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pediatric Boards > prevention > Flashcards

prevention Flashcards

0
Q

What are the common findings of lead poisoning on X-ray?

A

Lead lines - calcification of bones

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1
Q

5 Signs and symptoms of lead poisoning?

A

Headache, irritability, constipation, lethargy and microcytic anemia

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2
Q

What is the common Blood smear finding in lead poisoning ?

A

Basophilic stippling

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3
Q

At what lead level do children require chelation?

A

45

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4
Q

What can be seen in lead levels 10-20?

A

Mild cognitive delay

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5
Q

What 4 things should be done if elevated capillary lead level?

A

Venous lead level
FEP level
Abdominal film
Long bone X-ray

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6
Q

When should tdap be given?

A

Age 11-12 or 5 years after receiving Td

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7
Q

What tetanus prophylaxis do you give if a child with unknown or incomplete immunization status has a clean wound?

A

Tetanus vaccine

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8
Q

What do you do if a child had a clean wound and received a tetanus vaccine > 10 years ago?

A

Tetanus booster

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9
Q

What do you do if a child with incomplete vaccination status presents with a dirty wound?

A

Tetanus vaccine + tetanus immune globulin

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10
Q

What do you do if a child presents with a dirty wound and has not had a tetanus vaccine in >5 years?

A

Tetenus booster

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11
Q

When does a child only require 3 doses of dtap during catch up vaccines?

A

If the first dose was given after 12 months of age

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12
Q

How much time is required between catch up doses of dtap?

A

At least 4 weeks between doses 1, 2 and 3 and 6 months between the 3rd and 4th dose

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13
Q

At what age is dtap no longer indicated ?

A

After 7 years old

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14
Q

What do you do if a pregnant teenager is due for her tdap?

A

Administer anyways

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15
Q

At what age can pediarix no longer be given?

A

7

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16
Q

What should be done for an infant born to a mother with unknown hepatitis status?

A

Hep B immunoglobulin and vaccine

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17
Q

How soon should premies less than 2 kg receive hep b vaccine ?

A

Within 30 days if mother negative

Within 12 hours if mother positive plus immunoglobulin

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18
Q

What are hep B requirements in the event of a needle stick?

A

If antibody positive - do nothing

If antibody negative - IG and full re vaccination

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19
Q

What is the most common subtype that causes meningococcal disease and why is this a problem?

A

More than half of meningococcal disease in infants is caused by B subtype which is not protected from with the vaccine!!!!

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20
Q

When can you give the mcv vaccine before the scheduled dose at age 11?

A

After age 2 if HIV, complement deficiency, asplenic or travel to endemic regions

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21
Q

How much time must lapse between doses one and two of MMR?

A

4 weeks

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22
Q

What do you do if a 10 month old who gets an MMR vaccine for travel?

A

Doesn’t count as series dose. Repeat after 12 months

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23
Q

What do you do if a child is less than 12 months and is exposed to measles?

A

If within 72 hours of exposure, give vaccine. If more than 72 hours after exposure give immunoglobulin

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24
Q

What are 2 side effects of the MMR vaccine ?

A

Fever within 12 days or rash

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25
Q

What are contraindications for MMR?

A

Severe allergy
Pregnancy
Severe immune compromised
Anaphylaxis to neomycin or gelatin

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26
Q

How much time must pass between receiving MMR vaccine and getting a PPD?

A

You can give them together but can not give ppd within 4-6 weeks after MMR

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27
Q

What are the only 2 vaccines with a contraindication with egg allergy?

A

Influenza or the yellow fever vaccine

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28
Q

What size patient is epipen junior good for?

A

Up to 30 kg

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29
Q

What are the rules for giving measles and varicella vaccine in HIV patients?

A

Measles can be given unless severely immunocompromised but varicella can not be given if immunocompromised at all

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30
Q

When is varicella immunoglobulin indicated (5 answers) and what drug is given with it?

A

Immunocompromised
Pregnant women
Premies <28 weeks
Premies without evidence of maternal immunity
Any infant with mother with new onset varicella - give with acyclovir

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31
Q

What is pcv13 and when is it given ?

A

Prevnar - ages 2,4,6 and 12 months

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32
Q

What is ppv23 and when is it given ?

A

23 valent pneumococcal vaccine for kids >2 y/o with chronic illness or asplenia

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33
Q

When should rotavirus vaccination be started by and when must it be completed?

A

First dose between 6 and 14 weeks

Must be completed by 8 months old

34
Q

How much time must lapse between rotavirus vaccinations?

A

4 -10 weeks

35
Q

What should you do if a child gets rotavirus infection before vaccination?

A

Continue with vaccination

36
Q

When should hep A vaccine be given ?

A

Age 1 and then 6 months later

37
Q

Who is at high risk for influenza and requires annual immunization?

A

Chronic metabolic/renal/cardiac dz, Asthma/pulmonary disease,
HIV

38
Q

What should be done for hep A vaccination in traveling children?

A

If <1 year old give immune globulin

If >1 year old give hep A vaccine at least 4 weeks prior to departure

39
Q

What are contraindications for hep A vaccine?

A

Allergy to aluminum hydroxide and phenoxyethanol

40
Q

In which patients should influenza vaccination be a priority? (5 answers)

A 
Chronic pulmonary disease 
Symptomatic heart disease 
Sickle cell
Immunosuppressive 
long term aspirin therapy
41
Q

When should you start screening a patient for hypertension ?

A

Age 3 or children on stimulants

42
Q

What is the definition of HTN?

A

> 95th % taken on 3 separate occasions (one month apart)

43
Q

What is conductive hearing loss?

A

Anything that interferes with transmission of sound to the middle ear

44
Q

What is the most common cause of conductive hearing loss?

A

Otitis media with effusion

45
Q

What is the most severe cause of conductive hearing loss?

A

Atresia of the ear canal

46
Q

What do you do if an infant fails newborn screening?

A

Refer to audiology prior to 3 months

47
Q

What should you do if a child has any of the cholesterol risk factors ?

A

Non fasting cholesterol level

48
Q

What do you do if screening for cholesterol shows cholesterol >170?

A

Repeat or check fasting lipids

49
Q

What do you do if a child has a parent with cholesterol >240?

A

Check non fasting cholesterol

50
Q

What are the 5 risk factors for children having high cholesterol?

A 
Smoking
HTN 
Physical inactivity 
Diabetes
Obesity
51
Q

What do you do in a child whose parent or grandparent has coronary atherosclerosis (MI, angina, stroke, sudden cardiac death before age 55)?

A

Fasting lipids

52
Q

How should you treat a patient with fasting lipids >130?

A

Manage with diet

53
Q

What do you do for a patient with LDL >190?

A

Medication (after diet trial)

54
Q

What cholesterol levels are ideal for a patient with first degree relative with coronary atherosclerosis ?

A

<160

55
Q

What are 4 medications and 3 diseases that increase risk for high cholesterol?

A 
Steroids 
Anticonvulsants
Beta blockers
Alcohol
Chronic liver or renal disease
Hypothyroid
Anorexia nervosa
56
Q

In what 4 conditions should you consider hyperviscosity syndrome?

A

Twin twin transfusion
Delayed cord clamping
Down syndrome
Diabetic mother

57
Q

What are 3 things that can occur with polycythemia?

A

Hyperviscosity syndrome
Hyperbilirubinemia
Hypoglycemia

58
Q

What is the loss of visual acuity due to cortical suppression of vision in one eye?

A

Amblyopia

59
Q

What is esotropia?

A

Inward turning of eye (form of strabismus)

60
Q

What is the tendency for inward deviation when an eye is covered and then uncovered?

A

Esophoria

61
Q

What refractive state is normal until age 3?

A

Hyperopia

62
Q

What is the ability to see a moving target, follow it and then return to original gaze?

A

Optokinetic nystagmus

63
Q

What eye reflex do infants have in the first few months ?

A

Optokinetic nystagmus

64
Q

When do infant gain the ability to fixate on an object?

A

6 weeks

65
Q

When do infants gain color perception ?

A

2 months

66
Q

When do infants develop binocular vision with convergence?

A

3 months

67
Q

What is the normal visual acuity of a newborn?

A

20/200

68
Q

What is the visual acuity at age 1?

A

20/30

69
Q

In what conditions is 5-10mm TB screen considered abnormal?

A

Close contacts
Positive X-ray
Immunosuppression

70
Q

What should be done in a newborn with a mother who has active TB disease?

A

If negative cxr, treat with INH

If positive cxr, treat with triple meds

71
Q

When does a child need prophylactic treatment for H. Flu after exposure?

A

Children not fully immunized or immunocompromised if household contact

72
Q

When should children exposed to meningococcus receive prophylactic treatment ?

A

Household or preschool contacts
Direct exposure to secretions
Sat next to person on plane >8 hrs

73
Q

At what temp should water heaters be set?

A

120 degrees F

74
Q

What does UV A cause and when should it be a concern?

A

Drug induced photo sensitivity

The rays are constant throughout the day

75
Q

What does UV B cause and when is it a concern?

A

Skin aging, burns and cancer

Strongest from 10a - 5 p

76
Q

What are the rules to applying sunscreen?

A

At least SPF 15 applied 20 minutes before exposure

77
Q

When should an infant be in a rear facing car seat?

A

Until age 2 or 20 lbs

78
Q

How should rear facing car seats be positioned?

A

45 degree angle

79
Q

Up to what height should children be in a booster seat?

A

4’9”

80
Q

Why are bicycle Helmets important?

A

Reduce serious injury by 85%

81
Q

What is the most effective preventative measure for preventing drowning?

A

4 sided fence with locked gate

82
Q

What is the difference in growth and development in a children adopted from another country?

A

Children lose 1 month of linear growth for every 3 months in an orphanage
Developmental milestones should match linear growth

83
Q

How should you medically assist an adolescent to quit smoking?

A

Nicotine replacement is NOT FDA approved so use caution. If unsuccessful, bupropion plus counseling is approved

pediatric Boards (23 decks)

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