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1. Pediatrics > Preventive Pediatrics > Flashcards

Preventive Pediatrics Flashcards

1
Q

[Prev/CCHD]

Criteria for not passing CCHD? (3)

A
  1. SpO2 ≤ 89% in either the right hand or foot
  2. SpO2 90-94% in either the right hand or foot on 2 consecutive measurements separated by 1 hour
  3. ≥ 4% difference in SpO2 between right hand and foot on 2 consecutive measurements separated by 1 hour
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2
Q

[Pre/Eye]

Visual acuity cutoff for referral in preschoolers (<5 years)?

A

20/50
(Rule of 8, age + acuity ≤ 8, ie. age 3 + 5: acuity 20/50)

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3
Q

[Prev/Eye]

Visual acuity cutoff for referral in schoolers and above (≥ 5 years)?

A

20/30
(Reaching 20/20 by 5-7 years old)
(Rule of 8, age + acuity ≤ 8, ie. age 3 + 5: acuity 20/50)

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4
Q

[Prev/Hearing]

Infant hearing screening < ___ month
Hearing loss diagnosis < ___ months
Intervention (early intervention service) < ___ months

A

Infant hearing screening < 1 month
Hearing loss diagnosis < 3 months
Intervention (early intervention service) < 6 months

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5
Q

[Prev/BP]

Normal, elevated, stage 1 and 2 BP range (1-13 years of age)?

A

Normal BP: both systolic BP and diastolic BP < 90th %

Elevated BP: SBP and/or DBP ≥ 90th percentile but
< 95th percentile, or 120/80 mmHg to < 95th percentile (whichever is lower)

Stage 1 HTN: SBP and/or DBP > 95th percentile to < 95th percentile + 12 mmHg, or 130/80 to 139/89 mmHg (whichever is lower)

Stage 2 HTN: SBP and/or DBP > 95th percentile + 12 mmHg, or > 140/90 mmHg (whichever is lower)

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6
Q

[Prev/Lead]

Ages for universal lead screening?

A

2 screening
1 and 2 years of age

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7
Q

[Prev/Lead]

Repeat interval for elevated lead level? (2)

A

5-14 μg/dL, repeat in 1-3 months
15-44 μg/dL, repeat in 1-4 weeks

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8
Q

[Prev/Lead]

If lead level is > ___ μg/dL,
then start treatment of ____
and do ____ test for pica

A

≥ 45 μg/dL
Chelation therapy
Plain abdominal x-ray (lower level with pica)

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9
Q

[Prev/Lipid]

Routine screening ages for Dyslipidemia? (2)

A

(2 routine screening, as needed for high risk)
9-11 years old
17-21 years old

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10
Q

[Prev/Lipid]

Indication for statin therapy (age >10)? (2)

A
  1. After dietary change, LDL > 190 mg/dL
  2. LDL > 250 mg/dL, needs referral
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11
Q

[Prev/STD]

STD screening for men who have sex with men (2)

A

Annual HIV, syphilis, Urine chlamydia and gonorrhea

Depending on sexual practices, annual screening for
Rectal chlamydia and gonorrhea
Oropharyngeal gonorrhea (no pharyngeal chlamydia)

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12
Q

[Prev/STD]

HIV screening recommendation?

A

Once between 15-18 years of age
(As needed for high risk)

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13
Q

[Prev/Colic]

Definition of colic?

A

Normal infant < 3 months of age
Lasting >3 hours a day
At least 3 weeks

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14
Q

[Prev/Colic]

When colic usually resolves?

A

3-4 months

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15
Q

[Prev/Vaccine/Catchup]

Catchup vaccination schedule for Hib/PCV? (2)

A

Hib
≥ 15 months < 5 year old -> one dose
≥ 5 year old -> no dose

PCV
12 - 23 months 2 doses, 8 weeks apart
2-5 years, 1 dose
≥ 5 year old -> no dose

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16
Q

[Prev/Vaccine/Schedule]

Toddler vaccines and maximum age eligible for vaccines?

Rota: __
DTap: __
Hib/PCV: __

A

Rota 8 months
DTap 7 years
Hib/PCV 5 years

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17
Q

[Prev/Vaccine/Schedule]

Regular 2, 4, 6 months vaccination schedule?

A

2 months: Hep B, DTap, IPV, Hib, PCV, Rota
4 months: (no Hep B), DTap, IPV, Hib, PCV, Rota
6 months: Hep B, Dtap, IPV, (no Hib if PedvaxHIB), PCV, (no Rota if Rotarix), first Flu

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18
Q

[Prev/Vaccine/Schedule]

Regular 12 months, 15 months, 18 months vaccines schedule?

A

12 months: Hib, PCV, MMRV, Hep A #1
15 months: DTap
18 months: Hep A #2

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19
Q

[Prev/Vaccine/Schedule]

Regular 4 year, 11 year, 16 year vaccination schedule?

A

4 year DTap, IPV, MMRV
11 year Tdap, HPV, Men A #1 (HPV #2 6 -12 months later)
16 year Men A #2, (+/- Men B #1 and #2 in a month)

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20
Q

[Prev/Vaccine]

Subcutaneous injection vaccination?

A

MMRV
IPV

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21
Q

[Prev/Vaccine]

Which vaccination required evaluated before vaccination?
Egg allergy

A

Yellow fever

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22
Q

[Prev/Vaccine]

Which vaccination required evaluated before vaccination?
Hypersensitivity to yeast

A

Hep B

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23
Q

[Prev/Vaccine]

Which vaccination required evaluated before vaccination? (3)
Gelatin

A

MMRV, yellow fever, inactivated influenza

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24
Q

[Prev/Vaccine]

Which vaccine can suppress tuberculin skin test reactivity and how long wait?

A

MMR
TST 4-6 weeks after MMR

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25
Q

[Prev/Vaccine]

When to give Hep B vaccine for preterm infants < 2 kg with mother of hep b negative?

A

1 month of choronological age
Or at hospital discharge if going home before 1 month

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26
Q

[Prev/Vaccine]

Pediatrix combination?

A

DTap-IPV-HepB

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27
Q

[Prev/Vaccine]

Pentacel combination?

A

DTap-IPV-Hib

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28
Q

[Prev/Vaccine]

How many doses of HPV vaccines per age?

A

9 - 15 years: 2 doses (0 and 6-12 months)
≥ 15 years: 3 doses (0, 1-2, and 6 months)

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29
Q

[Prev/Vaccine]

Absolute contraindication for DTaP vaccine? (2)

A

History of encephalopathy within 7 days of dosing
Immediate anaphylactic reaction with previous dose

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30
Q

[Prev/Vaccine]

Neurologic complications of DTaP vaccine? (2)

A

Guillain-Barre syndrome within 6 weeks after receiving a tetanus toxoid-containing vaccine
Seizures within 3 days of vaccination (no neurologic sequalae after vaccination)

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31
Q

[Prev/Vaccine]

Indication of DT vaccination? (2)

A

children > 1 year: routine immunization with DTaP has been deferred due to, for example, an evolving neurologic disorder or progressive developmental delay of unknown etiology
unimmunized 1-6 years of age with a medical contraindication to a pertussis-containing vaccine

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32
Q

[Prev/Vaccine/Schedule]

Tdap vaccination routine schedule?

A

11-12 years of age
Every 10 years

33
Q

[Prev/Vaccine/Catchup]

Tdap schedule for
Unimmunized ≥ 7 years?

A

Unimmunized (no 5 completion)
1st Tdap 0,
2nd Tdap or Td in 4 weeks,
3rd Tdap or Td in 6 months

34
Q

[Prev/Vaccine/Wound&DTap]

When to give DTap with clean minor wounds? (2)

A

Tetanus doses < 3 or unknown
Tetanus doses ≥ 3 but ≥ 10 years since the last dose

35
Q

[Prev/Vaccine/Wound&DTap]

Tetanus vaccines and TIG indication for dirty wound?

A

Tetanus vaccines < 3 doses or unknown

36
Q

[Prev/Vaccine/Wound&DTap]

Tetanus vaccines indication for dirty wound?

A

Tetanus vaccines ≥ 3 doses AND ≥ 5 years since last dose

37
Q

[Prev/Vaccine/CIx]

Absolute contraindication for MMR? (3)

A

History of anaphylactic reaction to MMR, neomycin or gelatin
Severe immunodeficiency
Pregnancy

38
Q

[Prev/Vaccine]

Minimum age for MMR
when close contact of MMR

A

6 months (Not included for routine 2 dose series)

39
Q

[Prev/Vaccine/Catchup]

Catchup vaccine interval for Varicella by age?

A

2 dose series
< 13 years: 3 months apart
≥ 13 years: 4 weeks apart

40
Q

[Prev/Vaccine/Hib]

Hib vaccination schedule for Children < 24 months of age with invasive Hib infection?

A

Same schedule for unimmunized Hib
< 15 months: 3-4 doses
15 ≤ < 5 years: 1 dose
≥ 5 years: none

41
Q

[Prev/Vaccine/HepB]

Infants born to Hep B positive mother
Initial treatment and follow up?

A

Hep B vaccine and HBIG ≤ 12 hours of life
HBsAg and anti-HBs at 9-12 months of age

42
Q

[Prev/Vaccine/HepB]

Infants born to Hep B unknown mother
Initial treatment and follow up?

A

Hep B vaccine ≤ 12 hours of life
HBIG if positive no later than 7 days if > 2 kg
Hep B vaccine and HBIG ≤ 12 hours of life if < 2 kg

43
Q

[Prev/Vaccine/PCV]

Disorders associated with increased risk of invasive pneumococcal disease? (6)

A

Sickle cell, other hemoglobinopathies, funtional/anatomic asplenia
Cochlear implant
CSF leak
HIV
Chronic cardiac/pulmonary/kidney disease
DM, mallignancy

44
Q

[Prev/Vaccine/PCV]

PCV vaccination schedule for high-risk fully immunized patients?

A

PCV13 completion < 15 month or 2 doses >15 mo - 6 yo

PPSV23 at 2 years of age (at least 8 weeks apart from PCV13)
2nd dose at 5 years for sickle cell, hemoglobinopaties, functional/anatomic asplenemia
(no 2nd dose for chronic cardiac/pulmonary/kidney, CSF leak, cochlear implants)

45
Q

[Prev/Vaccine/MCV]

Minimal age for Men B vaccine?

A

≥ 10 years for high risk
(Routine 16-23 years)

46
Q

[Prev/Vaccine/MCV]

MCV vaccine schedule for high risk?

A
  • 2 months - 6 years of age:
    2 doses at 2 years (8-12 weeks apart)
    Booster at three years after primary immunization
    repeat boosters every 5 years thereafter
  • ≥ 7 years of age:
    every 5 years after primary series
47
Q

[Prev/Vaccine/Rota]

Initiation age and maximum of Rota vaccine?

Starting at ___ weeks
No initiation after ___ weeks
No Rota vaccine after ___ months of age

A

Starting at 6 weeks
No initiation after 15 weeks
No Rota vaccine after 8 months of age
(6 weeks ≤ < 15 weeks (14 weeks and 6 days))

48
Q

[Prev/Vaccine/Rota]

Contraindication of Rota vaccine? (3)

A
  1. History of intussusception
  2. SCID
  3. Severe allergy to the vaccine or its component
49
Q

[Prev/Vaccine/Flu]

Maximum age required initial 2-dose series for influenza vaccine?

A

< 9 years: needs 2 dose series
(≥ 9 years 1 annual dose)

50
Q

[Prev/Vaccine/Flu]

Contraindication of influenza vaccine (1)?

A

Anaphylactic reaction after previous influenza vaccination
(Egg allergy is not contraindication)

51
Q

[Prev/Sunscreen]

Minimal age for sunscreen?
Minimal age for DEET (insect repellent)

A

Sunscreen: 6 months
DEET: 2 months

52
Q

[Prev/BP]

Indications to measure blood pressure before 3 years old? (6)

A
  1. Obesity, Diabetes
  2. Kidney: Renal disease, Recurrent UTI, renal/urologic malformations, Family history of congenital renal disease
  3. Heart: Aortic arch obstruction, Those taking medications known to cause hypertension, Congenital heart disease (repaired or unrepaired)
  4. Prematurity: <32 weeks, SGA, VLBW, NICU stay or umbilical artery line
  5. Transplant
  6. Other systemic illnesses associated with HTN (eg, NF, TSC, sickle cell disease
53
Q

[Prev/BP]

Which gestational age of prematurity requires early blood pressure monitoring?

54
Q

[Prev/Immigration]

Initial laboratory test for all immigrant child? (9)

A
  1. CBC
  2. Lead (0-16 year old, now and 3-6 months later)
  3. Quantiferon (first line, tuberculin skin test second line)
  4. HIV (Ab for >18 months, RNA test for <18 mo)
  5. Syphilis
  6. Hep B surface antigen
  7. Hep C antibody
  8. Strongyloides serology
  9. Ova and parasite stool test (2-3 samples in 2-3 occasion) or presumptive treatment
    +/- NBS (<12m), TFT (<6yr), Preg/GC/CT (F>13 yr)
55
Q

[Prev/Immigration]

Newborn screening test for immigrant child if the child is less than ___ months old

A

Newborn screening test for immigrant child if the child is less than 12 months old

56
Q

[Prev/Immigration]

TSH and fT4 test for immigrant child if age is less than ___ years old

A

TSH and fT4 test for immigrant child if age is less than 6 years old

57
Q

[Prev/Immigration]

Laboratory test for Adolescent immigrant child (2)?

A
  1. Pregnancy test for female
  2. GC/CT for all
58
Q

[Prev/Immigration]

Schistosoma serology for immigrant child from ___

A

Schistosoma serology for immigrant child from Sub-saharan Africa

59
Q

[Prev/Immigration]

Presumptive treatment for soil-transmitted helminth (worm) infection

First line: ___
Second line: ___

A

First line: Albendazole once (contraindicated in pregnancy or allergy)
Second line: Pyrantel pamoate for 3 days

60
Q

[Prev/Immigration]

Presumptive treatment for

Strongyloidiasis: ___
Schistosomiasis: ___

A

Strongyloidiasis: Ivermectin (StrongyLiver)
Schistosomiasis: Praziquantel

61
Q

[Prev/Foster]

Routine visit intervals for a child under foster care

Every month till ___ months
Every 3 months till ___ months
Every 6 months till age ___ years old

A

Every month till 6 months
Every 3 months till 24 months
Every 6 months till age 21 years old

62
Q

[Prev/Vaccine/Live]

Patients being treated with ≥ __ mg/kg/day or max ___ mg/day of corticosteroid for more than ___ days should receive live-virus vaccines no earlier than ___ weeks

A

Patients being treated with ≥ 2 mg/kg/day or 20 mg/day of corticosteroid
For more than 14 days should receive live-virus vaccines
No earlier than 4 weeks

63
Q

[Prev/Vaccine/Live]

Contraindication for intranasal live attenuated influenza vaccine (LAIV)? (5)

A
  1. Asthma 2-4 yo or wheezing within 12 months
  2. Chronic heart/kidney disease, diabetes
  3. Cochlear implant, CSF leak, immunosuppressive therapy
  4. Daily salicylate therapy
  5. Household with immunocompromised
64
Q

[Prev/Vaccine/Live]

MMR and Varicella vaccine should be administered ___ months after immunoglobulin (IVIG) therapy.
If MMR and Varicella vaccination given ___ weeks before IVIG, vaccine needs to be repeated.

A

MMR and Varicella vaccine should be administered 8 months after immunoglobulin (IVIG) therapy.
(11 months for IVIG for Kawasaki)
If MMR and Varicella vaccination given 2 weeks before IVIG, vaccine needs to be repeated.

65
Q

[Prev/Vaccine]

Which vaccine needs to be stored frozen (-50C to -15C) (freezer vaccine)? (1)

66
Q

[Prev/Vaccine/Varicella]

Evidence of immunity for varicella vaccine? (3)

A
  1. Documentation of 2 doses series
  2. Antibodies or confirmation of disease (PCR)
  3. Physician documentation reported varicella infection
67
Q

[Prev/Vaccine/Sickle]

Additional vaccination for sickle cell disease? (2)

A

(PCV13 completion of 4 doses)

  1. PPSV23
    at ≥ 2 years of age (8 weeks apart from the last PCV13 and after PCV13 completion 4 doses)
    2nd PPSV23 5 years after 1st dose
  2. MenACWY:
    if < 24 months: Menveo 2, 4, 6, 12 months (Only Menveo approved <24 months)
    if ≥ 24 months: 2 doses of any MenACWY 8 weeks apart
68
Q

[Prev/Vaccine/Varicella]

Varicella vaccination is indicated

when ____ patient exposed
without history of ____
within ___ days of exposure

A
  1. All unimmunized or ≥ 12 months old and incomplete vaccination
  2. No prior history of natural infection
  3. Within 3 days of exposure
69
Q

[Prev/Vaccine/Varicella]

Varicella immunoglobulin (VARIZIG) indication after exposure? (3)

A
  1. Immunocompromized
  2. Infant of mother with varicella infection 5 days prior, 2 days after delivery
  3. Non-immune pregnant women
70
Q

[Prev/Vaccine/Schedule]

Vaccination minimal interval

Hep B
DTap/IPV
Hib/PCV

A

Hep B 4 week/8 week/16 week
DTap/IPV 4 week/4 week/6 month
Hib/PCV 4 week/4 week/8 week (> 15 mo 1 dose, > 5 yo no dose)

71
Q

[Prev/Vaccine/Catchup]

Catchup vaccine for unimmunized?
> 7 yo: __
5-7 yo: __
2-5 yo: __

A

> 7 yo: Hep B, Tdap, IPV, MMRV, Hep A, HPV, MenACWY
5-7 yo: Dtap instead of Tdap
2-5 yo: Hib/PCV one dose

72
Q

[Prev/Vaccine/Schedule]

Vaccination minimal interval

MMR
Hep A
MenACWY

A

MMR 4 week
Hep A 6 month
MenACWY 8 week

73
Q

[Prev/Vaccine/Schedule]

Regular MenACWY schedule?

A

First 13-15 yo
Second 16-18 yo
(One dose if first received > 16 yo)

74
Q

[Prev/Carseat]

Rear car seat till <____ lb, or as long as possible
Forward facing at least ___ age, and ___ lb
Belt-positioning at least ___ age

A
  1. rear-facing car safety seats as long as possible, < 40 lb
  2. forward-facing car safety seats from the time they outgrow rear-facing, at least 4 years of age, > 40 lb
  3. belt-positioning booster seats from the time they outgrow forward-facing seats, at least 8 years of age
75
Q

[Prev/Vaccine/Live]

Live vaccines? (6)

A

BCG
Intranasal influenza
Yellow
MMRV
Rotavirus
Oral poliovirus

76
Q

[Prev/Vaccine/Live]

Contraindicated vaccines for family with immunocompromised patient?

A

Intranasal influenza
Oral poliovirus
(MMRV, rota is okay since live attenuated)

77
Q

[Prev/Foster]

Foster parents do or do NOT have authorization to provide consent for medical decisions?

A

Foster parents do NOT have authorization
Birth parents need to consent or social service grant consent

78
Q

[Prev/Media]

AAP recommendation for media consumption by age?
< 18 months: ___
18-24 months: ___
2-5 years old: ___
>6 years old: ___

A

< 18 months: no screen media
18-24 moths: high-quality media with parents
2-5 years: < 1 hours with high-quality media
> 6 years: consistent limit on media

1. Pediatrics (22 decks)

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