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Preventive Pediatrics > Preventive > Flashcards

Preventive Flashcards

1
Q

contraindications to breastfeeding

A

galactosemia
maternal use of illegal drugs
ant-neoplastic agents
radiopharmaceuticals

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2
Q

folic acid recommended dosage for all women of childbearing age

A

0.4mg of folic acid daily

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3
Q

the only 6 diseases screened in NBS

A 
phenylketonuria (PKU)
MSUD
CAH
congenital hypothyroidism
galactosemia
G6PD
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4
Q

most common inborn of metabolism in the Philippines

A

MSUD

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5
Q

risk indicators for hearing screening (birth to 28 days)

A
  1. illness or condition requiring admission of 48 hours or greater to NICU
  2. stigmata or syndrome known to include sensorinueural or conductive hearing loss
  3. family history of permanent childhood sensorineural hearing loss
  4. ear and craniofacial deformities
  5. in utero infections (toxoplasmosis, rubella, cytomegalovirus or herpes)
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6
Q

risk indicators for hearing screening (29 days through 2 years)

A
  1. parental or caregiver concern regarding hearing, speech, language and/or developmental delay
  2. family hx of permanent childhood hearing loss
  3. stigmata or syndrome known to include sensorinueural or conductive hearing loss or Eustachian tube dysfunction
  4. postnatal infections associated with SNHL such as bacterial meningitis
  5. in utero infections
  6. hyperbilirubinemia requiring exchange transfusion, persistent pulmonary hypertension associated with mechanical ventilator
  7. syndromes associated with progressive hearing loss such as osteopetrosis, neurofibromatosis and Usher’s syndrome
  8. neurodegenerative disorders such as Hunter syndrome, or sensorimotor neuropathies such as Charcot-Marie-Tooth syndrome and Friedrich’s ataxia
  9. head trauma
  10. recurrent or persistent otitis media with effusion for at least 3 months
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7
Q

leading cause of childhood blindness

A

Vitamin A deficiency

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8
Q

AAP recommendation for eye examination

A

birth and well child visits

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9
Q

earliest possible age for visual acuity measurement

A

3 years old

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10
Q

located at front door of the car absorbs most of the impact energy in a collision

A

crumple zone

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11
Q

mandates installation and use of adult seat belts in front and rear seats

A

Republic act 8750 (RA 8750)

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12
Q

age prohibited from occupying the front seat of any moving motor vehicle

A

below 6 years old

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13
Q

specialized child seats required for

A

children weighing up to 60lbs (8years old)

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14
Q

Pedestrian safety rules

A
  1. cross only at corners so drivers can see you
  2. always use crosswalk when available
  3. cross only on the new green light
  4. cross with the “walk” sign only
  5. look all ways before crossing
  6. when crossing, watch for cars that are turning left or right
  7. never cross the street from between parked cars
  8. drivers can’s see you
  9. walk on the left side of the road, facing traffic, if sidewalks are not provided so you can see oncoming cars
  10. use a flashlight or wear or carry something retroreflective
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15
Q

leading cause of child injury and death in the Philippines

A

Drowning

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16
Q

leading mechanism of injury in burns

A

scalding

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17
Q

primary risk factor for developing ROP

A

prematurity

due to incomplete vascularization of the retina

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18
Q

the only consistent risk factors for ROP

A

decreasing gestational age and birth weight

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19
Q

mainstay therapy fro ROP

A

surgical intervention

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20
Q

screening guidelines for ROP

A

infants with birth weight <1500grams or <32 weeks gestation at birth

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21
Q

most common ingested poison

A

household cleaning agents

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22
Q

treatment for ingested watusi

A

children: 4-6 egg whites
adults: 6-8 egg whites

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23
Q

children should not carry backpacks weighing

A

more than 10% of their body weight and

never 4 inches below the waistline

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24
Q

most common non-nutritive sucking material used

A

pacifiers

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25
Q

advantages of pacifiers

A

soothe and calm the child
aids in dentition
can be used as analgesia for very preterm neonates
protective against sudden infant death syndrome

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26
Q

safe level for noise

A

less than 85 Db

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27
Q

WHO exposure limit to continuous noise in workplace

A

80 - 85 Db for maximum of 8 hours

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28
Q

WHO exposure limit to impulsive noise in workplace

A

140 Db at any one exposure

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29
Q

in Philippines, minimum employable age is

A

15 years old

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30
Q

children between 15 and 18 years old may be employed

A

in undertakings not hazardous or deleterious in nature; not more than 8 hours per day and not more than 40 hours per week

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31
Q

for neonates discharged in less than 48 hours after delivery, appointment should be made after?

A

48 hours

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32
Q

minimum criteria for discharging newborns <48 hours

A 
uncomplicated course
NSD, term, AGA, singleton
stable VS during preceding `12 hours
1 stool and urine
normal PE

has documented proper latch
no significant jaundice in the 1st 24 hours
educability and ability of parents to care for the child

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33
Q

if a neonate has to undergo blood transfusion, when is newborn screening done?

A

before 24 hours then repeat after 28 days

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34
Q

in neonates born in the hospital, hearing screening should be done

A

within 3 months of life

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35
Q

High risk infants should be referred to Ophthalmologist for comprehensive eye examination

A
  • Premature infants born <32 weeks or younger, 1500grams or lighter or >32 weeks but with stormy course
  • infants and children with metabolic disorders
  • infants and children with medical conditions known to have associated eye problems
  • infants and children with history of “squinting”
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36
Q

visual acuity of children 3 to 3 1/2

A

20/50

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37
Q

visual acuity of children 4 to 4 1/2

A

20/40

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38
Q

visual acuity of children 5yrs

A

20/30

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39
Q

developmental screening must be done

A

9, 18 and 30 months and yearly thereafter

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40
Q

autism screening tool is done at

A

18 and 24 months

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41
Q

included in Philippine National Immunization Program 2018

A 
BCG
Hep B
Pentavalent (DTwP-Hib-HepB)
Bivalent OPV, IPV
PCV
MMR
MR
Td
HPV

*no longer includes Rotavirus and Dengue

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42
Q

give the deworming schedule and dosage

A

Albendazole
12-23mos: 200mg, single dose q6 months
>24mos: 400mg, single dose q6months

Mebendazole
12 mos and above: 500mg single dose q6 months

Taken on full stomach

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43
Q

deworming warnings

A 
severe malnutrition
high grade fever
abdominal pain
serious illness
prev hypersensitivity to the drug
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44
Q

optimum time for 1st dental visit

A

time of first tooth eruption not later than 1 year old

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45
Q

recommended flouride in children 6 months to less than 2 years old

A

smear 2.5mm twice daily

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46
Q

recommended flouride in children 2 to 6 years old

A

pea size 5mm twice daily

47
Q

recommended flouride in children 6 years old and above

A

full length of bristle 10-20mm twice daily

48
Q

screening for Iron Deficiency Anemia (IDA)

A

CBC between the ff time intervals:
6-24 months
2- 6 years
10-19 years

49
Q

Adolescent Health care

A

CBC at every stage of adolescence
urinalysis during 1st encounter
For sexually active: recommend STI screening and confidential HIV testing
Pap smear for sexually active female adolescents

50
Q

Exposure to antigen leads to immunity through creation of antibodies by recipient

A

Active immunization

51
Q

Transfer of humoral immunity in form of antibodies

A

Passive immunization

52
Q

Transfer of maternal antibodies to fetus via placenta

A

Pssive immunization

53
Q

Person contracted disease and immune system creates antibodies

A

Active immunization

54
Q

Vaccination is what type of immunization

A

Active immunization

55
Q

Live attenuated virus

A 
BCG
Measles
MMR
Varicella
Rotavirus
Typhoid (oral)
Oral polio
Dengue tetravalent
Oral cholera
Yellow fever
Japanese B encephalitis
56
Q

Inactivated vaccine

A 
Hep B
DTwP or Dtap
Hib
Pneumococcal
Hepa A
Meningo
Influenza (IM)
HPV
Typhoid
Rabies
Cholera
Jap B
57
Q

Preferred site for IM injections in children younger than 1yr old

A

Anterolateral aspect of thigh

58
Q

Preferred site for IM injections in children more than 1yr old

A

Deltoid muscle

59
Q

Most vaccines can be safely and effectively given simultaneously except

A

Yellow fever and cholera (separate by at least 3 weeks)

60
Q

> /= 2 inactivated vaccines or inactivated and live vaccine combinations

A

Can be simultaneously or at any interval between doses

61
Q

Two parenteral vaccines

A

Can be given simultaneously

If not, interval of atleast 4 weeks

62
Q

Two permanent contraindications to immunization

A

Anaphylactic reaction

Encephalopathy not due to another identifiable cause occuring within 7 days after pertussis vaccination

63
Q

Two temporary contraindications to live vaccines but not with inactivated vaccines

A

Pregnancy

Immunosuppression

64
Q

When is PPD needed prior to BCG

A

Congenital TB
History of close contact to known cases
Clinical symptoms suggestive of TB and/or
Chest xray suggestive of TB

65
Q

Primary series and booster doses of DTwP-Hib-Hep B or DTaP-Hib-IPV are given when

A

Primary: 6-10-14 weeks
Booster: 12-18 months interval between 3rd and 4th dose is 6 months
And 4-6 years old

66
Q

Primary and booster dose of OPV are given

A

Primary: 6-10-14 weeks
Booster: 4 years

67
Q

Primary and booster dose of PCV 13 sre given

A

Primary: 6-10-14 weeks
booster: 6 months after 3rd dose

68
Q

Rotavirus monovalent (RV1)

A

2 doses at 6-10 weeks

69
Q

Rotavirus Pentavalent human Bovine vaccine (RV5)

A

3 doses 6-10-14 weeks

70
Q

Maximum age of rotavirus

A

32 weeks old

Do not begin in older than 15 weeks old

71
Q

How is Influenza vaccine given?

A

6 months to 8 yo: 2 doses with interval of 4 weeks if receiving for 1st time

9-18 yo: 1 dose annually

72
Q

When is Jap Encephalitis vaccine given?

A

9mos to 17yo: 2nd dose given 12-24 mos after 1st dose

> /= 18: Single dose

73
Q

When is MMR given?

A

2 doses atleast 4 weeks apart
2nd dose at 4-6yo

<12mos: given measles containing should receive additional 2 doses of MMR

74
Q

When is varicella vaccine given?

A

12 months
2 doses

2nd dose: 4-6yo

75
Q

When is Hepa A vaccine given?

A

12 months

2 doses 6 months apart

76
Q

HPV vaccine given at

A

9 years old

9-14yo: 0 and 6 months

15yo and older: 0, 2, 6 months (3 doses)

77
Q

For fully immunized 7-18 yo, when is Tdap given?

A

Received 5 doses of DTP or 4 doses DTP if 4th dose given >/= 4yo; 1 dose Tdap the Td booster every 10 years

78
Q

For unvaccinated 7-18 yo, when is Tdap given?

A

3 doses at 0, 1, 6 months with Tdap as 1st dose and Tx for remaining doses

79
Q

For incompletely vaccinated 7-18 yo, when is Tdap given?

A

1 dose Tdap then Td for remaining dose atleast 1 month after

80
Q

For fully immunized pregnant adolescent

A

Give 1 dose of Tdap anytime after 20 weeks AOG

81
Q

For unimmunized pregnant adolescent, when is Tdap given?

A

Give 3 doses of Td containing vaccine following 0-1-6 month schedule; Tdap should replace atd preferrably 20 weeks AOG

82
Q

Mother is HBsAg positive

A

Give Hep B vaccine and 0.5ml HBIg at separate sites within 12hours regardless of birth weight

Test for HBsAg and anti-HBS at 9-12month
If Hep B delayed: test 1-2 months after final dose

83
Q

Mother’s HBsAg status is unknown

A

Give Hep B vaccine within 12 hours regardless of weight

Infants <2000g: give 0.5ml HBIg in addition to Hep B vaccine within 12 hrs of birth
Determine mother’s HBsAg status immediately: if mother is HBsAg positive, give 0.5ml HBIg to infants >2000g asap, no later than 7 days of age

84
Q

Suspicious findings for sexual abuse

A 
Focal erythema in vestibule
Localized abrasions within vestibule
Laceration of posterior fourchette without history of straddle injury
Peaked notch in posterior hymen
STDs like herpes or chlamydia
85
Q

Definitive evidence of sexual abuse

A

Recent bleeding from laceration or transection of hymen
Presence of sperm
Recent anal laceration
Complete absence of hymenal tissue between 3 and 9 o’clock position
Pregnancy in pubertal minor
Syphilis or gonorrhea

86
Q

Deworming for children

A

1-12 years old

87
Q

Iron supplementation for low birth weight

A

Drops 15mg elemental iron per 0.6ml

Dose: 0.3ml OD to start at 2 months old until 6 months old

88
Q

Iron supplementation for infants 6-11 months old

A

Drops with 15mg elemental iron per 0.6ml

Dose: 0.6ml OD for 3 months

89
Q

Iron supplementation for children 1-5 years old

A

Syrup with 30mg elemental iron per 5 ml

Dose: 5ml OD for 3 months or 30mg once a week for 6 months with supervised administration

90
Q

Iron supplemetation for adolescent females 10-19 years old

A

Table with 60mg elemental iron with 400mcg folic acid (coated)

Dose: one tab once a day

91
Q

earliest to have dental check up for caries

A

12 months

92
Q

who are allowed to occupy front seat of any moving vehicle

A

AAP car seat policy: Use a rear-facing car seat from birth until ages 2–4. After outgrowing the rear-facing car seat, use a forward-facing car seat until at least age 5. Buckle all children aged 12 and under in the back seat

93
Q

“Child Safety in motor vehicles act”

A

RA 11229 “Child Safety in motor vehicles act”
Child= 12 y/o and below
Section 8: Children in rear seats
No child shall be allowed to sit in the front seat of motor vehicle with a running engine or while such child is being transported on any road, street or highway.
Exception: a child at least 150cm or 59inches or 4’11 and is properly secured using the regular adult seatbelt may seat in the front seat…

(1) rear-facing car safety seats as long as possible; (2) forward-facing car safety seats from the time they outgrow rear-facing seats for most children through at least 4 years of age; (3) belt-positioning booster seats from the time they outgrow forward-facing seats for most children through at least 8 years of age; and (4) lap and shoulder seat belts for all who have outgrown booster seats. In addition, a fifth evidence-based recommendation is for all children younger than 13 years to ride in the rear seats of vehicles.

94
Q

most common solid breast mass seen in adolescent girls

A

Fibroadenoma

95
Q

most common cause of breast pain in adolescents

A

exercise and benign breast changes

96
Q

most common cause of pelvic pain in adolescents

A

Primary dysmonorrhea

97
Q

most common cause of secondary dysmenorrhea in adolescents

A

endometriosis

98
Q

most common form of rape for victims 16-24 years

A

acquaintance rape

99
Q

permanent contraindications to vaccination

A

anaphylactic reaction and

encephalopathy not due to another cause occurring within 7 days after pertussis vaccination

100
Q

prophylactic DOC for animal bites category III

A

Co-Amoxiclav for 7 days

101
Q

first dental visit

A

time of eruption of 1st tooth

and not later than 12mos of age

102
Q

recommended age of deworming

A

all children 1-12 years old using Albendazole or Mebendazole every 6 months

103
Q

Visual acuity tests in children

A

Picture test/HOTV/Tumbling E chart for 3-5 years old

Snellen Chart for 6 years old and above

104
Q

reliable growth indicator when age is not known

A

weight for length/height

105
Q

screening tests for sexually active females

A

Vaginal wet mount
PAP smear
non-culture test for gonorrhea and Chlamydia

106
Q

screening tests for sexually active males

A

serologic tests for syphilis

non-culture test for gonorrhea and Chlamydia

107
Q

best prognostic factors for autism spectrum disorder outcome

A

language impairment and presence or absence of intellectual disability

108
Q

most common learning disability

A

dylexia

109
Q

most common method of attempted suicide

A

ingestion of medication

110
Q

most common preexisting psychiatric illness in those who complete suicide

A

Major depression

111
Q

Special protection of children against child abuse, Exploitation, and Discrimination act

A

RA 7610

112
Q

most common manifestation of physical abuse

A

Bruise

113
Q

most common fracture in abused infants

A

Rib
metaphyseal
skull

Preventive Pediatrics (1 decks)

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