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Peds EOR > Neurology/Developmental > Flashcards

Neurology/Developmental Flashcards

1
Q

What is Down syndrome?

A

a genetic chromosome 21 disorder causing developmental and intellectual delays

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2
Q

What is Down syndrome?

A

a genetic chromosome 21 disorder causing developmental and intellectual delays

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3
Q

What is the most common chromosomal disorder and cause of mental retardation?

A

down syndrome

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4
Q

What are the characteristic of Down syndrome?

A

characterized by trisomy 21 (most often) or chromosomal translocation

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5
Q

What are the risk factors for Down syndrome?

A

risk factors include advanced maternal age

  • 1:1500 in women under 20
  • 1:25 in women over 45
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6
Q

What is Down syndrome associated with?

A
  • acute lymphocytic leukemia
  • early-onset Alzheimer’s disease
  • atlantoaxial instability
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7
Q

What are the dysmorphic features of Down syndrome?

A
  • microcephaly, flat occiput, flattened face, epicentral folds, flat nasal bridge, upward-slanting palpebral fissures, small nose/mouth, protuberant tongue, low-set/small ears, short neck, excessive nuchal skin, Brushfield spots (small white/grayish spots on periphery of iris), shortened extremities, big gap between first toe (hallux)
  • other = single transverse palmer crease, short fifth finger with clinodactyly
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8
Q

How is Down syndrome dx?

A

Ultrasound

  • prenatal diagnosis = nuchal translucency (weeks 11-14)
  • increased nuchal translucency and a hypoplastic nasal bone in a first-trimester ultrasound

Lab results = prenatal diagnosis
-chorionic villus sampling/amniocentesis

Amniocentesis

  • an amniotic fluid sample is obtained with a fine needle through the abdomen and uterus
  • performed during 15th week of pregnancy or later
  • less risk to the child than chorionic villus sampling
  • usually indicated for mothers> 35 years old

Chorionic villus sampling (CVS)

  • placental tissue sampling is relieved via vagina and cervix
  • usually performed between the 10th and 12th week of pregnancy
  • more risk to the child, but can be performed earlier
  • usually indicated in mothers > 35 years of age

Quadruple screen (normally does some time between the 15th and 22nd): looks for four specific substances: AFP, hCG, estriol, and inhibin-A

  • increased serum beta-human chorionic gonadotropin (B-hCG), inhibin A
  • decreased unconjuaged estiol (uE3), alpha-fetoprotein (AFP)

Postnatal diagnosis

  • fluorescent in situ hybridization (FISH), karyotyping
  • postnatal diagnosis = clinical identification of dysmorphic features
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9
Q

How is Down syndrome dx?

A

Ultrasound

  • prenatal diagnosis = nuchal translucency (weeks 11-14)
  • increased nuchal translucency and a hypoplastic nasal bone in a first-trimester ultrasound

Lab results = prenatal diagnosis
-chorionic villus sampling/amniocentesis

Amniocentesis
-an amniotic fluid sample

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10
Q

What is the most common chromosomal disorder and cause of mental retardation?

A

down syndrome

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11
Q

What are the characteristic of Down syndrome?

A

characterized by trisomy 21 (most often) or chromosomal translocation

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12
Q

What are the risk factors of febrile seizure?

A
  • elevated fever (>38 C)
  • age - potentially due to developing nervous system being vulnerable to fever
  • viral infection (HHV-6, influenza virus)
  • family history - potential genetic component
  • recent immunizations - the absolute risk is small
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13
Q

What is Down syndrome associated with?

A
  • acute lymphocytic leukemia
  • early-onset Alzheimer’s disease
  • atlantoaxial instability
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14
Q

What is the tx of febrile seizure?

A
  • mostly counseling, reassurance, and education the parent, antipyretics help alleviate symptoms of fever
  • further consideration for complex febrile seizures more commonly associated with infection or structure abnormalities
  • consider obtaining EEG though not required
  • may treat with benzodiazepine if lasts > 5 minutes
  • terminate status epileptics with benzo or phenytoin
  • initiate status epileptics protocol if continues
  • rarely develops into epilepsy
  • monitor complex febrile seizures as more likely to recur
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15
Q

What are the most common issues for those affected with Down’s syndrome?

A
  • septal defects between atria
  • duodenal atresia
  • increased risk for acute lymphoblastic leukemia
  • mental retardation and an increased risk for Alzheimer disease
  • sterility in males
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16
Q

How is Down syndrome dx?

A

Ultrasound

  • prenatal diagnosis = nuchal translucency (weeks 11-14)
  • increased nuchal translucency and a hypoplastic nasal bone in a first-trimester ultrasound

Lab results = prenatal diagnosis
-chorionic villus sampling/amniocentesis

Amniocentesis
-an amniotic fluid sample

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17
Q

What is the tx of Down syndrome?

A

prenatal genetic counseling; supportive management of affected body systems

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18
Q

What is a febrile seizure?

A

convulsion associated with an elevated temperature greater than 38 (100.4 F)
-associated with fever without evidence of CNS infection, afebrile seizure history, or metabolic disturbance

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19
Q

What is the most common seizure in infants and young children?

A

febrile seizure

-occurs between 6 months and 5 years of age, with a slight male predominance

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20
Q

What are the risk factors of febrile seizure?

A
  • elevated fever (>38 C)
  • age - potentially due to developing nervous system being vulnerable to fever
  • viral infection (HHV-6, influenza virus)
  • family history - potential genetic component
  • recent immunizations - the absolute risk is small
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21
Q

How are febrile seizure dx?

A

clinical diagnosis

  • consider lumbar puncture if suspicious of meningitis
  • lack of Haemophilus influenza type B or streptococcus pneumonia vaccination
  • physical exam suggesting meningitis or some CNS infection
  • lab may be used for seizure evaluation in the setting of complex febrile seizure
  • do if useful to identify fever source
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22
Q

What is the tx of febrile seizure?

A
  • mostly counseling, reassurance, and education the parent, antipyretics help alleviate symptoms of fever
  • further consideration for complex febrile seizures more commonly associated with infection or structure abnormalities
  • consider obtaining EEG though not required
  • may treat with benzodiazepine if lasts > 5 minutes
  • terminate status epileptics with benzo or phenytoin
  • initiate status epileptics protocol if continues
  • rarely develops into epilepsy
  • monitor complex febrile seizures as more likely to recur
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23
Q

What are the CSF finding on lumbar puncture for meningitis?

A
  • bacterial: increase protein, decrease glucose (bacteria love to eat glucose
  • viral: no specific characteristics but may have lymphocytes

-make sure the patient does not have increased intracranial pressure prior to LP check for papilledema and get a CT scan if you are unsure if there is swelling in the brain (risks include age >60, immunocompromised, AMS, focal near finding or papilledema)

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24
Q

What is the classical triad of meningitis?

A

headache, fever, and a stiff neck (nuchal rigidity)

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25
Q

What are most cases of meningitis caused by?

A

viral infection, but bacterial, parasitic and fungal infections are other causes

  • unlike encephalitis no mental status changes
  • N. meningitidis (most likely if pt. has a rash) = petechiae
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26
Q

What are the physical exam findings of meningitis?

A

Kernig sign - knee extension causes pain in the neck

Brudzinski sign - leg raise when bend neck

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27
Q

What are the bacterial etiologies of meningitis?

A
  • neonate: E. coli (gram-negative rods) and S. agalactiae (group B streptococcus)
  • most people: S. pneumonia (gram-postive diplococci), n. meningitidis (gram-negative diplococci)
  • immunocompromised: cryptococcus neoformans (diagnosis: india ink stain
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28
Q

What are the viral etiologies of meningitis?

A
  • most cases in United States are caused by a group of viruses known as enteroviruses, which are most common in late summer and early fall
  • viruses such as herpes simplex virus, HIV, mumps, West Nile virus and other also can cause viral meningitis
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29
Q

What is the fungal etiology of meningitis?

A

cryptococcal meningitis is a common fungal form of the disease that affects people with immune deficiencies, such as AIDS

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30
Q

How is meningitis dx?

A

spinal tap: increased opening pressure, decreed glucose, increased WBC (neutrophils), increased protein

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31
Q

What is the tx of meningitis?

A

dexamethasone + empiric IV antibiotics (cephalosporin, vancomycin, penicillins)
-household contacts: treat with rifampin, Cipro, Levaquin, azithromycin, ceftriaxone

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32
Q

What is aseptic meningitis?

A
  • etiology: enterovirus, HSV, TB, fungus
  • spinal tap - normal pressure, increased WBC (lymphocytes)
  • treatment: symptomatic of IV acyclovir for HSV
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33
Q

What is a focal seizure with retained awareness (consciousness maintained)?

A
  • this type of focal seizure was previously known as a simple partial seizure
  • no alteration in consciousness
  • abnormal movements or sensations
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34
Q

What is a focal seizures with a loss of awareness (consciousness impaired)?

A
  • this type of focal seizure may also be called a focal dyscognitive seizure (previously known as complex partial seizures)
  • altered consciousness, automatisms (lip-smacking)
  • present with a postictal state (confusion and loss of memory) which differentiate them from absence seizures
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35
Q

What is the tx of focal seizure?

A

phenytoin, and carbamazepine are drugs of choice

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36
Q

When do generalized seizures occur?

A

when there is widespread seizure activity in the left and right hemispheres of the brain
-start midbrain or brainstem and spread to both cortices

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37
Q

What is an absence seizures?

A

(firmly known as petit Mal)

  • characterized by a brief impairment of consciousness with an abrupt beginning and ending
  • at times involuntary movements may occur, buy they are uncommon and the patient has no recollection and witnesses commonly miss them
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38
Q

What are tonic-clonic seizures?

A

or convulsie seizures (formerly known as grand Mal)

  • bilaterally symmetric and without focal onset
  • begins with a sudden loss of consciousness - a fall to the ground
  • tonic phase: very stiff and rigid 10-60 seconds
  • clonic phase: generalized convulsions and limb jerkin g
  • postical phase: a confused state
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39
Q

What is an atonic seizures?

A

also known as drop attacks

-looks like syncope, sudden loss of muscle tone

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40
Q

What is clonic seizure?

A
  • during a clonic seizure, a person may lost control of bodily functions and begin jerking in various parts of the body
  • he/she may temporarily lose consciousness, followed by confusion
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41
Q

What is a tonic seizure?

A

extreme rigidity then immediate LOC, but not followed by a clonic phase

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42
Q

What is a myoclonic seizure?

A

muscle jerking, but not the tonic phase, occurs in the morning

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43
Q

What is a febrile seizure?

A

convulsion associated with an elevated temperature greater than 38, >6 months <5 years, absence of central nervous system infection or inflammation

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44
Q

What is an infantile spasms?

A

type of epilepsy seizure but they do not fit into the category of focal or generalized seizures

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45
Q

What is a psychogenic non-epileptic seizure (PNES)?

A

not due to epilepsy but may look very similar to an epilepsy seizure

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46
Q

What is status epilepticus?

A

a single epileptic seizure lasting more than five minutes or two or more seizures within a five-minute period without there person returning to normal between them
-two forms: convulsive and non convulsive

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47
Q

What is convulsive status epileptics?

A

presents with a regular pattern of contraction and extension of the arms and legs

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48
Q

What is non convulsive status epilepticus?

A

includes complex partial status epilepticus and absence status epilepticus

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49
Q

What is the tx for seizures?

A

benzodiazepines (lorazepam) are the preferred initial treatment after which typically phenytoin is given

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50
Q

When does teething generally occur?

A

between 6 to 24 months of age

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51
Q

What teeth are the first teeth to come in?

A

the two bottom front teeth (lower central incisors) are usually the first to appear, followed by two top front teeth (upper central incisors)

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52
Q

What are the classic signs and symptoms fo teething?

A
  • excessive drooling
  • chewing on objects
  • irritability or crankiness
  • sore or tender gums
  • a slight increase in temperature - but no fever
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53
Q

What is the tx for teething?

A

the management of teething symptoms is palliative (chewing on a chilled [not frozen] teething ring or other teething devices, systemic analgesia)

  • teething rings and other chewing devices should be one piece
  • these devices should not be dipped in sugary substances
  • teething necklaces, bracelets, or anklets that are made of beads should be avoided
  • avoid over-the-counter (including homeopathic remedies) or prescription-strength topical analgesics (lidocaine, benzocaine) for teething pain
  • over-the-counter pain medications such as acetaminophen (Tylenol, others) or ibuprofen (advil, Motrin, others) if especially fussy
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54
Q

What is the routine dental care?

A
  • run a soft, clean cloth over baby’s gums twice a day - after the morning feeding and before bed
  • the cleansing can keep food debris and bacteria from building up in the baby’s mouth
  • when a baby’s first teeth appear, use a small, soft-bristled toothbrush to clean his or her teeth twice a day
  • until children learn to spit - at about age 3 - use a smear of fluoride toothpaste no bigger than the size of a grain of rice
  • then switch to a pea-sized dollop as children approach 2 to 3 years of age
  • the American dental association and the American academy of pediatric dentistry recommended scheduling a child’s first dental visit at or near his or her first birthday
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55
Q

What is Turner syndrome?

A

a genetic disorder caused by missing X chromosome in females (45XO)

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56
Q

What is the most common cause of primary amenorrhea (uterus present)?

A

turner syndrome

-most patients are infertile

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57
Q

What are the most common features of Turner syndrome?

A

features include streak ovaries, short stature, lymphedema, neck webbing, and congenital heart and renal defects

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58
Q

What are the symptoms of turner syndrome?

A
  • amenorrhea
  • short stature
  • webbed neck
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59
Q

What are the physical exam of turner syndrome?

A
  • amenorrhea with a present uterus
  • coarctation of the aorta may be evident on auscultation
  • low hairline in back
  • low-set ears
  • extremity edema
  • hypertension
  • signs of thyroid dysfunction
  • stool guaiac may identify GI bleedng
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60
Q

How is the dx of Turner syndrome made?

A

based primarily on physical exam and patient history

  • labs = low anti-mullerian hormone
  • karyotype analysis is the diagnostic test of choice = may identify 45XO, confirming the diagnosis
  • fertility testing may identify 45XO, confirming the diagnosis
  • endoscopy may identify GI telangiectatic causing lower GI bleeding
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61
Q

What is the tx of Turner syndrome?

A

growth hormone therapy and sex hormones replacement therapy

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62
Q

What is the injury prevention for birth and/or 3-5 days?

A
  • crib safety
  • hot water heaters <120 F
  • car safety seats
  • smoke detectors
  • back to sleep
  • crib safety
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63
Q

What is violence prevention for birth and/or 3-5 days?

A
  • assess bonding and attachment
  • identify family strife, lack of support, pathology
  • educate parents on nurturing
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64
Q

What is nutritional counseling for birth and/or 3-5 days?

A
  • exclusive breastfeeding encouraged (should breastfeed every 2-3 hours)
  • formula as the second-best option (every 3-4 hours)
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65
Q

What is the fostering optimal development for birth and/or 3-5 days?

A
  • discuss parenting skills

- refer for parenting education

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66
Q

What is the injury prevention for 2 weeks of 1 month?

A
  • fall back to sleep

- tummy time when awake: 5-10 minutes 2-3 times per day

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67
Q

What is the violence prevention for 2 weeks of 1 month?

A
  • discuss sibling rivalry

- assess if guns in the home

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68
Q

What is the nutritional counseling for 2 weeks of 1 month?

A
  • assess breastfeeding and offer encouragement, problem solving
  • should be back to birth weight at 2-weeks
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69
Q

What is fostering optimal development for 2 weeks of 1 month?

A
  • recognize and manage postpartum blues

- child care options

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70
Q

What is the injury prevention for 2 months?

A
  • burns/hot liquids

- back to sleep

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71
Q

What is violence prevention for 2 months?

A

reassess firearm safety

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72
Q

What is nutritional counseling for 2 months?

A

after 3 they do not need to eat during the night

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73
Q

What is fostering optimal development for 2 months?

A

parent getting enough rest and managing returning to work

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74
Q

What is injury prevention for 4 months?

A
  • infant walkers
  • choking/suffocation
  • back to sleep
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75
Q

What is the violence prevention for 4 months?

A

reasses

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76
Q

What is the nutritional counseling for 4 months?

A

introduction of solid foods

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77
Q

What is fostering optimal development for 4 months?

A
  • discuss central to peripheral motor devlopment

- praise good behavior

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78
Q

What is the injury prevention for 6 months?

A
  • burns/hot surfaces

- place on back to sleep, but once infant can roll no need to worry about rolling to tummy

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79
Q

What is the violence prevention for 6 months?

A

reassess

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80
Q

What is the nutrional counseling for 6 months?

A

start water and baby food

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81
Q

What is the fostering optimal development for 6 months?

A
  • consistent limit-setting versus “spoiling” an infant

- praise good behavior

82
Q

What is injury prevention for 9 months?

A
  • water safety
  • home safety review
  • ingestions/poisoning
83
Q

What is violence prevention for 9 months?

A

assess parents’ ideas on discipline and “spoiling”

84
Q

What is nutritional counseling for 9 months?

A
  • avoiding juice
  • begin to encourage practive with cup drinking
  • no honey until 1 yo
85
Q

What is fostering optimal development for 9 months?

A
  • assisting infants to sleep through the night if no accomplished
  • praise good behavior
86
Q

What is injury prevention for 12 months?

A
  • firearm hazards

- auto-pedestrian safety

87
Q

What is violence prevention for 12 months?

A
  • discuss timeout versus corporal punishment
  • avoiding media violence
  • review firearm safety
88
Q

What is nutritional counseling for 12 months?

A
  • introduction of whole cow’s milk (and constipation with change discussed)
  • assess anemia, discuss iron-rich foods
89
Q

What is fostering optimal development for 12 months?

A
  • safe exploration
  • proper shoes
  • praise good behavior
90
Q

What is injury prevention for 15 months?

A

review and reassess topics

91
Q

What is violence prevention for 15 months?

A

encourage nonviolent punishments (timeout or natural consequences)

92
Q

What is nutritional counseling for 15 months?

A
  • discuss decline in eating with slower growth

- assess food choices and variety

93
Q

What is fostering optimal development for 15 months?

A
  • fostering independence
  • reinforce good behavior
  • ignore annoying but not unsafe behaviors
94
Q

What is injury prevention for 18 months?

A
  • review and reassess topics

- rear-facing seat until 2 y/o

95
Q

What is violence prevention for 18 months?

A
  • limit punishment to high yield (not spilled milk)

- parents consistent in discipline

96
Q

What is nutritional counseling for 18 months?

A

discuss food choices, portions, “finicky” feeders

97
Q

What is fostering optimal development for 18 months?

A
  • preparation for toilet training

- reinforce good behavior

98
Q

What is the injury prevention for 2 years?

A
  • falls-play equipment

- forward-facing car seat

99
Q

What is violence prevention for 2 years?

A

assess and discuss any aggressive behaviors in the child

100
Q

What is nutritional counseling for 2 years?

A
  • assess body proportions and recommend low-fat milk

- assess family cholesterol and atherosclerosis risk

101
Q

What is fostering optimal development for 2 years?

A

toilet training and resistance

102
Q

What is injury prevention for 3 years?

A

review and reassess topics

103
Q

What is violence prevention for 3 years?

A

review, especially avoiding media violence

104
Q

What is nutritional counseling for 3 years?

A
  • discuss optimal eating and the food pyramid

- healthy snacks

105
Q

What is fostering optimal development for 3 years?

A
  • read to the child
  • socializing with other children
  • head start if possible
106
Q

What is injury prevention for 4 years?

A
  • booster seat versus seat belts

- bike helmets

107
Q

What is nutritional counseling for 4 years?

A

healthy snacks

108
Q

What is fostering optimal development for 4 years?

A
  • read to child

- head start or pre-K options

109
Q

What is injury prevention for 5 years?

A
  • bicycle safety

- water/pool safety

110
Q

What is violence prevention for 5 years?

A
  • developing consistent, clearly defined family rules and consequences
  • avoiding media violence
111
Q

What is nutritional counseling for 5 years?

A
  • assess for anemia

- discuss iron-rich foods

112
Q

What is fostering optimal development for 5 years?

A
  • reinforcing school topics
  • read to child
  • library card
  • chores begun at home
113
Q

What is injury prevention for 6 years?

A

fire safety

114
Q

What is violence prevention for 6 years?

A
  • reinforce consistent discipline
  • encourage nonviolent strategies
  • assess domestic violence
  • avoiding media violence
115
Q

What is nutritional counseling for 6 years?

A

asses content, offer specific suggestions

116
Q

What is fostering optimal development for 6 years?

A
  • reinforcing school topics
  • after-school programs
  • the responsibility is given for chores (and enforced)
117
Q

What is injury prevention for 7-10 years?

A
  • sports safety
  • firearm hazard
  • lap and shoulder safety belt in back seat (8-12 y/o)
118
Q

What is violence prevention for 7-10 years?

A
  • reinforcement
  • asses domestic violences
  • assess discipline techniques
  • avoiding media violence
  • walking away from fights (either victim or spectator)
119
Q

What is nutritional counseling for 7-10 years?

A

assess content, offer specific suggetions

120
Q

What is fostering optimal development for 7 -10 years?

A
  • reviewing homework and reinforcing school topics
  • after-school programs
  • introduce smoking and substance abuse prevention (concrete)
121
Q

What is injury prevention for 11-13 years?

A
  • review and reassess

- child can start sitting in the front seat at 13 y/o

122
Q

What is violence prevention for 11-13 years?

A
  • discuss strategies to avoid interpersonal conflicts
  • avoiding media violence
  • avoiding fights and walking away
  • discuss conflict resolution techniques
123
Q

What is nutritional counseling for 11-13 years?

A

junk food versus healthy eating

124
Q

What is fostering optimal development for 11-13 years?

A
  • reviewing homework and reinforcing school topics
  • smoking and substane abuse prevention (begin abstraction)
  • discuss and encourage abstinence
  • possibly discuss condoms and contraceptive options
  • avoiding violence
  • offer availability
125
Q

What is injury prevention fro 14-16 years?

A
  • motor vehicle safety

- avoiding riding with substance abuser

126
Q

What is violence prevention for 14-16 years?

A

establish new family rules related to curfews, school, and household responsibilities

127
Q

What is nutritional counseling for 14-16 years?

A

junk food versus healthy eating

128
Q

What is fostering optimal development for 14-16 years?

A
  • review school work
  • begin career discussions and college preparation (PSAT)
  • review substance abuse, sexuality, and violence regularly
  • discuss condoms, contraceptive options, including emergency contraception
  • discuss sexually transmitted disease, HIV
  • providing no questions-asked ride home form at-risk situations
129
Q

What is injury prevention for 17-21 years?

A

review and reassess

130
Q

What is violence prevention for 17-21 years?

A

establish new rules related to driving, dating, and substance abuse

131
Q

What is nutritional counseling for 17-21 years?

A

heart-healthy diet for life

132
Q

What is fostering optimal development for 17-21 years?

A
  • continuation of above topics
  • off to college or employment
  • new roles within the family
133
Q

When is the Hepatitis B vaccine given for 0-6 years?

A
  • first dose within first 24 hours of life
  • second dose at 1-2 months
  • thrid dose at 6-18 months
134
Q

What are the characteristics of Hepatitis B vaccine?

A
  • subunit vaccine

- in HBs-Ag positive mothers, the infant should receive the hepatitis B vaccine and hepatitis B immune globulin

135
Q

When is the rotavirus vaccine given for 0-6 years?

A
  • first dose at 2 months
  • second dose at 4 months
  • third dose at 6 months
136
Q

What are the characteristics of the rotavirus vaccine?

A
  • live-attenuated vaccine

- can increase the risk for intussusception

137
Q

When is diphtheria, tetanus, and/or pertussis vaccine given for 0-6 years?

A
  • first dose at 2 months
  • second dose at 4 months
  • third dose at 6 months
  • fourth dose at 15-18 months
  • fifth dose at 4-6 years
  • booster doesr are given starting at 11 years of age
138
Q

What are the characteristics of the diphtheria, tetanus, and/or pertussis vaccine?

A

inactivated vaccine

139
Q

When is the H. influenze type b conjugate given for 0-6 years?

A
  • first dose at 2 months
  • second dose at 4 months
  • third dose at 12-15 months
140
Q

What are the characteristics of H. influenze type b conjugate?

A

inactivated vaccine

141
Q

When is pneumococcal conjugate (PCV 13) given for 0-6 years?

A
  • first dose at 2 months
  • second dose at 4 months
  • third dose at 6 months
  • fourth dose at 12-15 months
142
Q

What are the characteristics of pneumococcal conjugate (PCV 13)?

A

inactivated vaccine

143
Q

When is the poliovirus vaccine given for 0-6 years?

A
  • first dose at 2 months
  • second dose at 4 months
  • third dose at 6-18 months
  • fourth dose at 4-6 years
144
Q

What are the characteristics of the poliovirus vaccine?

A

inactivated vaccine

145
Q

When is the influenza vaccine given for 0-6 years?

A

annually >6 months of age

146
Q

What are the characteristics of the influenza vaccine?

A
  • intramuscular vaccine is an inactivated vaccine

- intranasal vaccine is a live-attenuated vaccine

147
Q

When is the measles, mump, and rubella vaccine given for 0-6 years?

A
  • first dose at 12-15 months

- second dose at 4-6 years of age

148
Q

What are the characteristics of the measles, mump, and rubella vaccine?

A

live-attenuated vaccine

149
Q

When is the varicella vaccine given for 0-6 years?

A
  • first dose at 12-15 months

- second dose at 4-6 years of age

150
Q

What are the characteristics of the varicella vaccine?

A

live-attenuated vaccine

151
Q

When is the hepatitis A vaccine given for 0-6 years?

A
  • first dose at 12-24 months

- second dose given at least 6 months after the first dose

152
Q

What are the characteristics of hepatitis A?

A

inactivated vaccine

153
Q

When is the tetanus, diptheria, acellular pertussis (Tdap) given to 7-18 year old?

A

11-12 years of age

154
Q

What are the characteristics of the tetanus, diptheria, acellular pertussis?

A

inactivated vaccine

155
Q

When is the human papillomavirus to 7-18 year olds?

A
  • two doses at 9-14 years of age
  • in patients between the ages of 9-14, the 2 dose are administered 6-12 months after the first dose
  • three doses at >15 years of age
  • given at 0, 1-2 and 6 months
156
Q

What are the characteristics of human papillomavirus?

A
  • subunit vaccine

- three doses of this vaccine are also recommended in immunocompromised adolescent patients

157
Q

When is the meningococcal vaccine to 7-18 years old?

A
  • first dose at 11-12 years of age

- second dose at 16 years of age

158
Q

What are the characteristics of meningococcal vaccine?

A

inactivated vaccine

159
Q

When is the influenza vaccine given for 7-18 years old?

A

first dose given at 7-10 years of age and then annually

160
Q

What are the characteristics of the influenza vaccine?

A
  • intramuscular vaccine is an inactivated vaccine

- intranasal vaccine is a live-attenuated vaccine

161
Q

When is the influenza vaccine in >18 years of age?

A

one dose annually

162
Q

When is the tetanus, diphtheria, aceullar pertussis (Tdap) or tetanus and diphtheria (tTd)?

A

one dose Tdap and then Td booster every 10 years

163
Q

What are the characteristics of the tetanus, diphtheria, aceullar pertussis (Tdap) or tetanus and diphtheria (tTd)?

A

in pregnant women, 1 dose Tdap should be given during each pregnancy between 27-36 weeks gestation

164
Q

When is varicella given >18 years of age?

A

two doses 4-8 weeks apart if the patient is without immunity to varicella

165
Q

When is the zoster vaccine given >18 years of age?

A

two doses given 2-6 months apart at >50 years of age

166
Q

When is the pneumococcal (PPSV23) given >18 years of age?

A
  • given at least 1 years after PCV13 administration in adults >65 years of age
  • PPSV23 is indicated in patients 19-64 with the following
  • chronic heart disease (excluding hypertension)
  • chronic liver disease
  • chronic lung disease
  • diabetes mellitus
  • cigarette smoking
  • patients >19 with
  • immunodeficiency disorders
  • HIV
  • anatomical or functional asplenia
  • chronic renal failure or nephrotic syndrome
  • cerebral spinal fluid leak
  • cochlear implant
167
Q

What are the characteristics of pneumococcal (PPSV23)?

A
  • PPSV23 is given after PCV13

- PPSV23 is not conjugated and does not stimulate a helper T-cell response

168
Q

What is the motor development for 0-1 month old?

A

moro and grasp reflex, visual tracking

169
Q

What is the language for 0-1 month old?

A

crying

170
Q

What is the social interaction for 0-1 month?

A

minimal

171
Q

What is the motor development for 2 months?

A

holds head up, swipes at objects

172
Q

What is the language for 2 months?

A

cooing

173
Q

What is the social interaction for 2 months?

A

social smile

174
Q

What is the motor development for 3 months?

A

lifting head and chest, moro reflex disappears

175
Q

What is the motor development for 4 months?

A

rolls from prone to supine, grasp objects

176
Q

What is the language for 4 months?

A
  • orients to voice

- colic resolves in most babies by this age

177
Q

What is the social development for 4 months?

A

laughs

178
Q

What is the motor development for 6 months?

A

sits upright

179
Q

What is the language development for 6 months?

A

babbles

180
Q

What is social development for 6 months?

A

stranger anxiety

181
Q

What is motor development for 9 months?

A

crawls, pull-to-stand, pincer grasp, eats with fingers

182
Q

What is language development for 9 months?

A

mama-dada (nonspecific)

183
Q

What is the social development for 9-month-old?

A

waves bye-bye, responds to name

184
Q

What is the motor development for 12 month old?

A

stands

185
Q

What is the language development for 12 month old?

A

mama-dada (specific)

186
Q

What is social development for 12 month old?

A

picture book

187
Q

What is the motor development for 15 month old?

A

walks, uses cup

188
Q

What is the language development for 15 month?

A

severl words

189
Q

What is social development for 15 month old?

A

temper tantums

190
Q

What is motor development for 18 month olds?

A

walks up staris, throws ball

191
Q

What is language development for 18 month olds?

A

names objects

192
Q

What is social development for 18 month olds?

A

toilet-training begins

193
Q

What is the motor development for 24 month olds?

A

runs

194
Q

What is the language development for 24 month olds?

A

2-word sentences, several hundred word vobaculary

195
Q

What is the social development for 24 months?

A

follows 2-step commands

196
Q

What is motor development for 36 month old?

A

rides a tricycle (36 years), eats with utensils

197
Q

What is language development for 36 month old?

A

3-word sentences

198
Q

What is social development for 36 month old?

A

knows first and last name

199
Q

What is the development for 6-11 years?

A

development of conscience (the super-ego), has same-sex friends

200
Q

What is the normal development for girls age 11 and boys age 13 years?

A

abstract reasoning, the formation of personality, may have friends of the opposite sex

Peds EOR (12 decks)

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