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preventative Flashcards

1
Q

previously unvaccinated child, age 8, what do you give to protect against tetanus?

A

Tdap

>age 7

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2
Q

clean contaminated wound, but pt has received less than 3 tetanus vaccines

A

Tdap (if older than 7)

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3
Q

clean contaminated wound, pt has received 3 tetanus vaccines, but last vaccine was over 10 years ago… what do you give?

A

Tdap

OR Td if already received Tdap in the past

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4
Q

dirty contaminated wound, but pt has received less than 3 tetanus vaccines

A

tetanus immunoglobulin
or IVIG if TIG not available
also vaccinate!

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5
Q

dirty contaminated wound, pt has received 3 tetanus vaccines, but last vaccine was over 5 years ago… what do you give?

A

Tdap

OR Td if already received Tdap in the past

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6
Q

when do you give hep B immunoglobulin?

A
  • if mother is infected with HepB (HBsAg positive) or unknown status in the newborn’s first 12 HOL*
  • also to unvaccinated people and infants after needle stick or contaminated blood exposure

*also will need routine immunizations

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7
Q

when do you test for hepatitis in babies born to positive mothers?

A

test at 9-12 mos

**remember these kids need HBIG in first 12 HOL, then regular vaccine timeline

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8
Q

What do you do for a child who was exposed to a needle stick of contaminated blood with hepatitis, but they are previously vaccinated and Ab positive

A

nothing

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9
Q

What do you do for a child who was exposed to a needle stick of contaminated blood with hepatitis, they are previously vaccinated, but they are Ab negative

A

treat them as being unvaccinated

HBIG and vaccinate

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10
Q

what vaccine cause syncope?

A

meningococceal

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11
Q

what is the treatment for measles?

A

IF child is at least 6 months- you can give the measles vaccine if it is within 72 hours of exposures
if you are outside the 72 h window you can give measles IG

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12
Q

what are contraindications to giving the MMR and varicella vaccines? (3)

A

1- severe allergy (neomycin, gelatin)
2- pregnant
3- severely immunocompromised

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13
Q

contraindications to rota vaccine? (3)

A

1- h/o intussuception
2- SCID
3- allergy

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14
Q

what vaccines do you need to worry about in children with egg allergy

A

yellow fever

flu (if egg allergy is severe)

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15
Q

what should water heaters be set at to prevent burn?

A

120 degrees F

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16
Q

adolescents are most likely to drown where?

A

fresh water

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17
Q

what vaccines are given subQ (4)

A

1- MMR
2- varicella
3- MMRV
4- IPV

rest IM

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18
Q

at what age do you not need to immunize with HiB for catch up?

A

5

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19
Q

ppx for child <1 y/o going to Hep A endemic area

A

passive immunization with immunoglobulin 4 weeks prior to travel

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20
Q

ppx for child >1 y/o going to Hep A endemic area

A

vaccine

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21
Q

what is a common side effect of the MMR vaccines

A 
high fever (>103) within 12days that can last for 1-2 days
can also have rash (5%)
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22
Q

what are the live vaccines?

A 
LIVE! Small Yellow Chickens get Sabrin's &amp; MMR!
- small pox
- yellow fever
- varicella
- oral polio (sabins)
- MMR
&amp; rota
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23
Q

can you give the MMR and a PPD at the same time

A

YES
but if you give MMR without PPD, then you need to wait 4-6 wks to place PPD as the MMR can suppress tuberculin activity after a few days

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24
Q

you diagnose a child with varicella - who would you give acyclovir or VariZIG (Ig) to? (5)

A

1- immunocompromised + unimmunized
2- pregnant + unimmunized/neg Ab
3- hospitalized preemie (>28wk) whose mom lacks immunity
4- all hospitalized preemies <28 wks
5- newborn infants whose mother contracted varicella 5 days before birth-2 days after birth

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25
Q

when can you give a child on chemo live vaccines?

A

3 months after you stop chemo

except can give varivax to children in remission from ALL because benefit outweighs risk

26
Q

you diagnose an immunocompetent child >1 y/o with varicella, what do you do to treat

A

give varicella vaccine if it’s within 72 hours of exposure

27
Q

at what age do you not need to immunize with pneumococcal vaccine for catch up?

A

5

28
Q

when do you need to receive 2 doses of the flu vaccine?

A

the first year you receive the vaccine if you are age 6mo-8ys

29
Q

at what age do you screen of HTN

A

3yrs

30
Q

at what age do you screen for cholesterol

A

9-11 yrs

younger (5-9) if risk factors- family hx or high risk condition

31
Q

when do you use a rear-facing car seat?

A

<2 yrs or <20 lbs

position at a 45 degree angle

32
Q

what is the safest seat in a car

A

middle seat

33
Q

at what age can a child sit in the front seat

A

13

34
Q

__% of bicycle-related deaths are d/t head injuries

helmets reduce serious injuries by __%

A

75%

85%

35
Q

what % of households have guns

A

30%

36
Q

what vaccines contain eggs (3)

A

influenza and yellow fever and MMR

no a CI to giving flu

37
Q

what vaccines contain gelatin (2)

A

MMR and varicella

38
Q

what vaccine has component of streptomycin/neomycin(4)

A

OPV and IPV

neomycin- MMR and varicella

39
Q

what is the optimal water fluoridation content

A

0.7 ppm

40
Q

how much fluoride supplementation is needed for a child less than 3

A

6 mos-3yrs

give 0.25 mg only if water fluoridation is <0.3 ppm

41
Q

how much fluoride supplementation is needed for a child less than 6

A

3-6yrs
give 0.5 mg if water fluoridation is <0.3 ppm
give 0.25 mg if water fluoridation is 0.3-0.6 ppm

42
Q

how much fluoride supplementation is needed for a child older than 6

A

give 1 mg if water fluoridation is <0.3 ppm

give 0.5 mg if water fluoridation is 0.3-0.6 ppm

43
Q

what is the most common cause of mortality in kids <1

A

congenital anomalies

44
Q

what teeth erupt first

A

central incisors

then lateral incisors, canines, first molars, second molars

45
Q

what do you consider in a child with one central incisor

A

congenital panhypopituitarism

midline defect

46
Q

what lab tests are indicated for a immigrant child in the US

A 
CBC
lead
G6PD
Hgb electrophoresis
TSH
47
Q

crouzon syndrome

A

brachycephaly, exophthalmos, maxillary hypoplasia, short beaked nose, intracranial anomalies

48
Q

apert syndrome

A

brachycephaly, high cranium, wide-set eyes, midface hypoplasia, choanal stenosis, nasopharyngeal airway, obstruction, symmetrical extremity syndactyly

49
Q

when do you perform and US if you are concerned for developmental dysplasia of the hip

A
  • any questionable exam

- 4-6 wks in girls with breech positioning >34 weeks GA (even if nl exam)

50
Q

when do you get an xray in a child with scoliosis

A

scoliometer measurement >6-7 degrees

51
Q

when do you do bracing for scoliosis

A

30-39 degree curve

52
Q

when do you (definitely) do surgery for scoliosis

A

> 50 degrees

53
Q

at what age do children need to receive 2 flu vaccines

A

previously unimmunized children ages 6 mos- 8ys

54
Q

what is used for Hib chemoprophylaxis?

A

eradicates nasopharyngeal carriage of Hib and dreduces risk of developing invasive disease and/or transmission

*Rifampin 20 mg/kg (max 600) qd x4d

55
Q

who should receive Hib chemoprophylaxis?

A
  • all household contacts with >/= 1 unimmunized or underimmunized contact <4ys
  • all household contacts with child <12 mo who has not completed primary series
  • all household contacts with immunocompromised contact <18 y/o
  • index pt tx with regimen other than ctx who is <2 y/o
  • index pt tx with regimen other than ctx who lives with a child <4 who is underimmunized or immunocompromised
  • close contact in childcare/preschool who spent >4h with index pt for >5/7 days prior to dx
56
Q

what is the definition of what dose of steroids makes CI for child to receive MMR and varicella vaccines

A

> 2mg/kg/d (max 20) for at least 14d

57
Q

which vaccines contain egg antigen

A

flu (proceed with vaccine)

MMR (proceed with vaccine)

58
Q

which vaccine contains streptomycin

A

IPV

59
Q

which vaccines contain neomycin

A

IPV, MMR, varicella

60
Q

which vaccine contains polymyxin B

A

IPV

61
Q

which vaccines contain casein

A

DTaP, Tdap

immunize and observe if severely milk allergic

62
Q

which vaccines contain gelatin

A

MMR, varicella, MMRV, influenza

preventative peds (1 decks)

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