Growth, Development, Preventative Peds Flashcards
PPSV23 in Pediatrics - Dosing Regimen
8 weeks after last dose of PCV 3
Repeat Dose 5 years later x 1
Subcutaneous Vaccines
MMR, MMRV
Varicella
Measles Vaccine & PPD test
Measles vaccine can suppress tuberculin reactivity; wait 4-6 weeks to do PPD
Hib Vaccine & Cut Off Age
5 years of age, unless
HIV, functional/asplenia, leukemia, immunocompromised
First Dental Visit
within 6 months of first tooth eruption and no later than 12 months
BP Monitoring starts at age
3
monitor earlier if risk factors (prematurity, etc)
DTAP Contraindications
history of encephalopathy w/in 7 days of administration
anaphylaxis
?history of progressive neurological disorder
SubQ or IM Vaccines
PPSV23
IPV
MMR Series
12-15 months
4-6 years of age
Hep B testing for infants of Hep B + mothers
at 9-12 months or 1-2 months after last administration
Hep A Vaccines
Between 12 and 23 months, 2 doses at least 6 months apart
Hearing Screen
Before leaving the hospital with goal of all infants by 3 months
Cholesterol Screening
non-fasting between 9-11 & 17-21 years of age
Risk Factors to Measure a fasting lipid profile x 2
Mi/ACS/Stroke before 55 in males and 65 in females
parent with total cholesterol >240 or known dyslipidemia
BMI >95th percentile or obesity-related illness
Lead Screening
Recommended at 1 and 2 years of age
Leave to treat with Lead Poisioning
Unknown, but continue to follow/primary prevention if 5-44
chelation recommended >45
AAP Tooth Paste
rice size w/ first tooth
pea sized after 3 years
PPD Test, 5mm
Close contact w/ TB individual
Clinical Evidence of TB
Immunosuppressive conditions or treatment
PPD Test, 10mm
< 4 yeaers of age
other conditions (DM, RF)
Born/Travel to high prevalence regions
Exposure to right risk adults (HIV, homeless, IVDU, incarcerated)
Delayed tooth eruption
no teeth by 12-13 months
SIDS most common at what age
2nd and 3rd months
Colic
> 3 hours a day, >3 days a week, for at least 3 weeks
Testing for Children who Immigrate to US
CBC, Lead, TSH
NMSS if <2 years
MMR Contraindications
anaphylaxis to gelatin or meomycin
MMR Common Adverse Events
Fever 6-12 days after
joint pain 6-21 days after (rubella)
Varicella Vaccine for post-exposure
within 3-5 days
Menningococcal Serogroup B Indications
2 or 3 doses
children >10 w/ increased risk
HPV Vaccine Schedue
2 doses: 9-14
3 doses: 15-45
Breakthrough Varicella Rash
Maculopapular
usually limited to less than 50 lesions
Back to sleep until
1 year!
Rotavirus Contrainidciations
history of intusspecption
SCID
Congenital Heart Screen Passing
> /= 95% in right hand and foot
no more than 3% difference
Which Vaccine NOT to give to preterm infants
rotavirus
Two Doses of Influenza Required until
9 years old!
MCV4 Vaccine
All: 11-12 years,then 16
Increased risk: two doses starting at 2 months of age
Standard seat belts at age..
8-12y and at least 4’9
Peds Dedicious Teeth Rule
7+4 7 months: 1st tooth 11: 4 teeth 15: 8 teeth etc
Hep B Vaccination for infants <2 kgs
1 month of age or hospital discharge
head circumference in first 2 months of life
0.5cm/week for first two months, 10 cm for year
HC in 2nd year of life
2-3 cm
HC in childhood
5-6 cm total
Weight Patterns
dbl by 4 mths
triple by 12 months
quadruple by 2 years
~5lbs / year
Height Patterns
increase 50% in first year
double by 4
triple by 13
Genetic Short Statue and Bone Age
bone age = chronological age
Constituational Growth Delay and Bone Age
Bone age behind chronological age
Failure to thrive
<3% weight
<5% W for H
2 growth curves crossed
Overweight =
85th to 95th percentile
Obesity =
> 95th percentile
BMI =
wt/height^2
Pediatric Bariatric Indications
> 120% of the 95% + comorbidity
>140% of the 95%
MCHAT administered at`
18 and 24 months
Scaphocephaly
most common!
premature closure of the sagittal suture
long, narrow skull
Weight Gain in Infants
30g/d x 3 months
3-6m: 20g/d
6m-1 year: 10g/d
Object Permaenance
between 9-12 months
Anterior Plagiocephaly
premature closure of the coronal suture
drawn up appearance of orbit on the affected side
Brachycephalpy
bilateral closure of coronal sutures
associated with Apery Sydrome, Crouzon Disease
Trigonocephaly
premature closure of metopic suture
pointed forehead
Peak Height Velocity & Staging
stage 2-3 in girls (11.5)
stage 3-4 in boys (13.5)
Thumb Sucking should stop by
age 5
Separation Anxiety ages
can start at age 6, most noticable 9-18m of age
Head Banging and guidance
can start around age 8-9m, lasts till around 4 years
When should colic disappear by
3 months; rare past 4 months
1st permanent teeth to erupt
1st molars around 6 years of age
