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prevention Flashcards

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0
Q

What are the common findings of lead poisoning on X-ray?

A

Lead lines - calcification of bones

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1
Q

5 Signs and symptoms of lead poisoning?

A

Headache, irritability, constipation, lethargy and microcytic anemia

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2
Q

What is the common Blood smear finding in lead poisoning ?

A

Basophilic stippling

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3
Q

At what lead level do children require chelation?

A

45

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4
Q

What can be seen in lead levels 10-20?

A

Mild cognitive delay

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5
Q

What 4 things should be done if elevated capillary lead level?

A

Venous lead level
FEP level
Abdominal film
Long bone X-ray

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6
Q

When should tdap be given?

A

Age 11-12 or 5 years after receiving Td

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7
Q

What tetanus prophylaxis do you give if a child with unknown or incomplete immunization status has a clean wound?

A

Tetanus vaccine

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8
Q

What do you do if a child had a clean wound and received a tetanus vaccine > 10 years ago?

A

Tetanus booster

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9
Q

What do you do if a child with incomplete vaccination status presents with a dirty wound?

A

Tetanus vaccine + tetanus immune globulin

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10
Q

What do you do if a child presents with a dirty wound and has not had a tetanus vaccine in >5 years?

A

Tetenus booster

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11
Q

When does a child only require 3 doses of dtap during catch up vaccines?

A

If the first dose was given after 12 months of age

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12
Q

How much time is required between catch up doses of dtap?

A

At least 4 weeks between doses 1, 2 and 3 and 6 months between the 3rd and 4th dose

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13
Q

At what age is dtap no longer indicated ?

A

After 7 years old

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14
Q

What do you do if a pregnant teenager is due for her tdap?

A

Administer anyways

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15
Q

At what age can pediarix no longer be given?

A

7

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16
Q

What should be done for an infant born to a mother with unknown hepatitis status?

A

Hep B immunoglobulin and vaccine

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17
Q

How soon should premies less than 2 kg receive hep b vaccine ?

A

Within 30 days if mother negative

Within 12 hours if mother positive plus immunoglobulin

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18
Q

What are hep B requirements in the event of a needle stick?

A

If antibody positive - do nothing

If antibody negative - IG and full re vaccination

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19
Q

What is the most common subtype that causes meningococcal disease and why is this a problem?

A

More than half of meningococcal disease in infants is caused by B subtype which is not protected from with the vaccine!!!!

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20
Q

When can you give the mcv vaccine before the scheduled dose at age 11?

A

After age 2 if HIV, complement deficiency, asplenic or travel to endemic regions

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21
Q

How much time must lapse between doses one and two of MMR?

A

4 weeks

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22
Q

What do you do if a 10 month old who gets an MMR vaccine for travel?

A

Doesn’t count as series dose. Repeat after 12 months

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23
Q

What do you do if a child is less than 12 months and is exposed to measles?

A

If within 72 hours of exposure, give vaccine. If more than 72 hours after exposure give immunoglobulin

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24
What are 2 side effects of the MMR vaccine ?
Fever within 12 days or rash
25
What are contraindications for MMR?
Severe allergy Pregnancy Severe immune compromised Anaphylaxis to neomycin or gelatin
26
How much time must pass between receiving MMR vaccine and getting a PPD?
You can give them together but can not give ppd within 4-6 weeks after MMR
27
What are the only 2 vaccines with a contraindication with egg allergy?
Influenza or the yellow fever vaccine
28
What size patient is epipen junior good for?
Up to 30 kg
29
What are the rules for giving measles and varicella vaccine in HIV patients?
Measles can be given unless severely immunocompromised but varicella can not be given if immunocompromised at all
30
When is varicella immunoglobulin indicated (5 answers) and what drug is given with it?
Immunocompromised Pregnant women Premies <28 weeks Premies without evidence of maternal immunity Any infant with mother with new onset varicella - give with acyclovir
31
What is pcv13 and when is it given ?
Prevnar - ages 2,4,6 and 12 months
32
What is ppv23 and when is it given ?
23 valent pneumococcal vaccine for kids >2 y/o with chronic illness or asplenia
33
When should rotavirus vaccination be started by and when must it be completed?
First dose between 6 and 14 weeks | Must be completed by 8 months old
34
How much time must lapse between rotavirus vaccinations?
4 -10 weeks
35
What should you do if a child gets rotavirus infection before vaccination?
Continue with vaccination
36
When should hep A vaccine be given ?
Age 1 and then 6 months later
37
Who is at high risk for influenza and requires annual immunization?
Chronic metabolic/renal/cardiac dz, Asthma/pulmonary disease, HIV
38
What should be done for hep A vaccination in traveling children?
If <1 year old give immune globulin | If >1 year old give hep A vaccine at least 4 weeks prior to departure
39
What are contraindications for hep A vaccine?
Allergy to aluminum hydroxide and phenoxyethanol
40
In which patients should influenza vaccination be a priority? (5 answers)
``` Chronic pulmonary disease Symptomatic heart disease Sickle cell Immunosuppressive long term aspirin therapy ```
41
When should you start screening a patient for hypertension ?
Age 3 or children on stimulants
42
What is the definition of HTN?
>95th % taken on 3 separate occasions (one month apart)
43
What is conductive hearing loss?
Anything that interferes with transmission of sound to the middle ear
44
What is the most common cause of conductive hearing loss?
Otitis media with effusion
45
What is the most severe cause of conductive hearing loss?
Atresia of the ear canal
46
What do you do if an infant fails newborn screening?
Refer to audiology prior to 3 months
47
What should you do if a child has any of the cholesterol risk factors ?
Non fasting cholesterol level
48
What do you do if screening for cholesterol shows cholesterol >170?
Repeat or check fasting lipids
49
What do you do if a child has a parent with cholesterol >240?
Check non fasting cholesterol
50
What are the 5 risk factors for children having high cholesterol?
``` Smoking HTN Physical inactivity Diabetes Obesity ```
51
What do you do in a child whose parent or grandparent has coronary atherosclerosis (MI, angina, stroke, sudden cardiac death before age 55)?
Fasting lipids
52
How should you treat a patient with fasting lipids >130?
Manage with diet
53
What do you do for a patient with LDL >190?
Medication (after diet trial)
54
What cholesterol levels are ideal for a patient with first degree relative with coronary atherosclerosis ?
<160
55
What are 4 medications and 3 diseases that increase risk for high cholesterol?
``` Steroids Anticonvulsants Beta blockers Alcohol Chronic liver or renal disease Hypothyroid Anorexia nervosa ```
56
In what 4 conditions should you consider hyperviscosity syndrome?
Twin twin transfusion Delayed cord clamping Down syndrome Diabetic mother
57
What are 3 things that can occur with polycythemia?
Hyperviscosity syndrome Hyperbilirubinemia Hypoglycemia
58
What is the loss of visual acuity due to cortical suppression of vision in one eye?
Amblyopia
59
What is esotropia?
Inward turning of eye (form of strabismus)
60
What is the tendency for inward deviation when an eye is covered and then uncovered?
Esophoria
61
What refractive state is normal until age 3?
Hyperopia
62
What is the ability to see a moving target, follow it and then return to original gaze?
Optokinetic nystagmus
63
What eye reflex do infants have in the first few months ?
Optokinetic nystagmus
64
When do infant gain the ability to fixate on an object?
6 weeks
65
When do infants gain color perception ?
2 months
66
When do infants develop binocular vision with convergence?
3 months
67
What is the normal visual acuity of a newborn?
20/200
68
What is the visual acuity at age 1?
20/30
69
In what conditions is 5-10mm TB screen considered abnormal?
Close contacts Positive X-ray Immunosuppression
70
What should be done in a newborn with a mother who has active TB disease?
If negative cxr, treat with INH | If positive cxr, treat with triple meds
71
When does a child need prophylactic treatment for H. Flu after exposure?
Children not fully immunized or immunocompromised if household contact
72
When should children exposed to meningococcus receive prophylactic treatment ?
Household or preschool contacts Direct exposure to secretions Sat next to person on plane >8 hrs
73
At what temp should water heaters be set?
120 degrees F
74
What does UV A cause and when should it be a concern?
Drug induced photo sensitivity | The rays are constant throughout the day
75
What does UV B cause and when is it a concern?
Skin aging, burns and cancer | Strongest from 10a - 5 p
76
What are the rules to applying sunscreen?
At least SPF 15 applied 20 minutes before exposure
77
When should an infant be in a rear facing car seat?
Until age 2 or 20 lbs
78
How should rear facing car seats be positioned?
45 degree angle
79
Up to what height should children be in a booster seat?
4'9"
80
Why are bicycle Helmets important?
Reduce serious injury by 85%
81
What is the most effective preventative measure for preventing drowning?
4 sided fence with locked gate
82
What is the difference in growth and development in a children adopted from another country?
Children lose 1 month of linear growth for every 3 months in an orphanage Developmental milestones should match linear growth
83
How should you medically assist an adolescent to quit smoking?
Nicotine replacement is NOT FDA approved so use caution. If unsuccessful, bupropion plus counseling is approved

pediatric Boards (23 decks)

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