Preventive Pediatrics Flashcards
1
Q
EINC
A
Essential Intrapartum and Newborn Care
“Unang Yakap”
2
Q
EINC Steps
A
- immediate and thorough drying
- early skin-to-skin contact
- properly-timed cord clamping
- non-separation, early breastfeeding
3
Q
EINC Step 1
A
immediate and thorough drying
4
Q
EINC Step 2
A
early skin-to-skin contact
5
Q
EINC Step 3
A
properly-timed cord clamping
6
Q
EINC Step 4
A
non-separation, early breastfeeding
7
Q
Exclusive breastfeeding up to _____.
A
6 months
8
Q
Continued breastfeeding up to _____.
A
2 years
9
Q
Pregnant women should be informed about the deleterious effects of _____, _____ and _____ during pregnancy.
A
smoking, alcohol, teratogens
10
Q
_____ immunization should be started or continued during pregnancy.
A
Tetanus Toxoid
11
Q
Discharging newborns before 48 hours:
_____ antepartum, intrapartum and postpartum courses for both mother and newborn.
A
Uncomplicated
12
Q
Discharging newborns before 48 hours:
Outcome
A
SVD, singleton, ≥ 37 weeks, AGA
13
Q
Discharging newborns before 48 hours:
Vital Signs during the preceding 12 hours
A
RR < 60
HR 100-160
axillary T 36.5-37.4 (clothed, open crib)
14
Q
Discharging newborns before 48 hours:
Output
A
with UO
at least 1 BM
15
Q
Discharging newborns before 48 hours:
Breastfeeding
A
proper latch milk transfer swallowing infant satiety (-) nipple discomfort
16
Q
Discharging newborns before 48 hours:
PE
A
normal
17
Q
Discharging newborns before 48 hours:
Jaundice
A
(-) jaundice for the first 24 hours
18
Q
Discharging newborns before 48 hours:
_____ and ability of the parents to _____.
A
Educability, care for the child
19
Q
Discharging newborns before 48 hours:
Follow-Up
A
within 48 hours
20
Q
How often should adolescents undergo health screening?
A
annually
21
Q
HEEADSSS: H
A
Home
22
Q
HEEADSSS: E
A
Education/Employment
Eating
23
Q
HEEADSSS: A
A
Activities
24
Q
HEEADSSS: D
A
Drugs
25
HEEADSSS: S
Sexuality
Suicidal Ideations/Depression
Safety
26
Adolescent Health Care: PE
Tanner Staging/SMR
Breast Examination
Spine and Shoulders (scoliosis, kyphosis)
Genitals and Anus
27
Adolescent Health Care: CBC
every stage of adolescence
28
Adolescent Health Care: urinalysis
first encounter
29
Adolescent Health Care: vaginal wet mount/Pap smear
sexually active females
30
Adolescent Health Care: serologic syphilis test
sexually active males
31
Adolescent Health Care: test for gonorrhea and chlamydia
sexually active males and females
32
Adolescent Health Care: Anticipatory Guidance and Counseling
self breast examination
healthy lifestyle
sexual behavior (STDs, HIV)
injury and accident prevention
33
Developmental surveillance should be done _____.
at every well child visit
34
Developmental Surveillance Components
```
parent's concerns
developmental history
observation of the child
risk and protective factors
document the process and findings
```
35
Developmental Surveillance: specified ages
9, 18 and 30 months
| every year thereafter
36
Social-Emotional Red Flags:
| lack of smiles or other joyful expressions
6 months
37
Social-Emotional Red Flags:
| lack of reciprocal (back-and-forth sharing of) vocalizations, smiles, or other facial expressions
9 months
38
Social-Emotional Red Flags:
failure to respond to name when called
absence of babbling
lack of reciprocal gestures (showing, reaching, waving)
12 months
39
Social-Emotional Red Flags:
lack of proto-declarative pointing or other showing gestures
lack of single words
15 months
40
Social-Emotional Red Flags:
lack of simple pretend play
lack of spoken language/gesture combinations
18 months
41
Social-Emotional Red Flags:
| lack of two-word meaningful phrases (without imitating or repeating)
24 months
42
Social-Emotional Red Flags:
| loss of previously acquired babbling, speech or social skills
any age
43
Social-Emotional Red Flags:
| 6 months
lack of smiles or other joyful expressions
44
Social-Emotional Red Flags:
| 9 months
lack of reciprocal (back-and-forth sharing of) vocalizations, smiles, or other facial expressions
45
Social-Emotional Red Flags:
| 12 months
failure to respond to name when called
absence of babbling
lack of reciprocal gestures (showing, reaching, waving)
46
Social-Emotional Red Flags:
| 15 months
lack of proto-declarative pointing or other showing gestures, lack of single words
47
Social-Emotional Red Flags:
| 18 months
lack of simple pretend play
| lack of spoken language/gesture combinations
48
Social-Emotional Red Flags:
| 24 months
lack of two-word meaningful phrases (without imitating or repeating)
49
Social-Emotional Red Flags:
| any age
loss of previously acquired babbling, speech or social skills
50
Motor Red Flags:
| lack of steady head control when sitting
4 months
51
Motor Red Flags:
| inability to sit
9 months
52
Motor Red Flags:
| inability to walk independently
18 months
53
Motor Red Flags:
| 4 months
lack of steady head control when sitting
54
Motor Red Flags:
| 9 months
inability to sit
55
Motor Red Flags:
| 18 months
inability to walk independently
56
Receptive Language Red Flags:
| does not alert or quiet to sound
2 months
57
Receptive Language Red Flags:
| does not turn to source of sound
6 months
58
Receptive Language Red Flags:
| does not respond to own name
10 months
59
Receptive Language Red Flags:
| does not follow verbal routines/games
12 months
60
Receptive Language Red Flags:
does not understand simple questions
does not stop when told "NO"
does not understand at least 3 different words
15 months
61
Receptive Language Red Flags:
does not point to 3 body parts
does not follow simple commands
18 months
62
Receptive Language Red Flags:
| does not follow 2 part commands
30 months
63
Receptive Language Red Flags:
| does not answer simple questions
36 months
64
Receptive Language Red Flags:
| 2 months
does not alert or quiet to sound
65
Receptive Language Red Flags:
| 6 months
does not turn to source of sound
66
Receptive Language Red Flags:
| 10 months
does not respond to own name
67
Receptive Language Red Flags:
| 12 months
does not follow verbal routines/games
68
Receptive Language Red Flags:
| 15 months
does not understand simple questions
does not stop when told "NO"
does not understand at least 3 different words
69
Receptive Language Red Flags:
| 18 months
does not point to 3 body parts
| does not follow simple commands
70
Receptive Language Red Flags:
| 30 months
does not follow 2 part commands
71
Receptive Language Red Flags:
| 36 months
does not answer simple questions
72
Expressive Language Red Flags:
| does not coo
6 months
73
Expressive Language Red Flags:
| does not babble
10 months
74
Expressive Language Red Flags:
| 6 months
does not coo
75
Expressive Language Red Flags:
| absence of pointing
14 months
76
Expressive Language Red Flags:
| does not say 3 different spontaneous words
16 months
77
Expressive Language Red Flags:
vocabulary of not more than 35-50 words
does not produce 2-word phrases
24 months
78
Expressive Language Red Flags:
| no simple sentences
36 months
79
Expressive Language Red Flags:
| intelligibility to unfamiliar adult at 50%
42 months
80
Expressive Language Red Flags:
| not able to tell or retell a familiar story
54 months
81
Expressive Language Red Flags:
| not fully intelligible to an unfamiliar adult
60 months
82
Expressive Language Red Flags:
| not fully mature speech sounds
> 72 months
83
Expressive Language Red Flags:
| 6 months
does not coo
84
Expressive Language Red Flags:
| 10 months
does not babble
85
Expressive Language Red Flags:
| 12 months
absence of non-verbal purposeful messages (show objects)
86
Expressive Language Red Flags:
| 14 months
absence of pointing
87
Expressive Language Red Flags:
| 16 months
does not say 3 different spontaneous words
88
Expressive Language Red Flags:
| 24 months
vocabulary of not more than 35-50 words
| does not produce 2-word phrases
89
Expressive Language Red Flags:
| 36 months
no simple sentences
90
Expressive Language Red Flags:
| 42 months
intelligibility to unfamiliar adult at 50%
91
Expressive Language Red Flags:
| 54 months
not able to tell or retell a familiar story
92
Expressive Language Red Flags:
| 60 months
not fully intelligible to an unfamiliar adult
93
Expressive Language Red Flags:
| > 72 months
not fully mature speech sounds
94
Eye and Vision Screening:
| Premature infants who are _____, _____ and _____ should undergo screening.
≤ 32 weeks
≤ 1500 g
stormy medical course
95
Eye and Vision Screening:
| Infants and children with _____ and/or _____ should undergo screening.
metabolic disorders
| medical conditions with associated eye problems
96
Eye and Vision Screening:
| Infants and children with a history of _____, _____ and/or _____ should undergo screening.
squinting
head tilt
head turn
97
Eye and Vision Screening:
| Children with _____ and/or _____ should undergo screening.
visual difficulties
| learning problems
98
Eye and Vision Screening:
| Family History
```
strabismus
amblyopia
congenital cataract
congenital glaucoma
retinoblastoma
ocular and systemic genetic diseases
```
99
Visual Acuity Assessment Tests
Fixes and Follows Test
| Subjective/Formal Visual Acuity Testing
100
Visual Acuity Assessment:
| test for preschoolers or children who are not familiar with letters
LEA Pictures Chart
101
Visual Acuity Assessment:
| test for literate children
Sloan Letters
| HOTV Chart
102
Visual Acuity: 3 years old
20/50 (10/25)
103
Visual Acuity: 4 years old
20/40 (10/20)
104
Visual Acuity: 5 years old
20/30 (10/15)
105
Ocular Motility Assessment
Corneal Light Reflex
Versions and Ductions
Cross Cover Test
106
Red Orange Reflex Examination:
| Light reflects back from the _____.
choroidal blood vessels
107
LEA Chart:
| Age
3 years old
108
LEA Chart:
| Distance
```
6 meters (20 ft) or 3 meters (10 ft)
34-40 cm (14-16 in) - reading distance
```
109
LEA Chart:
| Test Result
at least 4/5 symbols read correctly
110
Use of Fluoride Toothpaste
twice daily
111
Use of Fluoride Toothpaste:
6 mos. to < 2 y.o.
Fluoride Concentration (ppm)
1000ppm
112
Use of Fluoride Toothpaste:
6 mos. to < 2 y.o.
Minimum Daily Use
twice daily
113
Use of Fluoride Toothpaste:
6 mos. to < 2 y.o.
Amount of Toothpaste
smear
| 2.5mm / 0.125g
114
Use of Fluoride Toothpaste:
6 mos. to < 2 y.o.
Amount of Fluoride (mg)
0.25mg
115
Use of Fluoride Toothpaste:
2-6 y.o.
Fluoride Concentration (ppm)
1000ppm
116
Use of Fluoride Toothpaste:
2-6 y.o.
Minimum Daily Use
twice daily
117
Use of Fluoride Toothpaste:
2-6 y.o.
Amount of Toothpaste
pea size
| 5mm / 0.25g
118
Use of Fluoride Toothpaste:
2-6 y.o.
Amount of Fluoride (mg)
0.5mg
119
Use of Fluoride Toothpaste:
> 6 y.o.
Fluoride Concentration (ppm)
1500ppm
120
Use of Fluoride Toothpaste:
> 6 y.o.
Minimum Daily Use
twice daily
121
Use of Fluoride Toothpaste:
> 6 y.o.
Amount of Toothpaste
full length of bristle
| 10-20mm / 0.5-1g
122
Use of Fluoride Toothpaste:
> 6 y.o.
Amount of Fluoride (mg)
1mg
123
Topical Fluoride Treatment
every 6 mos.
124
Benefits of Breastmilk
1. safe, sterile, always available
2. perfect nutrients up to 6 mos.
3. easily digested
4. contains antibodies
5. contains fats (DHA)
125
Advantages of Breastfeeding
1. emotional bonding
2. protects mother's health
3. return to pre-pregnancy weight
4. financial savings
126
Correct Breastfeeding Techniques:
| _____ the baby's head and the entire body.
Support
127
Correct Breastfeeding Techniques:
| Head, back and hips should be facing the _____ and aligned in a _____ manner.
breast, straight
128
Correct Breastfeeding Techniques:
| Maintain the position of the baby in such a way that he is _____.
face to face
chest to chest
tummy to tummy
129
Correct Breastfeeding Techniques:
| Support the breast with the hand of the _____ arm in a _____ position.
opposite, C-hold
130
Correct Breastfeeding Techniques:
| Stimulate the infant to open the mouth wide by _____.
stroking the corner of the baaby's lips
131
Correct Breastfeeding Techniques:
| Check that the chin touches the _____ and the lower lip is turned _____.
breast, outward
132
Correct Breastfeeding Techniques:
| Ensure that the baby grasps the _____.
entire nipple plus one inch of the surrounding areola
133
Correct Breastfeeding Techniques:
| Allow the baby to suck _____ per breast to extract both _____.
15-30 mins., foremilk and hindmilk
134
Correct Breastfeeding Techniques:
| Empty the breast around _____ a day.
8-10 times
135
Breastmilk Storage:
| Store in _____ containers labeled with _____ of breastmilk collection.
sterile polypropylene (cloudy hard plastic), date and time
136
```
Breastmilk Storage:
room temperature (<25°C)
```
4 hours
137
```
Breastmilk Storage:
room temperature (>25°C)
```
1 hour
138
Breastmilk Storage:
| refrigerator (4°C)
8 days
139
Breastmilk Storage:
| freezer of a 1-door refrigerator
2 weeks
140
Breastmilk Storage:
| freezer of a 2-door refrigerator
3 months
141
```
Breastmilk Storage:
deep freezer (-20°C)
```
6 months
142
Diet of a Lactating Mother:
| rice
6 cups
143
Diet of a Lactating Mother:
| fruits
vitamin C-rich
different varieties
4 pieces
144
Diet of a Lactating Mother:
| vegetables
green leafy
yellow
1 1/2 cups
145
Diet of a Lactating Mother:
| meat, fish, poultry, seafood
5 matchbox-size pieces
| 2 cups cut into small pieces
146
Diet of a Lactating Mother:
| eggs
4 pieces a week
147
Diet of a Lactating Mother:
| beans
1 1/2 cups 3x/week
148
Diet of a Lactating Mother:
| milk
2 glasses
149
Diet of a Lactating Mother:
| fats
7 teaspoons
150
Diet of a Lactating Mother:
| fluids
7 glasses of water
| 1 glass of fresh fruit juice
151
Complementary food must be:
1. timely
2. adequate
3. safe
4. properly fed
152
Introducing Complementary Food:
| Begin with _____ to be given for _____.
one new food at a time, 3 days
153
Introducing Complementary Food:
| Start with _____, giving _____ a day.
porridge, cereal, fruits, vegetables
| 1-2 teaspoons
154
Introducing Complementary Food:
| pureed food
6 months
155
Introducing Complementary Food:
| finger food
8 months
156
Introducing Complementary Food:
| lumpy or chopped food
10 months
157
Introducing Complementary Food:
| table food
12 months
158
Introducing Complementary Food:
| 6-8 mos., frequency
2-3x/day
159
Introducing Complementary Food:
| 9-24 mos., frequency
3-4x/day
160
Introducing Complementary Food:
| snacks
1-2x/day
161
Introducing Complementary Food:
| Do not add SALT before _____.
1 y.o.
162
Introducing Complementary Food:
| Give _____ if diet is primarily plant based.
iron, zinc, calcium, vitamin B12
163
Child Maltreatment:
| Recognize and report ongoing child maltreatment.
R.A. 7610
164
Child Maltreatment:
| R.A. 7610
Recognize and report ongoing child maltreatment.
165
Child Maltreatment:
| Establish Women and child protection in all government hospitals.
DOH Administrative Order 2013-0011
166
Child Maltreatment:
| DOH Administrative Order 2013-0011
Establish Women and child protection in all government hospitals.
167
Anticipatory Guidance for Prevention of Violence Against Children (VAC):
Infancy
domestic violence
infant crying
dangers of shaking
168
Anticipatory Guidance for Prevention of Violence Against Children (VAC):
Toddler
domestic violence
positive discipline
safety in others' homes or with other people
169
Anticipatory Guidance for Prevention of Violence Against Children (VAC):
Pre-School
```
domestic violence
positive discipline
safety in others' homes or with other people
normal sexual behavior
good vs. bad touch
```
170
Anticipatory Guidance for Prevention of Violence Against Children (VAC):
School Age
```
domestic violence
positive discipline
safety in others' homes or with other people
normal sexual behavior
good vs. bad touch
bullying
peer relationships
mobile phone and internet safety
```
171
Anticipatory Guidance for Prevention of Violence Against Children (VAC):
Adolescence
```
domestic violence
positive discipline
safety in others' homes or with other people
normal sexual behavior
good vs. bad touch
bullying
peer relationships
mobile phone and internet safety
alcohol and substance abuse
dating violence
```
172
Child Maltreatment:
| Protective Factors
```
secure attachment
parental care
(-) delinquent or substance-abusing peers
warm and supportive relationship
(-) abuse-related stress
```
173
Child Maltreatment:
| promising Child maltreatment Prevention Programs
Home Visits
Parent Education
Sexual Abuse Prevention (schools)
Hospital-Based Parent Education (Shaken Baby Syndrome)
174
7 Steps to Protect Children
1. Learn the facts.
2. Minimize opportunities for abuse.
3. Talk about it.
4. Stay alert.
5. Act on any suspicion of abuse.
6. Learn how to react.
7. Get involved.
175
Windows of Achievement:
| sitting w/o support
4-9 mos.
176
Windows of Achievement:
| standing with assistance
5-12 mos.
177
Windows of Achievement:
| crawling
5-14 mos.
178
Windows of Achievement:
| walking with assistance
6-14 mos.
179
Windows of Achievement:
| standing alone
7-17 mos.
180
Windows of Achievement:
| walking alone
8-18 mos.
181
Developmental Milestones of Early Literacy:
6-12 months
Motor Development
holds head steady
sits in lap without support
grasps book, puts in mouth
drops, throws book
182
Developmental Milestones of Early Literacy:
6-12 months
Communication and Cognition
```
smiles, babbles, coos
likes and wants your voice
likes pictures of baby faces
begins to say "ma", "ba", "da"
responds to own name
pats pictures to show interest
```
183
Developmental Milestones of Early Literacy:
6-12 months
Anticipatory Guidance
talk back and forth
```
make eye contact
cuddle, talk, sing, read,play
point at and name things
follow baby's cues ("more", "stop")
play games
```
184
Developmental Milestones of Early Literacy:
6-12 months
What to Read
board and cloth books
baby faces
nursery rhymes
185
Developmental Milestones of Early Literacy:
12-24 months
Motor Development
holds and walks with books
no longer puts book in mouth right away
turns book pages
186
Developmental Milestones of Early Literacy:
12-24 months
Communication and Cognition
```
says single words, then 2-4 word phrases
gives book to read
points at pictures
turns book right side up
names pictures
follows simple stories
```
187
Developmental Milestones of Early Literacy:
12-24 months
Anticipatory Guidance
smile and answer when your child speaks or points
let your child help turn the page
keep naming things
use books in family routines
use books to calm or distract while waiting
188
Developmental Milestones of Early Literacy:
12-24 months
What to Read
board books
rhymes
pictures
naming things
189
Developmental Milestones of Early Literacy:
2-3 years
Motor Development
learns to turn pages 2-3 pages at a time
| starts to scribble
190
Developmental Milestones of Early Literacy:
2-3 years
Communication and Cognition
adds 2-4 new words per day
names familiar objects
likes to read the same book
completes sentences and rhymes in familiar stories
191
Developmental Milestones of Early Literacy:
2-3 years
Anticipatory Guidance
ask questions ("where", "what")
read the same book
talk about the pictures
use books in daily routines
192
Developmental Milestones of Early Literacy:
2-3 years
What to Read
rhymes
pictures books that tell stories
search and find books
193
Developmental Milestones of Early Literacy:
3-4 years
Motor Development
turns pages one at a time, left to right
sits still for longer stories
scribbles and draws
194
Developmental Milestones of Early Literacy:
3-4 years
Communication and Cognition
recites whole phrases
moves toward letter recognition
begins to detect rhyme
pretends to read to toys
195
Developmental Milestones of Early Literacy:
3-4 years
Anticipatory Guidance
```
ask questions ("What happens next?")
point out letters and numbers
point out words and pictures that begin with the same sound
make up stories about the pictures together
```
196
Developmental Milestones of Early Literacy:
3-4 years
What to Read
picture books that tell longer stories
| counting and alphabet books
197
Developmental Milestones of Early Literacy:
4-5 years
Motor Development
starts to copy letters and numbers
| sits still for even longer stories
198
Developmental Milestones of Early Literacy:
4-5 years
Communication and Cognition
```
can listen longer
recognizes numbers and letters
can retell familiar stories
can make rhymes
learning letter names and sounds
```
199
Developmental Milestones of Early Literacy:
4-5 years
Anticipatory Guidance
relate the story to your child's own experiences
let your child see you read
ask your child to tell the story
encourage writing and drawing
point out the letters in your child's name
200
Developmental Milestones of Early Literacy:
4-5 years
What to Read
fairy tales and legends
books with longer stories
fewer pictures
201
Z-Score Interpretation:
| Length/Height for Age below 2
stunted
202
Z-Score Interpretation:
| Length/Height for Age below 3
severely stunted
203
Z-Score Interpretation:
| Weight for Age below 2
underweight
204
Z-Score Interpretation:
| Weight for Age below 3
severely underweight
205
Z-Score Interpretation:
| Weight for Length/Height above 3
obese
206
Z-Score Interpretation:
| Weight for Length/Height above 2
overweight
207
Z-Score Interpretation:
| Weight for Length/Height above 1
possible risk of overweight
208
Z-Score Interpretation:
| Weight for Length/Height below 2
wasted
209
Z-Score Interpretation:
| Weight for Length/Height below 3
severely wasted
210
Z-Score Interpretation:
| BMI for Age above 3
obese
211
Z-Score Interpretation:
| BMI for Age above 2
overweight
212
Z-Score Interpretation:
| BMI for Age above 1
possible risk for overweight
213
Z-Score Interpretation:
| BMI for Age below 2
wasted
214
Z-Score Interpretation:
| BMI for Age below 3
severely wasted
215
Immunization:
Bacillus-Calmette Guarin (BCG)
type
live attenuated
216
Immunization:
Bacillus-Calmette Guarin (BCG)
route
intradermal (ID)
217
Immunization:
Bacillus-Calmette Guarin (BCG)
dose
0. 05 ml for < 12 mos.
| 0. 1 ml for > 12 mos.
218
Immunization:
Bacillus-Calmette Guarin (BCG)
schedule
ideally at birth
| first 2 months
219
Immunization:
Bacillus-Calmette Guarin (BCG)
PPD prior to vaccination
congenital TB
close contact to case of TB
clinical/x-ray findings suggestive of TB
*induration > 5mm is considered positive
220
Immunization:
Hepatitis B (Hep B)
route
intramuscular (IM)
221
Immunization:
Hepatitis B (Hep B)
schedule
first 12 hours of life
222
```
Immunization:
Hepatitis B (Hep B)
minimum interval
```
4 weeks
223
```
Immunization:
Hepatitis B (Hep B)
final dose
```
not earlier than 24 weeks
*another dose is needed if the last dose was given at age < 24 weeks
224
Immunization:
Hepatitis B (Hep B)
preterm, HBsAg (-) mother
1st dose at 30 days
*another dose for those < 2 kg whose 1st dose was given at birth
225
Immunization:
Hepatitis B (Hep B)
HBsAg (+) mother
HBV and HBIg (0.5ml) within 12h, no later than 7 days
226
Immunization:
Hepatitis B (Hep B)
unknown HBsAg status, ≥ 2 kg
give HBV within 12 hours
| determine mother's HBsAg status
227
Immunization:
Hepatitis B (Hep B)
unknown HBsAg status, < 2 kg
HBV and HBIg (0.5ml) within 12h
228
Immunization:
Diphtheria and Tetanus Toxoid and Pertussis Vaccine (DTP)
route
intramuscular (IM)
229
Immunization:
Diphtheria and Tetanus Toxoid and Pertussis Vaccine (DTP)
schedule
minimum 6 weeks
230
Immunization:
Diphtheria and Tetanus Toxoid and Pertussis Vaccine (DTP)
interval
4 weeks
* 4-6 months between 3rd and 4th dose
* 5th dose may not be given if the 4th dose was given at ≥ 4 y.o.
231
Immunization:
Haemophilus influenzae type B (HiB)
type
conjugate vaccine
232
Immunization:
Haemophilus influenzae type B (HiB)
schedule
3-dose primary series
| minimum 6 weeks
233
Immunization:
Haemophilus influenzae type B (HiB)
interval
4 weeks
234
Immunization:
Haemophilus influenzae type B (HiB)
booster
12-15 months
| 6 months from 3rd dose
235
```
Immunization:
Poliovirus Vaccine (OPV/IPV)
type
```
live attenuated
236
Immunization:
Poliovirus Vaccine (OPV/IPV)
route
OPV - per orem (PO)
| IPV - intramuscular (IM)
237
Immunization:
Poliovirus Vaccine (OPV/IPV)
schedule
3-dose primary series
| minimum 6 weeks
238
```
Immunization:
Poliovirus Vaccine (OPV/IPV)
interval
```
4 weeks
239
Immunization:
Poliovirus Vaccine (OPV/IPV)
booster
≥ 4 y.o.
| 6 mos. from previous dose
240
Immunization:
Pneumococcal Conjugate Vaccines (PCV)
route
intramuscular (IM)
241
Immunization:
Pneumococcal Conjugate Vaccines (PCV)
schedule
3-dose primary series
| minimum 6 weeks
242
Immunization:
Pneumococcal Conjugate Vaccines (PCV)
interval
4 weeks
243
Immunization:
Pneumococcal Conjugate Vaccines (PCV)
booster
6 mos. after 3rd dose
244
Immunization:
Pneumococcal Conjugate Vaccines (PCV)
Healthy children 2-5 y.o. w/o previous PCV vaccination may be given _____ or _____.
1 dose of PCV 13
| 2 doses of PCV 10 8 weeks apart
245
Immunization:
Rotavirus Vaccine (RV)
route
per orem (PO)
246
Immunization:
Rotavirus Vaccine (RV)
schedule
minimum 6 weeks
* monovalent human RV (RV1) - 2 doses
* pentavalent human bovine (RV5) - 3 doses
247
```
Immunization:
Rotavirus Vaccine (RV)
interval
```
4 weeks
248
```
Immunization:
Rotavirus Vaccine (RV)
last dose
```
32 weeks
249
Immunization:
Influenza Vaccine
route
trivalent - intramuscular (IM) or subcutaneous (SC)
| quadrivalent - subcutaneous (SC)
250
Immunization:
Influenza Vaccine
schedule
minimum 6 months
251
Immunization:
Influenza Vaccine
dose
6-35 mos. - 0.25 ml
| 36 mos. - 18 y.o. - 0.5 ml
252
Immunization:
Influenza Vaccine
Children 6 mos. - 8 y.o. receiving influenza vaccine for the first time should be given _____.
2 doses with a 4 week interval
253
Immunization:
Influenza Vaccine
If only 1 dose was given during the previous influenza season, give _____ then _____ thereafter.
2 doses
| 1 dose annually
254
Immunization:
Influenza Vaccine
Children aged 9-18 y.o. should receive _____.
1 dose annually
255
Immunization:
Influenza Vaccine
Vaccination should begin in _____.
February
256
Immunization:
Measles Vaccine
type
live attenuated
257
Immunization:
Measles Vaccine
route
subcutaneous (SC)
258
Immunization:
Measles Vaccine
schedule
9 months
*6 months in cases of outbreaks
259
Immunization:
Japanese Encephalitis Vaccine (JE)
route
subcutaneous (SC)
260
Immunization:
Japanese Encephalitis Vaccine (JE)
schedule
one primary dose
| 9 mos. - 17 y.o.
261
Immunization:
Japanese Encephalitis Vaccine (JE)
booster
12-24 mos. after primary dose
262
Immunization:
Japanese Encephalitis Vaccine (JE)
Individuals ≥ 18 y.o. hould receive _____.
1 dose only
263
Immunization:
Measles-Mumps-Rubella (MMR)
type
live attenuated
264
Immunization:
Measles-Mumps-Rubella (MMR)
route
subcutaneous (SC)
265
Immunization:
Measles-Mumps-Rubella (MMR)
schedule
2-dose primary series
minimum 12 months
2nd dose at 4-6 y.o.
*given earlier if recommended by PH
266
Immunization:
Measles-Mumps-Rubella (MMR)
interval
4 weeks
267
Immunization:
Measles-Mumps-Rubella (MMR)
Children below 12 mos. given any Measles containing vaccine should be given _____.
2 additional doses
268
Immunization:
Varicella Vaccine
type
live attenuated
269
Immunization:
Varicella Vaccine
route
subcutaneous (SC)
270
Immunization:
Varicella Vaccine
schedule
2-dose primary series
1st dose at 12-15 mos.
2nd dose at 4-6 y.o.
271
Immunization:
Varicella Vaccine
interval
< 13 y.o. - 3 mos.
> 13 y.o. - 4 weeks
*if 2nd dose was administered 4 weeks after the first dose, it can be considered valid
272
Immunization:
Measles-Mumps-Rubella-Varicella (MMRV)
type
live attenuated
273
Immunization:
Measles-Mumps-Rubella-Varicella (MMRV)
schedule
12 mos. - 12 y.o.
274
Immunization:
Measles-Mumps-Rubella-Varicella (MMRV)
interval
3 months
275
Immunization:
Hepatitis A (Hep A)
route
intramuscular (IM)
276
Immunization:
Hepatitis A (Hep A)
schedule
2-doses primary series
minimum 12 mos.
*2nd dose is given 6 mos. after the 1st dose
277
Immunization:
Tetanus and Diptheria Toxoid (Td) / Tetanus and Diptheria Toxoid aand Acellular Pertussis (Tdap)
route
intramuscular (IM)
278
Immunization:
Tetanus and Diptheria Toxoid (Td) / Tetanus and Diptheria Toxoid aand Acellular Pertussis (Tdap)
booster
every 10 years
279
Immunization:
Tetanus and Diptheria Toxoid (Td) / Tetanus and Diptheria Toxoid aand Acellular Pertussis (Tdap)
fully immunized pregnant adolescent
1 dose of Tdap after 20 weeks AOG
280
Immunization:
Tetanus and Diptheria Toxoid (Td) / Tetanus and Diptheria Toxoid aand Acellular Pertussis (Tdap)
unimmunized pregnant adolescent
3-dose series
| 0-1-6 month schedule
281
Immunization:
Human Papilloma Virus (HPV)
route
intramuscular (IM)
282
Immunization:
Human Papilloma Virus (HPV)
schedule
3-dose series
minimum 9 y.o.
bivalent - 0-1-6 month schedule
quadrivalent - 0-2-6 month schedule
283
Immunization:
Human Papilloma Virus (HPV)
interval
1 mo. bet. 1st and 2nd dose
3 mos. bet. 2nd and 3rd dose
6 mos. bet. 1st and 3rd dose
284
Immunization:
Human Papilloma Virus (HPV)
A _____ is an option for girls 9-14 y.o.
2-dose schedule 6 mos. apart
285
Immunization:
Human Papilloma Virus (HPV)
The quadrivalent HPV can bbe given to males _____ of age for the prevention of _____.
9-18 y.o., anogenital warts
286
Immunization:
Rabies Vaccine
route
intramuscular (IM) or intradermal (ID)
287
Immunization:
Rabies Vaccine
Intramuscular Regimen
Purified Vero Cell Rabies Vaccine (PVRV) 0.5 ml
Purified Chick Embryo Cell Vaccine (PCECV) 1 ml
0-7-21-28 days
288
Immunization:
Rabies Vaccine
Intradermal Regimen
Purified Vero Cell Rabies Vaccine (PVRV) 0.1 ml
Purified Chick Embryo Cell Vaccine (PCECV) 0.1 ml
0-7-21-28 days
289
Immunization:
Rabies Vaccine
It should never be given in the _____ since absorption is unpredictable.
gluteal area
290
Immunization:
Rabies Vaccine
In subsequent exposure, those who completed _____ will only require booster doses on _____.
3 doses, 0-3 days
291
Immunization:
Rabies Vaccine
booster
IM - PVRV 0.5 ml or PCECV 1 ml
| ID - PVRV 0.1 ml or PCECV 0.1 ml
292
Immunization:
Typhoid Vaccine
route
intramuscular (IM)
293
Immunization:
Typhoid Vaccine
schedule
minimum 2 y.o.
| revaccination every 2-3 years
294
Immunization:
Typhoid Vaccine
Recommended for _____.
travelers to areas where there is risk of exposure and for outbreak situations
295
Immunization:
Dengue Vaccine
type
live attenuated
296
Immunization:
Dengue Vaccine
route
subcutaneous (SC)
297
Immunization:
Dengue Vaccine
schedule
3-dose series
9-45 y.o.
0-6-12 months
298
Immunization:
Cholera Vaccine
route
per orem (PO)
299
Immunization:
Cholera Vaccine
schedule
2-dose series
| minimum 12 mos.
300
Immunization:
Cholera Vaccine
interval
2 weeks
301
Immunization:
Cholera Vaccine
Recommended for _____.
outbreak situations
| natural diasters
302
Immunization:
Meningococcal Vaccine
route
tetravalent conjugate vaccine (ACYW-135, MCV4-D, MCV4-TT, MCV4-CRM) - intramuscular (IM)
tetravalent polysaccharide vaccine (MPSV4) - intramuscular (IM) or subcutaneous (SC)
303
Immunization:
Meningococcal Vaccine
Indicated for _____.
```
thoseat high risk for invasive disease
persistent complement comonent deficiencies
anatomic/functional asplenia
HIV
outbreak
hyperendemic areas
```
304
Immunization:
Meningococcal Vaccine
schedule - MCV4-D
9-23 mos.
2 doses 3 months apart
*≥ 2 y.o. give one dose only
305
Immunization:
Meningococcal Vaccine
schedule - MCV4-TT
12 mos.
| single dose
306
Immunization:
Meningococcal Vaccine
schedule - MCV4-CRM
2 y.o.
| single dose
307
Immunization:
Meningococcal Vaccine
Revaccinate with MCV4 every _____.
5 years
308
Immunization:
Meningococcal Vaccine
schedule - MPSV4
2 y.o.
| single dose
309
Immunization:
Meningococcal Vaccine
If MPSV4 is used for high risk individuals as the 1st dose, a 2nd dose using _____ should be given _____ later.
MCV4, 2 mos.
310
Immunization:
Meningococcal Vaccine
MCV4-D and PCV13 should be given _____ apart.
4 weeks
311
Immunization:
Pneumococcal Conjugate Vaccine (PCV) / Pneumococcal Polysaccharide Vaccine (PPSV)
route
intramuscular (IM)
312
Immunization:
Pneumococcal Conjugate Vaccine (PCV) / Pneumococcal Polysaccharide Vaccine (PPSV)
Indicated for children with _____.
high risk medical conditions
313
Immunization:
Pneumococcal Conjugate Vaccine (PCV) / Pneumococcal Polysaccharide Vaccine (PPSV)
2-5 y.o., incomplete schedule of 3 doses
1 dose of PCV 13
314
Immunization:
Pneumococcal Conjugate Vaccine (PCV) / Pneumococcal Polysaccharide Vaccine (PPSV)
2-5 y.o., unvacccinated or incomplete schedule of < 3 doses
2 doses of PCV 13 8 weeks apart
315
Immunization:
Pneumococcal Conjugate Vaccine (PCV) / Pneumococcal Polysaccharide Vaccine (PPSV)
2-5 y.o., 4 doses fo PCV 7
1 dose of PCV 13
316
Immunization:
Pneumococcal Conjugate Vaccine (PCV) / Pneumococcal Polysaccharide Vaccine (PPSV)
6-18 y.o., unvaccinated
1 dose of PCV 13 + 1 dose of PPSV after 8 weeks
317
Immunization:
Pneumococcal Conjugate Vaccine (PCV) / Pneumococcal Polysaccharide Vaccine (PPSV)
high risk medical conditions
2nd dose of PPSV 5 years after 1st dose
318
Immunization:
Haemophilus influenzae type B (HiB)
type
conjugate vaccine
319
Immunization:
Haemophilus influenzae type B (HiB)
route
intramuscular (IM)
320
Immunization:
Haemophilus influenzae type B (HiB)
12-59 mos., unimmunized or 1 dose of HiB before 12 mos.
2 additional doses 8 weeks apart
321
Immunization:
Haemophilus influenzae type B (HiB)
12-59 mos., ≥ 1 dose of HiB before 12 mos.
1 additional dose
322
Immunization:
Haemophilus influenzae type B (HiB)
≤ 5 y.o., HiB booster dosewithin 14 days of starting chemotherapy/RT
repeat dose 3 mos. after completion of therapy
323
Immunization:
Haemophilus influenzae type B (HiB)
hematopoetic stem cell transplant
reimmunized with 3 doses 4 weeks apart, 6-12 mos. after transplant
324
Immunization:
Haemophilus influenzae type B (HiB)
unimmunized children ≥ 15 mos. undergoing elective splenectomy
1 dose 14 days before procedure
325
Immunization:
Haemophilus influenzae type B (HiB)
unimmunized children 5-18 y.o. with anatomic/functional asplenia and HIV
1 dose
326
Immunization of Teens:
Hep B
recommended age
unvaccinated 7-18 y.o.
327
Immunization of Teens:
Hep B
dose
3
328
Immunization of Teens:
Hep B
schedule
0-1-6 months
329
Immunization of Teens:
Hep B
route
intramuscular (IM)
330
Immunization of Teens:
Hep B
precautions and contraindications
severe allergic reaction to vaccine component, moderate to severe illness
331
Immunization of Teens:
Hep A
recommended age
unvaccinated 7-18 y.o.
332
Immunization of Teens:
Hep A
dose
2
333
Immunization of Teens:
Hep A
schedule
2nd dose 6 months after 1st dose
334
Immunization of Teens:
Hep A
route
intramuscular (IM)
335
Immunization of Teens:
Hep A
precautions and contraindications
severe allergic reaction to vaccine component, moderate to severe illness
336
Immunization of Teens:
MMR
recommended age
unvaccinated 7-18 y.o.
| incompletely vaccinated 7-18 y.o.
337
Immunization of Teens:
MMR
dose, unvaccinated 7-18 y.o.
2
338
Immunization of Teens:
MMR
dose, incompletely vaccinated 7-18 y.o.
1
339
Immunization of Teens:
MMR
schedule, unvaccinated 7-18 y.o.
4 weeks betwen doses
340
Immunization of Teens:
MMR
schedule, incompletely vaccinated 7-18 y.o.
2nd dose 4 weeks after 1st dose
341
Immunization of Teens:
MMR
route
subcutaneous (SC)
342
Immunization of Teens:
MMR
precautions and contraindications
severe allergic reaction to vaccine component, moderate to severe illness, pregnancy, immunosuppression, recent blood transfusion
343
Immunization of Teens:
Varicella
recommended age
unvaccinated 7-12 y.o.
unvaccinated ≥ 13 y.o.
incompletely vaccinated 7-18 y.o.
344
Immunization of Teens:
Varicella
dose, unvaccinated 7-12 y.o.
2
345
Immunization of Teens:
Varicella
dose, unvaccinated ≥ 13 y.o.
2
346
Immunization of Teens:
Varicella
dose, incompletely vaccinated 7-18 y.o.
1
347
Immunization of Teens:
Varicella
schedule, unvaccinated 7-12 y.o.
3 month interval
348
Immunization of Teens:
Varicella
schedule, unvaccinated 7-12 y.o.
1 month interval
349
Immunization of Teens:
Varicella
schedule, incompletely vaccinated 7-18 y.o.
7-12 y.o. - 3 mos. from 1st dose
| ≥ 13 y.o. - 4 weeks from 1st dose
350
Immunization of Teens:
Varicella
route
subcutaneous (SC)
351
Immunization of Teens:
Varicella
precautions and contraindications
severe allergic reaction to vaccine component, moderate to severe illness, pregnancy, immunosuppression, recent blood transfusion
352
Immunization of Teens:
Influenza
recommended age
9-18 y.o.
353
Immunization of Teens:
Influenza
dose
annually
354
Immunization of Teens:
Influenza
schedule
begin immunization in February
355
Immunization of Teens:
Influenza
route
intramuscular (IM) or subcutaneous (SC)
356
Immunization of Teens:
Influenza
precautions and contraindications
severe allergic reaction to vaccine component, moderate to severe illness, history of Guillain-Barre Syndrome following previous dose
357
Immunization of Teens:
HPV
recommended age
females: 9-18 y.o. (bivalent, quadrivalent)
males: 9-18 (quadriavalent)
358
Immunization of Teens:
HPV
schedule
bivalent - 0-1-6 months
quadrivalent - 0-2-6 months
*females, 9-14 y.o., 2 doses, 0-6 months
359
Immunization of Teens:
HPV
route
intramuscular (IM)
360
Immunization of Teens:
HPV
precautions and contraindications
severe allergic reaction to vaccine component, moderate to severe illness, if found to be pregnant after starting immunization delay remaining doses until completion of pregnancy
361
Immunization of Teens:
Td/Tdap
recommended age
unvaccinated 7-18 y.o.
incompletely vaccinated 7-18 y.o.
fully vaccinated 7-18 y.o.
*fully vaccinated - 5 doses of DTap or 4 doses of DTap if the 4th dose was given ≥ 4 y.o.
362
Immunization of Teens:
Td/Tdap
dose, unvaccinated 7-18 y.o.
3
363
Immunization of Teens:
Td/Tdap
dose, incompletely vaccinated 7-18 y.o.
1-2
364
Immunization of Teens:
Td/Tdap
dose, fully vaccinated 7-18 y.o.
1
365
Immunization of Teens:
Td/Tdap
schedule, unvaccinated 7-18 y.o.
0-1-6 months with Tdap as the first dose then Td for the remaining doses
366
Immunization of Teens:
Td/Tdap
schedule, incompletely vaccinated 7-18 y.o.
1 dose Tdap and Td for the remaining doses
367
Immunization of Teens:
Td/Tdap
schedule, fully vaccinated 7-18 y.o.
1 dose Tdap the Td every 10 years
368
Immunization of Teens:
Td/Tdap
route
intramuscular (IM)
369
Immunization of Teens:
Td/Tdap
precautions and contraindications
severe allergic reaction to vaccine component, moderate to severe illness
370
Prenaatal Education Components
```
Breastfeeding
Newborn Care
Anticipatory Guidance
Avoidance of Smoking, Alcohol and Teratogens
Tetanus Toxoid Immunization
Maternal Nutrition
```
371
Every infant must be _____ at birth and monitored _____ until discharge.
appraised, daily
372
_____ is the perfect first food.
Colostrum
373
Latching-on and breastfeeding must be initiated during the first _____ after delivery.
30-60 min.
374
Red Flag Signs for Atopy
```
Respiratory
Nasal
Ocular
Skin
Gastrointestinal
```
375
Red Flag Signs for Atopy:
| Respiratory
```
chronic cough ± wheezing
shortness of breath
chest tightness
trouble sleeping due to coughing
fatigue
problems with feeding
grunting during infancy
```
376
Red Flag Signs for Atopy:
| Nasal
frequent sneezing
rhinorrhea
itchiness
nasal congestion
377
Red Flag Signs for Atopy:
| Ocular
```
bluish-brownish discoloration around both eyes
puffiness under the eyes
redness
tearing
itchiness
```
378
Red Flag Signs for Atopy:
| Skin
dryness
| itchiness
379
Red Flag Signs for Atopy:
| Gastrointestinal
```
itchiness of the roof of the mouth and throat
colic
vomiting
stomach cramps
diarrhea
bloody stools
```
380
Recumbent Length for children _____.
< 2 y.o.
381
Standing Height for children _____.
≥ 2 y.o.
382
Recumbent Length = Standing Height + _____
0.7 cm
383
_____ is a reliable growth indicator even when the age is unknown.
Weight-for-Length/Height
384
_____ measurement standards enable early detection and prevention of overweight and obesity problems.
Body Mass Index (BMI)
385
Routine BP measurement should start at _____ and should be done to _____.
3 y.o., ill patients, at rsk patients
386
BP < 90th percentile
normotensive
387
BP < 95th percentile
pre-hypertensive
*adolescents - 120/80
388
BP ≥ 95th percentile
hypertensive
*on 3 or more occasions
389
RA No. 9288
Newborn Screening Act of 2004
390
Newborn Screening should be done _____.
immediately 24 hours after birth.
391
Expanded Newborn Screening has been made available since _____.
December 2014
392
RA No. 9709
The Universal Newborn Hearing Screening and Intervention Act of 2009
393
Hearing screening should be done _____.
before discharge, first 3 months
394
If with (+) Hearing Screening result, referral for intervention should be done _____.
before the age of 6 mos.
395
RA No. 9482
Anti-Rabies Act of 200
396
Rabies pre-exposure prophylaxis for children _____.
5-14 y.o.
397
Iron Supplementation:
LBW Infants
Preparation
drops: 15 mg elemental iron/0.6 ml
398
Iron Supplementation:
LBW Infants
Dose/Duration
0.3 ml OD 2-6 mos.
399
Iron Supplementation:
6-11 mos.
Preparation
drops: 15 mg elemental iron/0.6 ml
400
Iron Supplementation:
6-11 mos.
Dose/Duration
0.6 ml OD x 3mos.
401
Iron Supplementation:
1-5 y.o.
Preparation
syrup: 30 mg elemental iron/5 ml
402
Iron Supplementation:
1-5 y.o.
Dose/Duration
1 tsp OD x 3 mos.
| 30 mg/week x 6 mos.
403
Iron Supplementation:
10-19 y.o. Adolescent Girls
Preparation
tablet: 60 mg elemental iron with 400 mcg folic acid
404
Iron Supplementation:
10-19 y.o. Adolescent Girls
Dose/Duration
1 tab OD
405
Vitamin A Supplementation:
6-11 mos.
Preparation
100,00 IU
406
Vitamin A Supplementation:
6-11 mos.
Dose/Duration
1 dose only
*usually given at 9 mos. during Measles immunization
407
Vitamin A Supplementation:
12-59 mos.
Preparation
200,000 IU
408
Vitamin A Supplementation:
12-59 mos.
DOse/Duration
1 capsule every 6 mos.
409
Zinc supplementation prevents _____.
pneumonia, diarrhea
410
Deworming shouldbe done for children _____.
1-12 y.o.
411
Deworming: Albendazole Dose
12-23 mos. - 200 mg, single dose every 6 mos.
| ≥ 24 mos. - 400mg, single dose every 6 mos.
412
Deworming: Mebendazole Dose
≥ 12 mos. - 500mg, single dose every 6 mos.
413
Albendazole and Mebendazole are given on a _____.
full stomach
414
Deworming should not be done on children with _____.
```
severe malnutrition
high-grade fever
profuse diarrhea
abdominal pain
serious illness
previous hypersensitivity to antihelminthic drug
```
415
In municipalities endemic for filariasis, mass treatment with _____ and _____ are given to children _____.
Diethylcarbamazine Citrate (DEC), Albendazole, ≥ 2 y.o.
416
First dental visit should be done at the time of _____ and no later than _____.
eruption of first tooth, 12 mos.
417
Age-Approprieate physical activities for children should be done _____ daily on _____.
60 min., most days of the week
418
Sedentary activity should be limited to _____.
2 hours/day
419
Parents and children should be counseled to prevent injuries from _____.
birth to adolescence
420
RA No. 7610
Anti Child Abuse Law
421
_____ is an ubiquitous environmental toxicant that can cause cognitive impairment.
Lead
422
CBC should be done at least once during _____.
6-24 mos.
2-6 years
10-19 years
423
CBC:
| Special attention should be given to infants _____.
6-12 mos.
| 12-23 mos.
424
PPD:
| Drugs Used
5 TTU PPD
| 2TU-RT23
425
PPD should be read _____ after
48-72 hours
426
PPD:
| > 5 mm induration is positive if there is _____.
history of close contact with known or suspected TB
clinical findings or CXR suggestive of TB
immunosuppressed condition
427
PPD:
| An induration of _____ is considered poritive.
> 10 mm
