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Preventive Pediatrics > Preventive Pediatrics Pt I + Policy Statements (Drowning, MVA, BF) > Flashcards

Preventive Pediatrics Pt I + Policy Statements (Drowning, MVA, BF) Flashcards

1
Q

Perfect first food for the newborn

A

Colostrum

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2
Q

Latching on and breastfeeding must be initiated during

A

First 30 minutes to 1 hour

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3
Q

Follow up of newborns discharged less than 48 hours should be within

A

48 hours of discharge

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4
Q

6 key motor development milestones

A

1) Sitting without support 2) Standing with assistance 3) Hand-and-knees crawling 4) Walking with assitance 5) Standing alone 6) Walking alone

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5
Q

Most powerful instruments available to the pediatrician in identifying concerns that may need monitoring or referral

A

History, observing the child, and thorough PE

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6
Q

Research shows that this helps children develop language and literacy skills, thus making them ready to learn and read in school

A

Reading aloud during the first years of life

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7
Q

Milestones of early literacy: Drops, throws book

A

6-12 mos

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8
Q

Milestones of early literacy: Turns board book pages

A

12-24 mos

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9
Q

Milestones of early literacy: Learns to turn paper pages

A

2-3 years

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10
Q

Milestones of early literacy: Starts to scribble

A

2-3 years

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11
Q

Milestones of early literacy: Turns pages one at a time

A

3-4 years

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12
Q

Milestones of early literacy: Sits still for longer stories

A

3-4 years

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13
Q

Milestones of early literacy: Scribbles and draws

A

3-4 years

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14
Q

Milestones of early literacy: Starts to copy letters and numbers

A

4-5 years

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15
Q

Milestones of early literacy: Likes pictures of baby faces

A

6-12 mos

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16
Q

Milestones of early literacy: Responds to own name

A

6-12 mos

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17
Q

Milestones of early literacy: Pats picture to show interest

A

6-12 mos

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18
Q

Milestones of early literacy: 2- to 4-word phrases

A

12-24 mos

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19
Q

Milestones of early literacy: Gives book to adult to read

A

12-24 mos

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20
Q

Milestones of early literacy: Points at picturs

A

12-24 mos

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21
Q

Milestones of early literacy: Turns book right-side up

A

12-24 mos

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22
Q

Milestones of early literacy: Adds 2-4 new words per day

A

2-3 yrs

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23
Q

Milestones of early literacy: Likes the same book again and again

A

2-3 yrs

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24
Q

Milestones of early literacy: Completes sentences and rhymes in familiar stories

A

2-3 yrs

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25
Q

Milestones of early literacy: Recites whole phrases from books

A

3-4 yrs

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26
Q

Milestones of early literacy: Moves toward letter recognition

A

3-4 yrs

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27
Q

Milestones of early literacy: Begins to detect rhyme

A

3-4 yrs

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28
Q

Milestones of early literacy: Pretends to read to dolls and stuffed animals

A

3-4 yrs

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29
Q

Milestones of early literacy: Recognizes numbers and letters

A

4-5 yrs

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30
Q

Milestones of early literacy: Can retell familiar stories

A

4-5 yrs

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31
Q

Milestones of early literacy: Can make rhymes

A

4-5 yrs

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32
Q

Red flag signs for atopy

A

Family history of atopy + recurrent or persistent symptoms of 1 or more of the ff: Ocular, nasal, respiratory, GI, skin

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33
Q

The Phil Society for Adol Med Specialists reccommends screening and preventive services scheduled every

A

Year/annually

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34
Q

T/F In adolescent PE, health care provider is preferably of the same gender as the teen patient

A

T

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35
Q

In addition to routine PE, what should be done

A

1) Tanner/SMR 2) Breast exam 3) Exam of spine and shoulders for scolio/kyphosis 4) Exam of genitals and anus

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36
Q

Adolescent check up schedule: CBC

A

Every stage of adolescence

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37
Q

Adolescent check up schedule: Urinalysis

A

First encounter

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38
Q

Special adolescent labs: Sexually active females

A

Vaginal wet mount, pap smear

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39
Q

Special adolescent labs: Sexually active males

A

Serologic test for syphilis

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40
Q

Special adolescent labs: Sexually active males and females

A

Non-culture test for gonorrhea and chlamydia

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41
Q

Immunization of Teens and Pre-teens: Recommended vaccines (7)

A

Hep A, Hep B, MMR, Varicella, Flu, Tdap/Td, HPV

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42
Q

Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): Hep B

A

Unvaccinated 7-18; 3; 016 mos; IM; severe allergy to component, mod-severe illness

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43
Q

Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): Hep A

A

Unvaccinated 7-18; 2; 06 mos; IM; severe allergy to component, mod-severe illness

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44
Q

Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): MMR

A

Unvaccinated or incompletely vaccinated 7-18 ; unvacc 2, incom 1; 01; SC; severe allergy to component, mod-severe illness, pregnancy, immunosuppression

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45
Q

Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): Varicella

A

Unvaccinated 7-12, >/13, incom 7-18; unvacc 2, incom 1; 7-12 03, >13 1, SC, severe allergy to component, mod-severe illness, pregnancy, immunosuppression

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46
Q

Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): Influenza

A

9-18; annual, starting Feb; IM/SC; severe allergy to component, mod-severe illness, history of Guillan-Barre following a previous dose

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47
Q

Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): HPV Bivalent

A

9-18 FEMALES; 3; 016; IM; severe allergy to component, mod-severe illness, if found to be pregnant after starting immunization delay remaining doses until completion of pregnancy

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48
Q

Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): HPV Quadrivalent

A

9-18 FEMALES and MALES; 2; 026; IM; severe allergy to component, mod-severe illness, if found to be pregnant after starting immunization delay remaining doses until completion of pregnancy

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49
Q

Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): HPV Bivalent alternate sched for females

A

9-14 FEMALES; 2; 06; IM; severe allergy to component, mod-severe illness, if found to be pregnant after starting immunization delay remaining doses until completion of pregnancy

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50
Q

Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): Td/Tdap

A

7-18 unvacc, incom, com; unvacc 3, incom 1-2, com 1; unvac 016, incom 1 Tdap, the rest Td, com 1 dose Tdap then Td every 10 years; IM; severe allergy to component, mod-severe illness

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51
Q

When to use recumbent length vs standing height

A

Recumbent length for <2 y/o, standing height for >/2 y/o (if <2 will not lie down, may measure standing; if >/2 will not stand, may measure recumbent WITH APPROPRIATE ADJUSTMENT IN VALUE MEASURED)

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52
Q

Difference between recumbent and standing height

A

Recumbent length is longer by ~0.7cm

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53
Q

Reliable growth indicator even when child’s age is not known

A

Weight for length or height

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54
Q

Enable early detection and prevention of overweight and obesity problems

A

BMI

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55
Q

What to do if measurements taken for plotting on WHO growth charts is done in a patient with edema

A

Note on growth chart that child has edema

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56
Q

A child is normotensive if BP is ___

A

<90percentile for age, height, and gender

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57
Q

The Pediatric Nephro Society recommends routine BP measurement for children starting what age

A

3 y/o; regardless of age on all patients who are ill and and at risk

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58
Q

Prehypertension in children is defined as

A

Average SBP AND/OR DBP >90th but <95th percentile; 120/80 in adolescents

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59
Q

Hypertension in children is defined as

A

SBP AND/OR DBP >/95th pecentile on THREE or more occasions

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60
Q

RA 9288

A

Newborn screening act of 2004

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61
Q

Article 3 Section 54 of the Newborn Screening Act of 2004

A

Obligation to Inform: Any health practitioner who delivers/assists in delivery of a newborn in the PH shall, PRIOR to delivery, inform parents or legal guardian of availability, nature, and benefits of NBS

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62
Q

NBS shall be ideally done when

A

Immediately after 24 hours from birth

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63
Q

Expanded NBS has been made available since

A

December 2014

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64
Q

The PPS Policy Statement on National Hearing Screening recommends screening for

A

All NB, whether high-risk or not

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65
Q

RA 9709

A

Universal NHS and Intervention Act of 2009

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66
Q

Section 5 of RA 9709

A

Obligation to Inform: Any health practitioner who delivers/assists in delivery of a newborn in the PH shall, PRIOR to delivery, inform parents or legal guardian of availability, nature, and benefits of hearing loss screening among NB or children 3 months old and below

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67
Q

Section 6 of RA 9709

A

Obligation to Perform

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68
Q

All infants born in hospitals in the PH shall be made to undergo NHS when

A

Before discharge, UNLESS parents or legal guardians of the newborn object

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69
Q

All infants who are not born in hospitals in the PH shall be made to undergo NHS when

A

Within 3 months after birth

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70
Q

In the event of a positive NHS, newborn shall undergo audiologic diagnostic evaluation when

A

In a timely manner to allow appropriate follow up, recall, and referral for intervention before 6 MONTHS

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71
Q

In the event of a positive NHS, newborn shall undergo audiologic diagnostic evaluation where

A

NHS centers duly CERTIFIED by the DOH

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72
Q

Recommended timing of regular eye and vision screening in pediatric patients

A

From infancy until maturation of their visual system

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73
Q

Single most effective way to determining a child’s eye health

A

Non-invasive and simple eye and vision screening test

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74
Q

Components of eye and vision screening in pediatric patients (5)

A

1) History 2) VA 3) External inspection 4) Ocular motility 5) ROR

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75
Q

High risk infants who should be referred to an ophtha for comprehensive eye exam

A

1) Premature infants: 32 weeks, 1500g, any age/weight with a stormy course in the NICU 2) With metab disorders 3) With medical conditions known to have associated eye problems 4) With history of squinting, head tilt, head turn 5) With history of visual difficulties and learning problems 6) Family history of eye problems

76
Q

VA test done for infants and pre-verbal children

A

Fix and follow test with unoccluded eyes and with 1 eye occluded

77
Q

VA test done for children who can participate in subjective/formal testing and are NOT familiar with letters

A

LEA pictures chart

78
Q

VA test done for children who can participate in subjective/formal testing and are literate

A

Sloan chart

79
Q

VA of children 3-3 11/12 y/o

A

20/50 (10/25) or better

80
Q

VA of children 4-4 11/12 y/o

A

20/40 (10/20) or better

81
Q

VA of children 5 y/o and older

A

20/30 (10/15) or better

82
Q

Tests done to assess ocular motility

A

1) Corneal light reflex 2) Versions and ductions 3) Cross cover test

83
Q

In corneal light reflex test, light reflex should be seen simultaneously at

A

Center of the pupil of each eye

84
Q

T/F Any limitations or lag in the eye movements in versions and ductions test should warrant a referral

A

T

85
Q

T/F Any movement noticed during the corss over test warrants a referral

A

T

86
Q

T/F The ROR test should be done under bright illumination

A

F, under a darkened surrounding

87
Q

In ROR test, where is light directed?

A

Through the pupil

88
Q

A normal ROR shows a red orange glow through the ophthalmoscope signifying light was able to enter the eye and reflected back from the

A

Choroidal blood vessels

89
Q

ROR findings that indicate referral to an ophtha

A

1) Absence of ROR 2) White reflex pupil

90
Q

LEA chart or its equivalent is preferably done at what age

A

3 years old

91
Q

Distance for VA should be tested at what distance

A

6m (20 ft) or 3m (10 ft) and reading distance of 34-40cm (14-16 inches)

92
Q

T/F VA testing in children should start with both eyes open

A

T, then with one of each eye occluded

93
Q

VA is recorded as

A

Last line on which 4 of the 5 symbols are read correctly

94
Q

T/F In VA testing in children, a child who wears glasses should wear his/her glasses

A

T

95
Q

T/F In VA testing in children, examiner pointing at the line to be read is preferable over pointing at a specific symbol

A

T

96
Q

Most common presenting signs of retinoblastoma

A

Leukocoria and strabismus

97
Q

RA 9482

A

Anti Rabies Act of 2007

98
Q

RA 9482 mandates provision of FREE routine immunization and pre exposure prophylaxis for what population

A

5-14 y/o

99
Q

Iron supplementation: LBW

A

15mg elemental iron/0.6mL, 0.3mL OD from 2m-6m old

100
Q

Iron supplementation: 6-11 months

A

15mg/0.6mL, 0.6mL OD x 3 mos

101
Q

Iron supplementation: 1-5 y/o

A

30mg/5mL, 1 tsp [5mL] OD x 3 mos OR once a week for 6 mos

102
Q

Iron supplementation: Adolescent girls (10-19)

A

60mg elemental iron with 400mcg folic, 1 tab OD

103
Q

Vitamin A supplementation: 6-11 mos

A

100,000 IU, 1 dose (capsule) only given at any time but usually at 9 months of age during measles immunization

104
Q

Vitamin A supplementation: 12-59 mos

A

200,000 IU, 1 cap every 6 months

105
Q

PPS Policy Statement on Zinc Supplementation in Children cites beneficial role in the prevention of

A

Pneumonia and Diarrhea

106
Q

Deworming should be done among children aged

A

1-12 y/o

107
Q

Drugs recommended for deworming

A

1) Albendazole 2) Mebendazole

108
Q

Dose of albendazole for deworming

A

12-23 mos: 200mg single dose every 6 months; 24 months and above: 400mg single dose every 6 months ON FULL STOMACH

109
Q

Dose of mebendazole for deworming

A

12 mos and above: 500mg single dose every 6 months ON FULL STOMACH

110
Q

Deworming must not be done in what conditions (6)

A

1) Severe malnut 2) High-grade fever 3) Profuse diarrhea 4) Abdominal pain 5) Serious illness 6) Previous hypersensitivity to antihelminthic drug

111
Q

Nat’l filariasis elimination program is implemented in municipalities endemic for filariasis and involves mass treatment with

A

DEC and Albendazole from 2 years and above

112
Q

Recommended first dental visit

A

Time of eruption of first tooth and no later than 12 mos of age

113
Q

Recommended frequency of use of flouride toothpaste among children

A

AT LEAST 2x a day

114
Q

T/F Children should be taught to spit out toothpaste and to avoid rinsing after brushing

A

T

115
Q

Recommended use of fluoride toothpaste in children: 6 mos to <2 y/o

A

1000ppm AT LEAST 2x a day; 2.5mm SMEAR; 0.125 x 2 = 0.25mg/day

116
Q

Recommended use of fluoride toothpaste in children: 2-6 y/o

A

1000ppm AT LEAST 2x a day; 5mm PEA-SIZE; 0.25 x 2 = 0.50mg/day

117
Q

Recommended use of fluoride toothpaste in children: 6 y/o and above

A

1500ppm AT LEAST 2x a day; 10-20mm full length of bristle; 0.50 x 2 = 1mg/day

118
Q

Has been proven to prevent or reverse enamel demineralization

A

Professionally applied topical fluoride

119
Q

Professionally applied topical fluoride is recommended for

A

1) Children at moderate risk for caries, at least every 6 months 2) Children at high risk for caries, more frequently

120
Q

T/F Cleansing infant’s teeth as soon as they erupt with either a washcloth or soft brush will help reduce bacterial colonization

A

T

121
Q

T/F Use of dental floss in children is important to reduce interproximal caries

A

T

122
Q

T/F Factors that impact child’s caries rate: Prolonged bottle feeding

A

T

123
Q

T/F Factors that impact child’s caries rate: Bottle feeding while asleep

A

T

124
Q

T/F Factors that impact child’s caries rate: Good oral hygiene in the mother

A

T

125
Q

Breastfeeding protects mother’s health against (3)

A

Cancer (breast, uterus, ovaries), obesity, post-partum hemorrhage

126
Q

T/F While breastfeeding, head, back, and hips should be aligned in a straight manner

A

T

127
Q

T/F While breastfeeding, support breast with the hand of the opposite arm in a C-hold position

A

T

128
Q

T/F While breastfeeding, the chin should touch the breast

A

T

129
Q

T/F While breastfeeding, ensure that the entire nipples plus 1 inch of the surrounding areola

A

T

130
Q

While breastfeeding, how long should the baby suck

A

15-30 mins per breast to extract both foremilk and hindmilk

131
Q

To ensure adequate milk supply, the breast should be emptied how many times per day

A

8-10x

132
Q

Material recommended for use in milk storage

A

Polypropylene plastic

133
Q

Recommended breastmilk storage period:

A 
>25C - 1 hr
<25C - 4 hrs
Ref (4C) - 8 days
Freezer (1-door ref) - 2 wks
Freezer (2-door ref) - 3 mos
Deep freezer with constant temp -20C - 6 mos
134
Q

Complementary food must be PAST

A

Properly fed, adequate, safe, timely

135
Q

Introducing complementary food: One food at a time to be given for

A

3 days

136
Q

Introducing complementary food: Start with

A

Lugaw or cereals, fruits or vegetables; 1-2 tsp a day

137
Q

Introducing complementary food: Start pureed food at

A

6 mos

138
Q

Introducing complementary food: Start finger foods at

A

8 mos

139
Q

Introducing complementary food: Start lumpy or chopped food at

A

10 mos

140
Q

Introducing complementary food: Start table food at

A

12 mos

141
Q

Introducing complementary food: Feed 6-8 month old ___x a day

A

2-3

142
Q

Introducing complementary food: Feed 9-24 month old ___x a day

A

3-4

143
Q

Introducing complementary food: Give additional nutritious snacks ___x a day

A

1-2

144
Q

Introducing complementary food: Do not add salt before

A

1 y/o

145
Q

Introducing complementary food: If diet is primarily plant-based, give supplements of (4)

A

Iron, zinc, calcium, vitamin B12

146
Q

Recommended duration and frequency of age-appropriate physical activities for children and adolescents

A

60 mins daily or on most days of the week

147
Q

Prolonged periods of sedentary activity is defined as a duration of

A

2 hours per day

148
Q

LEADING cause of childhood INJURY in the PH

A

Drowning

149
Q

T/F Drowning rates are higher in low-income countries

A

T

150
Q

In the Western Pacific Region, ___ is the leading cause of INJURY-RELATED DEATH among children less than 5

A

Drowning

151
Q

Case fatality rate of drowning is as high as

A

50%

152
Q

Epidemiologic characteristics and risk of unintentional drowning: 0-4 years

A

At home while bathing or in open water in urban settings

153
Q

Epidemiologic characteristics and risk of unintentional drowning: >/5 years

A

Natural bodies of water and public pools

154
Q

Epidemiologic characteristics and risk of unintentional drowning: adolescents 15-19

A

Associated with alcohol in 15%, majority in swimming pools

155
Q

3rd leading OVERALL cause of MORTALITY in the 5-15 age group

A

Traffic crashes

156
Q

RA that mandates the installation and use of adult seatbelts in front and rear seats of any private motor vehicle

A

RA 8750

157
Q

Children below ___ are prohibited from occupying the front seat of any moving motor vehicle

A

6 y/o

158
Q

T/F According to AAP, child seats provide effective restraint and minimize risk of death and injury during car crashes if used appropriately

A

T

159
Q

Specialized child seats are REQUIRED for children weighing up to ___ or ___ y/o

A

60lbs, 8 y/o

160
Q

Built in car seatbelts is mandated for children older than ___ y/o

A

8

161
Q

3rd leading cause of INJURY among hospitalized motor vehicle injury patients

A

Jeepney crashes

162
Q

4th leading cause of INJURY among hospitalized motor vehicle injury patients

A

Passenger tricycle injury

163
Q

T/F Pedestrian injuries account for majority of all road injuries

A

T, 51%

164
Q

2nd most common type of ACCIDENT in children 1-12 y/o

A

Traffic accidents

165
Q

Safety equipment that works by dissipating the sharp energy of a blow over a large surface area

A

Helmet

166
Q

Also known as the Rooming-In and Breastfeeding Act of 1992

A

RA 7600

167
Q

Studies show strong evidence that breastfeeding protects the infant from (6)

A

1) UTI 2) OM 3) Bacteremia 4) Bacterial meningitis 5) Botulism 6) Necrotizing enterocolitis

168
Q

T/F Infants who are breastfed have shown to have lowered risk for SIDS

A

T

169
Q

T/F Infants who are breastfed have shown to have lowered risk for IDDM

A

T

170
Q

T/F Breastfeeding improves long-term cognitive and motor abilities in term infants especially with prolonged breastfeeding

A

T

171
Q

Studies done in the PH showed that “not breastfeeding” especially within the first 6 months of life increased the rate of mortality associated with (2)

A

1) Diarrhea (8-10x) 2) Acute lower respiratory tract infection (6x)

172
Q

It has been shown that bottle feeding increase the risk of what childhood illnesses (2)

A

1) Otitis media 2) H. influenzae bacteremia and meningitis

173
Q

It has been shown that bottle feeding increase the risk of death from ___ as high as 20x

A

Diarrhea

174
Q

Absolute contraindications to breastfeeding (2)

A

1) Galactosemia 2) Maternal use of illicit drugs, anti-neoplastic agents, and radiopharmaceuticals

175
Q

Relative contraindications to breastfeeding

A

1) Active Tb infection 2) Maternal HIV infection

176
Q

T/F During the 2 weeks of treatment, breast milk can still be given to the infant

A

T, by cup or dropper

177
Q

T/F In feeding infants of mothers with active Tb in the first 2 weeks of treatment, milk expressed in an aseptic manner should be given to the infant by the mother

A

F, by a caregiver other than the mother

178
Q

This method has been shown to effectively kill HIV in expressed breast milk from an HIV-positive mother

A

Heat treatment

179
Q

T/F There are some instances when breastfeeding is preferred even if the mother is HIV-positive

A

T

180
Q

T/F Exclusive breastfeeding of infants of HIV-positive mothers for 3 months or more had no excess risk of HIV infection over 6 months than those never breastfed

A

T

181
Q

Feeding practice in the first 6 months of infancy that is proven to be related to higher cumulative probabilities of HIV detection by 6 months

A

Mixed breastfeeding

182
Q

“The Baby-Friendly Hospital Initiative” in 1992 advocates (10)

A

1) Written breastfeeding policy that is routinely communicated 2) Train health care staff in implementation 3) Inform pregnant women about benefits and management of BF 4) Help mothers initiate BF within half an hour of birth 5) Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants 6) No food or drink other than BM unless medically indicated 7) Practice rooming-in 8) BF on demand 9) No artificial teats/pacifiers 10) Foster establishment of support groups and refer mothers on discharge

183
Q

In 2003, only ___% of children <6 months are exclusively breastfed

A

37

184
Q

T/F Incentives for mothers who decide to breastfeed may be provided

A

T

185
Q

Policy on advertisements for milk formulas in the PH

A

Should first pass an Advertising board created by the DOH under the Maternal and Child Committee BEFORE ads are aired

Preventive Pediatrics (1 decks)

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