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Kaplan Lectures CCS > PEDIATRICS > Flashcards

PEDIATRICS Flashcards

1
Q

RED EYE

VIRAL: DENDRITIC DO NOT STEROID IT!
BACTERIAL: SELF LIMITING - SALINE
UVEITIS: PAIN - VA DIM - LAMP +
CORNEAL ABRASION: PAIN - STAIN
GLAUCOMA: PAIN - HEENT: ABN PUP RESP*
A

IM:

SCHNELLEN - VISUAL ACUITY*
FLUORESCEIN STAIN LAMP EXAM*

FM:
GRAM STAIN 4 BACT
GIEMSA STAIN 4 CLAM (RETIC OR ELEM BODIES)

OPHTHALMIA NEONATORUM

1-2 SILVER CHEMICAL
2-5 GONO
5-8 TRACHOMA WW1st - COB

FM:

SALINE
SALINE + IM CEFTRIAXONE
ORAL AZYTHROMICIN

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2
Q

IMPETIGO

DZX

CELLULITIS
ERYSIPELAS
VZ

A

IM:

DX VISUAL APPEARANCE*
CULTURE OF THE SKIN LESIONS

MILD:
TOPICAL MUPIROCIN BACITRACIN GENTAMYCIN 
GENERALIZED:
ORAL DICLOXACILLINA 
SEVERE INFECTIONS:
OXACILLIN
NAFCILLIN

ALLERGIES:
RASH: IM IV CEPHAZOLIN
ANGIOEDEMA: MILD PO CLYNDAMICIN SEVERE: IV VANCOMYCIN

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3
Q

RDS *

NASAL FLARING
CYANOSIS
GRUNTING

DZX

PNA
MECONIUM ASP SYNDROME
TTN
NON PULMONARY HYPOGLYCEMIA HYPOTHERMIA METABOLIC ACIDOSIS POLICYTHEMIA

A

MATERNAL AEROBIC CULTURES

UA
CBC
URINE TOXICOLOGY
CXR *

FETAL UMBILICAL ABG CBC D STICK
CPAP BPAP ETI
ENDOTRACHEAL INTUBATION
MULTIPLE DOSE SURFACTANT THERAPY
WEANING AS TOLERATED
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4
Q

GERD

PYLORIC
DUODENAL ATRESIA
ANTRAL WEB
VIRAL GASTROENTERITIS

A

IWU:

CBC
SMA 7
UA
US*
LYTES IMBALANCE

FM:

PYLOROMYOTOMY
FEEDING SLOWLY AFTER SURGERY WITHIN 48 HRS OF SURGERY

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5
Q

VOMITING NEONATE 3 WK

DZX

GERD: THICK FEED + PROKINET
VIRAL
D ATRESIA - D BUBBLE
PYLORIC

A 
IWU:
CBC
SMA7
UA
US *
FM:
NPO/TPN
LYTES FIRST IF + 
PYLOROMYOTOMY
FEEDING SLOW 48 H AFTER
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6
Q

CHILD ABD PAIN*

DZX

GASTROENTERITIS
CONSTIPATION
RLL PA
MES ADENITIS
UTI
APPY
PANCREATITIS
A

IWU:

CBC
UA
SMA7
AXR
CXR
AMYLASE- LIPASE
ABD US*

FM:

IVF LYTES
SURGERY* - APPY
NGT-NPO
PAIN MED
ABX
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7
Q

5 YO* W/ UNKNOWN* IMMUNIZATION STATUS

GENERAL IMMUNIZATION

IPV = INACT POLIO VACC
DPT= DTaP acelular  pertussis
A 
FIRST VISIT: DPT HBV MMR IPV 
HIB IF <5 YO
FU INTERVAL 1 MO DPT
2MOS HBV-IPV 
8 MOS HBV IPV
4-6 YRS ANOTHER DPT or DTaP BE4 ENTRY SCHOOL
IPV DOES NOT NEED 3RD DOSE AFTER 4 YO
11-12 YO MMR
VZ SINGLE DOSE IF NOT IMMUNE
Td RATHER THAN DPT IF > 7 YO 
Td EVERY 10 YRS
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8
Q

INSUSCEPTION

> 2YO
SEC: LYMPHOMMA FOREING B
MECKEL, POLYP

A

CBC
AXR
ABD US*
BARIUM ENEMA *

FM:
IF > 48 HR = PERF -SURGERY

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9
Q

8 YO O->
PAIN IN GROIN INNER THIGH

DZ X

SEPTIC ARTHRITIS
SCFE O>, OVER WT, ENDOC : SPINNING HEAD
JRA
STRESS  FRACTURE
TUMOR
CONVERSION REACTION
A

IWU:

IDP STANDING AP FROG LEG, LATERAL XR PELVIS*
CBC
ESR

FM:

PHYSICAL THERAPY
CONTAINMENT OF FEMORAL HEAD

LEG CALVE PERTHES > 6 YO POOR PROGNOSIS

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10
Q

FTT 5th PERCENTIL

EXTREME OF NORMAL EXCLUSION DZ*
PRIMARY SHORT STATURE
SECONDARY SHORT STATURE

HYPOTHYROIDISM: REPLACE T4, CORTISOL AND GH AS INDICATED.
CONSTITUTIONAL DELAY TESTOSTERONE IN SELECTED PATIENTS
FAMILY SHORT
CHRONIC CONDITIONS
DWARFISM
TURNER GH/OXANDROLONE SEX HRT.

A

IWU:

CBC
SMA 18
ESR
UA

TSH AND TRH
X RAY LEFT HAND WRIST ASK PARENT PATTERN CONSTITUTIONAL DELAYED GROWTH
IGF 1: CHRONIC ILLNESS + MALNUTRITION

FM:
REVIEW OLD RECORDS: NORMAL GROWTH VELOCITY
DROWN CROSSING THROUGH A NORMAL CURVE TO A LOW PERCENT IS GROWTH FAILURE*

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11
Q

GERD

VOMITTING
FTT
ATYPICAL SXS

A 
IWU:
SMA 18
UA
CXR
BARIUM*
TE FISTULOGRAPHY
HEM STOOL

FWU:
PH *
UPPER ENDOSCOPY

FM:
FOOD: SMALL THICK FREQs
POSITIONING ANTACIDS H2 BLOCKs
PRO KIN CISAPRIDE
PPIs
SURGERY FUNDOPLICATION
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12
Q

AMS
FALL BED
NEURO: UNRESPONSIVE LETHARGY
PE: FUNDOSCOPY*

CHILD ABUSE DZ X
MENINGITIS
ACCIDENTAL
SUBDURAL HEM AND RETINAL HEMO
METABOLIC RICKETS
IMMUNOLOGY ITP, SCHONLEIN HENOCH
HEMATOLOGY HEMOPHILIA, WwD
CONG MONGOLIAN SPOTS
OSTEOGENESIS IMPERFECTA BLUE SCLERAE 
BRITTLE BONE DISEASE
A 
IWU:
CBC
LFT
AMYLASE LIPASE
UA
CK
BLEEDING TIME
SMA 7
CT SCAN HEAD*
FM:
SKELETAL SURVEY
DRAINAGE OF SUBDURAL HEMATOMA
DIVISION OF YOUTH AND FAMILY SERVICES
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13
Q

FEVER 5DYS AND RASH MCLN SYND.
4/5: CRASH AND BURN*
PE: WORRISOME TKC GALLOP

DZ X
JRA
INFANTILE PAN
KAWASAKI
MYOCARDITIS VIRAL
LEPTOSPIROSIS
POSTREPTOCOCCAL DISEASE
DRUG TOXICITY
SJS: Mycoplasm, Sulf, Phenit
A

IWU:
CBC WBC
UA PROT

FWU:
2D ECHO CUTOFF  MORTALITY DIAM> 8 MM
ESR
CXR
EKG +
CRP A1 ANTITRYP HYPO ALBUMIN

TX:
IVIG FEBRILE LOWER CAD
HIGH DOSE 100 mg/kg SALICILATES
IF PERSISTENT LARGE ANEURYSM WARFARIN HEPARIN

FU:
STRESS TESTING AND ECHO CARD IF PERSISTENT CAD

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14
Q

OMA
MOPS

COMPLICATIONS
MASTOIDS
EFFUSION
MENINGITIS
HEARING LOSS
SLOWED SPEECH
LEARNING DISORDER
A 
INSUFFLATION*
TYMPANOMETRY
AMOXICILLIN FIRST LINE
W/ BETA LACTAMASE INHIB > 24 HRS IF PERSIST FEVER 
ANALGESIC
FU
2 WKS 
TUBE TYMPANOSTOMY IF 
LEARNING OR SPEECH
EFFUSION 4WK
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15
Q 
PICA 
MOVED OLD HOUSE*
COGNITIVE OR MS IMPAIRED*
IQ TO MEMORY TOP READING DISABILITY
PE: PALLOR AND II/VI M

LEAD POISONING

FANCONI SYND
PERIPHERAL NEUROPATHY
LATE:
INTRACTABLE SEIZURES ENCEPHALITIC
PERMANENT DISABILITY

DZ X

IRON DEF DZ X BASOPHILIA + FE STUDIES

HEPATITIS A AMS = LIVER DAMAGE = PT PROLONG HOSPITALIZE HIM + EXCLUDE SCHOOL FOR 1 WK

HYPOGLIC AMS = COCKTAIL D10%-50% BOL FB D5% INF OLDER DIAZOXIDE OR OCTEOTRIDE
THYROID

A

IWU:

CBC
BLOOD LEAD LEVEL*
LYTES
TSH
GLUCOSE
LFTs
PERIPHERAL SMEAR *
SERUM FERRITIN
BASICALLY Ca Na EDTA CHELATION TEST 4 RESPONSE EVAL

TX:
IVA
HYDRATE - NSS
Ca Na EDTA

15-19 SCREEN EVERY 3-4 MOS
>20 REMOVE FROM + LEAD ABATE AGENCY 
>45 URGENT MEDICAL ATTENTION 
ADD DIMECAPROL IF LEAD > 50 FOR RAPID CHELATION
59-69 EDTA or SUCCIMER
>70 INPATIENT
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16
Q

ASTHMA

CROUP

EPIGLOTTIS 
FOREIGN BODY ASPIRATION
ALLERGIC REACTION 
BRONCHIOLITIS
PNEUMONIA
A

IM :

OXYMETRY
PEAK FLOW 70%

FM:
OXY BY CATH
ALBUTEROL NEBULIZER
ORAL PREDNISONE
ABG NOT ROUTINE
IF OXY <95

FM:
CXR

OUTPATIENT MGMT
AVOID TRIGGERS

MILD INTERMITTENT SABA - LESS 2/WK 1/DY
MILD PERSISTENT SABA + LOW DOSE ANTINFLAMMATORY ICS OR CROMOLYN - MORE 2/WK LESS 1/DY

DAILY SXS
MODERATE PERSISTENT SABA + ICS MEDIUM TO HIGH DX + LABA
SEVERE PERSISTENT: FREQ HOSPIT + PO STEROID

17
Q

FBA

A

> 4YO
RIGHT MAINSTEM
CXR
RIGID SCOPE

18
Q

EPIGLOTTIS
3D: DROOLING DYSPHAGIA DISTRESS RESP
Hib 2 -7 YO
TRIPOD

A 
IWU:
L- NXR: THUMBPRINT*
AIRWAY CONTROLLED CONDITIONS
BLOOD CS
EPIGLOTIS CS*
ABx 3rd G CEPHALOSPORIN -AMOXICILLIN SULBACTAM
19
Q

CROUP

3 MOS TO 5 YO
PARAINFLUENZA

A 
IWU
AP NXR: STEEPLE* 
FM:
MILD:
CONT HUMIDIFICATION HOT OR COLD
SEVERE:
RACEMIC EPI + DEXAMETHASONE BOLUS SINGLE IM
OBSEVE 4 TO 6 HRS NO REBOUND = DISCHARGE
20
Q

PAINLESS ABDOMINAL MASS
HBP

WILMS NEUROBLASTOMA

DZ X

RENAL VEIN THROMBOSIS
CHOLEDOCAL CYST
ECTOPIC KIDNEY OR HORSESHOE
PANCREATIC CYST
FECAL MATERIA
TERATOMA
RENAL VEIN THROMBOSIS

ASOCIATIONS
WAGR 11 seq
BECKWITH WIDEMAN

OVERALL 5Y SV R
80% LOCAL
50% WIDESPREAD

A

IWU:

CBC
UA*
ABD US*
U CATHECOLAMINES VMA-HOMO VMA R/O NB
SMA 6 
LFT
FDP:
MRI: RENAL VEIN, CONTRALATERAL KIDNEY AND LIVER.
CT CHEST
ECHO CARDIOGRAM: R/O  T IN THE RA 
BX: SURGICAL SPECIMEN 4 11p13 del
COAGULATION STUDIES R/O Adq VwD
LAPAROTOMY

CHEM X 15 MOS

ACTINOMYCIN D + VINCRISTINE

21
Q 
RASH JOINT PAIN HANDS*
MISSING 11-12 YO MMR BOOST
PE: LAD RETRO AURICULAR
MILD CONJUNCT
RASH CONFLUENT ENTIRE FACE BEHIND EARS
ERITHEMA PAPULES
ENTIRE TRUNK

RNA TOGA VIRIDAE

DZX

RUBELLA 3 DYS MEASLES 
ROSEOLA INFANTUM
MEASLES CONJUNCT &amp; FEVER HIGHER 
SCARLET FEVER
INFECTIOUS MONONUCLEOSIS
A

IWU:
CBC

FWU:

RUBELLA SPECIFIC IgM TITER*
IgG TITER*
SERUM EBV ANTIBODIES

FM:

INCUB 14 -21 DYS
CONTAG 2 DYS BE4 RASH LASTS 3 DYS
EXCLUDE FROM SCHOOL 7 DYS AFTER RASH APPEARS

22
Q

ROSEOLA INFANTUM(EXANTHEMA SUBITO)
HHV6
6-15 MOS
FEVERFOR 3 TO 4 DYS

A

POST OCC LAD

5-6 DYS

23
Q 
SCARLET FEVER
PE:
AXILA GROIN NECK THE GENERALIZES
STRAWBERRY TONGUE -SANDPAPER LIKE RASH
PASTIA LINES - CIRCUMORAL PALOR 
MILIARIA SUDAMINA
A 
IM:
RAPID STREPT TEST: STREP BETA HEM G A PHARYNX
TITER's STREPTOLISIN SERIC - O ....
OFF DAY CARE OR SCHOOL 
24 HRS OF APPROPRIATE TX
PENICILINE G
ALLERGIES:
ERITHROMICINE
FIRST GENERATION CEPHALOSPORINE
CLINDAMICINA
24
Q

VZ*

RESP - PHARYNX - VIREMIA

DZ X

IMPETIGO BULLOUS OR STAPH
FOLLICULITIS
HFM SYND
DISEMINATED HSV

A

IM:
SUPPORTIVE
NON ASPIRIN COUNSEL REYES SYND
ACYCLOVIR: HIGH RISK CASES

PEP IVIG:
NEWBORNS EXPOSED MATERNAL VZ
INMUNOCOMP CHILDREN
PREGNANT WOMEN

FU:

RETURN TO DAY CARE WHEN AL LESIONS HAVE DRIED AND CRUSTED

25
Q

DISEMINATED HSV

ECZEMA HERPETICORUM

A 
IM:
TZANCK
PCR 4 HSV
ACYCLOVIR 
COVER LESION TO ATTEND DAYCARE OR SCHOOL
26
Q

HFM - SYND COXSACKIE A 16
PE:
ULCERS OROPHARYNX
LESIONS HAND FEET AND BUTTOCKS

A

SUPPORTIVE
CAN ATTEND SCHOOL
CAREFUL WASHING AND HYGIENE

27
Q

RSV*
BRONCHIOLITIS
2 % HOSP MORTALITY
SMALL AIRWAY AAA

DZ X

CHLAMYDIA
BACTERIAL PNA
ASTHMA
RSV

A

IWU:
CXR AAT + INTERSTITIAL
NASO SWAB RAPID Ag DETECTION TEST
PCR OR VIRAL CS SMEAR URT 4 SRV

SYMPTOMATIC TX
ADMIT 4 OBSERV
INPATIENT: RR> 60 OR < 3MOS, CHD, NEUROMUSC, IMMUNE, CHRONIC LUNG DISEASE - CLD

IM:
OXYGEN
ALL CHILD WHEEZING: AEROSOL ALBUTEROL TRIAL AND MOVE THE CLOCK’ AND UPDATE NURSE NOTE
AEROZOLIZED RACEMIC EPINEPHRINE

FM:
HIGH RISK TOO SICK PTS:
RIBAVIRIN SMALL PARTICLE AEROSOL
OXYGEN X 24 HRS X 3-5 DYS ADMIN EARLY

RSV IVIG PALIVIZUMAB: ALL <2 MOS, PRETERM, CLD
DO NOT USE IN CONGENITAL HEART DISEASE CHD

28
Q

BACT PNA*

TRIAD:
FEVER COUGH TACHIPNEA

BIRTH TO 2 MOS
GROUP B STREP
E. COLI
LISTERIA

A 
IWU:
CBC
CXR*
ABG
OXYG/M

FM:
COMPLETE SEPTIC WORK UP INCLUDE CSF*

TX:
AMPICILLIN + AMINOGLUCOSIDE
AMPICILLIN 3 rdG + CEPHALOSP

CLAMIDIA 6 MO TO 6 YO “STACCATO COUGH”
ERYTHROM X 14 DYS
MYCOPLASMA: AZYTHROMYCIN + CLARITHROMYCIN

29
Q

HSP W/ ACUTE ABDOMEN

PE PURPURA* + EDEMA 25%

SCROTAL EDEMA TORSION TESTICULAR
BOWEL INTUSUSCEPTION OR PERFORATION*
RENAL ACTIVITY 1% CHRONIC
ARTHRITIS
SEIZURES

PATH
IgA MEDIATED VASCULITIS
NON THROMBOCITOPENIC BUT LEUCOCYTOKLASTIC PURPURA

DZ X
ITP BUT PLATELETS
SEL ANA SMIDTH C3 C4

RMSF 3 HA FEVER PALE ROSE RASH INDIRECT IF Ab ASSAY DELAY + DEATH TX: TETRACYCLINE OR DOXICYCLINE

KD CRASH BURN - IVIG + HD ASA - ECHO FU

MENINGO PETECHIA PURPURA FUMINANS 16 %

JRA EXTRARTIC INITIAL: FEVER FEW MOS
SALMON PINK EVANESCENT RASH
FIRST LINE: NSAIDS

A

IWU:

FOBT
CBC
ESR
UA*

OUTPATIENT POSSIBLE:
DIET BLAND
STEROID 
SUPPORT
ACETAMINOPHEN
FM:
ADMIT 4 COMPLICATIONS 
ADB PAIN OR NEPHROTIC 
SURGERY CONSULT INSUSCEPTION
BE CONSEQUENT : AXR,NPO,NGT,TPN .....

FU:
RENAL FUNCTION

30
Q

ACNE VULGARIS

DZ X

SEBORRHEA GREASY ERYTHEMA YELLOW SALMON COLORED PLAQUES FROM DIAPER TO FACE TRUNK NECK SEBACEOUS RICH AREAS
MALAR RASH

ROSACEA >30 YO NOSE FOREHEAD CHIN NO COMEDONIAN
TOPICAL METRO OR PO TETRA
TELANGIECTASIA ERYTHEMA PAPULES PUSTULES
TOP NON GLUCOCORT

A

IA:

CAREFUL HX
FACTORS THAT INFLUENCE FLARES OF SKIN CHANGES
DIET, STRESS, MENSES, TOPICAL MED, FACE CARE, COSMETICS, ANTIBACTERIAL SOAPS, LOTIONS.

FM:

BENZYL PEROXIDE TOPICAL
TOPICAL
(PREFERED) CLYNDAMICIN/ ERYTHROMYCIN 
PO DOXICYCLINE TETRACYCLINE  
PLAIN SOAPS

U BHCG

CONTRACEPTION 1 MO AFTER AND BE 4 ISOTREONIN
ISOTREONIN: SEVER NODULO CYSTIC
LOW DOSE INTRACYSTIC MID POTENCY GLUCOCORTICOID INJECTIONS

31
Q

KNEE PAIN - DISCOLORATION TX W RICE
TRAUMA INDUCED DELAYED BLEEDING IN DEEP TISSUE*

DZ X HEMARTHROSIS

VwD: TXX - FFP, CRYOPRECIPTATE OR DDAVD
HEMOPHILIA
INFECTIOUS ARTHRITIS
TRAUMATIC INJURY/LIGAMENT TEAR

LONG TERM COMP:
PRONE TO FACTOR V III Ab RESISTANCE
CRYPRECIP ARE POOLED FROM MULT DONORS AIDS AND HEP C

DDZ:

MILD TO MODERATE HEMOPHILIA

A

IWU:

CBC
PT NORMAL!!! EXTRINSIC F II V VII X LIVER
PTT PROLONGED!!! INTRINSIC F VIII IX XI XII HEMOPHILIA*
INR
FIBRINOGEN
ASPIRATION OF KNEE

CLINICAL THINKING:
YOUNG MALE X LINKED RECESSIVE
MILD HEMOPHILIA OR FACTOR INHIBITOR
TO BE OR NOT TO BE

FWU:

MIXING STUDIES: DOES CORRECT *
BLEEDING TIME
FACTOR LEVELS 5% OF NORMAL FACTOR VIII

FM:
INFUSION OF FACTOR VIII CONCENTRATE OR CRYO PRECIPITATED TO RAISE FACTOR VIII TO 25 % OF NORMAL
IMMOBILIZATION OF THE JOIN
ORTHOPEDIC AND PHYSICAL THERAPY FOLLOW UP

32
Q

ROTAVIRUS WATERY STOOLS ES FOBT POS
WINTER
CAN CAUSE DEATH

DZ X

SHIGELA WBC PMN BANDS
APPY
VIRAL ENTERITIS
PROTOZOA: ENTAMOEBA, GIARDIA, CRIPTOSPORIDIUM
INTUSUSCEPTION
A

IWU:

CBC WBC LYMPHO
LYTES, BUN - CREA, GLUCOSE Na 133 K 3.5 Cl 100 BIC 15 BUN 20 CREA 0.7 A GAP 18
FOBT + BUT FECAL LEUKOCYTES NO DZX SHIGELLA
UA GRAVIDITY >1030

FM:
ENZYME IMMUNOASSAY 4 ROTAVIRUS*
STOOL CULTURE

33
Q

LEADING CAUSE OF DEATH BIRTH TO 10 YO

A

CONDITIONS ORIGINATING IN PERINATAL PERIOD
CONGENITAL ANOMALIES
SUDDEN INFANT DEATH SYNDROME UNINTENTIONAL NON MVA
MVA

34
Q

INTERVENTIONS CONSIDERED FOR THE PERIODIC HEALTH EXAMINATION

SCREENING

A 
HT and WT 
BP
VISION SCREEN AT AGE 3-4
AT BIRTH
ELECTROPHORESIS Hgb
Phe LEVEL 
T4, TSH
35
Q

INTERVENTIONS CONSIDERED FOR THE PERIODIC HEALTH EXAMINATION

COUNSELING

A 
SAFETY CAR SEATS < 5 YO
LAD SHOULDER BELTS > 5 YO
BICYCLE HELMET BICYCLING NEAR TRAFFIC
SMOKE DETECTOR
FLAME RETARDANT SLEEPWEAR
HOT WATER HEATER TEMPERATURE <120-130F
WINDOWS/STAIRS GUARDS POOL FENCE
SAFE STORAGE
FIREARMS MATCHES TOXINS DRUGS
SYRUP IPECAC POISON CONTROL PHONE NUMBER
LIMIT FAT AND CHOLESTEROL MAINTAIN CALORIC BALANCE EMPHASIZE FRUITS GRAINS VEGETABLES
AGE >2 YO
REGULAR PHYSICAL ACTIVITY
CPR FOR CAREGIVERS/PARENTS
36
Q

VACCINES

A 
DTP
OPV
MMR
Hib CONJUGATE
HB 
VZ
PCV
OCULAR PROF AT BIRTH
37
Q

HIGH RISK POPULATION

A 
PRETERM 
LOW INCOME IMMIGRANTS
INFANTS OF MOTHERS AT RISK OF HIV
TB CONTACTS
NATIVE AMERICAN/ ALASKA NATIVE
TRAVELLING TO DEVELOPING COUNTRIES
LONG TERM CARE FACILITIES RESIDENTS
CERTAIN CHRONIC MEDICAL CONDITIONS
INCREASE INDIVIDUALS OR COMMUNITY LEAD EXPOSURE
INADEQUATE WATER FLUORIDATION
FAMILY HISTORY OF SKIN CANCER NEVI FAIR SKIN EYES HAIR
38
Q

POTENTIAL INTERVENTION FOR HIGH RISK

POPULATION

A 
Hb Hto
HIV TESTING
PPD
HEP A 
PCV
INFLUENZA
BLOOD LEAD LEVEL
DAILY FLUORIDE SUPPLEMENT
AVOID EXCESSIVE MID DAY SUN - SUN PROTECTIVE CLOTHES

Kaplan Lectures CCS (17 decks)

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