Health supervision

Question 1

microcephaly - definition

Answer 1

head size 2-3 standard deviations below mean age

Question 2

congenital microcephaly - association

Answer 2

abnormal induction and migration of brain tissue

Question 3

acquired microcephaly- association

Answer 3

cerebral insult in late third trimester, prenatal period, first year of life -
children usually born with normal head circumference

Question 4

craniosynostosis definition

Answer 4

premature closure of one or more of the cranial sutures

Question 5

craniosynostosis - etiology

Answer 5

80-90% are sporadic - 10-20% are familial or a part of a genetic syndrome

Question 6

when should sutures close by?

Answer 6

90% closure by age 2 and complete by age 5

Question 7

elongated skull - what is the first suture to close?

Answer 7

sagittal suture

Question 8

most common form of craniosynostosis?

Answer 8

dolichocephaly/scapholocephaly

elongated skull from closure of the sagittal suture

Question 9

brachycephaly - what is it?

Answer 9

coronal suture closure – shortened skull

Question 10

most complicated craniosynostosis?

Answer 10

brachycephaly - associated with men and optic nerve atrophy

Question 11

trigonocephaly

Answer 11

closure of the metopic suture

Question 12

when is craniosynostosis usually noted by?

Answer 12

6 months of age

Question 13

plagiocephaly- definition

Answer 13

asymmetry of the infant head shape usually not associated with premature suture closure

Question 14

most common plagiocephaly?

Answer 14

postional plagiocephaly

flattening of the occiput and prominence of the ipsilateral frontal area

Question 15

what is plagiocephaly associated with?

Answer 15

congenital muscular torticollis

Question 16

macrocephaly - definition

Answer 16

head circumference >95%

Question 17

macrocephaly etiology - (6)

Answer 17

1. familial
2. overgrowth syndrome (sotos syndrome)
3. metabolic storage disorder
4. neurofibromatosis
5. achondroplasia
6. hydrocephalus

Question 18

which kids should not get live vaccinated?

Answer 18

compromised immunity -

– cancer, congenital or drug-induced immunodeficiency

Question 19

examples of live vaccines

Answer 19

OPV- polio
varicella
measles,mumps and rubella (MMR)

Question 20

non-live vaccines examples

Answer 20

TDaP - diptheria, tetanus, acellular pertussis,
Hepatitis A and B
HIB
influenza
pneumococcal and meningococcal vaccines

Question 21

HBV timing

Answer 21

3 times within the 1st year

Question 22

TDaP - type of vaccine, timing of vaccine

Answer 22

inactivated
2, 4, 6 months with boosters at 12-18, and 4-6yrs
dT should then be given at 12 and then every 10 yrs after that

Question 23

opv- what is it and how does it work?

Answer 23

oral polio vaccine
it is good - because oral and will come out in poop - and vaccinate those around
BUT it might cause a polio related disease

Question 24

when is IPV given?

Answer 24

2 and 4 months - booster at 6-18 months and 4-6 yrs

Question 25

HIB vaccine - when given?

Answer 25

2, 4, 6 months with booster at 12-15 months or 2, 4, 12 months

Question 26

MMR - timing

Answer 26

12-15 months

Question 27

varicella- timing

Answer 27

12-18 months

Question 28

Hepatitis A - timing

Answer 28

2yo

Question 29

what is the most common cause of otitis media in younger than 3 yo? (bacteria)

Answer 29

pneumococcus (Streptoccocus)

Question 30

pneumovax - advantages and disadvantage

Answer 30

will treat almost all causes of bacterial meningigitis and bacteremia during childhood
disadvantage - little immunogenicity in younger than 2yo

Question 31

when to use pneumovax?

Answer 31

high risk children with sickle cell, asplenic, immunodeficiency, chronic liver disease,

Question 32

what is part of the neonatal metabolic screen

Answer 32

congenital hypothyroid
PKU
galactosemia 
sickle cell anemia 
congenital adrenal hyperplasia

Question 33

RF for iron def. anemia

Answer 33

prematurity
low birth weight
early introduction of cow's milk 
insufficient dietary intake of iron
low socioeconomic status

Question 34

acute lead intoxication- what does it look like?

Answer 34

acute onset of anorexia, apathy, lethargy, anemia, irritability, vomiting

Question 35

chronic lead intoxication - what does it look like?

Answer 35

asymptomatic, neurologic sequela might occur, developmental delay, learning problems and MR

Question 36

balanitis- what is it? and what causes it?

Answer 36

inflammation of the glans of the penis-

candida or gram negative infection in infants and STI in adults