PPS Policy Statements COPY Flashcards
Bioactive Components in Breastmilk
lysozymes immunoglobulins hormones growth factors immune function modulators anti-inflammatory components cellular components
Failing to breastfeed in the first 6 mos. of life resulted in _____ increase in diarrheal mortality.
8-10x
Bottle feeding was shown to increase the risk of _____.
otitis media
H. influenzae bacteremia and meningitis
Contraindications to Breastfeeding
galactosemia
illegal drugs
chemotherapy
radiopharmaceuticals
Active TB is a _____ contraindication to breastfeeding.
relative
Breastfeeding should be done after observed treatment with anti-Koch’s therapy for _____.
2 weeks
HIV is a _____ contraindication to breastfeeding.
relative
_____ of expressed breastmilk from an HIV+ mother has been proven to be effective in killing the virus.
Heat Treatment
The WHO/UNICEF launched a 10-step program called _____ in _____.
The Baby-Friendly Hospital Initiative
1992
The Baby-Friendly Hospital Initiative
- written breastfeeding policy
- train health care staff
- inform pregnant women of the benefits of BF
- initiate BF within 30 min. after birth
- initiate BF and maintain lactation
- no food or drink other than breastmilk
- rooming in
- BF per demand
- no artificial teats or pacifiers
- support groups
RA No. 7600
The Rooming-In and Breastfeeding Act of 1992
Maternal employment is significantly associated with _____ of breastfeeding.
early cessation
Challenges to BF in the Workplace
lack of break time
inadequate facilities
lack of resources
lack of support
House Bill No. 6661
Breastfeeding Promotion Act
February 5, 2004
An Act Promoting Breastfeeding by Establishing and maintaining Lactation Stations in Workplaces for Working Mothers, Providing for Penalties for Violation thereof and for other purposes
Breastfeeding Promotion Act
House BIll No. 6661
February 5, 2004
The neural tube usually closes within the first _____ of life.
21-28 days
_____ is the most common major CNS malformation.
Anencephaly
Anencphaly is seen _____ more in females than in males.
37x
_____ of neural tube defects could be prevented with _____.
50-70%, folic acid
Women of childbearing age should be given _____ of folic acid to reduce the risk for neural tube defects.
0.4 mg (400 mcg) daily
RA No. 8976
The Philippine Food Fortification Act
November 2000
Newborn Screening began in _____ when _____ designed an assay for _____.
1961, Dr. Robert Guthrie, phenylketonuria (PKU)
Newborn Screening was introduced to the Philippines in _____.
1996
First Newborn Screening Components
PKU CAH Congenital Hypothyroidism Galactosemia Homocystinuria
Newborn Screening Components
PKU CAH Congenital Hypothyroidism Galactosemia G6PD (1998) MSUD (2012)
Administrative Order No. 1-A s 2000
Policies on the Nationwide Implementation of Newborn Screening
_____ is the act requiring every newborn in the Philippines be offered NBS.
Newborn Screening Act of 2004
_____ is the most common IEM in the Philippines.
MSUD
The incidence of bilateral hearing loss is _____.
1-3 per 1000
Risk Factors for Hearing Loss
birth - 28 days
NICU admission ≥ 48 hours syndromes ear and craniofacial abnormalities family history of sensorineural hearing loss in utero infections
Risk Factors for Hearing Loss
29 days - 2 years
concern regarding hearing, speech, development family history of childhood hearing loss syndromes postnatal infection in utero infections neonatal indicators neurodegenerative disorders head trauma recurrent or persistent otitis media (3 mos.)
_____ is the 3rd leading cause of disability.
Hearing Impairment
Detection of hearing loss at _____ and intervention at _____ prevents or reduces its effects.
3 mos., 6 mos.
5 Elements of Universal Newborn Hearing Screening Program (UNHSP)
screening tracking follow-up identification intervention evaluation
_____, _____ and _____ are among the leading causes of blindness among Filipinos.
poor nutrition, measles, premature birth
_____ deficiency is the leading cause of childhood blindness.
Vitamin A
Vitamin A capsules should be given to _____.
9-11 mo. infants
12-59 mo. children
sick and malnourished children
The WHO global initiative to eliminate avoidable blindness by 2020
Vision 2020: The Right to Sight
1999, Geneva, Switzerland
The AAP advocates eye examination at _____.
birth, all well child visits
The earliest possible age for visual acuity measurement is at _____.
3 y.o.
The act which requires all vehicles to be equipped with seat belts
The Seat Belts Use Act of 1999
In the 5-15 y.o. age group, _____ are the 3rd leading cause of mortality.
traffic crashes
_____ reduce the incidence of wheel locking and skidding.
Anti-Lock Brakes
The _____ located at the front of the car absorbs most of the impact energy in a collision.
crumple zone
_____ are designed to inflate during a crash in order to cushion the passenger at impact.
Airbags
_____ cushion the blow of a side impact.
Side-Impact Beams
_____ prevent the individual’s head from snapping back in rear-end crashes.
Head Restraints
RA No. 8750
The Seat Belts Use Act of 1999
Children _____ of age are prohibited from occupying the front seat.
< 6 years
Specialized child seats are required for children weighing _____.
60 lbs.
8 y.o.
Built-in seat belts may be used for children _____.
> 8 y.o.
Risk Factors for Adolescent VC
lack of driving experience risk-taking behavior use of alcohol and drugs low rate of seat belt use (33%) lack of experience in night-time driving
In Metro Manila, _____ are the 3rd leading cause of motor vehicle injury.
jeepney crashes (6%)
In Metro Manila, _____ are the 4th leading cause of motor vehicle injury.
tricycle crashes (5%)
In Metro Manila, _____ account for 51% of all road injuries.
pedestrian injuries
The leading causes of pedestrian-vehicle collisions are _____.
pedestrians at roadsides
crossing violations
Traffic accidents are the 2nd most common type of accident in the _____ and _____ age groups
1-4 y.o., 5-12 y.o.
Pedestrian Safety Rules
- cross only at corners
- use crosswalks
- follow the green light
- cross with the walk sign
- look all ways before crossing
- watch for turning cars
- never cross between parked cars
- drivers can’t see you
- walk on the L side of the road facing traffic
- use a flashlight or something retroreflective
A bicycle helmet can effectively reduce the occurrence of brain injury by _____.
63-88%
Helmets provide cyclists an equal level of protection from crashes involving _____.
motor vehicles (69%) other causes (68%)
_____ is the leading cause of child injury death in the Philippines.
Drowning
Among Filipino children aged 1-4 y.o., accidents caused by submersion, suffocation and FB ranked _____ overall cause of mortality in 1998.
7th
_____ are the 5th leading cause of mortality in the Philippines in 1995.
Burns
_____ can increase the likelihood of burns.
absence of water supply
low salary
crowding
_____ is the leading mechanism causing burns.
Scalding
_____ causes 10% of the fire deaths worldwide.
Smoking
Fire Safety Measures:
Always have a _____ available in your house.
fire extinguisher
Fire Safety Measures:
Preventing Fire
inspect electrical wirings
circuits should not be overloaded
remove leaves and paper
don’t store flammable liquids near the stove
don’t use alcohol or gasoline to start a fire
put off all candles and lights before bed
do not place candles where they may be toppled over
lamps should not be placed near flammable objects
crush cigarette butts
don’t smoke in bed
keep flammable materials from children
Fire Safety Measures:
When Fire is at Hand
call for help stay close to the floor put a wet cloth over your face close the doors and windows behind you feel the door before opening it know the fire exits
Fire Safety Measures:
When Your Clothes Catch Fire
don't run wrap yourself in a blanket drop to the floor and roll over stay close to the floor in a horizontal position douse yourself with water
_____ is one of the oldest surgical procedures in the world.
Circumcision
In the Philippines, circumcision is largely determined by _____.
peer pressure
religious and cultural influences
More than _____ of Filipinos are circumcised.
90%
_____ is one of the most common chronic childhood diseases.
Early Childhood Caries
Early Childhood Caries is the presence of _____ in _____ in a child _____.
≥ 1 decayed, missing or filled tooth
any primary tooth
≤ 71 mos.
Filipino children have the _____ caries prevalence in the Western Pacific Region.
2nd highest
PPS recommends the use of _____ to prevent dental caries.
fluoride varnish
Postnatal exposure to second-hand smoke has been causally linked to _____.
SIDS
_____ students live in households with members who smoke.
6 in 10
_____ is the single most important location of cigarette smoke exposure.
Home
RA 9211
Tobacco Regulation Act of 2003
RA 8749
Philippine Clean Air Act of 1999
The Philippines is the _____ ranking country in SEA having the most smokers and the _____ ranking in most number of young smokers.
3rd, top
_____ of women smoke while pregnant.
12-22%
Effects of Maternal Smoking
spontaneous abortion low birth weight preterm delivery SIDS ADHD idiopathic MR behavioral problems
In the 10-14 y.o. age group, _____ ranks as the 4th leading cause of overall mortality with a death rate of _____.
injuries undetermined whether accidental or purposefully inflicted, 3.1 per 100,000
Media is taking a larger role as a _____ for many Filipino youths.
surrogate babysitter
Teenagers take _____ of broadcast media weekly.
30 hours
Effects of Media Exposure
violent behavior
high-risk behavior
tobacco use
early onset of sexual activity
Children _____ are developmentally unable to understand the difference between advertising and regular programming.
< 8 years
_____ creates misconceptions about the nutritional value of food and how to maintain good health.
Advertising
In the Philippines, _____ of young children and _____ of adolescents are overweight.
1% (0-10 y.o.)
3% (11-17 y.o.)
_____ is a key component to healthy living and provides many well-documented benefits to children.
Regular Physical Activity
_____ plays an important role in developing good exercise habits in children.
School
_____ is the 2nd leading cause of mortality among Filipino children.
Diarrhea
Diarrhea is closely associated with _____.
poverty
lack of safe water supply
poor hygiene
_____ has been the substantial source of municipal water.
Groundwater (45.5%)
_____ has been the most effective means for the disinfection of public water supply.
Chlorination
Disposal of _____ is a major health problem with _____ being common areas of disposal.
solid waste, open dumpsites
The average first coitus among Filipino adolescents is _____.
18 - males
18.3 - females
_____, rather than Abstinence Only Sex Education, is more effective in helping adolescents make healthy decisions regarding sex.
Comprehensive Sex Education
According to the 2002 Young Adolescent Fertility and Sexual Survey, _____ of youth already had premarital sex.
23%
_____ of adolescents do not use contraception.
74%
Adolescents contribute _____ to the overall fertility.
30%
4 Goals of Comprehensive Sex Education
- Information
- Attitudes, Values, and Insights
- Relationships and Interpersonal Skills
- Responsibility
Groups Addressed by Sex Education:
_____ are those who do not anticipate having sex in the next year.
Delayers
Groups Addressed by Sex Education:
_____ are those who anticipate initiating sex in the next year.
Anticipators
Groups Addressed by Sex Education:
_____ are those who have had 1 sexual partner.
Singles
Groups Addressed by Sex Education:
_____ are those who have had ≥ 2 partners.
Multiples
Retinal vascular development begins at _____.
15-18 weeks AOG
_____ are critical to the development of retinal vessels.
Undifferentiated Endothelial Cells
Exposure to _____ damages developing retinal vessels and temporarily arrests their development leading to _____ and _____.
stress, ischemia, avascularized periphery
Retinal vessels whose development has been arrested resumes development at _____.
30-34 weeks AOG
In ROP, the eye may become inflamed and hazy and exudates may form along the retinal vessels with engorgement and tortuosity of the _____.
posterior pole vessels (Plus Disease)
ROP Zones:
most posterior area, 2x the distance from the optic nerve head to the fovea
Zone 1
ROP Zones:
surrounds Zone 1 with the nasal ora serrata as its nasal border
Zone 2
ROP Zones:
the crescent that Zone 2 did not encompass temporally
Zone 3
ROP Stages:
demarcation line separating the avascular retina anteriorly from the vascularized retina posteriorly with abnormal branching of small vessels immediately posterior to this
Stage 1
ROP Stages:
intraretinal ridge - the demarcation line has increased in volume but this proliferative tissue remains intraretinal
Stage 2
ROP Stages:
ridge with extra-retinal fibrovascular proliferation
Stage 3
ROP Stages:
partial retinal detachment
Stage 4
The primary risk factor for developing ROP is _____ mainly because of _____.
prematurity, incomplete vascularization of the retina
_____ prevents the further progression of ROP by destroying the cells that may release angiogenic factors.
Cryotherapy
Findings in ROP
Myopia (80%)
Strabismus
Amblyopia
_____ is commonly prescribed in the treatment of strabismus and amblyopia.
Eye Patching
Pathogenesis of ROP
disruption in the arborisation of the retinal vasculature → hyperproliferation of retinal vessels
Risk Factors for ROP
↓ AOG, ↓ birth weight
ROP Screening should be done on infants with:
BW < 1500 g
< 32 weeks AOG
BW 1500-2000 g with unstable course
ROP Screening should be done at a minimum age of _____ or within _____, whichever come later.
4 weeks chronologic age
31-33 weeks PCA
_____ is the mainstay treatment of ROP.
Surgery
Good nutrition is linked to _____.
learning readiness
academic achievement
decreased discipline problems
decreased emotional problems
Unhealthy Foods
too salty
too sweet
too oily
too fatty
Non-nutritious foods do not contribute to nutrients that the body needs except _____.
empty calories
The Philippines ranked _____ in terms of worldwide soft drink consumption.
28th
Excessive consumption of soft drinks increases the risk for dental caries because of its _____.
acidity - ↑ dentin permeability and hypersensitivity
Children _____ are at greatest risk for home poisoning due to hand-to-mouth exploratory activities.
< 6 y.o.
_____ are effective in reducing death rate from poisoning.
Child-Safe Containers
Warning labels are considered _____ in reducing deaths due to child poisoning.
ineffective
The ready availability of _____ as commercial products has made poisoning from these substances among the most common non-accidental poisoning cases in the country.
acids and alkali
Top 3 Ingested Poison
1 - household cleaning agents
2 - hydrocarbon
3 - jathropa seeds
The 2 most importnant factors that led to the decrease of unintentional poisoing in the US have been _____
child-resistant closures
safer medications
_____ are among the most common poison exposures in children, 2nd to household products.
Pain Relievers
Approximately _____ of methylsalicylate can be lethal for a young child.
1-2 tsp (5-10 ml)
Toxic effects of iron poisoning occur at doses of _____.
10-20 mg/kg elemental iron
Isoniazid Toxicity:
Minimum Dose
1.5 g
Isoniazid Toxicity:
Seizures
30 mg/kg
Isoniazid Toxicity:
Fatal
80-150 mg/kg
_____ is a matchstick-like firework made of yellow phosphorus, potassium chlorate, potassium nitrate and trinitrotoluene.
Watusi
After ingestion of watusi, _____ should be given.
children - 4-6 egg whites
adults - 6-8 egg whites
Watusi Poisoning Symptoms
hypocalcemia
hypoprothrombinemia
metabolic acidosis
mucosal injury
Lead poisoning is defined as BLL of _____.
> 10 mg/dl
*1 venous specimen or 2 capillary specimen within 12 weeks of each other
Lead is absorbed through _____.
ingestion
inhalation
Up to 95% of absorbed lead is found in _____.
erythrocytes
Lead absorbed in _____ is responsible for bringing lead to the bones along with calcium.
plasma
Lead encephalopathy occurs at BLL of _____
> 70 mg/dl
_____ is the natural or induced production of genetically identical molecules, cells, tissues, plants or animals.
Cloning
_____ is also known as Recombinant DNA Technology or Molecular Cloning where a DNA fragment is transferred to a self-replicating genetic element (bacterial plasmid).
Gene Cloning
_____ is also known as Biomedical Cloning which sources cells from the embryo to produce tissue or whole organs.
Therapeutic Cloning
_____ is also known as Somatic Cell Nuclear Transfer where the embryois allowed to develop to maturity. Chromosomal or genetic DNA is similar to the donor but the mitochondrial DNA is that of the enucleated cell.
Reproductive Cloning
Ethical Arguments in Human Reproductive Cloning
physical harm research standards autonomy conflicts of interest psychological or social harm dignity justice
_____ nations have laws which forbid reproductive cloning.
35
WHO: Orphan Disorders are conditions which affect _____.
< 1000 per 1M
There are _____ orphan disorders.
5000
Philippines: Orphan Disorders are conditions which affect _____.
1 in 20,000
Children should not carry backpacks weighing _____ and never _____.
> 10% of their body weight
4 in. below the waistline
Students carrying _____ of their body weight are more susceptible to low back pain.
> 10-20%
_____ are at a greater risk for developing low back pain from backpacks.
females
younger children
Carrying _____ of the body weight is too much to maintain standing posture in adolescents.
> 15%
Carrying _____ of the body weight is most effective at maintaining balance.
≤ 5%
Sucking satisfies both the nutritive and non-nutritive needs of a child, with greatest occurence at _____.
0-18 mos.
_____ are the most non-nutritive sucking materials used.
Pacifiers
Advantages of Pacifiers
soothes and calms
aids dentition
analgesia for preterm neonates
protective against SIDS
Adverse Effects of Pacifiers
shortened breastfeeding poor latch-on technique nipple confusion altered dental arches altered oral myofunctional structures malocclusion open bite gastroenteritis respiratory tract infection otitis media oral candida asphyxia
Noise intensity is measured in _____, a logarithmic scale wherein a 10 _____ increase represents a 10-fold increase in noise intensity.
decibels
Community Noise is also called _____.
Residential Noise
Environmental Noise
Domestic Noise
Community Noise is the noise emitted from all sources except the _____.
industrial workplace
Safe Level of Community Noise
< 85 dB
_____ is the most prevalent and most damaging source of noise.
Street Traffic
Cars produce noise levels in the range of _____.
67-75 dB
Motorcycles produce noise levels in the range of _____.
72-83 dB
*can reach 120 dB
Tricycles produce noise at _____.
80 dB
Adverse Effects of Noise
impairment of functional capacity
impairment of the capacity to compensate for additional stress
increased susceptibility to harmful effects of other environmental influences
Non-Auditory Effects of Noise
stress
psychological effects
behavioral effects
safety concerns
Auditory Effects of Noise
acoustic trauma
hearing impairment
_____ is the increase in the threshold of hearing characterized as having ringing or buzzing sounds in the ear.
Hearing Impairment
Hearing loss occurs at _____ first.
higher frequencies
_____ is the most common effect of noise on people.
Annoyance
Noise level exposure of _____ is the maximum set point at which adverse effects can result.
85 dB
_____ is the noise present in the workplace.
Occupational Noise
Occupational Noise:
noise whose sound level peaks are ≤ 1 sec. apart
Continuous Type
Occupational Noise:
has a steep rise in sound level to a high peak followed by rapid decay with peaks > 1 sec. apart
Impulsive Type
WHO Recommended Exposure Limit (REL) for Continuous Noise in the Workplace
80-85 dB x 8 hours
WHO Recommended Exposure Limit (REL) for Impulsive Noise in the Workplace
140 dB at any one exposure
Effects of Excessive Occupational Noise
increased risk for coronary heart disease
hypertension
vibroacoustic disease → airway aggression
cognitive impairment
deficits in performance, attentiveness and problem-solving skills
nervousness
aggression
annoyance
work-related injuries
noise-induced hearing loss
_____ accounts for > 16% of disabling hearing loss worldwide.
Occupational Noise
_____ is the precursor to noise-induced hearing loss which is defined as change in hearing threshold of 10 dB or more at 2000-4000 Hz in either ear.
Transient Threshold Shifts
DOH has set a permissible noise level of _____.
90 dB x 8 hours
_____ is the noise derived from leisure activities, many of which are musical in origin.
Recreational Noise
Determining Factors of the Extent of Noise-Induced Hearing Loss
type of noise duration of exposure intensity type of noise environment distance from source physical position individual suscceptibility general health number of other exposures to noise and other ototoxic agents
When using a portable music player, the sound is too loud when _____.
the volume is > 60% of the maximum
one cannot hear conversations
people nearby can hear one’s music
shouting when talking to other people
Set the sound level no more than _____ of the maximum volume for no more than _____.
60%, 30 min./day
For neonates, the maximum average Day-Night Sound Level (DNL) is _____.
55 dB - waking hours
45 dB - nighttime
For neonates in hospitals, the maximum average Day-Night Sound Level (DNL) is _____.
45 dB - waking hours
35 dB - nighttime
At around the _____, the fetus can already perceive, store, and react to auditory information.
23-26 weeks AOG
The _____ is one of the last systems to develop and is more vulnerable to insults than other older systems.
Auditory System
_____ hearing develops later and is therefore more vulnerable.
High-Frequency
The _____ is the target organ of noise.
Cochlea
Sound in the environment travels to reach the fetus through _____.
bone conduction
Effects of Noise > 85-90 dB in Pregnant Women
birth defects low birth weight IUGR prematurity SGA fetal death atypical brain development high freqency hearing loss
Effects of Noise on Infants in the NICU
increased HR, RR, BP and ICP decreased oxygenation annoyance confusion lack of adequate and peaceful sleep
Use of CPAP results in damage to the _____ because noise is amplified inside the incubator.
cochlea
DOH encourages the use of _____ as alternatives to firecrackers and attending _____ rather than personal use of fireworks.
noise-making devices
public fireworks displays
The obesity epidemic is said to be caused by _____
consumption of high energy and high fat foods reduced physical activity increasing urbanization economic growth modernization globalization of food markets
_____ was more prevalent in public schools while _____ was more prevalent in private schools.
undernutrition - public
overnutrition - private
The foods that have been forbidden in childhood may be _____ when the child finally has access to them later on.
overconsumed
A large fast food meal could contain _____ which would require an entire marathon to burn off.
2200 kcal
The most common leisure activities of Filipino children aged 8-10 y.o. are _____.
playing computer games
reading
watching television
Being severely overweight in children is associated with _____.
pseudotumor cerebri slipped capital femoral epiphysis steatohepatitis cholelithiasis sleep apnea
The most significant morbidities for overweight children and adolescents are _____.
psychosocial
Children have a right to _____.
life adequate standard of living parental care and uspport social security a name, nationality and identity information leisure recreation cultural activities opinion freedom of thought conscience religion freedom of association privacy
An estimated_____ children around the world engage in child labor with at least _____ working in agriculture.
246 million, 70%
_____ are the most common workplace hazards.
Physical Environment Hazards
Physical Hazards
temperature or humidity (most common) slip/trip fall hazards noise radiation ultraviolet microwave pressure
RA No. 9231
Anti Child Labor Law
Anti Child Labor Law Features
- prohibit the worst forms of child labor
- provides for the working hours of children 15-18 y.o.
- ownership, usage and administration of the income
- trust fund for the child
- stiffer penalties
- speedy prosecution
Worst Forms of Child Labor
slavery (Anti-Trafficking in Persons Act of 2003)
prostitution
pornography
illegal activities
hazards to the health, safety and morals of a child
The minimum employable age is the Philippines is _____.
15 y.o.
Children below 15 y.o. are not permitted to work unless _____.
they work directly under their parents
they can go to school
the child’s life, safety, health, morals and development are not endangered
Children < 15 y.o. are not allowed to work more than _____.
4 hours/day, 5 days/week
Children 15-18 y.o. are not allowed to work more than _____.
8 hours/day
Not more than _____ of the child’s income may be used for the collective needs of the family.
20%
A trust fund must be set up with at least _____ of the child’s wages whose earnings amount to at least P200,000 anually.
30%
Anti Child Labor Law Penalties
P10,000 - P100,000 fine
30 days - 1 year community service
Child Labor Definition
economic exploitation
likely hazardous
interferes with education
harmful to the child’s health or physical, mental, spiritual, moral or social development
Walker-experienced infants scored _____ on Bayley scales of mental and motor development.
lower
Walker-experienced infants had _____ Denver Developmental Screening Test Results.
abnormal
Inside a walker, the speed of the infant can reach up to _____.
3 feet/sec.
Infants riding a walker may be more prone to burns and poisonings due to _____.
increased access to the kitchen and other dangerous areas
Minor Injuries from Walkers
pinch injuries abrasions contusions lacerations fractures soft tissue injuries
_____ is the most widely consumed psychoactive substance with 120,000 tons of it consumed anually.
Caffeine
Caffeine is a _____ and its effects are mediated through its action on the _____.
xanthine derivative, cerebral cortex and brainstem
At doses of _____, caffeine may increase alertness and wakefulness, faster and clearer flow of thought, better general body coordination, loss of fine motor control and dizziness
100-200mg
At doses of _____, caffeine can cause restlessness, anxiety, irritability, tremors, sleeplessness, headaches, nausea, diarrhea and abnormal cardiac rhythms.
500-600mg
Caffeine Poisoning Symptoms
alternating tension-relaxation of muscles rapid deep breathing nausea vomiting rapid HR shock tremors
Maximum Caffeine Intake
4-6 y.o. - 45 mg/day
7-9 y.o. - 62.5 mg/day
10-12 y.o. - 85 mg/day
_____ has the highest caffeine content among soft drinks.
Mountain Dew (55 mg/12 oz.)
_____ has the highest caffeine content among coffee preparations.
drip brewed coffee (135 mg/8 oz.)
The Magna Carta of Students requires that school authorities endeavor to provide _____ to students.
free annual physical check-ups
Purpose of Annual Check-Ups
identify the high-risk population
fulfill a public health service role
The elements of the medical interview and physical examination prior to issuing a medical certificate are _____.
medical history immunization status language, social and adaptive development height and weight BP and HR full physical examination fine and gross motor development
_____ is the major methodology in minimizing surgical complications.
Pre-Operative Risk Assessment and Evaluation
Pre-operative evaluation is a must for all _____.
surgical procedures
medical testing requiring anesthesia
All patients undergoing a procedure must undergo pre-operative assessment except for _____.
healthy patients requiring nerve blocks, local or topical anesthesia, no more than 50% nitrogen oxide, oxygen and no other sedative or analgesic agents
sedation analgesia or conscious sedation
The greatest risk in pediatric surgeries are _____.
pulmonary and airway complications
High-risk surgical patients are categorized into _____.
cardiovascular risk
non-cardiovascular risk
_____ is the most important component of the pre-operative evaluation.
Medical History
Physical examination for pre-operative evaluation must include _____.
anthropometrics
full min. HR and RR at sleep
Abnormal findings elicited from pre-operative medical history and PE may require _____.
further evaluation
laboratory examination
Routine Pre-Operative Labs
CBC with Hct, diff. ct. an PC
CXR PAL
_____, more commonly known as a preparticipation physical evaluation or athletic screening is often asked of an individual who will indulge in sports activities.
Sports Clearance
Objectives of Sports Clearance
detect medical or musculoskeletal conditions
detect potentially life-threatening or disabling conditions
determine general health
assess fitness level and appropriateness for the sport
counsel and educate children in health related issues
_____ is the leading cause of sports related sudden death in the US.
Hypertrophic Cardiomyopathy
Cardiovascular History for Athletes
exertional chest pain or discomfort syncope or near-syncope shortness of breath exercise-induced fatigue murmur hypertension hypertrophic cardiomyopathy dilated cardiomyopathy long QT syndrome Marfan syndrome arrhythmias family history of premature death or significant disability from cardiovascular disease (< 50 y.o.)
