Module 1 General Flashcards
Primary prevention of disease
We are able to stop a disease or injury prior to occurrence (most cost-effective)
Secondary prevention of disease
We impact a disease that has already occurred, sometimes providing cures (to minimize impact)
-early detection of the potential for development of a disease or condition, or the existence of a disease while asymptomatic
Tertiary prevention of disease
We manage disease that is chronic in order for it not to progress or worsen (to minimize the impact of a disease)
Ankyloglossia
tight frenum
-feeding problems including difficulty latching or pain during nursing
Teeth eruption
-primary teeth A-T: around 7MO but may appear as early as 3-4MO and as late as 12-16MO
-complete set of permanent teeth (with exception of third molars) = have adolescent dentition
Oral Hygiene
-Help brush and floss from tooth eruption to 8yrs old
What is most effective in caries prevention?
Fluoride
How many times a day to brush teeth?
Twice
Fluoride varnish for high-risk population
aids in reducing dental caries among vulnerable children
-Dry teeth with gauze before application with small brush
-Instruct caregiver not to brush or floss or give soft foods until next morning to allow it to be absorbed into enamel
PKU Screening
Phenylketouria: autosomal recessive trait; prevalence is 1:10,000 caucasian live births
-Developed by elevated phenylalanine levels from normal neonate diet –> if untreated, severe intellectual disability, hyperactivity, seizures, a light complexion, and eczema
-Initial screening must take place within 1st MO. Thus, initial screening = ALL infants during 1st few days of life. Second screening necessary when newborn screened before 24hours of age and should be completed by second week of life
*Tx: reduce phenylalanine levels to <360 via dietary restriction. Must continue this diet throughout life.
Hypothyroidism congenital screening
-If left untreated, can lead to severe neurocognitive impairment
-Screened shortly after birth (T4 or TSH levels)
-Administer levothyroxine 10-15mcg ASAP
-If therapy initiated within 1 month of age, prognosis is good for neurocognitive ability
-Monitor levels with total T4 or FT4 concentration for initial therapy to ensure adequacy of tx
Sickle Cell Disease Screening
-Hemolysis and marked reduction in RBC lifespan, increases thickness of blood, and predisposes to inflammation, coagulation activation, and vaso-occlusion
-1:4000 African American, 1:1200 Hispanic
-IEF or HPLC determine severity of sickle cell: results indicative of possible sickle cell disease require prompt confirmation no later than 2MO of age
-Sickle cell anemia: HgbS, F, A2; Sickle cell trait: Hgb FAS (A>S)
-Hemoglobin electrophoresis (confirmatory testing) is REQUIRED
-Infants with sickle cell anemia should get prophylactic penicillin starting by age 2mO; pneumococcal immunization at recommended intervals
Rear-facing only carseat
-weight
-length
-22-25lbs
-26-35”
Rear-facing convertible
-weight
-how many point harness?
-age until forward facing?
-40-50lbs, 5 point harness equipped
-2 years old until forward facing
Booster seat use
-Use until vehicle seat belt fits properly, typically when they have reached 4ft 9in and are 8-12 yrs old
Allowable width of crib bars:
2 3/8”
Infant allowable toy size
1 3/4” in diameter or smaller than 2 inches long = choking hazard
Set water heater to what temperature?
120F
Baby blues
May appear suddenly in 3-4 days of delivery
-extra caution in women with hx of depression
-symptoms of crying, anxiety, irritation, restlessness; impatience, extreme fatigue, difficulty sleeping, frequent mood swings, poor concentration, appetite loss, trouble making decisions, feeling inadequate
*psychosis can also develop
Weight loss of baby after birth
-Should regain weight by 7-10 days after birth; should double birth weight by 6MO and triple by 1YR
Feeding and output (breastfeed)
-Breastfeed 8-12x/day
-Should have 6-8 wet diapers daily
-Normal stool is yellow-green-seedy-pasty texture
-May have 3-4 stools/day or one after each feeding
-Requires vitD supplementation
Feeding and output (formula)
-16-24oz/day; drinks about 2-4oz of formula every 2-4hr
-Never prop bottle; look at baby to promote bonding
-Should have 6-8 wet diapers daily
-Normal stool is yellow-brown pudding texture (may have 3-4 stools/day)
-Does not require vitD supplementation
ABCs for baby sleep
A: alone
B: back
C: crib
How long does it take for umbilical cord to fall off?
About 2 weeks
How long does it take for circumcision to heal?
7-10 days
How are food allergy reactions classified?
- IgE mediated: angioedema, gastrointestinal anaphylaxis, oral allergy syndrome, urticaria
- Non-IgE mediated: subacute, chronic symptoms that are isolated to GI tract or skin
Who is at high risk for developing food allergy?
infant with severe eczema and/or egg allergy
-at risk is infant with mild or moderate eczema
At what age should infant be exposed to peanut butter to decrease risk of peanut butter allergy?
6MO
How old before feeding solids?
Not before 4 months (AAP recommends exclusive breastfeeding for 6MO)
Once introduced and tolerated, peanut containing foods should be eaten how often weekly?
3x weekly
VIS
Document produced by CDC that informs vaccine recipients (or their parents or legal representatives) about the benefits and risks of a vaccine they are receiving (located on CDC website)
**Required by law
-must be given before each dose of a multi-dose series; must be given regardless of age of recipient
-MUST offer copy to take away; can be declined
Provider responsibilities related to VIS
-Distribution
-Record specific info in pt’s EMR, or in permanent office log: edition date of VIS, date VIS provided, office address and name/title of person administering vaccine, date the vaccine is administered, vaccine manufacturer and lot number
When can’t you vaccinate a child?
-Chronic health condition (like cancer)
-Weakened immune sx (undergoing chemotherapy or is on certain meds after transplant)
-Convulsion thought to be caused by vaccine
-Had a severe allergic rxn to previous dose of vaccine or an ingredient in a vaccine
-Rxns to a vaccine, such as fever
*You may need to wait if patient has moderate-severe illness (with or without fever) –> may need to wait until they are better; antiviral drugs (Tamiflu) might affect how body responds to some vaccines
Active immunity: how long does it take for immunization to have onset?
2-4 weeks
Duration of active immunity?
Years to lifetime
Ex. children bitten by poisonous snack receives what type of immunity?
Passive
Ex. infants born to mothers with HepB receive what type of immunity?
Passive
Onset of passive immunity?
Within 24 hours of dose; duration is about 4-6 months
What percent of population has to be vaccinated to produce herd immunity? (Each vaccine is different, but what is the generality?)
90-95%
Essentials of Dx for autism spectrum disorders
Two core features:
1. Persistent deficits in social communication and social interaction across multiple contexts
2. Restricted repetitive patterns of behavior, interests, or activities
Features of ASD
present prior to 3 years of age, but some may not be present until social demands become greater
-typical features MUST cause “clinically significant impairment” with the social communication component impaired in comparison to the individual’s “general developmental level”
Severity ranges of ASD
Level I (requiring support)
Level II (requiring substantial support)
Level III (requiring very substantial support)
Occurrence of ASD in children
1 in 54, males overrepresented by about 4:1
*strong familial component: parent of 1 child with autism of unknown etiology have 7-23% chance of having 2nd child with autism, higher prevalence if 2nd child is male or affected child is female
When do children get dx with ASD?
3-4YRS
What is an important precursor to social interaction?
Sharing affect or enjoyment
Tools to screen for autism
M-CHAT-R/F (16-30MO old, 20 yes/no questions); STAT (toddlers/young children)
-administer MCHAT at 18MO and 24-30MO
