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2ND YEAR-PEDIA > 2B : Preventive Pediatrics > Flashcards

2B : Preventive Pediatrics Flashcards

(105 cards)

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1
Q

@ the core of the field of Pediatrics

A

Preventive Pediatric Health Care

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2
Q

Tasks of preventive pediatric health care

A

Disease Detection
Disease Prevention
Health Promotion
Anticipatory Guidance

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3
Q

Screening , Surveillance

A

Disease Detection

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4
Q

○ ANEMIA
what is SURVEILLANCE
what is DETECTION

A

■ Surveillance: Dietary hx; PE
■ Screening: Hb, Hct

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5
Q

○ DEVELOPMENT
■ Surveillance:
■ Screening:

A

■ Surveillance: observation
■ Screening: structured developmental tool

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6
Q

○ Fluoridation of water
○ Tetanus immunization
○ Counselling parents about poisons and drugs

A

primary prevention

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7
Q

avoiding disease before they occur

A

primary

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8
Q

early identification and treatment before disease progression

A

SECONDARY

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9
Q

○ Screening programs for scoliosis
○ Lead levels
○ Tx of a Strep infxn w/ antibiotics

A

secondary

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10
Q

directed @ ameliorating or halting disabilities

A

tertiary

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11
Q

○ Physical therapy - Cerebral Palsy
○ Chest physiotx - Cystic Fibrosis

A

tertiary

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12
Q

● Focus on wellness , strengths of the family

A

Health Promotion & Anticipatory Guidance

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13
Q

Opportunity to help the family address relationship issues; broach on safety topics; access community services

A

Health Promotion & Anticipatory Guidance

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14
Q

Ultimate goal of immunization:

A

eradication of disease

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15
Q

Immediate goal of immunization:

A

prevention of disease

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16
Q

person w/ disease ->
Immune system -> Abs

A

● Natural active immunization

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17
Q

●part/whole microorgs are introduce–> Abs

A

Artificial active immunization

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18
Q

Transfer of humoral immunity in the form of Abs

A

passive immunization

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19
Q

maternal Abs to fetus

A

● Natural passive immunization

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20
Q

high levels of pathogen or toxin-specific Abs given to non-immune persons

A

atificial passive immunization

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21
Q

indications of active immunization

A
  • Induce protective immune responses vs. attack of the natural infection
  • Once immunized, individual less likely be a source of infection
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22
Q

indications of PASSIVE IMMUNIZATION

A

●** Congenital/ acquired B-cell defects** alone or in combination w/ other Immunodeficiencies
● When time does not allow protection w/ active immunization alone. (eg. Rabies, Hepatitis B)
● When a person is susceptible and w/ high risk of complications (eg. leukemia)
● (+) Disease : Abs may help in suppressing its toxic effects (eg. tetanus, Kawasaki)

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23
Q

● BCG
● MEASLES
● MMR

A

LIVE ATTENUATED

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24
Q

● VARICELLA
● ROTAVIRUS
● INFLUENZA (INTRANASAL)

A

LIVE ATTENUATED

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25
● **TYPHOID FEVER(ORAL)** ● ORAL POLIO ● DENGUE TETRAVALENT
LIVE ATTENUATED
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● YELOW FEVER ● JAPANESE B ENCEPHALITIS
LIVE ATTENUATED
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**● HEPATITIS B** ● DTwP or DTaP or Tdap ● H. influenzae B
INACTIVATED (KILLED)
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PNEUMOCOCCAL HEPATITIS A MENINGOCOCCAL
INACTIVATED (KILLED)
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INFLUENZA HUMAN PAPILLOMA VIRUS TYPHOID FEVER RABIES INACTIVATED POLIO VIR
INACTIVATED (KILLED)
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○ Modified, weakened virus or bacteria
● LIVE Attenuated vaccines
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○ Retain the ability to replicate , produce immunity ○ Produce immunologic memory that is similar to that acquired by having the natural dse
LIVE ATTENUATED VACCINES
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○ Killed microorgs or inactivated components like toxoids, subunit or subvirion products or cell wall polysaccharides
INACTIVTED VACCINES
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○ LESS affected by circulating Abs ○ Produce Humoral IMMUNE RESPONSE **○ Multiple doses needed to BOOST Ab titers**
INACTIVATED VACCINES
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CLASSIFICATIONS OF VACCINES * Toxoids, whole cell * Toxoids , inactivated component * Toxoids * Polysaccharide Protein Conjugate
INACTIVATED BACTERIAL
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DTwP classification: types: route:
* inactivated bacterial * Toxoids, whole cell * IM
36
DTaP, Tdap classification: types: route:
* inactivated bacterial * toxoids, inactivated component * IM
37
Tetanus, Td classification: types: route:
* inactivated bacterial * Toxoids * IM
38
Hemophilus influenza type B (HIB) classification: types: route:
* inactivated bacterial * polysaccharide protein conjugate * IM
39
Cholera classification: types: route:
* inactivated bacterial * inactivated whole * oral
40
Meningococcal Typhoid fever classification: types: route:
* inactivated bacterial * polysaccharides * IM
41
Poliovirus (IPV) Rabies Hepatitis A classification: types: route:
* inactivated viral * inactivated virus * IM
42
Hepatitis B classification: types: route:
* INACTIVATED VIRAL * Recombinant subunit * IM
43
Influenza classification: types: route:
* inactivated viral * inactivated viral components * IM
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Human Papilloma Virus classification: types: route:
* inactivated viral * recombinant viral Ag * IM
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classification: types: route: DTP-base combi: DTaP-IPV-Hib DTaP-IPV-Hib-HepB DTaP-IPV DTwP-Hib-HepB
* Combination inactivated viral and bacterial * Toxoids, inactivated bacterial components, recombinant viral Ag, polysaccharide-protein conjugate * IM
46
Measles Measles-Mummps-Rubella (MMR) Measles-Mumps-Rubella-Varicella (MMRV) Varicella Polio virus (OPV) classification: types: route:
* live viral * live attenuated virus * SQ
47
classification: types: route: Bacillus Calmette-Guerin (BCG)
* live bacterial * live bacteria * ID
48
TYPES OF ROUTE FOR INJECTION
* IM - 90 degrees * Subcutaneous - 45 degrees * intravenous - 25 degrees * Intradermal - 10-15 degrees
49
based on volume of injected material and muscle size
IM
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site for IM injection for **less than 1 year old**
ANTERO-LATERAL THIGH
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site for IM injection of **more than 1 year old**
deltoids
52
can you inject in Upper, outer buttocks
: A BIG NO, NO!
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● SIMULTANEOUS ADMINISTRATION OF MULTIPLE VACCINES
○ Use **separate syringes, sites**
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○ >/ 2 **inactivated vaccines** or inactivated and **live vaccine combinations**
Given simultaneously or @ any interval between doses
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2 parenteral live vaccines
Given simultaneously or **interval of 4 wks**
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Cholera & Yellow Fever vaccine
(3 wks interval)
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● LAPSED IMMUNIZATIONS
○ **No need to reinstitute** the **entire** series ○ **Subsequent immunizations given in the next visit**
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● UNKnown/UNCERTAIN IMMUNIZATION STATUS
○ Initiated w/out delay on a sched commensurate with the person’s age ○ NO evidence that giving vaccines to already immune recipients are harmful
59
contraindications: Anaphylactic reaction
permanent
60
contraindications pregnancy
temporary to live vaccines
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contraindications immunosuppressions
temporary to liove vaccines
62
contraindications encephalopathy **within 7 days** after **pertussis vaccination**
permanent
63
Vaccination course given prior to an exposure
pre exposure prophylaxis
64
Preventive med tx given after exposure to a pathogen
PEP post exposure prophylaxis (PrEP)
65
Preventive med tx given after exposure to a pathogen
PEP post exposure prophylaxis
66
NB, w/in the 2 months of life
BCG
67
TB Meningitis, Disseminated TB
BCG
68
● Vaccine preparations available for BCG
○ Freeze Dried Glutamate BCG vaccine (Japan) ○ BCG vaccine powder and solvent for suspension for injection
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● Dosage & Sched: for BCG
○ Intradermal(ID) ○ **< 12 months**: **0.05 ml** ○**> 12 months**: ***0.10 ml***
70
● Purified Protein Derivative (PPD) prior to BCG vaccination in what conditions
in any of the following: ○ **Suspected Congenital TB** ○ **Hx of close contact** to known or suspected infectious cases of TB ○ **Clinical findings suggestive of TB** and/or **CXR suggestive of TB**
71
● Adverse reactions for BCG
○ LAD ○ Abscess injection site
72
● Normal reaction to BCG vaccination? ○ @ 3 wks
small area of erythema
73
● Normal reaction to BCG vaccination? @ 6-10 wks
: raised papule w/ redness
74
● Normal reaction to BCG vaccination? @ 14 weeks
shallow ulceration
75
● Target popn: ○**Infants , children 6 weeks and older** ○ Susceptible, unvaccinated children, adolescents, adults
DIPHTHERIA-PERTUSSIS-TETANUS (DPT) (EPI)
76
Causative agents and transmission: Diphtheria
* Corynebacterium diphtheria * person-to-person transmission via respiratory droplets
77
Causative agents and transmission: Pertussis
* Bordetella pertussis * respiratory droplets
78
Causative agents and transmission: Tetanus
* Clostridium tetani * Contaminated wounds
79
general guidelines for ● 6 wks - 6 yo :
DTaP ● DTaP pediatric formulation **(diphtheria-tetanus-acellular pertussis)**
80
general guidfelines for 7- 9 yo
Td ● Td w/out pertussis component (diphtheria-tetanus)
81
general guidelines for 10-64 yo
Tdap (esp w/ close contact w/ infant) ● Tdap reduced Ag formulation
82
general guidelines for 65 yo
Td ( esp if w/ close contact w/ infant) ● Td w/out pertussis component (diphtheria-tetanus)
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dpt PRIMARY 1 dose minimum age
6 weeks
84
interval for DPT primary 2 dose
4 weeks
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interval for DPT primary 3 dose
4 weeks
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interval for DPT primary 4 dose
6 months
87
○ Booster doses DPT
**5th dose** @ **4-6 yrs of age** **before school entry**
88
DPT SCHEDULE Older/Adolescents:
* Incomplete immunization **7-18 yo** **I dose of Tdap** and **Td** for the remaining dose **2 doses given 4 wks apart**
89
Unimmunized 7-18 yo
**3 dose primary series** @ **0,1,6 months w/Tdap (1st dose)** , Td after
90
ADVERSE REACTION DPT
○ Local reactions: erythema, tenderness ○ Abscess
91
SYSTEMIC REACTION DPT
* Fever (less common) * **Arthus-type rxns**: exagg rxns 2-8 hrs after injection; **extensive painful swelling from shoulder to elbow** * Less frequent: high fever, persistent crying (>3 hrs), **hypotonic hypo-responsive episodes (HHE)**; seizures * Rarely: gen. Urticaria, anaphylaxis, **acute encephalopathy (pertussis vaccine)**, peripheral neuropathy, **GBS ( tetanus vaccine)**
92
TARGET POPULATION FOR HAEMOPHILUS INFLUENZAE TYPE B (Hib)
6wks-5 yo
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CHILDREN >5 yo: FOR HIB
○ Functional or anatomic asplenia ○ Immunodeficiency ○ On immunosuppressants ○ HIV/AIDS ○ Transplant pxs
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● Disease prevented: H. influenzae type b infection
○ Acute Otitis Media, Sinusitis ○ PNM ○ Bacteremia ○ Meningitis
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● Transmission for HiB
○ Direct PTP via droplets ○ Autoinoculation ○ Aspiration of AF or direct contact with genitalia during delivery
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● Vaccine preparations available for HiB
○ **Monovalent PRP-T** (Polyribosylribitol PO4-Tetanus toxoid) H. influenzae type b conjugate vaccine ○ **Combination vaccine w/ DPT, IPV, Hepatitis B** ○ **Pentavalent w/ DPT, Hep B**
97
Age @ 1st dose 6 wks-6 mos primary series? booster?
* Primary series **3 doses, 1-2 mos apart** * Booster **12-15 mos**
98
Age @ 1st dose 7-11 mos primary series? booster?
2 doses, 1-2 months apart booster at 18 mos
99
Age @ 1st dose 12-59 primary series? booster?
primary series: 1 dose booster no
100
● UNVACCINATED OLDER CHILDREN for HIB 12-14 mos
1 dose ffd by 1 booster dose
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● UNVACCINATED OLDER CHILDREN for HIB 15-59 mos
1 dose
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● UNVACCINATED OLDER CHILDREN for HIB > 59 mos
**NOT Reco unless w/:** * Functional or anatomic asplenia * Immunodeficiency On immunosuppressants * HIV/AIDS * Transplant pxs **1 dose of Hib only vaccine**
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● Adverse reactions of HiB ○ Local (MC)
■ Pain, swelling, erythema
104
● Adverse reactions of HiB systemic
Fever, irritability, severe allergic rxn (rare)
105
contraindication for HiB vaccine
* severe anaphylactic rxn; * mod-severe illness (precaution)

2ND YEAR-PEDIA (11 decks)

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