Screening In Children

Question 0

Over 60% of the states test for what other metabolic disorders?

Answer 0

1- galactosemia

2- hemoglobinopathies

Question 1

All states currently agree on screening for what two newborn metabolic screens?

Answer 1

1- congenital hypothyroidism

2- PKU

Question 2

For newborn screening when should testing be performed?

Answer 2

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.

Question 3

When should you refer a 5-6 year old based on what visual abnormality?

Answer 3

A child who cannot read the majority of the 20/30 line.

Question 4

Is there any abnormality in visual testing that should make you refer at any age?

Answer 4

Any child at any age who has a difference of > 1 line in acuity between left and right eye

Question 5

When should screening of hearing occur?

Answer 5

100% by age 3 months.

Question 6

When doing a hearing evaluation what is the loss that is important?

Answer 6

Hearing loss of 35 db or greater in the 500 Hz to 4000 Hz range.

Question 7

In what situations should hearing be testing?

Answer 7

Bacterial meningitis, neonatal infection (cmv, HSV, rubella, toxo, syphilis), pro toxic drugs (gent), mumps/measles.

Question 8

When should routine blood pressure screening occur?

Answer 8

Starting at 3 years of age.

Question 9

How is blood pressure determined for high normal and hypertension?

Answer 9

3 separate readings over a period of days to weeks.

Question 10

Is universal screening for dyslipidemia recommended?

Answer 10

No

Question 11

When is the recommendation for screening a child for dyslipidemia?

Answer 11

1- a positive history of family dyslipidemia.

2- premature CVD in father < 55 yr and < 65 yr in mother.

Question 12

What are other criteria for dyslipidemia screening?

Answer 12

1- family history not known
2- CVD risk factors of 
    a- overweight bmi > 85%
    b- obesity > 95%
    c- cigarette smoking
    d- diabetes

Question 13

What is the recommendation for lead screening?

Answer 13

1- region specific screening

2- if regional prevalence of lead is unknown

Question 14

What ages should be screened for lead?

Answer 14

6-72 months

Question 15

What are known risk factors for lead?

Answer 15

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

Question 16

At what age should risk factors of lead toxicity be assessed?

Answer 16

6 months

Question 17

What type of blood test should be obtained for possible lead poisoning be done?

Answer 17

Venous blood

Question 18

Is universal screening for anemia recommended (except for AAP Bright Futures)

Answer 18

No

Question 19

What is the 4 month visit risk factors to test for anemia?

Answer 19

History of prematurity, low birth weight, use of low iron formula, and early introduction of cow’s milk,

Question 20

What are the 18 month, 2, 3, 4, and 5 year risk factors for anemia screening?

Answer 20

Low iron diet (low meat) , poverty, limited access to food, special Heath care needs

Question 21

What are the 6-10year old risk factors to check for anemia?

Answer 21

A strict vegan diet and not receiving iron supplements

Question 22

What are the 11-21 year old risk factors for anemia in girls?

Answer 22

All females should be screened every 5-10 years if they have heavy menses, low iron intake, eating disorder or previous iron deficiency

Question 23

Is there a bad time to screen for anemia

Answer 23

Yes, during an illness, or in the several weeks following a fever

Question 24

Which is more accurate for screening for anemia?

Answer 24

Venous is better that capillary blood draws.

Question 25

Are there any organizations that suggest routine UA or urine cultures?

Answer 25

No

Question 26

The AAP recommends annual dipstick urine testing for leukocyte a for what group?

Answer 26

Looking for Chlamydia and Gonorrhea in sexually active males between 11 - 21.

Question 27

Is routine screening for TB recommended?

Answer 27

No

Question 28

In breastfeeding the colostrum is rich in what?

Answer 28

Antibodies

Question 29

Poor breastfeeding results in what to the volume of milk?

Answer 29

Less volume and likely future lactation.

Question 30

If breastfeeding and initial attempts are poor, a supplement of bottle feeding is suggested?

Answer 30

No

Question 31

So breastfed babies feed more than bottle fed babies?

Answer 31

Yes, due to protein composition of breast milk.

Question 32

Should soy formula be used in infants less than 1800 grams?

Answer 32

No

Question 33

Beyond infants who are 6 months of age what supplement is reminded if they are still breastfeeding?

Answer 33

Elemental iron supplements of 1 mg/kg/day

Question 34

When should fluoride supplementation start if needed?

Answer 34

Not before 6 months.

Question 35

Under what conditions should fluoride supplements be used?

Answer 35

After 6 months if the fluoride in the water is less than 0.3 PPM

Question 36

What is the concentration of fluoride when it does not need supplementation?

Answer 36

> 0.6 PPM

Question 37

How does fluoride work?

Answer 37

Enhances tooth mineralization, reverses de-mineralization, and inhabits acid-producing bacteria.

Question 38

How long should cow's milk be delayed per AAP?

Answer 38

Until 12 months of age.

Question 39

When should 2% milk be transitioned?

Answer 39

2 years of age

Question 40

During teething is methemoglobin possible?

Answer 40

Yes, due to OTC teething preparations.

Question 41

Should baby teeth be re implanted if lost?

Answer 41

No

Question 42

How long does the typical newborn sleep?

Answer 42

18 hours

Question 43

When do naps usually disappear?

Answer 43

4 years

Question 44

At what age do infants began to put themselves back to sleep?

Answer 44

3-4 months

Question 45

What should the hot water heater temperature be?

Answer 45

120 F