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Preventive Pediatrics 2018 > Preventive Pediatrics 2018 > Flashcards

Preventive Pediatrics 2018 Flashcards

1
Q

Prenatal education should include

A
  • breastfeeding
  • newborn care and procedures at birth
  • anticipatory guidance to decrease the risk injury and identify risk factors for child maltreatment
  • prevention of smoking, alcohol intake and exposure to teratogens
  • tetanus toxoid immunization for the mother
  • maternal nutrition (include folic acid supplementation)
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2
Q

Perfect first food for the newborn

A

Colustrum

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3
Q

When should infants latch and start breastfeeding

A

First 30 minutes to 1 hour after delivery

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4
Q

Optimal time of discharge of a healthy term newborn

A

Less than 48 hours after delivery

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5
Q

Red flag signs for atopy

A

Any child with family Hx of asthma, AD, AR, drug/food allergy who presents with symptoms of 1 or more of the ff:
1. Respiratory symptoms: chronic cough with or without wheezing, shortness of breath, chest tightness, trouble sleeping due to coughing, fatigue, problems with feeding or grunting
2. Nasal symptoms: frequent sneezing, rhinorrhea, itchiness, nasal congestion
3. Ocular symptoms: bluish, brownish discoloration around both eyes, puffiness under the eyes, dryness and itchiness
4. Skin symptoms: dryness and itchines
5. GI symptoms: itchiness of the roof of the mouth and throat, colic, vomiting, stomah cramps, diarrhea and bloody stools

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6
Q

If a child is <2 years old, measure
a. recumbent length
b. standing height

A

a. recumbent length

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7
Q

If a child is 2 years or more and able to stand, measure
a. recumbent length
b. standing height

A

b. Standing height

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8
Q

In general, standing height is _____ than recumbent length

A

0.7 cm less

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9
Q

Reliable growth indicator even when the age is not known

A

Weight for length/height

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10
Q

PNSP recommends routine BP measurement annually for all children

A

> 3 years of age or patients at risk
- children with obesity
- taking medications known to increase bp
-have renal disease
- has history if aortic branch obstruction or COA or diabetes

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11
Q

Normotension for 1-13 years old

A

BP <90th percentile for age, gender and height percentile

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12
Q

Normotension for 13 years old and above

A

120-129/80

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13
Q

Stage 1 hypertension for 1-13 years old

A

BP >95th percentile to <95th percentile +12 OR BP 130-149/80-89 which lever is lower

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14
Q

Stage 1 hypertension fir >13 years old

A

BP > 130/80 to 139/89

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15
Q

Stage 2 hypertension for 1-13 years old

A

BP >95th percentile + 12 or >140/90 whichever is lower

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16
Q

Stage 2 hypertension >13 years old

A

BP > 140/90

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17
Q

States obligation to inform - any health care practitioner who delivers or assists in the delivery of a newborn in the Philippines shall prior to delivery inform the parents or legal guardian of the newborn of the availability nature and benefits of newborn screening

A

RA 9288 (article 3 section 54)
Newborn screening act of 2004

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18
Q

Newborn screening should be ideally done ________ regardless of gestational age and clinical status

A

Immediately after 24 hours from birth

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19
Q

Preterm (<37 weeks), LBW (<2000 g) and sick neonates (in NICU) may have a sample taken _______ but otherwise a sample should be taken _______ and a repeat screening should be collected st the ______

A

before 24 hours from birth if blood transfusion will be done;
After 24 hours from birth;
28th day of life

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20
Q

eNBS available since

A

December 2014

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21
Q

How many disorders is covered by eNBS

A

28 disorders

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22
Q

States obligation to inform - any health care practitioner who delivers or assists in the delivery of a newborn in the Philippines shall prior to delivery inform the parents or legal guardian of the newborn of the availability nature and benefits of hearing loss screening among newborn or children 3 months and below

A

RA 9709
The universal newborn hearing screening and intervention act of 2009

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23
Q

RA 9288

A

Newborn screening act of 2004

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24
Q

RA 9709

A

Universal Newborn Hearing Screening and Intervention Act of 2009

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25
Q

All infants born in hospitals in the Philippines shall be made to undergo newborn hearing loss screening _______ unless the parents or legal guardians of the newborn object to the screening

A

Before discharge

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26
Q

Infants who are not born in hospitals should be screened

A

Within 3 months after birth

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27
Q

In the event of a positive newborn hearing loss screening result, the newborn shall undergo audiologic diagnostic evaluation in a timely manner to allow appropriate follow up, recall and referral for intervention ______

A

Before the age of 6 months

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28
Q

Single most effective way of determining eye’s health is through

A

Eye and vision screening test

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29
Q

PPS blindness prevention and vision screening asserts the following

A
  • proper dietary supplementation
  • measles immunization
  • routine pediatric eye evaluation for all patients
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30
Q

Most common presenting signs of retinoblastoma

A

Leukocoria and strabismus

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31
Q

Mandates the creation of a national rabies prevention and control program

A

RA 9482 (Anti Rabies Act of 2007)

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32
Q

Criteria for screening retinopathy of prematurity

A
  1. 32 weeks or younger
  2. 1500g or lighter
  3. > 32 weeks and >1500g with a stormy medical course in the NICU
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33
Q

High risk infants should be referred to an ophthalmologist

A
  1. Premature infants whose age of gestation or weight meets the criteria for screening of retinopathy of prematurity
  2. Infants and children with metabolic disorders
  3. Infants and children with medical conditions known to have associated eye problems (Down syndrome, idiopathic arthritis, neurofibromatosis)
  4. Infants and children with history of squinting, head tilt or head turn
  5. Children with history of visual difficulties
  6. Family history of strabismus, amblyopia, congenital cataract, congenital glaucoma, retinoblastoma, ocular and systemic genetic disease
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34
Q

Visual acuity assessment for infants and preverbal children

A

Fixes and follows test - fixation behavior can be determined by using a toy, picture, or other interesting objects as a target, unoccluded eyes and with one eye occluded.

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35
Q

Visual acuity test for preschoolers who are not familiar with letters

A

LEA chart

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36
Q

Visual acuity test for literate children

A

HOTV chart

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37
Q

Children age 3 to 3 11/12 years old and below should be able to read at least

A

20/50 (10/25) or better

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38
Q

Children age 4 to 4 11/12 years old should be able to read at least

A

20/40 (10/20) or better

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39
Q

Children 5 years old and older are expected to read

A

20/30 (10/15)

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40
Q

Using LEA or its equivalent is preferably done at distance and near starting

A

3 years of age

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41
Q

Distance visual acuity should be tested ____ meters (_____ feet) or ____ (____ feet)

A

6 meters (20 feet); 3 meters (10 feet)

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42
Q

Reading distance should be tested at

A

34-40 cm (14-16 inches)

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43
Q

Iron supplementation for low birth weight infants

A

0.3 mL once a day starting at 2 months to 6 months
(Drops: 15mg elemental iron/0.6 mL)

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44
Q

Iron supplementation 6-11 months

A

0.6 mL once a day for 3 months
(15mg elemental iron/0.6mL)

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45
Q

Iron supplementation for children 1-5 years old

A

1 teaspoonful/5mL once a day for 3 months or 1 teaspoon/5mL once a week for 6 months
(30mg elemental iron/5mL)

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46
Q

Iron supplementation adolescent girls (10-19)

A

1 tab once a day
(Tablet containing 60mg elemental iron with 400mcg folic acid)

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47
Q

Vitamin A supplementation 6-11 months

A

1 dose of 100,000 IU - given anytime between 6-11 months (usually at 9 months during measles immunization)

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48
Q

Vitamin A supplementation children 12-59 months

A

1 capsule (200,000 IU) every 6 months

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49
Q

Zinc supplementation has beneficial rile in the prevention of

A

Pneumonia and diarrhea

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50
Q

Dewroming is recommended for all children aged

A

1-12 tears old

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51
Q

Deworming 12-23 months

A

Albendazole 200 mg single dose every 6 months

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52
Q

Deworming > 12 months

A

Mebendazole 500 mg single dose every 6 months

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53
Q

Deworming > 24 months

A

Albendazole 400 mg single dose every 6 months or
Mebendazole 500 mg single dose every 6 months

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54
Q

Deworming must not be done in children with

A
  1. Severe malnutrition
  2. High grade fever
  3. Abdominal pain
  4. Profuse diarrhea
  5. Severe illness
  6. Previous hypersensitivity to antihelminthic drug
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55
Q

Mass treatment with ______ for areas endemic with filiariasis

A

Diethylcarbamazine citrate and albendazole for children 2 years and above

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56
Q

First dental visit should be done

A

First tooth eruptuin and no longer than 12 months

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57
Q

Use of flouride containing toothpaste as primary preventive measure

A

Twice daily

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58
Q

Recommended flouride toothpaste 6 months to less than 2 years old

A

1000 ppm, twice daily, smear (2.5 mm, 0.125 g)

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59
Q

Recommended use of flouride toothpaste in children 2 to 6 years old

A

1000 ppm, twice daily, pea size (5mm, 0.25 mg)

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60
Q

Recommended use of lfouride toothpaste in children 6 years and above

A

1500 ppm, twice daily, full length of bristle (10-20mm) 0.5-1.0 g

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61
Q

Children at moderate caries risk shoukd receive a professional fluoride treatment

A

At least every 6 months

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62
Q

Mothers must be encouraged to exclusively breastfeed up to

A

6 months and continued on up to 2 years old and beyond

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63
Q

Allow the baby to suck _______ minutes per breast to extract foremilk and hindmilk

A

25-30 minutes per breast

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64
Q

Empty the breadt around _______ to ensure adequate milk supply

A

8 - 10 times a day

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65
Q

Recommended breastmilk storage period in room temp >25 C

A

1 hour

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66
Q

Recommended breastmilk storage period in room temp <25 C

A

4 hours

67
Q

Recommended breastmilk storage period in room temp refrigerator 4 C

A

8 days

68
Q

Recommended breastmilk storage period in freezer of a 1 door ref

A

2 weeks

69
Q

Recommended breastmilk storage period in freezer of a 2 door ref

A

3 months

70
Q

Recommended breastmilk storage period in deep freezer with constant temp of -20 C

A

6 months

71
Q

Complimentary feeding start pureed foods at

A

6 months

72
Q

Introduce finger foods around

A

8 months of age

73
Q

Introduce lumpy or chopped foods at

A

10 months of age

74
Q

Introduce table food at

A

12 months of age

75
Q

Frequency of complimentary feeding for 6-8 months

A

2-3x a day

76
Q

Frequency of complimentary feeding for 9-24 months

A

3-4x a day

77
Q

How to introduce conplimentary feeding

A
  • begin with one new food at a time to be given for 3 days
  • start with lugaw, cereal, fruits and vegetables one to 2 teaspoons a day
  • pureed food at 6 months
  • finger food at 8 months
  • lumpy or chopped food at 10 months
  • table food at 12 months
  • offer a variety of food
  • avoid drinks with low nutrient value (sweet beverages)
  • do not add salt to the infant’s diet BEFORE 1 year of age
    -give supplements of iron, zinc, calcium and vitamin B12 if diet is primarily plant based
  • practice responsive feeding
    -feed sliwly and patiently
  • do not force feed
    -make feeding a pleasurabke experience
78
Q

Age appropriate physical activities for chcikdren and adolescents for

A

60 minutes daily or on most days of the week

79
Q

States that the head of any public or private hospital, medical clinic and similar institution, as well as attending physician and nurse, shall report either orally or in writing to the dswd the examination and/or treatment of a chikd who appears to have suffered abuse within 48 hours from knowledge

A

RA 7610 (Anti child abuse law)

80
Q

Best studied effect of lead is

A

Cognitive impairment

81
Q

CBC at least once between the following intervals for those at risk of IDA

A

6-24 months, 2-6 years, 10-19 years

82
Q

Philippine society of adolescent medicine specialists recommends a CBC

A

at each stage of adolescence

83
Q

Annual health screening of adolescents for sexually active females should include

A

Vaginal wet mount and PAP smear

84
Q

Sexually active males must undergo serologic test for

A

Syphilis

85
Q

Both male and female sexually active adolescents should have annual

A

Non culture test for gonorrhea and chlamydia

86
Q

PPD is considered positive if

A

> 5 mm in the presence of history of close contact with a known ir suspected case of tb, clinical findings suggestive of th, chest xray suggestive of tb, immunosuppressed condition

> 10 mm in the absence of above factors

87
Q

EINC sequence

A

Immediate and thorough drying
Early skin to skin contact between mother and newborn
Nonseparation of newborn and mother
Early breastfeeding

88
Q

Minimum criteria for dischcarging newborns before 48 hours

A

-uncomplicated antepartum, intrapartyn and postpartum courses for the mother and newborn
-vaginal delivery, singleton, completed 37 weeks AGA
- normal and stable VS during the preceeding 12 hours
- has urinated and passed at least one stool
- has documented proper latch, milk transfer, swallowing, infant satiety and absence of nipple discomfort
- normal PE
- no evidence of significant jaundice in the first 24 hours of life
-educability and ability of the parents to care for their child
- must folloe up within the next 48 hours

89
Q

Screening for scoliosis for females

A

10-12 years

90
Q

Screening for scoliosis for males

A

13-14 years

91
Q

Psychosocial assessment using HEADSSSS frequency

A

Annual

92
Q

Alcohil, tobacco and drug substance use assessment using CRAFFT

A

Annual

93
Q

Depression screening using PH-Q 9

A

Annual starting at 12 years old

94
Q

Developmental surveillance should be done

A

Every well child visit

95
Q

Process by which a health care professional recognizes the children who may be at risk of developmental and behavioral conditions

A

Developmental surveillance

96
Q

Developmental screening should be done at

A

9, 18 and 30 months then yearly thereafter

97
Q

Provess of administering a standardized took designed to identify children who are at risk for developmental and behavioral disorders

A

Developmental screening

98
Q

At ___ and ___ months, an ASD specific screening tool (MCHAT) should be routinely administered

A

18 and 24 months

99
Q

Dose of BCG for < 12 months of age

A

0.05 mL

100
Q

Dose of BCG for > 12 months of age

A

0.1 mL

101
Q

BCG is given at the ______ within the first ______ of life.

A

Earliest time after birth
Within first 2 months of life

102
Q

PPD is recommended prior to BCG vaccination for infants and children > 2 months if

A
  1. Congenital TB
  2. History of close contact to known or suspected infectious TB cases
  3. Clinical findings suggestive of TB
103
Q

Administer the first dose of monovalent HBV

A

All newborns > 2kgs within 24 hours of life

104
Q

For infants born to HbsAg (+) mothers

A

Administer HBV and HBIG (0.5mL) WITHIN 12 hours of life.

HBIG should bot be administered not later than 7 days of age if not immediately available

105
Q

For infants born to mothers witth unknown HBsAg with birthweight > 2 kgs

A

Administer HBV within 12 hours of birth and determine the mother’s HBsAg ASAP.

If HBsAg (+) administer also HBIG nt later than 7 days of age

106
Q

For infants born to mothers with unknown HBsAg with birthweight < 2 kgs

A

Administer HBIG in addition to HBV within 12 hours of life

107
Q

For preterm infants born to HBsAg (-) mothers and medically stable, 1st dose of HBC may be given

A

30 days of chronological age regardless of weight and this can be counted as part of the 3 dose primary series

108
Q

For preterm infants <2 kgs

A

1st dose received at birth is not counted as part of vaccine series. Additional 3 HBV doses are needed

109
Q

How many doses of DTP should be given

A

5 dose series at 2, 4, 6, 14, and 18 months and 4 through 6 years

110
Q

Primary series of IPV consist of

A

3 doses

111
Q

Last dose of rotavirus should be administered not later than

A

32 weeks of age

112
Q

Monovalent human rotavirus vaccine is given as

A

2 dose series

113
Q

Pentavalent human bovine rotavirus vaccine is given as

A

3 dose series

114
Q

Primary vaccination with PCV consists of ___ doses with an interval of at least _ weeks plus a booster dose given _ months after the last dose

A

3 doses;
4 week interval;
6 months after 3rd dose

115
Q

Healthy children 2 to 5 years old who do not have previous PCV vaccination may be given

A

1 dose of PCV 13 or
2 doses of PCV 10 at least 8 weeks apart

116
Q

Trivalent influenza vaccine is given

A

IM or SQ

117
Q

Quadrivalent influenza vaccine is given

A

IM

118
Q

Influenza vaccine is given at a minimum age of

A

6 months

119
Q

Dose of influenza vaccine is ___ mL for children 6 - 35 months

A

0.25 mL

120
Q

Dose of influenza vaccine is ___ mL for children 36 months - 18 years

A

0.5 mL

121
Q

Annual influenza vaccination should begin in _____

A

February but may be given throughout the year

122
Q

BCG is given

A

Intradermally

123
Q

Hepatitis B vaccine is given

A

Intramuscularly

124
Q

PentaHib is given

A

Intramuscularly

125
Q

IPV is given

A

Intramuscularly

126
Q

Rotavirus vaccine is given

A

Per orem

127
Q

PCV is given

A

Intramuscularly

128
Q

Measles vaccine is given

A

Subcutaneously

129
Q

Measles vaccine is given at the age of

A

9 months, but as early as 6 months in cases of outbreaks

130
Q

Japanese encephalitis vaccine is given

A

Subcutaneously

131
Q

Minimum age of giving JE vaccine

A

9 months

132
Q

Children 9 months to 17 years old should receive JE vaccine

A

1 primary dose followed by a booster dose 12-24 months after the primary dose

133
Q

Individuals 18 years and older should receive JE vaccine

A

Single dose only

134
Q

MMR vaccine is given

A

Subcutaneously

135
Q

Minimum age of giving MMR

A

12 months of age

136
Q

Recommended doses of MMR

A

2 doses, 2nd dose usually given 4-6 years of age but may be given at an earlier age with a minimum of 4 weeks interval between doses

137
Q

Varicella vaccine is given

A

Subcutaneously

138
Q

Minimum age of giving varicella vaccine

A

12 months

139
Q

Recommended doses ot varicella vaccine

A

2 doses

140
Q

Hepatitis A vaccine is given

A

IM

141
Q

Minimum age of giving HAV

A

12 months

142
Q

HPV is given

A

IM

143
Q

Recommended doses for HPV in children 9-14 years old

A

2 dose series of bivalent, quadrivalent or nonavalent given at 0 and 6 months

144
Q

Recommended doses of HPV in 15 years old above

A

3 dose series of bivalent, quadrivalent or nonavalent at 0, 2, 6 months

145
Q

Td/Tdap is given

A

IM

146
Q

For children who are fully immunized, Td booster is given

A

Every 10 years

147
Q

For fully immunized pregnant adolescents with TDap, administer

A

1 dose of Tdap vaccine during 27 to 36 weeks AOG regardless of previous Td or Tdap vaccination

148
Q

For unimmunized pregnant adolescents with TDap, administer

A

3 dose Td vaccine following a 0-1-6 month schedule.

149
Q

For unimmunized pregnant adolescents with TDap, administer

A

3 dose Td vaccine following a 0-1-6 month schedule.

150
Q

Hib conjugate vaccine is given

A

IM

151
Q

For chikdren <= 5 years old who received a Hib vaccine dose during or within 14 days of starting chemotherapy or radiation treatment

A

Repeat dose of Hib vaccine at least 3 months after completion of therapy

152
Q

For children who are hematopoetic stem cell transplant recipients revaccination with Hib vaccine

A

3 doses given 4 weeks apart, starting 6-12 months after transplant is recommended regardless of vaccination history

153
Q

Unimmunized children >=15 months and undergoing elective splenectomy should be given

A

1 dose of Hib containing vaccine at least 14 days before the procedure

154
Q

Unimmunized children 5-18 years ild with either anatomic or functiinak asplenia (including sickle cell disease) or HIV infection, should be given

A

1 dose of Hib vavcine

155
Q

Tetravalent meningococcal vaccine is given

A

IM

156
Q

Meningococcal vaccine is indicated for those at high risk for invasive disease such as

A

Persistent complement component deficiencies ( inherited or chronic deficiencies in C3, C5-9, properidin, factor D, factor H), anatomic/functional asplenia, HIV, travelers to or resident of areas where meningococcak disease is hyperendemic

157
Q

Minimum age for MCV4-D (meningococcal vaccine)

A

9 months

158
Q

Rabies vaccine is given

A

IM or ID

159
Q

Rabies preexposure prophylaxis

A

Intramuscular regimen: PVRV 0.5 mL or PCECV 1 mL given on days 0, 7, 21, or 28

Intradermal regimen: PVRV or PCECV 1 mL given on days 0, 7, 21 or 28

160
Q

In the event of subsequent rabies exposure, those who have completed 3 doses of preexposyre prophylaxis regardless of the interval between exposure and last dose of the vaccine will require

A

Only booster doses given on day 0 and 3. No need to give immuneglobulin

161
Q

Typhoid vaccine is given

A

IM

162
Q

Minimum age of giving typhoid vaccine and revacinnation every

A

2 years old with revaccination every 2-3 years

163
Q

Cholera vaccine is given

A

Per orem

164
Q

Minimum age of giving cholera vaccine

A

12 months as a 2 dose series 2 weeks apart

Preventive Pediatrics 2018 (1 decks)

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