prevention Flashcards
What are the common findings of lead poisoning on X-ray?
Lead lines - calcification of bones
What is the common Blood smear finding in lead poisoning ?
Basophilic stippling
At what lead level do children require chelation?
45
What can be seen in lead levels 10-20?
Mild cognitive delay
What 4 things should be done if elevated capillary lead level?
Venous lead level
FEP level
Abdominal film
Long bone X-ray
When should tdap be given?
Age 11-12 or 5 years after receiving Td
What tetanus prophylaxis do you give if a child with unknown or incomplete immunization status has a clean wound?
Tetanus vaccine
What do you do if a child had a clean wound and received a tetanus vaccine > 10 years ago?
Tetanus booster
What do you do if a child with incomplete vaccination status presents with a dirty wound?
Tetanus vaccine + tetanus immune globulin
What do you do if a child presents with a dirty wound and has not had a tetanus vaccine in >5 years?
Tetenus booster
When does a child only require 3 doses of dtap during catch up vaccines?
If the first dose was given after 12 months of age
How much time is required between catch up doses of dtap?
At least 4 weeks between doses 1, 2 and 3 and 6 months between the 3rd and 4th dose
At what age is dtap no longer indicated ?
After 7 years old
What do you do if a pregnant teenager is due for her tdap?
Administer anyways
At what age can pediarix no longer be given?
7
What should be done for an infant born to a mother with unknown hepatitis status?
Hep B immunoglobulin and vaccine
How soon should premies less than 2 kg receive hep b vaccine ?
Within 30 days if mother negative
Within 12 hours if mother positive plus immunoglobulin
What are hep B requirements in the event of a needle stick?
If antibody positive - do nothing
If antibody negative - IG and full re vaccination
What is the most common subtype that causes meningococcal disease and why is this a problem?
More than half of meningococcal disease in infants is caused by B subtype which is not protected from with the vaccine!!!!
When can you give the mcv vaccine before the scheduled dose at age 11?
After age 2 if HIV, complement deficiency, asplenic or travel to endemic regions
How much time must lapse between doses one and two of MMR?
4 weeks
What do you do if a 10 month old who gets an MMR vaccine for travel?
Doesn’t count as series dose. Repeat after 12 months
What do you do if a child is less than 12 months and is exposed to measles?
If within 72 hours of exposure, give vaccine. If more than 72 hours after exposure give immunoglobulin
What are 2 side effects of the MMR vaccine ?
Fever within 12 days or rash
What are contraindications for MMR?
Severe allergy
Pregnancy
Severe immune compromised
Anaphylaxis to neomycin or gelatin
How much time must pass between receiving MMR vaccine and getting a PPD?
You can give them together but can not give ppd within 4-6 weeks after MMR
What are the only 2 vaccines with a contraindication with egg allergy?
Influenza or the yellow fever vaccine
What size patient is epipen junior good for?
Up to 30 kg
What are the rules for giving measles and varicella vaccine in HIV patients?
Measles can be given unless severely immunocompromised but varicella can not be given if immunocompromised at all
When is varicella immunoglobulin indicated (5 answers) and what drug is given with it?
Immunocompromised
Pregnant women
Premies <28 weeks
Premies without evidence of maternal immunity
Any infant with mother with new onset varicella - give with acyclovir
What is pcv13 and when is it given ?
Prevnar - ages 2,4,6 and 12 months
What is ppv23 and when is it given ?
23 valent pneumococcal vaccine for kids >2 y/o with chronic illness or asplenia
When should rotavirus vaccination be started by and when must it be completed?
First dose between 6 and 14 weeks
Must be completed by 8 months old