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

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Flashcards in Preventive Pediatrics Pt I + Policy Statements (Drowning, MVA, BF) Deck (185):
1

Perfect first food for the newborn

Colostrum

2

Latching on and breastfeeding must be initiated during

First 30 minutes to 1 hour

3

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

48 hours of discharge

4

6 key motor development milestones

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

5

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

History, observing the child, and thorough PE

6

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

Reading aloud during the first years of life

7

Milestones of early literacy: Drops, throws book

6-12 mos

8

Milestones of early literacy: Turns board book pages

12-24 mos

9

Milestones of early literacy: Learns to turn paper pages

2-3 years

10

Milestones of early literacy: Starts to scribble

2-3 years

11

Milestones of early literacy: Turns pages one at a time

3-4 years

12

Milestones of early literacy: Sits still for longer stories

3-4 years

13

Milestones of early literacy: Scribbles and draws

3-4 years

14

Milestones of early literacy: Starts to copy letters and numbers

4-5 years

15

Milestones of early literacy: Likes pictures of baby faces

6-12 mos

16

Milestones of early literacy: Responds to own name

6-12 mos

17

Milestones of early literacy: Pats picture to show interest

6-12 mos

18

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

12-24 mos

19

Milestones of early literacy: Gives book to adult to read

12-24 mos

20

Milestones of early literacy: Points at picturs

12-24 mos

21

Milestones of early literacy: Turns book right-side up

12-24 mos

22

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

2-3 yrs

23

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

2-3 yrs

24

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

2-3 yrs

25

Milestones of early literacy: Recites whole phrases from books

3-4 yrs

26

Milestones of early literacy: Moves toward letter recognition

3-4 yrs

27

Milestones of early literacy: Begins to detect rhyme

3-4 yrs

28

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

3-4 yrs

29

Milestones of early literacy: Recognizes numbers and letters

4-5 yrs

30

Milestones of early literacy: Can retell familiar stories

4-5 yrs

31

Milestones of early literacy: Can make rhymes

4-5 yrs

32

Red flag signs for atopy

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

33

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

Year/annually

34

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

T

35

In addition to routine PE, what should be done

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

36

Adolescent check up schedule: CBC

Every stage of adolescence

37

Adolescent check up schedule: Urinalysis

First encounter

38

Special adolescent labs: Sexually active females

Vaginal wet mount, pap smear

39

Special adolescent labs: Sexually active males

Serologic test for syphilis

40

Special adolescent labs: Sexually active males and females

Non-culture test for gonorrhea and chlamydia

41

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

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

42

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

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

43

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

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

44

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

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

45

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

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

46

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

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

47

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

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

48

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

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

49

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

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

50

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

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

51

When to use recumbent length vs standing height

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)

52

Difference between recumbent and standing height

Recumbent length is longer by ~0.7cm

53

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

Weight for length or height

54

Enable early detection and prevention of overweight and obesity problems

BMI

55

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

Note on growth chart that child has edema

56

A child is normotensive if BP is ___

<90percentile for age, height, and gender

57

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

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

58

Prehypertension in children is defined as

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

59

Hypertension in children is defined as

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

60

RA 9288

Newborn screening act of 2004

61

Article 3 Section 54 of the Newborn Screening Act of 2004

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

62

NBS shall be ideally done when

Immediately after 24 hours from birth

63

Expanded NBS has been made available since

December 2014

64

The PPS Policy Statement on National Hearing Screening recommends screening for

All NB, whether high-risk or not

65

RA 9709

Universal NHS and Intervention Act of 2009

66

Section 5 of RA 9709

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

67

Section 6 of RA 9709

Obligation to Perform

68

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

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

69

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

Within 3 months after birth

70

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

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

71

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

NHS centers duly CERTIFIED by the DOH

72

Recommended timing of regular eye and vision screening in pediatric patients

From infancy until maturation of their visual system

73

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

Non-invasive and simple eye and vision screening test

74

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

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

75

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

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

VA test done for infants and pre-verbal children

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

77

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

LEA pictures chart

78

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

Sloan chart

79

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

20/50 (10/25) or better

80

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

20/40 (10/20) or better

81

VA of children 5 y/o and older

20/30 (10/15) or better

82

Tests done to assess ocular motility

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

83

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

Center of the pupil of each eye

84

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

T

85

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

T

86

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

F, under a darkened surrounding

87

In ROR test, where is light directed?

Through the pupil

88

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

Choroidal blood vessels

89

ROR findings that indicate referral to an ophtha

1) Absence of ROR 2) White reflex pupil

90

LEA chart or its equivalent is preferably done at what age

3 years old

91

Distance for VA should be tested at what distance

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

92

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

T, then with one of each eye occluded

93

VA is recorded as

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

94

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

T

95

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

T

96

Most common presenting signs of retinoblastoma

Leukocoria and strabismus

97

RA 9482

Anti Rabies Act of 2007

98

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

5-14 y/o

99

Iron supplementation: LBW

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

100

Iron supplementation: 6-11 months

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

101

Iron supplementation: 1-5 y/o

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

102

Iron supplementation: Adolescent girls (10-19)

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

103

Vitamin A supplementation: 6-11 mos

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

104

Vitamin A supplementation: 12-59 mos

200,000 IU, 1 cap every 6 months

105

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

Pneumonia and Diarrhea

106

Deworming should be done among children aged

1-12 y/o

107

Drugs recommended for deworming

1) Albendazole 2) Mebendazole

108

Dose of albendazole for deworming

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

109

Dose of mebendazole for deworming

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

110

Deworming must not be done in what conditions (6)

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

111

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

DEC and Albendazole from 2 years and above

112

Recommended first dental visit

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

113

Recommended frequency of use of flouride toothpaste among children

AT LEAST 2x a day

114

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

T

115

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

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

116

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

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

117

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

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

118

Has been proven to prevent or reverse enamel demineralization

Professionally applied topical fluoride

119

Professionally applied topical fluoride is recommended for

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

120

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

T

121

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

T

122

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

T

123

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

T

124

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

T

125

Breastfeeding protects mother's health against (3)

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

126

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

T

127

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

T

128

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

T

129

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

T

130

While breastfeeding, how long should the baby suck

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

131

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

8-10x

132

Material recommended for use in milk storage

Polypropylene plastic

133

Recommended breastmilk storage period:

>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

Complementary food must be PAST

Properly fed, adequate, safe, timely

135

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

3 days

136

Introducing complementary food: Start with

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

137

Introducing complementary food: Start pureed food at

6 mos

138

Introducing complementary food: Start finger foods at

8 mos

139

Introducing complementary food: Start lumpy or chopped food at

10 mos

140

Introducing complementary food: Start table food at

12 mos

141

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

2-3

142

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

3-4

143

Introducing complementary food: Give additional nutritious snacks ___x a day

1-2

144

Introducing complementary food: Do not add salt before

1 y/o

145

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

Iron, zinc, calcium, vitamin B12

146

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

60 mins daily or on most days of the week

147

Prolonged periods of sedentary activity is defined as a duration of

2 hours per day

148

LEADING cause of childhood INJURY in the PH

Drowning

149

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

T

150

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

Drowning

151

Case fatality rate of drowning is as high as

50%

152

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

At home while bathing or in open water in urban settings

153

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

Natural bodies of water and public pools

154

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

Associated with alcohol in 15%, majority in swimming pools

155

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

Traffic crashes

156

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

RA 8750

157

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

6 y/o

158

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

T

159

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

60lbs, 8 y/o

160

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

8

161

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

Jeepney crashes

162

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

Passenger tricycle injury

163

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

T, 51%

164

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

Traffic accidents

165

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

Helmet

166

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

RA 7600

167

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

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

168

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

T

169

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

T

170

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

T

171

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)

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

172

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

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

173

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

Diarrhea

174

Absolute contraindications to breastfeeding (2)

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

175

Relative contraindications to breastfeeding

1) Active Tb infection 2) Maternal HIV infection

176

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

T, by cup or dropper

177

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

F, by a caregiver other than the mother

178

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

Heat treatment

179

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

T

180

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

T

181

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

Mixed breastfeeding

182

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

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

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

37

184

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

T

185

Policy on advertisements for milk formulas in the PH

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