Preventive Pediatrics Generated Questions - Sheet2 Flashcards

1
Q

What is the significance of colostrum as the first food for the newborn as per prenatal education guidelines?

A

Colostrum is the perfect first food for the newborn. It must be initiated within the first 30 to 60 minutes after delivery of the infant as it is rich in antibodies and provides the essential nutrients required for the newborn’s initial growth and development. |

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2
Q

Within what time frame after birth should a newborn be totally appraised according to the data provided?

A

A newborn must be totally appraised at birth and monitored daily until discharge to ensure that any issues are identified and managed in a timely manner. |

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3
Q

When should the first appointment for the infant be scheduled post-discharge?

A

A definitive appointment must be made for the infant to be examined within 48 hours of discharge to ensure continuity of care and address any emerging concerns early. |

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4
Q

What developmental milestones are included in the WHO Child Growth Standards “Windows of Achievement”?

A

The “Windows of Achievement” describe the range and timelines for six key motor development milestones that must be interpreted in light of other neurodevelopmental findings in a child. |

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5
Q

What are the ‘red flag’ signs for asthma that require a pediatrician’s attention?

A

Red flag signs for asthma include persistent symptoms of chronic cough with or without wheezing, shortness of breath, chest tightness, frequent missing of school due to respiratory symptoms, and a family history of atopy, among others. |

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6
Q

What are the recommendations for screening for iron deficiency anemia in children?

A

For children at risk, a complete blood count at least once between the following intervals is recommended: 2-6 months, 2-6 years, and 10-19 years. |

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7
Q

What is the recommended age for a child’s first dental visit according to the Philippine Pediatric Dental Society?

A

The first dental visit should be at the time of eruption of the first tooth and no later than 12 months of age. |

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8
Q

For how long should breastfeeding be encouraged according to the data provided?

A

Mothers must be encouraged to exclusively breastfeed up to six (6) months and continue on up to two (2) years and beyond, complementing with proper feeding practices. |

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9
Q

What are the current recommendations for physical activity for children and adolescents?

A

Age-appropriate physical activities for children and adolescents for 60 minutes daily (PASOO) or on most days of the week are recommended. |

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10
Q

What is the dosage and frequency of Vitamin A supplementation for children aged 12-59 months?

A

Children aged 12-59 months should receive 200,000 IU of Vitamin A every 6 months. |

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11
Q

What is the new normative BP reading for children aged 1-13 years old?

A

A BP reading less than the 90th percentile for age, gender, and height is considered normative for children aged 1-13 years old. |

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12
Q

How soon after birth should the initial newborn screening test be ideally done?

A

Newborn screening should ideally be done immediately after 24 hours from birth and a repeat screening should be collected at the 28th day of life. |

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13
Q

What mandates the screening of newborns for hearing loss in the Philippines?

A

The PPS Policy Statement on “Neonatal Hearing Screening” mandates that all infants born in hospitals in the Philippines are to undergo newborn hearing loss screening before discharge unless the parents or legal guardians of the newborn object to the screening subject to Section 7 of the Act. |

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14
Q

What is the recommended dose of iron drops for infants 6-11 months of age?

A

Infants 6-11 months of age should be given drops containing 15mg elemental iron/0.6ml once a day for 3 months. |

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15
Q

What is the recommended TB skin test read time and interpretation for screening purposes?

A

Using 5 TU PPD or 2 TU-RT23 test read at 48-72. |

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16
Q

What is the primary cognitive effect of lead exposure in children?

A

The best-studied effect of lead exposure in children is cognitive impairment. |

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17
Q

What act mandates the reporting of suspected cases of child abuse in the Philippines?

A

The Republic Act 7610 (Anti Child Abuse Law) mandates that suspected cases of child abuse must be reported to the appropriate authorities within 48 hours from knowledge of the case. |

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18
Q

Which tests are recommended for sexually active adolescent females?

A

Vaginal wet mount and PAP smear are recommended for sexually active adolescent females. |

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19
Q

Which individuals are targeted for tuberculosis screening?

A

Tuberculosis screening is targeted among individuals who are at risk for developing the disease, including those with a known or suspected case of TB, chest x-ray suggestive of TB, and immunosuppressed condition. |

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20
Q

What is the recommended dosage of Albendazole for children aged 12 months to 23 months?

A

For children aged 12 months to 23 months, the recommended dosage of Albendazole is a single dose of 200mg every 6 months. |

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21
Q

What is emphasized in age-appropriate discussion and counseling at each pediatric visit?

A

Age-appropriate discussion and counseling should be an integral part of each visit, with a focus on developmental milestones and preventive healthcare. |

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22
Q

What is the threshold for hypertension in children aged 1-13 years according to the new normative BP tables?

A

Hypertension for aged 1-13 years old is defined as BP more than the 95th percentile to less than the 95th percentile +12 mmHg or 130/80 to 139/89 mmHg. |

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23
Q

At what age should newborns not born in hospitals undergo hearing loss screening according to the PPS policy?

A

Infants who are not born in hospitals should be screened within the first three (3) months after birth. |

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24
Q

What is the specific iron supplementation recommendation for adolescent girls?

A

Adolescent girls (10-19 years) should take a tablet containing 60mg elemental iron with 400mcg folic acid once a day. |

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25
Q

At what intervals should children aged 6-11 months receive Vitamin A supplements?

A

Infants aged 6-11 months should receive one dose of 100,000 IU of Vitamin A anytime between 6-11 months of age during the measles immunization. |

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26
Q

What are the recommendations for the introduction of complementary foods alongside breastfeeding?

A

Complementary foods should be introduced at 6 months to meet the evolving nutritional requirements of infants, while breastfeeding continues up to two years and beyond. |

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27
Q

What is the maximum recommended screen time for children regarding television and computer use?

A

Children should not be exposed to screen time (TV viewing and computer games) for periods greater than two hours per day. |

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28
Q

When should fluoride varnish be applied to prevent early childhood caries?

A

Fluoride varnish should be applied as per the recommendations on the use of fluoride varnish to prevent early childhood caries. |

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29
Q

What specific attention should be given to infants 6 to less than 12 months regarding anemia prevention?

A

Special attention should be given to ensure infants 6 months to less than 12 months, and 12 months to 23 months, receive appropriate screening for anemia prevention. |

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30
Q

When is a screening urinalysis recommended by the Philippine Society of Adolescent Medicine Specialists?

A

Screening urinalysis is recommended on the first encounter with an adolescent patient and for all patients with signs and symptoms referable to a possible renal disease regardless of age. |

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31
Q

Which policy statement addresses obesity in children and adolescents?

A

The policy statement on “Obesity in Children and the Adolescents” addresses this issue. |

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32
Q

What is the main purpose of the HEADSSS format used during an adolescent’s well-child visit?

A

The HEADSSS format is used to perform a complete risk assessment and screening of adolescent patients. It is a comprehensive psychosocial interview guide that helps healthcare professionals to evaluate overall development and identify any issues needing monitoring or referral. |

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33
Q

Which symptom is not typically considered a ‘red flag’ for asthma in children?

A

Red flags for asthma typically include respiratory symptoms like chronic cough and wheezing, but the presence of itchy skin without respiratory symptoms is not typically a red flag for asthma. |

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34
Q

According to the WHO Child Growth Standards, how is growth assessed for children less than 2 years old?

A

For children less than 2 years old, growth is assessed by measuring recumbent length. If the child is 2 years or older and can stand, standing height is measured. |

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35
Q

Why is BMI considered a reliable growth indicator even when the age of a child is unknown?

A

BMI is a reliable indicator because it correlates with body fat and provides a more relevant growth measure even when the age is not known. It enables early detection and prevention of overweight and obesity problems. |

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36
Q

What groups of children are particularly recommended to receive a complete blood count at each stage of adolescence to screen for anemia?

A

Actively menstruating female adolescents and fad dieters are at risk for anemia and thus are recommended to have a complete blood count at each stage of adolescence. |

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37
Q

When is urinalysis specifically recommended for adolescents according to the Philippine Society of Adolescent Medicine Specialists?

A

Urinalysis is recommended on the first encounter with an adolescent patient and for all patients with signs and symptoms referable to a possible renal disease, regardless of age. |

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38
Q

Sexual Health: What screenings are recommended annually for sexually active males according to the provided data?

A

Sexually active males must undergo serologic test for syphilis while both male and female sexually active adolescents should have an annual non-culture test for gonorrhea and Chlamydia.

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39
Q

Tuberculosis (TB) Screening: What is considered a positive Tuberculin Skin Test (TST) for individuals without known TB risks?

A

For individuals without known TB risks, an induration of 10 mm or more is considered positive.

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40
Q

Dental Health: What are dentists assessing during a child’s first dental visit?

A

During the first dental visit, the dentist assesses the child’s general health, growth and behavior, oral hygiene, and periodontal health, and provides education on infant oral health and fluoride exposure.

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41
Q

Nutrition and Health: What is the stance of the Philippine Pediatric Society regarding the influence of media on children’s food choices?

A

The society recognizes that media food advertising, especially for convenience foods, processed foods, or sweetened drinks may influence children’s choices toward higher-fat or higher-energy foods.

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42
Q

Prenatal Education: What aspect of prenatal education is targeted at preventing child maltreatment?

A

Anticipatory guidance to decrease the risk of injury and identify risk factors for child maltreatment is a crucial aspect of prenatal education.

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43
Q

Well-Baby Discharge Criteria: What is the protocol for follow-up after a healthy term newborn’s discharge?

A

For a well-baby, the follow-up appointment must be scheduled to be examined within 48 hours of discharge.

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44
Q

Adolescent Health Care: Which developmental assessment tool is recommended for pediatricians to use during adolescent wellness visits?

A

The HEADSSS format is part of a complete history taking of adolescent patients and is recommended for developmental assessment.

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45
Q

Developmental Surveillance: What initiative by the Philippine Ambulatory Pediatrics Association is aimed at promoting literacy in children?

A

The initiative strongly recommends that pediatricians advise parents about the importance of reading aloud to their children during the first years of life to develop language and literacy skills.

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46
Q

Asthma Management: What are the first steps in managing a child with a history of frequent wheezing episodes?

A

Close monitoring, investigation, or referral to the subspecialty is required if there are recurrent or persistent symptoms of wheezing.

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47
Q

Growth Monitoring: How are Z-scores used in the interpretation of growth standards for children?

A

The WHO Child Growth Standards use Z-scores, which are standard deviation scores, to interpret the growth points of children.

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48
Q

Lead Toxicity: What is a recognized strategy for preventing cognitive impairment due to lead exposure in children?

A

Lead exposure prevention strategies and recommendations by the Philippine Pediatric Society include cognitive impairment prevention through risk communication.

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49
Q

Anemia Screening: Which children are at increased risk for iron deficiency anemia?

A

Children with poor nutritional history, those with a past or family history of anemia, and particularly those with cognitive and psychomotor abnormalities are at increased risk.

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50
Q

Dental Health Care: What law requires the reporting of suspected child abuse cases by medical practitioners in the Philippines?

A

The Implementing Rules and Regulation of Republic Act 7610 (Anti Child Abuse Law) requires reporting by attending physicians and nurses within 48 hours from knowledge of the case.

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51
Q

Nutritional Counseling: Up to what age is breastfeeding encouraged in well-child visits?

A

Breastfeeding is encouraged to continue up to two (2) years and beyond.

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52
Q

Physical Activity Recommendations: What is the recommended duration of daily physical activity for children and adolescents?

A

Children and adolescents should engage in age-appropriate physical activities for at least 60 minutes daily.

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53
Q

Policy Advocacy: Name a policy statement of the Philippine Pediatric Society focused on environmental concerns.

A

The Philippine Pediatric Society has policy statements on “Noise in the Environment” and “Recreational Noise” related to environmental concerns.

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54
Q

Eye Health: What is the purpose of the Simple Eye and Vision Screening Test recommended by the Philippine Society of Pediatric Ophthalmology and Strabismus?

A

The test is used as a screening tool for early detection of leukocoria and strabismus, which are presenting signs of retinoblastoma.

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55
Q

Iron Supplementation Protocol: According to the iron supplementation table, what is the preparation and dose for low birth weight infants?

A

Low birth weight infants should receive drops containing 15mg elemental iron/0.6ml once a day starting at two months of age until 6 months when complementary foods are given.

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56
Q

Vitamin A Supplementation: When is Vitamin A supplementation indicated for children according to the provided guidelines?

A

Vitamin A supplementation is indicated for all infants aged 6-11 months with a single dose of 100,000 IU and for children 12-59 months with a dose of 200,000 IU every 6 months.

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57
Q

Screening for Developmental Delays: What is a key motor development milestone mentioned in the WHO Child Growth Standards “Windows of Achievement”?

A

The “Windows of Achievement” include key motor development milestones such as sitting without support, standing with assistance, and walking well, which should be interpreted in light of other neurodevelopmental findings in a child.

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58
Q

Immunization Schedules: What immunization is mandated by the Anti Rabies Act of 2007 for schoolchildren aged 5 to 14 years in the Philippines?

A

The Anti Rabies Act of 2007 mandates the creation of a National Rabies Prevention and Control Program, which includes rabies immunization or Pre Exposure Prophylaxis (PEP) for schoolchildren aged 5 to 14 years.

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59
Q

Anemia Screening: At what intervals is a complete blood count recommended for children at risk of anemia?

A

A complete blood count is recommended at least once between the intervals of 2-6 months, 2-6 years, and 10-19 years for those at risk of anemia.

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60
Q

Nutritional Counseling: What is the recommended age for exclusive breastfeeding according to the Philippine Society of Pediatric Gastroenterology and Nutrition?

A

Exclusive breastfeeding is recommended for up to six (6) months, with continued breastfeeding along with appropriate complementary foods up to two (2) years and beyond.

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61
Q

Child Safety Advocacy: Which policy statement by the Philippine Pediatric Society addresses the risk of injury in children related to environmental exposure?

A

The Philippine Pediatric Society issues policy statements on environmental risks such as Child Safety in Private Motor Vehicles, Child Pedestrian Injury Prevention, and Child Helmet Use to address injury risks.

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62
Q

Early Childhood Caries Prevention: What does the Philippine Pediatric Dental Society recommend for the first dental visit?

A

The first dental visit is recommended to be done at the time of eruption of the first tooth and no later than 12 months of age, during which the dentist will assess the child’s oral health and provide education on oral health and fluoride exposure.

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63
Q

Child Abuse Surveillance: What action is required of healthcare workers under the Republic Act 7610 if they suspect child abuse?

A

Under Republic Act 7610, healthcare workers are required to report suspected cases of child abuse to the proper authorities within 48 hours from knowledge of the case.

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64
Q

Iron Supplementation in Infants: What is the iron supplementation dose for infants 6-11 months old?

A

Infants 6-11 months old should receive iron drops containing 15mg of elemental iron/0.6ml once a day for 3 months.

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65
Q

Physical Activity Guidelines: What is the maximum recommended screen time for children according to the Philippine Pediatric Society’s policy on physical activity?

A

The Philippine Pediatric Society recommends that children should not engage in screen activities (TV viewing and computer games) for periods greater than two hours per day.

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66
Q

Tuberculosis Risk Assessment: What is the recommended action for children who have a history of contact with a known or suspected case of tuberculosis?

A

Children with a history of contact with a known or suspected case of tuberculosis should receive a Tuberculin Skin Test (TST) and be evaluated for signs and symptoms of TB, including a chest x-ray if indicated.

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67
Q

Hearing Loss Screening in Newborns: What is the mandated time frame for conducting newborn hearing loss screening in the Philippines?

A

Newborn hearing loss screening should be performed before discharge from the hospital, or within the first three (3) months after birth if not born in a hospital.

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68
Q

Breastfeeding and Maternal Nutrition: What supplement is recommended during the prenatal period to decrease the risk of neural tube defects?

A

Maternal nutrition during the prenatal period should include folic acid supplementation to decrease the risk of neural tube defects.

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69
Q

Childhood Obesity Prevention: How is BMI used to assess overweight and obesity in children according to the guidelines?

A

BMI is a reliable indicator even when the age of a child is unknown and helps to assess the risk of overweight and obesity by correlating with body fat.

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70
Q

Nutrition: Breastfeeding: What age is exclusive breastfeeding recommended until, as per the guidelines?

A

Exclusive breastfeeding is recommended for infants up to six (6) months of age.

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71
Q

Growth Monitoring: Weight-for-Length/Height: Why is weight-for-length/height a preferred growth indicator for children under 2 years old?

A

Weight-for-length/height is preferred for children under 2 years old because it accurately reflects body composition regardless of age and helps in the early detection of overweight and obesity.

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72
Q

Childhood Obesity: Body Mass Index (BMI): What additional measure is suggested if a growth chart indicates a child with low weight might have edema?

A

If a growth chart indicates low weight, and there is a suspicion of edema, a note should be made on the growth chart to investigate possible edema, which can hide severe malnutrition like kwashiorkor.

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73
Q

Child Abuse: Reporting Protocol: According to the uploaded data, within how many hours should a suspected child abuse case be reported?

A

Suspected child abuse cases should be reported within 48 hours from the knowledge of the case.

74
Q

Dental Health: First Dental Visit: What key assessments should be made during a child’s first dental visit?

A

During the first dental visit, assessments of the child’s general health, growth and behavior, oral hygiene, and periodontal health should be made.

75
Q

Anemia: Screening Intervals: At what ages should a complete blood count be performed to screen for anemia in children?

A

A complete blood count should be performed at least once between 2-6 months, 2-6 years, and 10-19 years.

76
Q

Vitamin A Supplementation: What is the Vitamin A dose for infants aged 6-11 months according to the guidelines?

A

Infants aged 6-11 months should receive one dose of 100,000 IU of Vitamin A.

77
Q

Blood Pressure: Normative Values: What is considered a normative blood pressure reading for a child aged 1-13 years according to the guidelines?

A

A normative blood pressure reading for a child aged 1-13 years is less than the 90th percentile for age, gender, and height.

78
Q

Newborn Screening: Timing: What is the recommended time frame for the initial and repeat newborn screening test?

A

The initial newborn screening test should ideally be done 24 hours after birth, and a repeat screening should be collected at the 28th day of life.

79
Q

Neonatal Hearing Screening: Mandates: According to the policy, when should newborn hearing loss screening be conducted?

A

Newborn hearing loss screening should be conducted before discharge from the hospital or within the first three (3) months after birth.

80
Q

Iron Supplementation: Dosage: What is the recommended iron supplement dosage for children 1-5 years old?

A

Children 1-5 years old should receive syrup containing 30mg elemental iron/5ml once a day for 3 months or 30mg once a week for 6 months with supervised administration.

81
Q

Tuberculosis (TB) Screening: TST Reading: What induration size is considered a positive TB skin test result in a child with no known risks?

A

An induration size of 10 mm or more is considered positive in a child with no known risk factors for TB.

82
Q

Adolescent Medicine: Urinalysis: When is a screening urinalysis recommended for adolescents?

A

Screening urinalysis is recommended on the first encounter with an adolescent patient and for all patients with signs and symptoms referable to a possible renal disease, regardless of age.

83
Q

Sexual Health: Annual Screening: What annual screenings are advised for sexually active adolescents?

A

Sexually active adolescents should undergo annual serologic tests for syphilis and a non-culture test for gonorrhea and Chlamydia.

84
Q

Developmental Surveillance: Literacy: According to the Philippine Ambulatory Pediatrics Association, why is reading aloud to children important?

A

Reading aloud to children is important for developing language and literacy skills, which prepares them for learning to read and succeed in school.

85
Q

Prenatal Education: According to the guidelines, what is the importance of anticipatory guidance during prenatal education?

A

Anticipatory guidance in prenatal education is crucial for decreasing the risk of injury and identifying risk factors for child maltreatment.

86
Q

Newborn Assessment: Why is it essential to initiate breastfeeding within the first 30 minutes to 1 hour after delivery?

A

It is essential because colostrum, which is the first food for the newborn, contains high levels of antibodies and nutrients vital for the newborn’s initial growth and immune system development.

87
Q

Discharge of Well-Baby: What is the recommended follow-up protocol for a newborn discharged less than 48 hours after delivery?

A

Newborns discharged less than 48 hours after delivery should have a definitive appointment for examination within 48 hours of discharge.

88
Q

Wellness Visit Updates: When a child comes under care for the first time or has missed any items on the preventive care schedule, what should be done?

A

The preventive care services should be brought up to date at the earliest possible time.

89
Q

Adolescent Health Care: What does the HEADSSS format stand for, and why is it used in adolescent health care?

A

The HEADSSS format stands for Home, Education/Employment, Activities, Drugs, Sexuality, Suicide/Depression, and Safety, and it is used for comprehensive risk assessment and screening.

90
Q

Developmental Surveillance: How do the WHO Child Growth Standards’ “Windows of Achievement” assist healthcare professionals?

A

They describe the range and timelines for key motor development milestones, aiding in the evaluation of overall child development.

91
Q

Atopy Identification: What are the ‘red flag’ signs from the Philippine Society of Allergy, Asthma, and Immunology indicating atopy that requires close monitoring or referral?

A

Red flag signs for atopy requiring monitoring or referral include chronic cough with or without wheezing, nasal symptoms like frequent sneezing, and skin symptoms such as dryness and itchiness.

92
Q

Age-Appropriate History and Physical Examination (PE): What is the recommended approach to the physical examination and interpretation of findings in older children?

A

The approach should be age-appropriate, respecting the child’s privacy and minimizing discomfort, with additional procedures for adolescents outlined in Appendix 3.

93
Q

Growth Monitoring: How should a child’s growth be assessed if they are less than 2 years old?

A

For children less than 2 years old, recumbent length should be measured.

94
Q

Blood Pressure Monitoring: What is the new normative blood pressure reading for a normotensive child aged 1-13 years?

A

A normotensive child aged 1-13 years has a blood pressure reading less than the 90th percentile for age, gender, and height.

95
Q

Newborn Screening Act: When should newborn screening ideally be performed?

A

Newborn screening should ideally be performed 24 hours after birth, regardless of gestational age and clinical status.

96
Q

Neonatal Hearing Screening: What does the Universal Newborn Hearing Screening and Intervention Act of 2009 require of health practitioners?

A

Health practitioners are required to inform parents about the availability, nature, and benefits of hearing loss screening among newborns.

97
Q

Eye and Vision Screening: What is the most effective way of determining a child’s eye health according to the PSPOS and PAO?

A

A non-invasive and simple Eye and Vision Screening Test is the most effective method.

98
Q

Immunization Updates: According to the Republic Act no. 9482, what is provided for schoolchildren aged five to fourteen years?

A

The Anti Rabies Act of 2007 provides for free routine immunization or Pre Exposure Prophylaxis (PEP).

99
Q

Iron Supplementation: What is the iron supplementation recommendation for low birth weight infants?

A

Low birth weight infants should receive drops containing 15mg elemental iron/0.6ml starting at two months of age until 6 months.

100
Q

Vitamin A Supplementation: What is the dosage of Vitamin A for children aged 6-11 months?

A

Infants aged 6-11 months should receive one dose of 100,000 IU of Vitamin A during measles immunization

101
Q

Education During Prenatal Period: What areas should prenatal education encompass as per the preventive pediatric guidelines?

A

Prenatal education should cover breastfeeding, newborn care and birth procedures, risk reduction for child maltreatment, avoiding harmful substances, tetanus immunization for the mother, and maternal nutrition including folic acid.

102
Q

Assessment of Neonates: What is the significance of the immediate appraisal and daily monitoring of newborns?

A

Immediate appraisal and daily monitoring are crucial for assessing the health and detecting any early issues that could affect the newborn’s well-being and require intervention.

103
Q

Well-Baby Discharge Protocol: What is the post-discharge follow-up recommendation for a newborn released from the hospital before 48 hours?

A

An infant discharged in less than 48 hours after birth should be scheduled to have a health examination within 48 hours post-discharge.

104
Q

Missed Wellness Visits: If a wellness visit is missed, what is the recommended action for the pediatric care provider?

A

Any missed items on the preventive care schedule should be updated at the earliest opportunity when the child comes under care.

105
Q

Adolescent HEADSSS Assessment: Describe the significance of utilizing the HEADSSS format in the history-taking of an adolescent.

A

The HEADSSS format is significant for a thorough psychosocial evaluation of adolescents, identifying risks, and guiding appropriate interventions.

106
Q

Childhood Development Evaluation: Why is it critical to evaluate the child’s development at every well-child visit?

A

It’s critical because it allows the healthcare professional to assess development, catch any delays or issues early, and make referrals or interventions as necessary.

107
Q

Reading Aloud to Children: How does reading aloud to children support their early development, according to the Philippine Ambulatory Pediatrics Association?

A

Reading aloud supports language and literacy skill development, crucial for making children ready to learn and succeed academically.

108
Q

Indicators of Atopy in Pediatrics: Which clinical symptoms indicate the need for an in-depth evaluation of a child for atopy?

A

Clinical symptoms such as chronic cough with or without wheezing, frequent rhinorrhea, and itchy skin warrant a more thorough assessment for atopy.

109
Q

Considerations for Pediatric Examination: What are the key considerations for conducting a physical examination in an older pediatric patient?

A

Key considerations include respecting the child’s privacy, minimizing discomfort, and tailoring the examination to the child’s developmental stage.

110
Q

Assessing Child Growth: How should growth be assessed in a child who is over two years old and cannot stand?

A

For a child over two years old who cannot stand, recumbent length should be measured and adjusted to estimate height.

111
Q

Pediatric Blood Pressure Evaluation: What constitutes a normotensive blood pressure for a child older than 13 years?

A

For children older than 13 years, a normotensive blood pressure is less than 120/80 mmHg.

112
Q

Neonatal Screening Guidelines: What does the Newborn Screening Act require of healthcare practitioners before delivery?

A

The Act requires healthcare practitioners to inform parents about the availability and benefits of newborn screening before delivery.

113
Q

Importance of Neonatal Hearing Screening: What are the implications of a positive result in neonatal hearing screening?

A

A positive result necessitates timely audiologic evaluation to allow for appropriate intervention to prevent potential developmental delays.

114
Q

Routine Eye Examinations for Children: What is the recommended regular eye examination for children and its purpose according to PSPOS and PAO?

A

Regular eye examinations are recommended to detect issues such as leukocoria and strabismus early, which are signs of retinoblastoma, to prevent blindness.

115
Q

Immunization Update at Each Visit: What should be assessed regarding a child’s immunization status during each visit?

A

At each visit, the child’s immunization status should be reviewed and updated as necessary to ensure protection against preventable diseases.

116
Q

Iron Supplementation for Adolescents: What is the advised iron supplementation for adolescent girls according to the guidelines?

A

Adolescent girls should take a tablet containing 60mg of elemental iron with 400mcg folic acid once daily.

117
Q

Atopy in Pediatric Patients: Which combination of symptoms should prompt a pediatrician to investigate a child for atopy, especially if there’s a known family history of atopic diseases?

A

A child presenting with a combination of chronic cough, difficulty sleeping due to coughing, nasal congestion, bluish discoloration around the eyes, skin dryness, and gastrointestinal discomfort like vomiting or diarrhea should be investigated for atopy.

118
Q

Growth Measurement Standards: How should a healthcare worker correct the height measurement of a 2-year-old child who cannot stand, according to the 2018 guidelines?

A

For a 2-year-old child who cannot stand, measure the recumbent length and subtract 0.7 cm to convert it to height.

119
Q

Assessment of Growth using Z-scores: Why are Z-scores preferred over percentile scores for interpreting growth points according to WHO Child Growth Standards?

A

Z-scores are preferred because they provide a more precise assessment of how far and in what direction a child deviates from the median or average growth standards, facilitating early identification of growth abnormalities.

120
Q

Management of Pediatric Edema in Growth Monitoring: When plotting the weight of a child with edema, what caution must healthcare workers take, according to WHO guidelines?

A

Healthcare workers must note on the growth chart that the child has edema, as it can mask severe malnutrition like kwashiorkor by artificially inflating the child’s weight.

121
Q

Blood Pressure Management in Pediatrics: What new feature in the blood pressure tables assists in the categorization of hypertension stages in children?

A

The new feature is that BP values are now presented according to updated definitions of BP Categories and Stages, facilitating a more accurate assessment of hypertension risk.

122
Q

Normotensive Blood Pressure in Children: What is the definition of normotensive blood pressure for a child aged more than 13 years, as per the latest guidelines?

A

For a child aged more than 13 years, normotensive blood pressure is defined as less than 120/80 mmHg.

123
Q

Intervention for Elevated Blood Pressure: Describe the recommended intervention for a child aged 1-13 years with elevated blood pressure.

A

For a child with elevated blood pressure, counseling on a healthy diet, sleep, physical work, and, if obese, diet management is recommended. Additionally, medical investigation for underlying conditions requiring pharmacological treatment is advised.

124
Q

Stage 1 Hypertension in Children: What is the criteria for diagnosing Stage 1 Hypertension in a child aged 1-13 years?

A

Stage 1 Hypertension is defined as blood pressure more than the 95th percentile to less than the 95th percentile +12 mmHg, or 130/80 to 139/89 mmHg (whichever is lower).

125
Q

Referral Criteria for Hypertensive Pediatric Patients: When should a pediatric patient with hypertension be referred to a subspecialist?

A

Pediatric patients with Stage 2 Hypertension, defined as BP more than the 95th percentile +12mmHg or more than 140/90 mmHg (whichever is lower), must be referred for further investigation and management.

126
Q

BMI as a Growth Indicator: How does the measurement of Body Mass Index (BMI) contribute to the early detection and prevention of overweight and obesity issues in children?

A

BMI measurement standards allow for the assessment of body fat in relation to height and weight, enabling early detection of overweight and obesity, which are critical for preventing related health problems.

127
Q

Identifying Atopy through Ocular Symptoms: What ocular symptoms are considered red flags for atopy in children with a family history of allergic conditions?

A

Bluish or brownish discoloration around both eyes, puffiness under the eyes, redness and tearing, and itchiness are ocular symptoms that signal atopy in predisposed children.

128
Q

Correcting Length Measurements for Young Children: For growth measurement accuracy, how should the standing height of a child who is exactly two years old and able to stand be corrected?

A

The standing height of a two-year-old child who can stand should be measured directly without any need for correction. For children who cannot stand, recumbent length is measured and adjusted accordingly.

129
Q

Atopy Recognition and Management: What management strategy is recommended for a child with a family history of atopy presenting with persistent respiratory and skin symptoms?

A

Such a child should be closely monitored, investigated, or referred to a subspecialist due to the risk of developing conditions like asthma or atopic dermatitis.

130
Q

Growth Assessment in Pediatrics: How does the WHO recommend adjusting the measurement of standing height to recumbent length in children under 2 years old?

A

For children under 2 unable to stand, measure recumbent length and subtract 0.7 cm to convert it to estimated standing height.

131
Q

Pediatric Blood Pressure Management: What is the definition of Stage 1 Hypertension in children aged 1-13 years according to the latest guidelines?

A

Stage 1 Hypertension in children aged 1-13 years is defined as a blood pressure more than the 95th percentile to less than the 95th percentile +12 mmHg or 130/80 to 139/89 mmHg, whichever is lower.

132
Q

Newborn Screening Protocol: When should a repeat newborn screening be collected for preterm neonates who underwent screening before 24 hours of age?

A

A repeat screening should be collected at the 28th day of life for preterm neonates who had an initial screening before 24 hours of age.

133
Q

Deworming Guidelines for Pediatric Patients: What are the recommended deworming medications and dosages for children aged 12 months to 23 months?

A

Children aged 12 months to 23 months should receive a single dose of 200mg Albendazole every 6 months.

134
Q

Identifying Atopy in Pediatrics: For a child with atopic dermatitis and a strong family history of allergies, what are the significant ocular symptoms that may require subspecialist referral?

A

Significant ocular symptoms include bluish or brownish discoloration around both eyes, puffiness under the eyes, redness and tearing, and itchiness.

135
Q

Interpreting Growth Metrics in Children: Explain the significance of Z-scores in interpreting the WHO Child Growth Standards for pediatric patients.

A

Z-scores, or standard deviation scores, are used to interpret a child’s growth relative to the normative population, aiding in identifying undernutrition, normal growth, and obesity.

136
Q

Blood Pressure Categories in Pediatric Patients: Differentiate between normotensive and elevated blood pressure in children over 13 years old.

A

For children over 13, normotensive blood pressure is <120/<80 mmHg, and elevated blood pressure ranges from 120/<80 to 129/<80 mmHg.

137
Q

Early Intervention through Newborn Screening: What is the goal of the expanded newborn screening program introduced in December 2014?

A

The goal is early detection of up to twenty-eight disorders to ensure timely intervention and prevent life-threatening complications.

138
Q

Contraindications to Deworming in Pediatrics: What conditions should preclude the administration of antihelminthic drugs in children according to the Department of Health guidelines?

A

Deworming should not be performed in children with severe malnutrition, high-grade fever, profuse diarrhea, abdominal pain, serious illness, or known hypersensitivity to the drug.

139
Q

Atopy in Children]] Q: In pediatric patients with a family history of atopy, which combination of symptoms warrants a referral to a subspecialist for further evaluation?

A

Recurrent or persistent respiratory, nasal, ocular, skin, and gastrointestinal symptoms in a child with a family history of atopy necessitate closer monitoring and possibly a referral to a subspecialist.

140
Q

Growth Monitoring Standards: How does the WHO Child Growth Standards recommend differentiating between length and height measurements in children under and over 2 years old?

A

For children under 2 years, recumbent length is measured. For those 2 years and older, standing height is measured, adjusting 0.7 cm if conversion between the two is necessary.

141
Q

Blood Pressure Categories in Pediatrics: What defines elevated blood pressure in children aged 1 to 13 years, according to the updated definitions of BP Categories and Stages?

A

Elevated BP is defined as >90th percentile to <95th percentile or 120/80 mmHg to <95th percentile, whichever is lower, for ages 1 to 13 years.

142
Q

Newborn Screening Timing: What is the ideal timing for newborn screening to ensure early detection of disorders, according to NSRC Memorandum 2014-015?

A

Newborn screening should ideally be performed immediately after 24 hours from birth, regardless of gestational age and clinical status.

143
Q

Deworming Guidelines for Pediatric Patients: What contraindications should be considered before administering deworming treatment to children, as outlined by the DOH Administrative Order 2015-0054?

A

Contraindications include severe malnutrition, high-grade fever, profuse diarrhea, abdominal pain, serious illness, and previous hypersensitivity to antihelminthic drugs.

144
Q

Iron Deficiency Anemia Screening: For children at risk of iron deficiency anemia, during which age intervals does the Philippine Society of Pediatric Hematology recommend a complete blood count?

A

A complete blood count is recommended at least once between the age intervals of 2-6 months, 2-6 years, and 10-19 years.

145
Q

Atopy Advanced Care: What specific ocular symptoms in children with a family history of atopy indicate the need for subspecialty evaluation?

A

Bluish or brownish discoloration around both eyes, puffiness under the eyes, redness and tearing, and itchiness are ocular symptoms indicating a need for evaluation.

146
Q

Complex Growth Evaluation: In assessing growth, how should healthcare professionals address the presence of edema in children, according to WHO cautions?

A

The presence of edema, especially in children with very low weight, should be noted on the growth chart as it can mask severe malnutrition.

147
Q

Pediatric Hypertension Staging: How is Stage 2 Hypertension defined in children aged 1-13 years and those older than 13 years?

A

For ages 1-13, Stage 2 Hypertension is BP more than 95th percentile +12mmHg or more than 140/90 mmHg, whichever is lower. For older than 13 years, it’s a BP more than 140/90 mmHg.

148
Q

Expanded Newborn Screening: What significant change did the expansion of newborn screening introduce in December 2014?

A

The expansion increased the number of screening disorders from six to twenty-eight.

149
Q

Specific Deworming Doses: What is the recommended Albendazole dose for children aged 12 to 23 months, as per WHO and DOH guidelines?

A

The recommended dose is 200mg, taken as a single dose every 6 months.

150
Q

Targeted Anemia Prevention: Which specific pediatric populations are emphasized for screening due to their heightened risk of iron deficiency anemia?

A

Infants 6 to less than 12 months, children 12 to 23 months, actively menstruating female adolescents, and fad dieters are emphasized for screening.

151
Q

Breastmilk Composition: How does the fat content in breastmilk, specifically DHA, contribute to neonatal development?

A

DHA in breastmilk enhances brain development and intelligence in the neonate due to its role in the formation of neuronal cell membranes and myelin.

152
Q

Breastfeeding Benefits: What is the primary immunological advantage of breastmilk in the prevention of neonatal infections?

A

Breastmilk contains antibodies and other protective substances that provide passive immunity to the infant, protecting against infection.

153
Q

Breastfeeding and Maternal Health: Which health outcomes for the mother are improved by breastfeeding, according to the data provided?

A

Breastfeeding is shown to protect maternal health by reducing the risk of certain cancers, obesity, and post-partum hemorrhage, and promotes a quicker return to pre-pregnancy weight.

154
Q

Correct Breastfeeding Techniques: What is the recommended duration a baby should be allowed to suck per breast to ensure adequate milk transfer, including both foremilk and hindmilk?

A

The baby should be allowed to suck 15 to 30 minutes per breast to ensure both foremilk and hindmilk are adequately received.

155
Q

Breastmilk Storage: What is the maximum recommended storage duration for breastmilk in a deep freezer at constant temperatures below -20°C?

A

Breastmilk can be stored in a deep freezer at constant temperatures below -20°C for up to 6 months.

156
Q

Introducing Complementary Foods: At what age is it recommended to start introducing pureed foods to an infant’s diet?

A

Pureed foods should be introduced at 6 months of age.

157
Q

Nutritionally Adequate Complementary Foods: Which dietary supplements are recommended when feeding primarily plant-based complementary foods to infants?

A

Supplements of iron, zinc, calcium, and vitamin B12 are recommended if the diet is primarily plant-based.

158
Q

Responsive Feeding Practices: Describe the approach to responsive feeding for infants and young children as outlined in the guidelines.

A

Responsive feeding involves feeding infants directly and assisting older children, feeding slowly and patiently, without force-feeding, to make feeding a pleasurable experience.

159
Q

Breastfeeding Financial Benefits: How does breastfeeding provide financial savings for a family, as mentioned in the guidelines?

A

Breastfeeding offers financial savings by reducing the need for commercial infant formula, which can be costly.

160
Q

Breastmilk Expression: What are the recommended conditions for storing expressed breastmilk in the refrigerator at 4°C?

A

Expressed breastmilk should be stored in sterile polypropylene containers, properly labeled with the date and time of collection, and can be stored at 4°C for up to 8 days.

161
Q

Complementary Feeding Introduction: What is the protocol for introducing new foods to an infant’s diet to minimize the risk of adverse reactions?

A

New foods should be introduced one at a time and given for 3 days to observe for any reactions.

162
Q

Breastfeeding Emotional Benefits: Discuss the psychological benefit of breastfeeding for both mother and infant.

A

Breastfeeding promotes emotional bonding between mother and baby, which is important for the infant’s psychological development and maternal mental health.

163
Q

Meal Frequency for Infants: What is the recommended meal frequency for infants aged 6-8 months?

A

Infants aged 6-8 months should be fed 2-3 times a day with complementary foods in addition to breastmilk.

164
Q

Feeding Techniques for Infants: How should an infant be positioned during breastfeeding to ensure proper latch and milk transfer?

A

The infant should be positioned “face to face” and “tummy to tummy” with the mother, supporting the breast with a C-hold and ensuring the baby’s chin touches the breast and the lower lip is turned outward.

165
Q

Maternal Post-Partum Recovery: How does breastfeeding impact maternal post-partum recovery?

A

Breastfeeding helps in the maternal post-partum recovery process by promoting uterine contraction and reducing bleeding, which helps in quicker recovery and reduces the risk of hemorrhage.

166
Q

Breastfeeding Frequency for Newborns: According to the guidelines, how frequently should a newborn be breastfed to ensure adequate nutrition?

A

Newborns should be breastfed 8 to 10 times or more a day to ensure an adequate supply of milk.

167
Q

Breastmilk Storage and Temperature: What is the recommended storage time for breastmilk at room temperature below 25°C?

A

Breastmilk can be stored at room temperature (<25°C) for up to 4 hours.

168
Q

Benefits of DHA in Breastmilk: Describe the role of DHA contained in breastmilk and its benefits to neonatal health.

A

DHA in breastmilk is crucial for enhancing brain development and intelligence, as it contributes to the development of the nervous system.

169
Q

Transition to Complementary Feeding: What is the recommended progression of food consistency when introducing complementary foods to an infant at 6 months?

A

The progression should begin with pureed food, proceed to “finger foods” around 8 months, and then lumpy or chopped foods at 10 months, transitioning to table food by 12 months.

170
Q

Feeding Methods for Older Infants: How should 9–24-month-old infants be fed according to the guidelines?

A

Infants 9–24 months old should be fed 3-4 times a day with additional nutritious snacks once or twice a day.

171
Q

Iron Supplementation in Complementary Feeding: Why is iron supplementation particularly important when introducing complementary foods to an infant’s diet?

A

Iron is vital for preventing anemia and ensuring proper cognitive and physical development, especially in infants transitioning to solid foods.

172
Q

Maintaining Breastmilk Supply: What technique is recommended for mothers to maintain their breastmilk supply if they are separated from their infants due to work or other reasons?

A

Expressing breastmilk by hand or using a breast pump when supply is abundant can maintain milk supply.

173
Q

Proper Hygiene in Complementary Feeding: What hygienic practices should be followed when preparing and storing complementary foods for infants?

A

Foods should be hygienically prepared and stored, served with clean utensils, not bottles and nipples, and meals should be properly fed using clean hands, spoons, forks, cups, and bowls.

174
Q

Psychological Benefits of Breastfeeding: Apart from nutritional benefits, what is a psychological advantage of breastfeeding for the infant?

A

Breastfeeding promotes emotional bonding between the baby and mother, which is beneficial for the baby’s emotional development.

175
Q

Financial Benefits of Breastfeeding: How does breastfeeding result in financial savings for families?

A

Breastfeeding results in financial savings by reducing the need to purchase formula and other feeding supplies, as well as potentially lowering healthcare costs due to improved infant health.

176
Q

Breastmilk Expression Timing: When is it advisable for mothers to express breastmilk?

A

Mothers should consider expressing breastmilk when the milk supply is abundant or when planning to return to work.

177
Q

Improving Quality of Food Intake in Children: According to the guidelines, what strategy should be employed to improve the quality of food intake in children during complementary feeding?

A

Offering a variety of foods to improve the quality of intake and avoiding low-nutrient value drinks and snacks is recommended.

178
Q

Storage of Expressed Breastmilk: What is the maximum duration for storing expressed breastmilk in a refrigerator at 4°C?

A

Expressed breastmilk can be stored in a refrigerator at 4°C for up to 8 days.

179
Q

Feeding Frequency for Young Infants: What is the recommended feeding frequency for a 6–8-month-old infant?

A

A 6–8-month-old infant should be fed complementary foods 2–3 times a day in addition to breastfeeding.

180
Q

Infant Feeding Position: How should the baby’s body be positioned in relation to the mother during breastfeeding to ensure effective latching?

A

The baby should be supported head-to-toe in a straight manner, facing the breast, with the baby’s head, back, and hips aligned, and “chest to chest” and “tummy to tummy” with the mother.