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Pediatrics > Well- Child > Flashcards

Well- Child Flashcards

1
Q

What is well child visit dedicated too?

A

prevention

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2
Q

What is “more challenging” later on?

A

adolescence visits

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3
Q

What is a medical home?

A

comprehensive “one-stop shop” that has all the care needed, affordable, convienient

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4
Q

What is the Periodicity schedule

A 
Newborn
2 weeks
1 mo
2 mo
4 mo
6 mo
9 mo
12 mo
15 mo
18 mo
24 mo
30 mo
36 mo
annually afterwards
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5
Q

What is the “Texas Health Steps”

A

well child periodicity visits

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6
Q

What are 6 benefits of a well child visit?

A 
Focus on prevention
Tracking growth and development
Screening and surveillance
Opportunity to raise concerns
Team approach
Form long lasting relationships with families
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7
Q

What are the 8 unique components to a well child care?

A 
Growth/ nutrition
Developmental surveillance
Psychosocial history
Mental health screening
Others (vision/hearing)
Immunizations
Unclothed physical exam
Anticipatory guidance/counseling
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8
Q

What are 6 things plotted on a growth chart?

A 
Nutritional history
Weight
Recumbent length
Height
Head circumference
Body mass index
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9
Q

When is body mass index charted?

A

after age 2 yrs

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10
Q

How long is milestone assessed?

A

till age 6yrs

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11
Q

What are the 2 screenings for developmental surveillance?

A

ASQ/PEDS

M-CHAT

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12
Q

What is ASQ/PEDS screening for?

A

aging/staging

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13
Q

When is ASQ/PEDS screened performed?

A

9 mo, 18mo, 24 mo, 36 mo, 48 mo

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14
Q

What is M-CHAT screening for?

A

Autism

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15
Q

When is M-CHAT screening performed?

A

18 and 24 mo

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16
Q

What screening is done in older adolescents?

A

School/social performance, ECI (early childhood intervention)

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17
Q

What is Adverse Childhood experiences (ACE)

A

living in a home of domestic violence, child abuse

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18
Q

What does ACE increase the risk for?

A

cardiovascular events later in life

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19
Q

What are the protective topics for teens?

A

Txt for STD, STI
Reproductive (pregnancy, not abortions)
Contraceptions (except IUDs)
Substance Abuse

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20
Q

What is SSHADESS?

A

a screening tool for teens

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21
Q

What does SSHADESS mean?

A 
S- Strengths
S- School
H- Home
A- Activities
D- Drugs/ substance use
E- Emotions/ eating/ depression
S- Sexuality
S- Safety
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22
Q

What type of questioning should be used at every mental screening?

A

subjective

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23
Q

What age are mental health screenings required?

A

12-18yrs

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24
Q

What mental screening should be used for new/pregnant mothers?

A

PHQ-9

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25
Q

What mental screening should be used for adolescents?

A

PHQ-9,, PSC, CRAFT, SCARED

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26
Q

How should mental screenings be performed?

A

alone

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27
Q

What age should TB be screened?

A

> 12 months

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28
Q

What age should anemia be screened?

A

12 mo and 24 mo

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29
Q

What age should lead poisoning be screened?

A

24mo - 6yrs

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30
Q

What age should hyperlipidemia be screened?

A

age 9-11yr, 18-21yrs

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31
Q

What age should HIV be screened?

A

16-18yr

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32
Q

What age should subjective vision be screened?

A

birth- 30 mo

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33
Q

What age should visual acuity screening start?

A

36 mo

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34
Q

What age should subjective hearing be screened?

A

birth - 36 mo

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35
Q

What age should audiometric screening start?

A

48 mo

36
Q

What age should Tb screening start?

A

> 12mo

37
Q

What is the most critical public health interventions of all time?

A

immunizations

38
Q

When is the most important opportunity to vaccinate?

A

every visit

39
Q

What schedule is used for catch-up immunizations?

A

“catch-up” vaccination schedule

40
Q

How should physical exams be performed?

A

unclothed

41
Q

What procedure should be used to start a physical exam?

A

least invasive

42
Q

What are considered more invasive exams?

A

ears and mouth

43
Q

What isa critical portion of every well child visit?

A

Anticipatory Guidance

44
Q

What is Anticipatory Guidance?

A

Education

45
Q

What is the bible for Anticipatory Guidance?

A

Bright Futures

46
Q

What is Anticipatory Guidance tailored too?

A

patient’s age and family dynamics

47
Q

What are 3 exemptions to vaccines?

A

Medical reasons
Personal Beliefs
Religious Beliefs

48
Q

How long does a well child check up suppose to last?

A

15-20 min (typically 1hr)

49
Q

What age are parents usually asked to step out of the room?

A

12-13yr

50
Q

How is SSHADESS assessment done?

A

with the pt clothed

51
Q

What 5 things make up the psychosocial history?

A

home environment
school environment
social determinants of health
adverse childhood experiences (ACE)

52
Q

What is the best way to communicate with a teen?

A

Eye contact during greeting

Find their interest

53
Q

What state ranks #1 for uninsured population, children, women 18-44?

A

Texas

54
Q

What is at a historic low in Texas?

A

Child uninsurance

55
Q

What states aren’t doing so hot in child uninsurance?

A

Southern States

56
Q

How are most kids covered in the U.S.?

A

employer/ private insurance

57
Q

How are most kids covered in Texas?

A

employer

58
Q

What is Medicaid?

A

public health insurance program

59
Q

Single largest insurer of children nationwide and in Texas

A

Medicaid

60
Q

Primary sources of health care for low income parents, disabled, and elderly (long term care)

A

Medicaid

61
Q

Largest sources of behavioral health care?

A

Medicaid

62
Q

Who is covered by the largest amount of Medicaid?

A

Children

63
Q

Who does Medicaid cover?

A 
Children w/ special health care needs (CSHCN)
Children in foster care
Elderly in long term care
Disabled
Pregnant women
64
Q

Who makes up the caseload in medicaid?

A

non-disabled children (68%)

65
Q

Who makes up expenditures?

A

aged and disability related (68%)

66
Q

Whom does Medicaid cover?

A

Vulnerable populations

67
Q

Up to what age does Medicaid cover foster care children?

A

26yr

68
Q

Unique to Medicaid?

A

EPSDT (Early, Periodic, Screening, Diagnostic, and Treatment)

69
Q

What does EPSDT include?

A

comprehensive preventive

70
Q

Who does Medicaid not Cover?

A
  • NOT available to all poor or low income Texans
  • Healthy childless adults “able- bodied”
  • Parents earning more than $3,800/yr
  • Undocumented immigrant
  • Legal immigrants (Green-card holders)
71
Q

What is coverage gap?

A

those that don’t meet ACA premium (138%) and fall below the line

72
Q

Who is in the coverage gap?

A

Parents of most pts

73
Q

What is ACA premium?

A

138%

74
Q

How many Texans are in the “coverage gap”

A

1-2 million

75
Q

What is CHIP?

A

Public health insurance program

76
Q

What is CHIP match rate?

A

15% higher than Medicaid

77
Q

What is CHIP designed to cover?

A

children in “working poor” families

78
Q

What does CHIP cover?

A

fetus of expectant mothers

79
Q

What program is much larger?

A

Medicaid

80
Q

Which program is newer?

A

CHIP (1997)

81
Q

Which program has EPSDT?

A

Medicaid

82
Q

Which has a better match rate?

A

CHIP

83
Q

Which has no cost sharing?

A

Medicaid

84
Q

What is cost sharing?

A

copayment, premiums, deductibles

85
Q

Which program has cost sharing?

A

CHIP

86
Q

Which program is less state flexible?

A

Medicaid

87
Q

Which program has more political will?

A

CHIP

Pediatrics (7 decks)

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