterior on the side of occipital flattening (parallelogram)
Positional plagiocephaly
Anterior displacement of the occiput on one side and frontal bossing on the contralateral side and the ear is displaced more posteriorly (trapezoid)
Posterior plagiocephaly (craniosynostosis)
The most common type of craniosynostosis
Long narrow head (scaphocephaly), which is an early closure of the sagittal sutures
A 6-month-old with progressive head enlargement and crossing percentiles from 25th percentile at 2months to 98th percentile at 6months well visits. The head is elongated in the anterior–posterior diameter and shortened in the biparietal diameter. Ridging of the sagittal suture is palpable
Scaphocephaly (craniosynostosis)
What is the next best step in a child with suspected craniosynostosis?
Refer to a pediatric neurosurgeon (imaging studies are not required to make the diagnosis in typical cases)
What is the only vaccine that can be given at birth?
Hepatitis B
Infant born to HBsAg positive mom what should be given?
Hepatitis B and HepB immunoglobulin in the first 12h
What is the maximum age you can give DTaP?
DTaP is only for children younger than 7years old
Encephalopathy within 7days of administration is an absolute contraindication in which vaccine?
DTaP
When can Tdap or Td be given?
7years and older
Rotavirus, measles, mumps, rubella (MMR), oral poliovirus vaccine (OPV), and varicella are
Live attenuated virus vaccines
How are MMR, varicella, and inactivated polio (IPV) given?
Subcutaneously (IPV can be given either IM or SC)
Can you give MMR vaccine and perform a purified protein derivative (PPD) test at the same time?
Yes
If you give only MMR vaccine, how long should you wait to do PPD test?
4–6weeks
Which vaccines are contraindicated to be given to immunocompromised children?
Live vaccines, e.g., MMR, varicella, and rotavirus
Anaphylaxis reaction to neomycin or gelatin is an absolute contraindication to which vaccine?
MMR
The child who received MMR vaccine 2weeks ago is now having pain in the hip joints. Which component of the vaccine is responsible for this reaction?
Rubella
When does Haemophilus influenzae type b vaccination not need to be given to healthy children?
5years or older
When does pneumococcal (PCV13) vaccination not need to be given to healthy children?
5years or older
For which conditions can you give Haemophilus influenzae type b vaccination at 5years of age or older?
One dose for unimmunized persons with functional or anatomical asplenia and HIV infection. 3 doses after hematopoietic stem cell transplant (HSCT) regardless of the history of HIB immunization
Which pneumococcal vaccines should be given to high-risk children 2years and older, e.g., HIV, sickle cell disease, asplenia, cochlear implant?
PCV13, and PPSV23 (PPSV23 is given at least 8weeks after any prior PCV13)
An 11-year-old female is here for HPV vaccination; how many doses are recommended?
2 doses 6–12months apart
A 15-year-old female is here for HPV vaccination; how many doses are recommended?
3 doses 0, 1–2months, and 6months are recommended
Children younger than 9years of age, never been vaccinated for influenza before; how many doses should they receive during the first instance of influenza vaccination?
2 doses 1month apart
Child has a severe egg allergy (anaphylaxis). Can he or she receive the MMR vaccine?
Yes
Child is allergic to eggs (only hives). Can he or she receive the influenza vaccine today?
Yes
Child has a severe egg allergy (anaphylaxis). Can he or she receive the influenza vaccine?
Yes. Under the supervision of a health care provider who can recognize and manage severe allergic conditions