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Pediatrics > Preventative Peds > Flashcards

Preventative Peds Flashcards

1
Q

Routine testing for refugee children coming in

A

Hep B serology
Hep C
Syphilis
HIV
CBC
Stool Ova & parasite
IGRA/PPD
T. cruzi (Chagas; if endemic- Brazil)
If eosinophilia: toxocara canis, strongyloides, schistosoma (subsaharan Africa, SE asia, latin america)
>2 yo lymphatic filariasis serology

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2
Q

When is Rotavirus contraindicated

A

history of intussusception
SCID

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3
Q

When should you NOT start rotavirus series (age)

A

15 weeks

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4
Q

When should you not give rotavirus (max age of any vaccination)

A

8 mo

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5
Q

Earliest that first dose of rota can be given is ___

A

6 weeks

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6
Q

Blood pressure monitoring, who should get them

A

Healthy: start at 3 yo

Annually:
- obesity
- renal disease
- diabetes
- aortic arch obstruction
- taking meds that cause HTN
-* h/o prematurity <32 wk, SGA, very low birth weight, neonatal complication requiring UVL/UAL*
- congenital heart disease +/- repair
- Recurrent UTI, hematuria, proteinuria
- Urologic malformation
- f/o congenital renal disease
- Solid-organ transplant
- malignancy/ bone marrow transplant
- systemic illnesses associated with HTN
- evidence of increased ICP

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7
Q

Where should you take a BP, and when can you not

A

right arm
unless there is atypical aortic arch anatomy

cuff must circle 80-100% of mid-arm circumference

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8
Q

What’s the window of time that you have to give HBIG

A

within 12 hours of birth for <2g infants
within 7 days of birth for >2g infants

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9
Q

What is the “window period” in Hep B serology

A

When Hep B sAg disappears before HBsAb appears. HepB core Ab (IgM) will be still positive

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10
Q

When should you test infants born to HBsAg-positive mothers?

A

1-2 mo after last vaccine dose (>9mo)

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11
Q

Normal Hep B series

A

3-doses, ok to give 4th dose in combo vaccines
minimum intervals, 4wk, 8wk, 8wk (respectively between subsequent doses)

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12
Q

Shortest time between PCV13 and PPSV23

A

8 weeks

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13
Q

Normal PCV13 schedule

A

4-doses
2, 4, 6, 12

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14
Q

If premature infant has sustained desaturation <90%, >20 s, bradycardia <80) in car seat challenge, what’s the next step

A

rechallenge neonate in a car bed

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15
Q

Strabismus exam

A

Cover “good” eye, and the resting eye should move to where it is not.

“Good” eye should not move when resting eye is covered

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16
Q

Difference between eso/exo-phoria vs. eso/exo-tropia

A

phoria: manifests under cover-uncover test
tropia: constantly present

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17
Q

Diagnosis of burn infection

A

Tissue biopsy revealing 10^5 bacteria

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18
Q

All children ages 9-11 yo must obtain what routine screening?

A

lipid profile (non-fasting)

If you have risk factors, must obtain FASTING lipid profile

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19
Q

Criteria for receiving live vaccine after chemo

A

They have to be in remission
Needs evidence of immunocompetence

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20
Q

Cut-off age for 2-dose vs. 3-dose vaccine series for HPV

A

15 yo

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21
Q

Are infant walkers recommended?

A

NO – risk of injuries

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22
Q

Routine Hep A vaccine schedule

A

1yo, then 6 mo after

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23
Q

Risk factors for dental decay (7)

A

use of bottle/sippy cup
sleeping with bottle
frequent snacks with sugar
sugar-sweetened beverages
sugary medications
prematurity
Other meds: CF, DM, Sjogren

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24
Q

Toothpaste size per year old

A

<3yo: rice grain sized
>3yo: pea sized

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25
Q

When to start fluoride

A

6mo or when first tooth erupts

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26
Q

When does cerebral hypoxia start during drowning

A

3-5m after submersion

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27
Q

Age at which you must have adult supervision around any water

A

4yo or younger

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27
Q

Age at which you must have adult supervision around any water

A

4yo or younger

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28
Q

Meningitis ACWY routine schedule

A

2-dose
11-12 or 13-15, booster at 16yo

If first dose at 16yo, no need for booster

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29
Q

contraindication to MMR vaccination

A

severe anaphylactic allergy to neomycin or gelatin or severe allergy to previous MMR

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30
Q

do not give MMR and __ vaccine together because of risk of ___

A

varicella
febrile seizure

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31
Q

Preferred PEP for measles

A

vaccination

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32
Q

When should you give measles Ig

A

pregnant women, infants <6mo, immunocompromised individuals, those who received previous dose <28d prior

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33
Q

DTaP doses have to be how far apart?

A

1st and 2nd: 4 wk
2nd and 3rd: 4 wk
3rd and 4th: 6 mo
4th and 5th: 6 mo

34
Q

Thin, tired children with macrocytic anemia, vegetarian, decreased DTR. Dx?

A

B12 deficiency

34
Q

Thin, tired children with macrocytic anemia, vegetarian, decreased DTR. Dx?

A

B12 deficiency

35
Q

Best way to feed infants intubated with respiratory failure

A

Nasojejunal feeding

NOT NGT

36
Q

When do you place a G-tube?

A

when you expect infant requires feeding for 3 mo

37
Q

CF patients usually have trouble absorbing which vitamins?

A

ADEK (fat soluble)

38
Q

exclusively breastfed infants stool once every ___ days

A

3-4

39
Q

Nutrition need for chronic liver disease and CF

A

fat and protein
+ MCTs and fat soluble vitamins

40
Q

Nutrition for those with EoE

A

elimination of most common food allergens
amino acid-based elemental diet

41
Q

Nutrition for FPIES

A

eliminate causative food

42
Q

Nutrition for GERD

A

Infants: thickened (not enough evidence & xantham gum can cause NEC), reduce volume, increase frequency of feeds, protein hydrolysate formula
If severe, amino acid-based formulas

Older children: avoid coffee, chocolate, fatty, spicy foods.

43
Q

Nutrition for IBD

A

monitor: iron, vitamin D, micronutrients
If ileal desease/resection, supplement fat soluble vitamins ?parenteral vit B12

44
Q

Short bowel syndrome

A

May require MCT +/- vitamin supplement

45
Q

High doses of folic acid might ___

A

mask vitamin B12 deficiency

46
Q

If you see a child with multiple low-impact fractures who is otherwise healthy, what is the first thing you screen for?

A

Vitamin D 25 level

47
Q

Nutrition need for Burn patients >40% of body

A

Requires more calories for increased resting energy expenditure

Enteral
+ nitrogen balance + reduce GI translocation
Vitamin C, A, zinc for wound healing

48
Q

Children consuming ketogenic diet are at risk for ___

A

kidney stones

Others (more common): constipation, emesis, abd pain, HLD

49
Q

Ketogenic diet screening consists of

A

urine calcium-creatinine ratio every 3 mo
Routine labs with serum acylcarnitine profile

50
Q

Those who have had cancer treatment especially hypothalamic radiation therapy are at increased risk of ___

A

metabolic syndrome

51
Q

Difference between preterm formula and term formula

A

Preterm formula has higher levels of protein, sodium, potassium, calcium, phos, and iron

52
Q

WHen should preterm formula continue to be used?

A

Until corrected GA of 40 weeks

53
Q

What is acrodermatitis enteropathica

A

congenital disorder of zinc metabolism

54
Q

Kids with CKD should restrict ___ in their diet

A

phosphorous

55
Q

For infant with prematurity and birth weight lower than 1800g, what calorie formula should they have?

A

22 cal/oz

56
Q

Goal weight gain/day after reaching 2kg (infants)

A

20-30g/day

57
Q

Who needs higher-calorie formula >24 cal/oz?

A

premature infants with bronchopulmonary dysplasia/poor weight gain while in NICU

58
Q

Wight cutoff for “very low-birth-weight infants” and what formula should they have

A

<1500g
high calories (22-24 cal/oz), fortified human milk

59
Q

Who should be given soy protein-based formula and what carbohydrate does it contain?

A

Congenital lactase deficiency
Galactosemia

Sucrose and corn syrup

60
Q

Who can you start to introduce peanuts in and who shouldn’t you

A

Yes – no eczema to mild-mod eczema
No – severe eczema +/- egg allergy (need to test peanut allergens in office)

61
Q

How do you test for protein-losing enteropathy (PLE)?

A

fecal alpha1-antitrypsin (marker of protein loss in intestine)

62
Q

What is associated with protein-losing enteropathy?

A
  • CMV, c. diff
  • IBD, celiac, eosinophilic enteropathy
  • Primary/ secondary lymphangiectasia
  • Lymphoma
  • NSAID
  • HSP, SLE
63
Q

Youngest age to give zofran

A

> 6 mo

64
Q

Infant with diarrhea, arching with feeds on cow milk-based protein. What should you try next?

A

elemental/extensively hydrolyzed protein formula

65
Q

Proximal bowel disease can decrease which serum vitamins? (3)

A

iron, folate, vitamin D

66
Q

Weight gain goals for
0-3 mo
3-6 mo
6-12 mo

A

0-3 mo: 30g/day
3-6 mo: 15g/day
6-12 mo: 10g/day

67
Q

Premature infant caloric need in kcal/kg/day

A

105-130

68
Q

Specific nutrition need for premature infants
protein
fat
iron

A

protein: 3-4 g/kg
fat: 5-7 g/kg
iron: 2-4 g/kg

69
Q

Recommended kcal/kg/day for congestive heart failure

A

140 kcal/kg/day

70
Q

What can you give kids with ESRD to improve adult height

A

growth hormone!

71
Q

Normal growth velocity in childhood

A

5-7 cm/year

72
Q

Definition of adult growth restriction

A

Adult height of below 2.5 percentile

73
Q

What maternal factor can contribute to developmental delay?

A

Postpartum depression

Screen until 6 mo

74
Q

Short child with concordant bone age, high upper-to-lower body segment ratio (long trunk to leg ratio), normal BMI. What’t the diagnosis?

A

Skeletal dysplasia
OR precocious puberty

Lower segment = pubis symphysis down
Upper segment = height - pubis symphysis

75
Q

Low upper-to-lower body ratio ddx

A

Klinefelter
Delayed puberty

76
Q

Clues for constitutional delay of growth and puberty

A

Delayed bone age
Family history of delayed puberty/growth

77
Q

Clues for familial short stature

A

height percentile corelates with adjusted midparental height

78
Q

Calculate mid-parental height (girls and boys)

A

Girls: father’s height minus 13 cm (5in) + mother’s height /2

Boys: mother’s height plus 13 cm (5 in) + father’s height /2

79
Q

For foster children, how often should they routinely visit the pediatrician?

A

Every 6 months between 24 mo and 21 yo

80
Q

If you suspect that children/adolescents are sexualy exploited (human trafficking, comercial sexual exploitation), who do you report to?

A

the national trafficking organization hotline

be cautious of reporting to CPS, also many states still view commercial sexual exploitation of children as prostitution so minors can be criminals rather than seen as victims

81
Q

When toddlers see parents go thru a divorce, what can be their response?

A

Separation anxiety

Older preschoolers or younger school-aged children might blame themselves

Pediatrics (26 decks)

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