IMCI 1.1 (AB) Flashcards by Shiela Micah Gascon

What age group is covered by the IMCI?

Newborns up to 5 years old.

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What are the two age groups in IMCI?

0-2 months and 2 months to 5 years old.

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Why was IMCI created?

To assist community health workers in managing childhood illness in resource-limited settings.

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Are laboratory tests or auscultation required in IMCI?

No.

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What are the most common causes of morbidity and mortality in children under 5?

Acute respiratory infections and diarrhea.

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How does malnutrition affect childhood illness?

It increases complications by 2-6 times compared to well-nourished children.

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Name some current nutrition programs under IMCI.

Food fortification. Deworming. Supplementation. Education like Pinggang Pinoy and Kumainments.

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What foods are limited in school canteens under IMCI guidance?

Oily foods. Sugary foods. Sodas.

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Why is IMCI especially beneficial in the Philippines?

Due to isolated communities and limited access to healthcare.

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Which illnesses are prioritized in IMCI?

Acute respiratory infections. Diarrhea. Measles. Malaria. Perinatal conditions.

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What are the principles of IMCI clinical case management?

Examine all sick children. Assess main symptoms. Check nutritional and immunization status. Use limited clinical signs. Classify illness.

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What are the main symptoms assessed in older children?

Cough or difficulty breathing. Diarrhea. Fever. Ear infection.

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What are the main symptoms assessed in young infants?

Local bacterial infection. Diarrhea. Jaundice.

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What color classification in IMCI requires hospital referral?

Pink.

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What treatment should be given before hospital referral?

Pre-referral treatment such as oxygen. Diazepam. Keeping warm. Feeding if possible.

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What color classification indicates outpatient treatment?

Yellow.

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What color classification indicates home care?

Green.

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What are the four general danger signs in IMCI?

Does not drink or feed. Vomits everything. Lethargic or drowsy. Seizure.

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What is the basic IMCI protocol sequence?

Assess. Classify. Treat.

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What is the next step if a danger sign is found?

Classify as Pink and refer to a hospital.

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What medications are commonly available in IMCI settings?

Amoxicillin. Ciprofloxacin. Zinc. Diazepam.

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What are key components of caregiver counseling in IMCI?

Feeding and fluids. When to return immediately. When to follow up.

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What are the steps to treating a child under IMCI?

Give treatment in clinic. Prescribe home medications. Teach caregiver how to administer treatment.

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When should a follow-up visit be scheduled?

Depends on the illness and classification.

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How is diazepam administered in a seizure?

Rectally using a tuberculin syringe without a needle.

What respiratory rate defines fast breathing in 0-2 months?

60 or more breaths per minute.

What respiratory rate defines fast breathing in 2-12 months?

50 or more breaths per minute.

What respiratory rate defines fast breathing in 12 months to 5 years?

40 or more breaths per minute.

What is the diagnosis for a child with cough

normal breathing

What is the diagnosis if a child has cough and chest indrawing?

Severe pneumonia or very severe disease.

What is the diagnosis for a 10-month-old with cough and RR of 55 but no chest indrawing?

Pneumonia.

What treatment is given for pneumonia under IMCI?

Oral antibiotic for 5 days. Safe remedy for cough. Advise when to return. Follow-up in 2 days.

What is the diagnosis for a child with cough

no danger signs

What should be done if cough lasts more than 30 days?

Refer for further assessment.

What is the first thing a health worker should ask the caregiver?

What are the child’s problems.

When should the health worker use the follow-up instructions in IMCI?

If it is a follow-up visit.

What are the signs of severe dehydration?

Lethargic or unconscious. Sunken eyes. Not able to drink or drinking poorly. Skin pinch goes back very slowly.

How is severe dehydration classified?

If two or more signs of severe dehydration are present.

What is the treatment for severe dehydration?

Give fluid for severe dehydration (Plan C) or refer urgently to hospital with ORS on the way. Continue breastfeeding. Give antibiotic for cholera if ≥2 years and cholera is in the area.

What are the signs of some dehydration?

Restless or irritable. Sunken eyes. Drinks eagerly or is thirsty. Skin pinch goes back slowly.

What is the treatment for some dehydration?

Give fluid and food (Plan B). If severe classification is also present refer urgently. Continue breastfeeding. Advise when to return immediately. Follow-up in 5 days.

What are the signs of no dehydration?

Not enough signs to classify as some or severe dehydration.

What is the treatment for no dehydration?

Treat diarrhea at home with Plan A. Give extra fluid. Give zinc. Continue feeding. Advise when to return. Follow-up in 5 days.

What does a very slow skin pinch return (>3 seconds) indicate?

Severe dehydration.

What does a slow skin pinch return (2-3 seconds) indicate?

Some dehydration.

When is the skin pinch test unreliable?

In elderly or patients with severe wasting.

What are the 4 rules of home treatment for diarrhea?

Give extra fluid. Give zinc supplements. Continue feeding. Know when to return.

What is Plan A for dehydration?

Home treatment with extra fluids. Zinc. Continued feeding. Return advice.

What is Plan B for dehydration?

ORS treatment for 4 hours in clinic. Reassess and follow up with appropriate plan.

How do you calculate ORS volume in Plan B?

Weight in kg × 75 mL = volume for 4 hours.

What is Plan C for dehydration?

IV fluids immediately. If IV not possible

How much IV fluid is given first in Plan C for infants?

30 mL/kg in 1 hour followed by 70 mL/kg in 5 hours.

How much IV fluid is given first in Plan C for children 12 months to 5 years?

30 mL/kg in 30 minutes followed by 70 mL/kg in 2.5 hours.

When should ORS be given during Plan C?

As soon as the child can drink. About 5 mL/kg/hour.

What is the zinc dose for 2–6 months old?

1/2 tablet (10 mg) daily for 14 days.

What is the zinc dose for 6 months to 5 years?

1 tablet (20 mg) daily for 14 days.

How is zinc given to infants?

Dissolve in small amount of breast milk. ORS. or clean water.

What are signs that a child should be referred immediately?

Lethargy. unconsciousness. not drinking. severe dehydration. or any danger signs.

How is persistent diarrhea classified?

If diarrhea lasts 14 days or more.

What is severe persistent diarrhea?

Persistent diarrhea with dehydration. Requires hospitalization.

What is persistent diarrhea?

Diarrhea for ≥14 days without dehydration. Managed with feeding advice and follow-up.

What is the treatment for dysentery?

Start antibiotics immediately.

What should you suspect if a child in a high malaria risk area has fever?

Malaria.

What area in the Philippines is considered high malaria risk?

Palawan.

What are danger signs of a very severe febrile disease?

Any general danger sign or stiff neck.

What is the treatment for very severe febrile disease?

Give quinine for severe malaria (first dose). Give first dose of an appropriate antibiotic. Treat to prevent low blood sugar. Give paracetamol if fever is 38.5C or above. Refer urgently.

When should you treat with an oral antimalarial?

If there is fever with no cough and no fast breathing in high malaria risk area.

What do you give if fever is present and cough with fast breathing is observed?

Cotrimoxazole for 5 days.

When should you follow-up if fever persists?

Follow up in 2 days.

What if fever is present every day for more than 7 days?

Refer for assessment.

If runny nose or measles or other cause of fever is present, how do you classify the fever?

Classify as Fever: No malaria. This applies when the child has another apparent cause of fever such as measles, runny nose, or other localized infections, and lives in a low malaria risk area or has no danger signs and no malaria-specific symptoms.

What is the treatment for fever—malaria unlikely?

Paracetamol if fever 38.5C or above. Advise mother when to return. Follow up in 2 days. Refer if fever lasts >7 days.

When should a child with stiff neck be referred?

Immediately

What CNS signs suggest infection or electrolyte imbalance?

Changes in sensorium.

What is given for clouding of cornea in severe measles?

Tetracycline eye ointment.

What classifies a child as having severe complicated measles?

Any general danger sign. Clouding of cornea. Deep or extensive mouth ulcers.

What is the treatment for severe complicated measles?

Vitamin A. Appropriate antibiotic. Tetracycline eye ointment if eye symptoms. Refer urgently.

What signs indicate measles with eye or mouth complications?

Pus from the eye. Mouth ulcers.

How do you treat measles with mouth ulcers?

Vitamin A. Treat with gentian violet.

What do you give to all measles cases regardless of severity?

Vitamin A.

What are other measles complications not classified under measles?

Pneumonia. Stridor. Diarrhoea. Ear infection. Malnutrition.

What is mastoiditis?

Tender swelling behind the ear.

What is the treatment for mastoiditis?

First dose of antibiotic. First dose of paracetamol. Refer urgently.

What classifies acute ear infection?

Pus draining <14 days or ear pain.

How do you treat acute ear infection?

Antibiotics 5 days. Paracetamol. Wick ear dry. Follow-up in 5 days.

How do you treat chronic ear infection?

Wick ear dry. Follow-up in 5 days.

What do you do if there's no ear pain or pus?

No ear infection. No additional treatment.

What classifies severe malnutrition or anemia?

Visible severe wasting. Severe palmar pallor. Oedema of both feet.

How do you treat severe malnutrition or anemia?

Give Vitamin A. Refer urgently.

What classifies anemia or very low weight?

Some palmar pallor or very low weight for age.

What are treatments for anemia?

Iron. Oral antimalarial if high malaria risk. Mebendazole if 2+ years and no dose in last 6 months.

When do you follow up anemia?

14 days.

When do you follow up very low weight for age?

30 days.

What do you do if weight is not very low and no other signs?

No anemia and not very low weight. Assess and counsel on feeding.

When is BCG contraindicated?

If child has AIDS. If child has had convulsions or shock within 3 days If child hs recurrent convulsions or other CNS disease.

When is DPT2 or DPT3 contraindicated?

If child had convulsion or shock within 3 days of most recent dose.

When is DPT completely contraindicated?

Recurrent convulsions or active CNS disease.

What to do if child has diarrhea and due for OPV?

Give OPV but do not count the dose. Ask to return in 4 weeks.

What if a health worker cannot manage a condition?

Refer the child.

When should referral be done immediately?

Any general danger sign or serious condition after pre-referral treatment.

When may referral be avoided in severe dehydration?

If Plan C improves danger signs and IV fluids available in the community.