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Pediatric Board Prep > Preventative Pediatrics > Flashcards

Preventative Pediatrics Flashcards

1
Q

What are high risk factors that should prompt initiation of statin therapy if lifestyle modification does not improve cholesterol? (7)

A
  1. Type 2 diabetes
  2. BMI > 97 percentile
  3. HTN requiring tx
  4. cigarette smoking
  5. chronic renal disease
  6. post renal/ heart transplant
  7. Kawasaki disease with current coronary aneurysm
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2
Q

What tetanus prophylaxis should be given to an adolescent (10-18 years) who requires tetanus toxoid containing vaccine as part of wound management?

A

Tdap (to include pertussis if has not received as adolescent)
(if clean wound, if no tetanus in 10 years)
(if contaminated wound, if no tetanus in 5 years)

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3
Q

How many doses of Hib is required for a child aged 15-59 months who was not previously vaccinated?

A

1 dose

should receive 2 or 3 doses depending on manufacture at 2, 4 and 6 months old

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4
Q

How many doses of PCV13 (Prevnar) are required for a child aged 24-59 months of age who was not previously vaccinated?

A

1 dose

should receive 4 doses if less than 24 months old at 2, 4 and 6 months and then 12-15 months old

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5
Q

What vaccines must be administered intramuscularly? (4)

A
  1. hep B
  2. DTaP
  3. Hib
  4. PCV 13
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6
Q

What vaccine must be administered subcutaneously?

A

MMR and Varicella

IPV can be either

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7
Q

If MMR, varicella and/or live attenuated intranasal influenza vaccine are not given at the same time, how long do you need to wait before giving the other live parental vaccine?

A

28 days

if given before, can result in decreased efficacy & impaired immune response

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8
Q

True or false. A child who has received a Hib vaccine at > 15 months of age does not require another Hib vaccine regardless of number of prior Hib vaccines.

A

True

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9
Q

What is the oldest age a patient can receive their rotavirus vaccine?

A

8 months 0 days old

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10
Q

At what age and interval do children routinely receive their Hep A vaccination?

A

starting at 12-23 months old with 6 months between the 2 doses

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11
Q

What vaccines are not indicated for a child older than 5 years old whose immunization status is unknown or never started? (3)

A
  1. Hib
  2. Prevnar
  3. Rotavirus
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12
Q

What is the typical characteristics of varicella in previously vaccinated children (known as break through varicella)?

A

predominately maculopapular rather than vesicular, occurring anywhere, usually less than 50 lesions

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13
Q

Why are children given MMR and varicella as vaccinations separately during ages of 12-23 months old?

A

increased risk of fever and febrile seizures at 5-12 day postvaccination

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14
Q

What complication has been reported with the administration of Influenza or Menactra (MCV4) vaccinations?

A

Guillain-Barre syndrome

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15
Q

At what age, should a preterm infant weighing less than 2 kg receive their first HepB vaccine?

A

1 month of age (or hospital discharge if comes 1st)

prior to that, less chance of seroconversion

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16
Q

What vaccine is required to be stored frozen between -50 degress and -15 degress C?

A

Varicella

MMR can be frozen or refrigerated

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17
Q

What is the recommendations for PPSV23 vaccine?

A

given to kids with congenital or acquired asplenia (including sickle cell) at > 2 years old and 8 weeks after last PCV13 vaccine; 2 dose series 5 years apart

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18
Q

Which patients should receive Menveo (meningococcal vaccine available for infants) starting at age 2 months? (4)

A
  1. HIV pts
  2. Sickle cell
  3. functional or anatomic asplenia
  4. complement deficiencies

(given at 2, 4, 6, and 12 months of age)

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19
Q

Treatment with what therapeutic agent requires administration of MMR and varicella vaccine to be delayed and for how long?

A

IVIG and transfusion of blood products; for 3-11 months after receiving IVIG

(will need repeat dose if vaccine given less than 2 weeks prior to IVIG)

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20
Q

What are contraindications for pertussis-containing vaccine?

A
  1. Encephalopathy within 7 days of previous vaccination

2. Anaphylaxis

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21
Q

What are contraindications for rotavirus vaccine? (2)

A
  1. History of intussusception
  2. SCID (Severe combined immunodeficiency)
  3. Anaphylaxis
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22
Q

What is the current recommendation for the use of pneumococcal vaccines in sickle cell patients?

A

PCV13 at 2, 4, 6 and 12 months of age

PPSV23 at 2 years old followed by 2nd dose 5 years later

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23
Q

What is the most common adverse effect of pertussis-containing vaccines?

A

extreme irritability and crying for an extended period of time (> 3 hours)

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24
Q

What is the most likely diagnosis of a pt presenting with whitish lines running across chalky-brown, discolored and pitted teeth?

A

Fluorosis (excessive fluoride)

  • use rice grain size fluoride toothpaste after 1st tooth eruption
  • use pea size fluoride toothpaste after 3 years old
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25
Q

What are the contraindications for varicella vaccination?

A
  1. Anaphylaxis
  2. Severe immunosuppression
  3. pregnancy (possible pregnancy in 4 weeks)
  4. IVIG

(can give varicella and MMR to HIV pts with Tcell count > 15%)

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26
Q

What is the recommendation for HPV vaccination in pt less than 15 years old?

A

start at 11-12 years old, 2 doses 6 months apart

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27
Q

What is the recommendation for HPV vaccination in pt older than 15 years old?

A

3 doses, 2nd dose 1-2 months after 1st, 3rd dose 6 months after 1st

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28
Q

What is the most frequently reported vaccine associated with post-vaccination syncope?

A

HPV vaccine

due to vasovagal

29
Q

What is the typical sequence for eruption of primary teeth?

A

mandibular (lower) central incisors then maxillary (upper) central incisors then mandibular lateral incisors then 1st molars then canines

(7+ 4 rule for timing of eruption, starting at 7 months and going up by 4 months and 4 teeth)

30
Q

What is a true contraindication to receiving the yellow fever vaccine?

A

Egg hypersensitivity/ allergy

31
Q

What is the recommendation to increase the likelihood that an avulsed permanent tooth remains viable on way to dental office?

A

rinse with water, avoid holding by root, and transport in cold cow’s milk or holding it in place

32
Q

When should routine blood pressure screening begin?

A

At 3 years of age

33
Q

What is the routine recommendation for the meningococcal (MCV4) vaccine?

A

1st dose at 11-12 years old, 2nd dose at 16 years old

single dose if initial dose given at 16 or older

34
Q

At what age is DTaP not recommended?

A

7 years or older

should receive Tdap

35
Q

What is the potential adverse effect of giving the pnemococcal (PCV13) and trivalent inactivated influenza vaccine simutaneously?

A

Febrile seizures during the initial 24 hours after vaccines

36
Q

True or False. MMR vaccine can be administered the same day as the tuberculin skin test (TST), but if MMR given previously, you must postpone the TST for 4-6 weeks.

A

True

MMR vaccine given earlier can suppress reactivity to TST

37
Q

When does visual acuity reach the adult level of 20/20?

A

by 3-5 years old

38
Q

What is the treatment for labial adhesions?

A

Topical estrogen cream BID

(side effect of breast bud formation transient)

(peaks at 12-24 months of age)

39
Q

What is the recommended duration between dose 1 and dose 2 of varicella?

A

at least 3 months

1 month if older than 13 years old

40
Q

what is the recommendation for MMR vaccination for infants less than 12 months old traveling abroad to endemic area?

A

all infants 6-11 months should receive at least 1 MMR vaccine

(still require 2 doses of MMR after 12 months of age)

41
Q

What is the minimum age at which only 1 dose of influenza vaccine is recommended for children who have not previously received an influenza vaccine?

A

9 years old

42
Q

What test modality is the most accurate and specific regarding sensorineural hearing loss, especially following meningitis?

A

Auditory brainstem response (ABR)

43
Q

What is the recommended catch-up schedule for a patient who has never received pertussis/ tetanus containing vaccine?

A

Tdap followed by Td in 4 weeks followed by 2nd Td 6 months later

44
Q

what is the contraindication for the Rotarix (live, oral human attenuated monovalent rotavirus) vaccine?

A

Anaphylactic allergy to latex

45
Q

Is it safe to administer the varicella vaccine to nursing mothers without evidence of immunity regardless of the age of their infant?

A

Yes (does not transmit into breastmilk)

do not give to pregnant women

46
Q

When can children move from booster seats to standard seat blets?

A

reached 4 feet 9 inches tall and between ages of 8-12 years old

(should still be in the rear with a lap and shoulder belt)

47
Q

What are the first permanent teeth to erupt?

A

1st molars (known as the 6 year molars) or the lower central incisors

48
Q

What is the next best step in management of an unimmunized child that is in contact with a person with active varicella infection and has no personal history of prior varciella infection?

A

Varicella vaccine administration within 3-5 days of contact

as long as older than 12 months

49
Q

What are the recommendations for routine cholesterol screening?

A

universal screening at 9-11 years old and again at 17-21 years old

50
Q

How long should a pt wait to receive a live attenuated vaccine after being treated with more than 2 mg/kg/day of steroids for more than 14 days?

A

at least 4 weeks after steroids complete

51
Q

What is the appropriate needle size for an intramuscular vaccination?

A

1 inch for 4 month old thigh

1.5 inch for 120 kg deltoid muscle

52
Q

How often should sexually active adolescents be screened for gonorrhea and chlamydia?

A

yearly

53
Q

what is the recommended varicella vaccination schedule for an unimmunized child older than 13 years old?

A

2 doses at least 4 weeks apart

54
Q

How long should a patient remain in a forward facing 5 point harness carseat?

A

until exceed the weight and height limitations of the carseat, then transition to booster seat

55
Q

What vaccines are contraindicated for pregnant women?

A

Live attenuated vaccines

MMR, Varicella, live influenza

56
Q

What are contraindications for flu mist?

A

1) asthma/ reactive airway
2) pregnancy
3) diabetes
4) immunocompromised
5) chronic heart disease
6) chronic renal disease

57
Q

What is the typical time period that the MMR vaccine is not effective if patient receives IVIG?

A

2 weeks prior to IVIG and up to 11 months after IVIG

58
Q

What is the possible risk of given a patient younger than 4 years old Proquad (MMRV)?

A

febrile seizures

59
Q

What is the recommendation regarding Polio vaccination for patients traveling to country with active polio cases for longer than 4 weeks?

A

5th Polio dose if last dose was over 1 year ago

60
Q

What vaccination is contraindicated for individuals who live with severely immunocompromised individuals?

A

live attentuated Influenza

61
Q

When should an MMR or Varicella vaccine be given if a patient is on high dose ( greater than 2 mg/kg/day) of prednisone?

A

At least 4 weeks after completing prednisone treatment

62
Q

What is the potential complication related to breastfeeding a preterm infant without supplementation?

A

hypoproteinemia (low protein due to rapid growth and high protein demand)

63
Q

What is a possible adverse reaction that can occur with the Dtap vaccination?

A

prolonged period of crying and inconsolable state for more than 3 hours

64
Q

what are the 2 requirements for a passing CCHD test?

A

1) oxygen saturation of 95% or above

2) 3% or less difference between upper and lower extremity

65
Q

what is the preferred test to assess for TB in patient under 2 years old?

A

TST

66
Q

What is the best initial step in management for patient under 4 years old who had direct contact with TB positive person?

A

start latent TB infection treatment (despite negative TB screen) and repeat screen in 10-12 weeks (if negative, then can stop tx)

67
Q

What is the recommended catch-up vaccination schedule for patients older than 15 months of age and who have not had a prior HIB vaccine?

A

single dose needed

68
Q

What is the recommended catch-up vaccination schedule for patients older than 24 months of age who have not had a prior prevnar vaccine?

A

single dose needed

69
Q

What is the minimum age at which only 1 dose of Influenza vaccine is recommended in children who have not been previously vaccinated?

A

9 years old

Pediatric Board Prep (26 decks)

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