Integrated Managemetn of Childhood Illness (IMCI)

Question 1

is a globally recognized, evidence based strategy designed to reduce child mortality, promote healthy growth, and improve quality of care for sick children—especially in low resource settings

Answer 1

IMCI

Question 2

It emphasizes integrated assessment and standardized treatment protocols for the most common and deadly childhood conditions

Answer 2

IMCI

Question 3

THREE MAJOR COMPONENTS OF IMCI:

Answer 3

1. IMPROVING CASE MANAGEMENT SKILLS OF HEALTH WORKERS.
2. IMPROVING THE HEALTH SYSTEMS TO DELIVER IMCI.
3. IMPROVING FAMILY AND COMMUNITY HEALTH PRACTICES.

Question 4

The Case Management Process

Answer 4

1. ASSESS THE CHILD OR YOUNG INFANT
2. CLASSIFY THE ILLNESSES
3. IDENTIFY THE TREATMENT
4. TREAT THE CHILD/ REFER
5. COUNSEL THE MOTHER
6. GIVE FOLLOW-UP CARE

Question 5

ASSESS THE CHILD OR YOUNG INFANT
What are the General danger signs?

Answer 5

Convulsions (during this illness)
Lethargy/unconsciousness
Inability to drink/breastfeed
Vomits Everything

Question 6

The children and infants are then assessed for main symptoms:
In older children (2 months to 5 months), the main
symptoms include:

Answer 6

◦ Cough or difficulty breathing,
◦ Diarrhea,
◦ Fever, and
◦ Ear infection.

Question 7

In young infants (until 2 months), the main symptoms
include:

Answer 7

◦ Local bacterial infection,
◦ Diarrhea, and
◦ Jaundice.

Question 8

Other Assessments
Then in addition, all sick children are routinely checked for:

Answer 8

◦ Nutritional and immunization status,
◦ HIV status in high HIV settings, and
◦ Other potential problems.

Question 9

indicates urgent hospital referral or admission

Answer 9

“PINK”

Question 10

indicates initiation of specific outpatient treatment

Answer 10

“YELLOW”

Question 11

indicates supportive home care.

Answer 11

“GREEN”

Question 12

Any general danger sign

Answer 12

Pink: VERY SEVERE DISEASE

Question 13

Give ________________ if convulsing now

Answer 13

diazepam

Question 14

is a common and reversible cause of seizures in children.

Answer 14

hypoglycemia

Question 15

2 months up to 6 months (5 - 7 kg)

Answer 15

0.5 ml

Question 16

6 months up to 12months (7 - <10 kg)

Answer 16

1.0 ml

Question 17

12 months up to 3 years (10 - <14 kg)

Answer 17

1.5 ml

Question 18

3 years up to 5 years (14-19 kg)

Answer 18

2.0 ml

Question 19

If the child is not able to breastfeed but is able to swallow

Answer 19

• Give expressed breast milk or a breast-milk substitute.
• If neither of these is available, give sugar water*.
• Give 30 - 50 ml of milk or sugar water* before departure.

Question 20

If the child is not able to swallow:

Answer 20

• Give 50 ml of milk or sugar water* by nasogastric tube.
• If no nasogastric tube available, give 1 teaspoon of sugar moistened with 1-2 drops of water sublingually and repeat doses every 20 minutes to prevent relapse.

Question 21

If no nasogastric tube available, give __ teaspoon of sugar moistened with ___ drops of water __________________ and repeat doses every __ minutes to prevent relapse.

Answer 21

1; 1-2; sublingually; 20

Question 22

To make sugar water: Dissolve __ level teaspoons of sugar (20 grams) in a ___-ml cup of clean water.

Answer 22

4; 200

Question 23

If the child is: 2 months up to 12 months
Fast breathing is:

Answer 23

50 breaths per minute or more

Question 24

If the child is: 12 Months up to 5 years
Fast breathing is:

Answer 24

40 breaths per minute or more

Question 25

- Any general danger sign or - Stridor in calm child.

Answer 25

SEVERE PNEUMONIA OR VERY SEVERE DISEASE

Question 26

Chest indrawing or Fast breathing.

Answer 26

Yellow: PNEUMONIA

Question 27

SEVERE PNEUMONIA OR VERY SEVERE DISEASE interventions

Answer 27

Give first dose of an appropriate antibiotic Refer URGENTLY to hospital**

Question 28

Yellow: PNEUMONIA interventions - Give oral_______________________*** - If wheezing (or disappeared after rapidly acting bronchodilator) give an __________________________**** - If chest indrawing in HIV exposed/infected child, give first dose of __________________ and refer. - Soothe the throat and relieve the cough with a safe remedy - If coughing for more than ________ or recurrent wheeze, refer for possible _________________ assessment - Advise mother when to return immediately - Follow-up in ____________

Answer 28

Amoxicillin for 5 days; inhaled bronchodilator for 5 days; amoxicillin; 14 days; TB or asthma; 3 days

Question 29

No signs of pneumonia or very severe disease

Answer 29

Green: COUGH OR COLD

Question 30

Green: COUGH OR COLD - If wheezing (or disappeared after rapidly acting bronchodilator) give an inhaled bronchodilator for 5 days**** - Soothe the throat and relieve the cough with a safe remedy - If coughing for more than 14 days or recurrent wheezing, refer for possible TB or asthma assessment - Advise mother when to return immediately - Follow-up in __ days if not improving

Answer 30

5

Question 31

ould be used in patients with fast breathing but no chest indrawing in low HIV settings.

Answer 31

Oral Amoxicillin for 3 days

Question 32

In settings where inhaled bronchodilator is not available, __________________ may be tried but not recommended for treatement of severe acute wheeze

Answer 32

oral salbutamol

Question 33

signs of severe dehydration

Answer 33

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

Question 34

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

Answer 34

Pink: SEVERE DEHYDRATION

Question 35

- Restless, irritable - Sunken eyes - Drinks eagerly, thirsty - Skin pinch goes back slowly.

Answer 35

Yellow: SOME DEHYDRATION

Question 36

what plan is Give fluid for severe dehydration

Answer 36

Plan C

Question 37

what plan is Give fluid, zinc supplements, and food for some dehydration

Answer 37

Plan B

Question 38

In Yellow: SOME DEHYDRATION, follow up is

Answer 38

Follow-up in 5 days if not improving

Question 39

what plan is Give fluid, zinc supplements, and food to treat diarrhoea at home

Answer 39

Plan A

Question 40

classification if if diarrhoea 14 days or more and dehydration is present.

Answer 40

Pink: SEVERE PERSISTENT DIARRHOEA

Question 41

classification if if diarrhoea 14 days or more and no dehydration is present.

Answer 41

Yellow: PERSISTENT DIARRHOEA

Question 42

classification of diarrhea that has blood in stool

Answer 42

Yellow: DYSENTERY

Question 43

interventions for Yellow: DYSENTERY

Answer 43

Give ciprofloxacin for 3 days Follow-up in 3 days

Question 44

1. SHOW THE MOTHER HOW MUCH FLUID TO GIVE IN ADDITION TO THE USUAL FLUID INTAKE: * Up to 2 years 50 to _________ ml after each loose stool * 2 years or more _________________ ml after each loose stool

Answer 44

100; 100 to 200

Question 45

TELL THE MOTHER HOW MUCH ZINC TO GIVE (20 mg tab): 2 months up to 6 months - ____ tablet ____________ for ___________________ 6 months or more - __ tablet ___________ for _____________

Answer 45

1/2; daily; 14 days; 1; daily; 14 days

Question 46

Any general danger sign or Stiff neck.

Answer 46

Pink: VERY SEVERE FEBRILE DISEASE

Question 47

Give first dose of _________________ for severe malaria

Answer 47

artesunate or quinine

Question 48

Malaria test POSITIVE.

Answer 48

Yellow: MALARIA

Question 49

Malaria test NEGATIVE Other cause of fever PRESENT

Answer 49

Green: FEVER: NO MALARIA

Question 50

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

Answer 50

SEVERE COMPLICATED MEASLES****

Question 51

Pus draining from the eye or Mouth ulcers.

Answer 51

Yellow: MEASLES WITH EYE OR MOUTH COMPLICATIONS

Question 52

Measles now or within the last 3 months.

Answer 52

Green: MEASLES

Question 53

Viatmin use for measles

Answer 53

Vitamin A

Question 54

Tender swelling behind the ear

Answer 54

Pink: MASTOIDITIS

Question 55

- Pus is seen draining from the ear and discharge is reported for less than 14 days, or - Ear pain

Answer 55

Yellow: ACUTE EAR INFECTION

Question 56

- Pus is seen draining from the ear and discharge is reported for 14 days or more

Answer 56

Yellow: CHRONIC EAR INFECTION

Question 57

- No ear pain and - No pus seen draining from the ear.

Answer 57

Green: NO EAR INFECTION

Question 58

Oedema of both feet OR WFH/L less than -3 zscores OR MUAC less than 115 mm AND any one of the following: Medical complication present or Not able to finish RUTF or Breastfeeding problem.

Answer 58

Pink: COMPLICATED SEVERE ACUTE MALNUTRITION

Question 59

WFH/L less than -3 zscores OR MUAC less than 115 mm AND Able to finish RUTF

Answer 59

Yellow: UNCOMPLICATED SEVERE ACUTE MALNUTRITION

Question 60

WFH/L between -3 and - 2 z-scores OR MUAC 115 up to 125 mm.

Answer 60

Yellow: MODERATE ACUTE MALNUTRITION

Question 61

WFH/L - 2 z-scores or more OR MUAC 125 mm or more.

Answer 61

Green: NO ACUTE MALNUTRITION

Question 62

Severe palmar pallor

Answer 62

SEVERE ANAEMIA

Question 63

Some pallor

Answer 63

Yellow: ANAEMIA

Question 64

No palmar pallor

Answer 64

Green: NO ANAEMIA

Question 65

Give ______________________ to all HIV infected and HIV-exposed children utill confirmed negative after cessation of breastfeeding

Answer 65

cotrimoxazole prophylaxis