Screening In Children Flashcards
Over 60% of the states test for what other metabolic disorders?
1- galactosemia
2- hemoglobinopathies
All states currently agree on screening for what two newborn metabolic screens?
1- congenital hypothyroidism
2- PKU
For newborn screening when should testing be performed?
Before discharge and never later than 7 days. If done less than 24 hours then do not wait longer than 1-2 weeks or PKU damage can occur.
When should you refer a 5-6 year old based on what visual abnormality?
A child who cannot read the majority of the 20/30 line.
Is there any abnormality in visual testing that should make you refer at any age?
Any child at any age who has a difference of > 1 line in acuity between left and right eye
When should screening of hearing occur?
100% by age 3 months.
When doing a hearing evaluation what is the loss that is important?
Hearing loss of 35 db or greater in the 500 Hz to 4000 Hz range.
In what situations should hearing be testing?
Bacterial meningitis, neonatal infection (cmv, HSV, rubella, toxo, syphilis), pro toxic drugs (gent), mumps/measles.
When should routine blood pressure screening occur?
Starting at 3 years of age.
How is blood pressure determined for high normal and hypertension?
3 separate readings over a period of days to weeks.
Is universal screening for dyslipidemia recommended?
No
When is the recommendation for screening a child for dyslipidemia?
1- a positive history of family dyslipidemia.
2- premature CVD in father < 55 yr and < 65 yr in mother.
What are other criteria for dyslipidemia screening?
1- family history not known
2- CVD risk factors of
a- overweight bmi > 85%
b- obesity > 95%
c- cigarette smoking
d- diabetesWhat is the recommendation for lead screening?
1- region specific screening
2- if regional prevalence of lead is unknown
What ages should be screened for lead?
6-72 months
What are known risk factors for lead?
1-lives or visits a house built before 1950 or remodeling of a house built before 1978
2-child plays with someone with high levels
3- family has rituals remedies with lead
4-parent exposed due to occupation
5- environment known to be high
At what age should risk factors of lead toxicity be assessed?
6 months
What type of blood test should be obtained for possible lead poisoning be done?
Venous blood
Is universal screening for anemia recommended (except for AAP Bright Futures)
No
What is the 4 month visit risk factors to test for anemia?
History of prematurity, low birth weight, use of low iron formula, and early introduction of cow’s milk,
What are the 18 month, 2, 3, 4, and 5 year risk factors for anemia screening?
Low iron diet (low meat) , poverty, limited access to food, special Heath care needs
What are the 6-10year old risk factors to check for anemia?
A strict vegan diet and not receiving iron supplements
What are the 11-21 year old risk factors for anemia in girls?
All females should be screened every 5-10 years if they have heavy menses, low iron intake, eating disorder or previous iron deficiency
Is there a bad time to screen for anemia
Yes, during an illness, or in the several weeks following a fever
Which is more accurate for screening for anemia?
Venous is better that capillary blood draws.
Are there any organizations that suggest routine UA or urine cultures?
No
The AAP recommends annual dipstick urine testing for leukocyte a for what group?
Looking for Chlamydia and Gonorrhea in sexually active males between 11 - 21.
Is routine screening for TB recommended?
No
In breastfeeding the colostrum is rich in what?
Antibodies
Poor breastfeeding results in what to the volume of milk?
Less volume and likely future lactation.
If breastfeeding and initial attempts are poor, a supplement of bottle feeding is suggested?
No
So breastfed babies feed more than bottle fed babies?
Yes, due to protein composition of breast milk.
Should soy formula be used in infants less than 1800 grams?
No
Beyond infants who are 6 months of age what supplement is reminded if they are still breastfeeding?
Elemental iron supplements of 1 mg/kg/day
When should fluoride supplementation start if needed?
Not before 6 months.
Under what conditions should fluoride supplements be used?
After 6 months if the fluoride in the water is less than 0.3 PPM
What is the concentration of fluoride when it does not need supplementation?
> 0.6 PPM
How does fluoride work?
Enhances tooth mineralization, reverses de-mineralization, and inhabits acid-producing bacteria.
How long should cow’s milk be delayed per AAP?
Until 12 months of age.
When should 2% milk be transitioned?
2 years of age
During teething is methemoglobin possible?
Yes, due to OTC teething preparations.
Should baby teeth be re implanted if lost?
No
How long does the typical newborn sleep?
18 hours
When do naps usually disappear?
4 years
At what age do infants began to put themselves back to sleep?
3-4 months
What should the hot water heater temperature be?
120 F
