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CMN571 > Module 2 EB > Flashcards

Module 2 EB Flashcards

1
Q

developmental milestones: children can dress themselves

A

middle childhood

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2
Q

developmental milestones: can catch a ball using only their hands

A

middle childhood

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3
Q

developmental milestones: can tie their shoes

A

middle childhood

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4
Q

developmental milestones: having independence from family becomes more important now

A

middle childhood

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5
Q

developmental milestones: events such as starting school bring children this age into regular contact with larger world

A

middle childhood

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6
Q

developmental milestones: friendships become more and more important

A

middle childhood

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7
Q

developmental milestones: physical, social, mental skills develop quickly at this time

A

middle childhood

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8
Q

developmental milestones: critical time for children to develop confidence in all areas of life, such as friends, school work, and sports

A

middle childhoodd

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9
Q

developmental milestones: behavioral patterns developed during adolescence will comprise the Adolescence health status and the risk of developing future chronic diseases in their adulthood

A

adolescence

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10
Q

developmental milestone: puberty and somatic growth are completed during this period

A

adolescence

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11
Q

developmental milestone: thinking moves from concrete to abstract

A

adolescence

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12
Q

developmental milestone: independent identity and separation from family occur

A

adolescence

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13
Q

developmental milestone: preparations made for future careers or vocations

A

adolescence

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14
Q

developmental milestone: exposed to cell phones, driving, smoking/drinking etc.

A

adolescence

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15
Q

age ranges for adolescence

A

age ranges vary but adolescence typically begins with puberty and ends with adulthood
-since individuality occurs, ranges are usually 10 years to 19 years

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16
Q

separation-individuation theme initiated during this time

A

5

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17
Q

ready to relate to peers in an interactive manner

A

5

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18
Q

brain has reached 90% of its adult weight

A

5

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19
Q

sensorimotor coordination has matured (facilitates pencil/paper tasks, sports)

A

5

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20
Q

cognitive abilities: at preoperational stage (focus on one variable in a problem at a time)

A

5

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21
Q

activities to be observed: can catch ball

A

5-6yrs

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22
Q

activities to be observed: skips smoothly

A

5-6yrs

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23
Q

activities to be observed: copies a + already drawn

A

5-6yrs

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24
Q

activities to be observed: tells age

A

5-6yrs

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25
Q

activities to be observed: concept of 10 (eg. counts 10 tongue depressors). May recite to higher number by rote

A

5-6yrs

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26
Q

activities to be observed: knows right and left hand

A

5-6yrs

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27
Q

activities to be observed: draws recognizable person with at least 8 details

A

5-6yrs

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28
Q

activities to be observed: can describe favorite television program in some detail

A

5-6yrs

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29
Q

activities related by parent: does simple chores at home (taking out garbage, drying silverware)

A

5-6yrs

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30
Q

activities related by parent: goes to school unattended or meets school bus

A

5-6yrs

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31
Q

activities related by parent: good motor ability but little awareness of dangers

A

5-6yrs

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32
Q

mastered conservations of length

A

5 1/2 yrs

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33
Q

recognizes numbers, letters, words

A

6

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34
Q

learns to write

A

6

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35
Q

beginning of concrete operations (perform mental operations concerning concrete objects that involve more than one variable)

A

6

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36
Q

can order, number, classify (relate to concrete objects in the environment)

A

6

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37
Q

magical thinking diminishes

A

6

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38
Q

reality of cause-effect relationships is better understood

A

6

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39
Q

fantasy and imagination are still reflected in themes of play

A

6

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40
Q

activities to be observed: copies a triangle

A

6-7yrs

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41
Q

activities to be observed: defines words by use (“what is an orange?” “to eat.”)

A

6-7yrs

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42
Q

activities to be observed: knows if morning or afternoon

A

6-7yrs

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43
Q

activities to be observed: draws a person with 12 details

A

6-7yrs

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44
Q

activities to be observed: reads several 1-syllable printed words (my, dog, see, boy)

A

6-7yrs

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45
Q

activities to be observed: language - approximately 2560 words; intelligible 6- or 7-word sentences

A

6-7yrs

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46
Q

what is the age range for middle childhood?

A

7-10yrs

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47
Q

what do children devote most of their time to during middle childhood?

A

school and peer group interactions

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48
Q

major developmental tasts are achievement in school and acceptance by peers

A

7

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49
Q

academic expectations intensify, become more abstract, require child to concentrate on, attend to, and process increasingly complex auditory/visual info

A

7

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50
Q

language is at adult proficiency by what age?

A

7

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51
Q

activities to be observed: counts by 2s and 5s

A

7-8yrs

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52
Q

activities to be observed: ties shoes

A

7-8yrs

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53
Q

activities to be observed: copies a diamond

A

7-8yrs

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54
Q

activities to be observed: knows what day of the week it is (not date or year)

A

7-8yrs

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55
Q

activities to be observed: no evidence of sound substitutions in speech (eg. fr for thr)

A

7-8yrs

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56
Q

activities to be observed: draws a man with 16 details

A

7-8yrs

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57
Q

reads paragraph #1 Durrell

A

7-8yrs

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58
Q

corresponding arithmetic: adds and subtracts 1-digit numbers

A

7-8yrs

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59
Q

Learning disabilities or attention, organization, and impulsivity problems occur

A

8-9yrs
-may have significant issues with these tasks, receiving negative reinforcement from teachers/parents = poor self-image manifested by behavioral difficulties
–> pediatrician must evaluate potential learning disabilities in any child not developing adequately at this stage or present with emotional/behavioral issues

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60
Q

what determines the difference in success at school for 8-9yr olds?

A

quality of the response, attentional abilities, and child’s emotional approach

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61
Q

activities to be observed: defines words better than by use (“what is an orange?” “a fruit.”)

A

8-9yrs

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62
Q

activities to be observed: can give an appropriate answer to the following: “What is the thing for you to do if…”
-you’ve broken something that belongs to someone else?
-a playmate hits you without meaning to do so?

A

8-9yrs

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63
Q

reading: reads paragraph #2 Durrell

A

8-9yrs

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64
Q

Corresponding arithmetic: learning borrowing and carrying processes in addition to subtraction

A

8-9yrs

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65
Q

Activities to be observed: knows the month, day, and year

A

9-10yrs

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66
Q

activities to be observed: names the months in order (15 sec, 1 error)

A

9-10yrs

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67
Q

activities to be observed: makes a sentence with these three words in it (1 or 2; can use words orally in proper context –> 1. work, money, men; 2. boy, river, ball)

A

9-10yrs

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68
Q

reading: reads paragraph #3 Durrell (should be able to read and comprehend literature)

A

9-10yrs

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69
Q

Corresponding arithmetic: learning simple multiplication

A

9-10yrs

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70
Q

what is viewed as part of a continuum of responses by the child to a variety of internal/external experiences (biological/environmental)?

A

behavioral variations

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71
Q

definition: temperament

A

genetically influenced behavioral disposition that is stable over time; “how” of behavior vs the “why” = motivation of the “what” = ability; independent psychological attribute that is expressed as a response to an external stimulus (experiences –> influences temperament –> influences responses of others in child’s environment); hard to evaluate in younger ages d/o variety of internal/external experiences

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72
Q

how common is it for a child in 1st grade to wet the bed? (%)

A

20%

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73
Q

Enuresis: prevalence
-boys or girls?
-age?

A

boys, among 7-9yr olds

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74
Q

Enuresis: definition

A

repeated urination into clothing during the day and into the bed at night by child who is chronologically and developmentally OLDER THAN 5 YEARS
-this pattern of urination MUST OCCUR at least TWICE A WEEK for 3 MONTHS

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75
Q

Enuresis: two types

A
  1. monosymptomatic (never have been dry at night for >6MO with no daytime accidents)
    -reflects a maturational disorders (delay in the maturation of the urologic and neurologic systems) with no underlying organic problem
  2. complicated/non-monosymptomatic (involves nocturnal enuresis and daytime incontinence; reflects underlying disorder)
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76
Q

Enuresis type 1
-causes
-evaluation

A

-genetic; children have higher threshold for arousal (don’t wake to full bladder sensation); overproduction of urine from dec production of desmopressin or resistance to ADH
-hx and physical exam; every child should have UA including specific gravity; obtain urine culture in girls

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77
Q

Enuresis type 1
-first line treatment
-second line treatment

A

-education and avoidance of being judgmental/shameful towards child; behavioral strategies used for 3 months every night (limit liquids before bed, awaken child at night, bedwetting alarms); parents need to be active participants (most common cause of failure is child does not awaken or parents do not wake child)
-desmopressin acetate (DDAVP) –> decreases urine production; high relapse rate when medications are stopped

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78
Q

Enuresis type 2
-evaluation
-treatment

A

-consider underlying pathology (cystitis, diabetes insipidus, seizure disorders, neurogenic bladder, anatomical abnormalities of urinary tract system, constipation, and psychological stress/child maltreatment. obtain complete hx and physical exam, diary that includes daily record of voiding and fecal elimination
-correct underlying cause; referral to peds specialist

79
Q

Encopresis
-prevalence (ages)
-definition

A

-1-3% children experience this problem; occurs most between 5-6yrs
-repeated passage of stool into inappropriate places (underpants) by child who is chronologically or developmentally older than 4 years. occurs EACH MONTH for at least 3 MONTHS and is NOT ATTRIBUTABLE to physiologic effects of substance of other medical condition except to mechanisms involving constipation

80
Q

Encopresis - what does it most often result from?

A

constipation (90%)

81
Q

Encopresis:
-evaluation
-treatment

A

-complete hx, physical exam, rectal exam; abd XR (to note degree of constipation, appearance of bowel, if obstruction present)
-education, support; behavioral strategies (sit on toilet after meals), do not punish/no guilt; establish regular bowel regimen; encourage BM daily

82
Q

what is the first line treatment for sleep disorders related to pediatric insomnia?

A

sleep hygiene education and cognitive behavioral therapy = first line treatments

83
Q

how much sleep should a newborn get?

A

10-19hrss/day in 2-5hr blocks

84
Q

first year of life - what is the sleep length of time?

A

9-12hr blocks

85
Q

Total # hours of sleep per day: 1-2yrs

A

11-14

86
Q

Total # hours of sleep per day: 3-5yrs

A

10-13

87
Q

Total # hours of sleep per day: 6-13

A

9-11

88
Q

Total # hours of sleep per day: adolescents

A

9-9.5

89
Q

what percent of children experience sleep disturbance at some point in first 4yrs of life?

A

20-40%
-% decreases in school aged children

90
Q

most common pediatric sleep disorder

A

insomnia of difficulty initiating/maintaining sleep

91
Q

sleep is controlled by 2 mechanisms:

A
  1. homeostatic drive (increase in pressure to fall asleep over course of day)
  2. circadian rhythm
92
Q

what are our two different biologic clocks (in relation to sleep/wake)?

A
  1. circadian rhythm: daily sleep-wake cycle
  2. ultradian rhythm (occurs several times per night) - stages of sleep = stages of sleep cycle every 50-60min (infants) and every 90 in (adolescents)
93
Q

two major sleep stages

A
  1. NREM/non-REM: divided into 3 stages
  2. REM: occurs throughout the night but INCREASES DURING LATTER HALF OF NIGHT
94
Q

What stage of sleep?
Light sleep. Reduced body movements, slow eye rolling, sometimes opening/closing of eyelids

A

N1
Stage 1

95
Q

What stage of sleep?
Slowing eye movements, respirations, HR, and relaxation of muscles. Mature individuals spend 50% of sleep time in this stage.

A

N2
Stage 2

96
Q

What stage of sleep?
Slow-wave sleep. Body is relaxed, breathing is slow/shallow, HR is slow. Deepest NREM sleep occurs 1-3hrs after going to sleep.

A

N3
Stage 3

97
Q

What stage of sleep?
Muscle tone relaxed, sleeper may twitched/grimace. Eyes move erratically beneath closed lids.

A

REM
Stage R

98
Q

Night terrors
-how quickly does this occur after falling asleep?
-what stage of sleep does this occur?
-common ages
-management

A

-within 2hrs falling asleep
-during deepest NREM sleep (stage 3)
-3-8yrs
-ensuring environment is free of obstacles/lock doors outside, put bell on child’s door

99
Q

Night terrors
-what does the child do?
-have memory of event?

A

-sit-up in bed screaming, thrashing about, exhibiting rapid breathing, tachycardia, sweating; child incoherent and unresponsive to comforting (can last up to 30 min)
-no memory of event next day

100
Q

Sleepwalking
-when does it occur?
-common ages
-management

A

-slow-wave/deep sleep (stage 3)
-ages 4-8yrs
-ensuring environment is free of obstacles/lock doors outside, put bell on child’s door

101
Q

Nightmares
-occur during which stage of sleep?
-how will child act?
-associated with what?

A

-REM sleep (stage R)
-awakens alert, can describe nightmare, talk about it next day; child seeks and responds to parental reassurance. Difficulty going back to sleep afterward.
-stress, trauma, anxiety, sleep deprivation

102
Q

BEARS mneumonic for sleep disorder management

A

Bedtime resistance
Excessive daytime sleepiness
Awakening during the night
Regularity and duration of sleep
Sleep-disordered breathing

103
Q

How often are you assessing a child for sleep disorders?

A

Screen child for quality and quantity of sleep at EVERY well-child visit

104
Q

ABCs of SLEEPING

A

Age-appropriate Bedtimes and wake times with Consistency
Schedule and routines
Location
Exercise and diet
no Electronics in bedroom or before bed
Positivity (positive home environment)
Independence when falling asleep
Needs of child met during the day =
Great sleep

105
Q

What type of children is melatonin useful for?

A

children with visual impairment, developmental disability and ASD

106
Q

what is included for every routine middle childhood exam?

A

height, weight, BMI, BP, vision, hearing

107
Q

what is the most common neurodevelopmental disorder?

A

ADHD (2-10% of school-aged children)

108
Q

biologic factors that influence development are…?

A

Genetic!

109
Q

what questionnaire is used for ADHD?

A

Vanderbilt ADHD Diagnostic parent/teacher rating scales

110
Q

what is the triad of symptoms related to ADHD?

A

hyperactivity-impulsive, inattentive, combined type

111
Q

common type of ADD/ADHD overall, girls, boys

A

overall: combined
girls: inattentive subtype
boys: hyperactive subtype

112
Q

ADHD
-what are the diagnostic features

A

-<17yrs
-must exhibit 6+ sx listen in either domain
-sx must be present PRIOR to age 12 yr
-sx have persisted for at least 6 MO
-must occur in more than one setting
-affects quality of life
-not attributable to another psychiatric condition (mood, anxiety, SA)

113
Q

ADD/ADHD Medications: stimulants
-what schedule? meaning?

A

-schedule 2; high potential for abuse and dependence

114
Q

monitoring parameters in relation to ADD/ADHD medications - stimulants

A

-baseline cardiac evaluation in patients with risk factors
-BP, HR at baseline, after dose increase, and periodically
-Height/weight in pediatrics at baseline and periodically
**consider in those with prolonged tx: CBC w/ diff + platelets annually

115
Q

types of drugs that are stimulants for ADD/ADHD (2)

A

-Methylphenidates (azstarys, concerta, daytrana, focalin/XR, Jornay, QuilliChewER/XR, Ritalin
-amphetamines (Adderall, Adderall XR, Dexedrine, mydayis, Vyvanse)

116
Q

can stimulants and nonstimulant medications for ADD/ADHD be used simultaneously?

A

YES
-Intuniv, Kapvay, Qelbree, Strattera

117
Q

Off label ADHD meds

A

Bupropion (Wellbutrin), clonidine ER, guanfacine

118
Q

Features of ASD

A

“clinically significant impairment” with social communication component impaired in comparison to the individual’s “general developmental level”

119
Q

how common is ASD diagnosis?

A

1 in 54 children, with male overrepresented by about 4:1

120
Q

what screening tool is used to diagnose ASD?

A

M-CHAT
Administered at 18 and 24-30MO

121
Q

how many hours/week of intensive behavioral intervention for ASD children is recommended?

A

25hr/week

122
Q

Definition of intellectual disability
-what two items must be present for dx
-IQ <?

A

-adaptive function and cognitive standardized testing must be >2 standard deviations BELOW mean to quality for ID
-IQ <70

123
Q

at what age is puberty complete?

A

16-18yrs

124
Q

what four items demonstrate developmental passage from childhood to adulthood?

A
  1. completing puberty and somatic growth
  2. developing socially, emotionally, and cognitively, and moving from concrete thinking to abstract thinking
  3. establishing an independent identity and separating from family
  4. preparing for a career or vocation
125
Q

three leading causes of mortality in adolescents (15-19yrs)

A
  1. unintentional injury (41%; primary cause MVA, poisoning inc prescription drugs - opioids)
  2. suicide (18%, firearms)
  3. homicide (15%, firearms)
126
Q

Major casues of morbidity in adolescents

A

-psychosocial
-related to poverty

127
Q

at what age do you conduct a physician visit with only the adolescent, and then with parent present?

A

-starting at age 11-12

128
Q

when do you utilize the HEADSS assessment? what does each letter stand for?

A

-used as a good psychosocial history tool to assess on the questionnaire before an appointment
-home, education/employment, activities, drugs, sexuality, and suicide/depression

129
Q

Early middle adolescence (Male)
-process to create testosterone

A

-increase in LH/FSH secretion –> stimulates gonads to produce estrogen/testosterone
-LH stimulates interstitial cells of testes –> testosterone
-FSH stimulates production of spermatocytes in presence of testosterone

*circulating testosterone levels increase more than 20-fold during puberty (levels of testosterone correlate with physical stages of puberty and degree of skeletal maturation)

130
Q

Early middle adolescence (female)
-female maturation

A

-FSH stimulates ovarian maturation, granulosa cell function, estradiol secretion
-LH important in ovulation and involved in corpus luteum formation progesterone secretion
-estradiol levels progressively inc –> maturation of female genital tract/breasts

131
Q

growth spurts in boys vs growth spurts in girls (adolescents)

A

girls grow 2 years before boys (girls peak 11.5 and 12 years, boys peak 13.5 and 14 years)

132
Q

Sexual Maturity Rating (SMR)
-5 phases

A
  1. SMR 1: pre-puberty
  2. SMR 2: pubic hair sparse, fine, nonpigmented and downy; male genitalia development begins
  3. pubic hair is pigmented and curly, increases in amount
  4. pubic hair is adult in texture but limited in area
  5. adult maturity
133
Q

first measurable sign of puberty in girls

A

height spurt

134
Q

first conspicuous sign of puberty in girls

A

breast buds between 8-11yrs

135
Q

first sign of puberty in boys (usually 10-12yrs)

A

scrotal and testicular growth

136
Q

when does axillary hair, deepened voice, and chest hair occur in boys during puberty?

A

usually 2 years after growth of pubic hair

137
Q

complications associated with marijuana use

A

tachycardia, HTN, bronchodilation, decreased fertility, learning problems, coordination and memory

138
Q

what are the greatest barriers to screening adolescents for substance abuse in the primary care setting?

A

-insufficient time
-lack of training

139
Q

screening tools for SA

A

BSTAD & S2BI

140
Q

CAGE questionnaire

A

used to assess SA
-Their need to Cut down; Annoyance if asked about it; feeling Guilty about the use; need for an Eye opener
*score of 2 or more is highly suggestive of abuse

141
Q

when must a chaperone be present during an adolescent exam?

A

during pelvic exam or stressful/painful procedure

142
Q

how often should vision and hearing be assessed by practitioner?

A

at every health supervision visit

143
Q

what should visual acuity be in 3-5yr olds?
what should visual acuity be in >equal 6hr olds?

A

-20/40
-20/30

144
Q

how often is hearing screen performed?

A

ages 4, 5, 6, 8, 10 years of age, and several times during adolescence

145
Q

After age 4, hearing screen
-hz tested
-at what db?

A

500, 1000, 2000, 4000hz
20dB

146
Q

when is BMI graphed?

A

starting at age 2yrs

147
Q

at what age are practitioners screening children for obesity?

A

6yrs old

148
Q

how is BMI measured in relation to sex and age?

A

it is sex and age specific

149
Q

tests to run when obesity is dx

A

fasting lipid profile, fasting glucose and/or hemoglobin A1c, ALT

150
Q

when do BP screening begin at well child visits?

A

by age 3

151
Q

what is HTN frequently caused by in the pediatric population?

A

renal or obesity

152
Q

how should the width of the BP cuff fit around a child?

A

40-50% of the circumference of the limb

153
Q

how is HTN dx in pediatric population?

A

3 separate occasions of elevated BPs

154
Q

stages of HTN (pediatric)

A

-Elevated BP: 90-95%
-Stage 1 HTN: >than between the 95th and 99th percentile plus 12mmHg
-Stage 2 HTN: >99th percentile plus 12mmHg

155
Q

define scoliosis

A

lateral curvature of the spine greater than 10 degrees of deviated from straight

156
Q

at what age are children screened for scoliosis? (boys and girls)

A

-girls: ages 10 and 12 yrs
-boys: ages 13 or 14 yrs (only once)

157
Q

Signs of scoliosis (3)

A

-uneven shoulders
-curve of spine
-uneven hips

158
Q

how is scoliosis classified?

A

anatomical location (thoracic or lumbar)

159
Q

what is the most common type of scoliosis?
-other types

A

idiopathic (80%)
-seen in adolescent girls during growth spurt ages (10-18yrs; 10-12yr most often, but can be seen earlier)
-other types: congenital, neuromuscular, syndromic

160
Q

at what age does scoliosis tend to occur?

A

ages 8-10yrs, but can occur earlier
-incidence is same in males and females; though, females have 10-fold greater risk of curve progression (seen during growth spurt 10-12yrs)

161
Q

adam’s forward bend test

A

patient stands and bends forward at waist, with the examiner assessing for symmetry of the back from behind and beside the patient

162
Q

at what degree of scoliosis is a Cobb angle required?

A

10 degrees

163
Q

cobb angle measurement

A

measurement for quantifying spine curvature of scoliosis (measured on a standing PA XR of spine)
-described maximum distance degree of side-to-side curvature
*needed for official dx of scoliosis
**no pulmonary impairment is usually seen with Cobb angle <35 degrees

164
Q

scoliosis treatment

A

<20 degrees - observation (unless progression observed)
20-40 degrees - back bracing
>40 degrees - surgery

165
Q

what is the most common cause of severe kyphosis?

A

scheuermann disease

166
Q

pap smear screenings
-when does it start
-how often is the screening

A

-age 21
-every 3 years

167
Q

at what age should a provider obtain a lipid panel with nonfasting nonHDL chol or fasting lipid panel?

A

9-11yrs and 18-21yrs

168
Q

at what age should provider obtain fasting lipid profile if familial HDL newly positive, parent with dyslipidemia, and any other RFs or high-risk conditions

A

12-17yrs

169
Q

when to start screening for BP in pediatric patient?

A

3yrs

170
Q

when to start screening for obesity in pediatric patient?

A

6 years

171
Q

when to start screening for diabetes in pediatric patient?

A

> equal 10 yrs with >equal 2 RFs; should be screened q2yrs

172
Q

when to start screening for scoliosis in female and male pediatric patients?

A

-ages 10 and 12 yrs
-ages 13 or 14 yrs

173
Q

when to start screening for anemia in pediatric patients?

A

annually for RFs
screen those with RFs with Hbg or HCT

174
Q

when to start screening for depression in pediatric patients?

A

> equal 12 yrs with PHQ2 screening (self-report rating scales that are easily used in primary care to assist in assessment and monitoring response to treatment

175
Q

when to start screening for substance use in pediatric patients?

A

> equal 11 yrs with CRAFFT screening

176
Q

when to start screening for tobacco use in pediatric patients?

A

> equal 11 yrs

177
Q

when to screen for chlamydia

A

sexually active females <25yrs annually; retest >equal 3MO after tx

178
Q

when to screen for gonorrhea

A

sexually active females <25yrs annually; retest >equal 3MO after tx
-screen at least annually for sexually active MSM at sites of contact regardless of condom use. screen every 3-6MO if increased risk

179
Q

when to screen for HSV

A

consider HSV serology in men/women coming fro STI evaluation esp if multiple partners

180
Q

when to screen for HIV

A

screen between 15-18yr, at least once; repeat screening if RFs for infection present

181
Q

when to screen for syphilis

A

screen sexually active MSM at least annually and q3-6MO if at increased risk for infection

182
Q

percent of children depressed before adolescence, during adolescence
-when does the rate of depression in females approach adult levels?

A

-1-3% before puberty
-around 8% for adolescents
-age 15

183
Q

What is the HEADSS screening tool used for?

A

to screen for health concerns from the patient
Home
Education/employment
Activities
Drugs
Sexuality
Suicide/depressions

184
Q

what is the third most chronic illness of adolescent girls in US?

A

AN

185
Q

contraindications for VAR vaccine

A

-hx of anaphylactic/anaphylactoid reaction to gelatin, neomycin, or any other component of the vaccine
-blood dyscrasias, leukemia, lymphomas, or malignant neoplasms affecting bone marrow or lymphatic system
-primary or acquired immunodeficiency, inc persons with immunosuppression associated with cellular immunodeficiencies and AIDS or severe immunosuppression associated with HIV infection
-receiving prolonged high-dose immunosuppressive therapy (>equal 2weeks) (steroids, etc.)
-moderate or severe concurrent illenss
-family hx of congenital hereditary immunodeficiency, unless person has been determined to be immunocompetent
-is or may be pregnant

186
Q

vaccinations due at kindergarten

A

Dtap - 5
MMR - 2
VAR - 2
Flu - annual
IPV - 4

187
Q

vaccinations dur at ages 11-12yrs

A

Tdap - 1
Flu - annually
HPV - 1-2 doses; given as early as 9yrs; 2 or 3 shot series
MenACWY - 1

188
Q

vaccinations due at 18+ (college)

A

-MenACWY - 2 total (1 more)
-MenB - 1

189
Q

contraindications of MenB

A

None
Precautions of mod-severe illness with/without fever; pregnancy; latex sensitivity

190
Q

contraindications of MenACWY

A

severe allergic rxn to any Dtap containing vaccine and rubber latex

191
Q

contraindications of Tdap

A

encephalopathy not attributable too another identifiable cause within 7d of administration of previous dose of DTP, Tdap, or DTaP

192
Q

contraindications of HPV

A

pregnancy

193
Q
A

CMN571 (8 decks)

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