Pediatrics

Question 1

Normal Vital signs for an infant < 1yr

Answer 1

RR:30-60
pulse:100-160
SBP: >60

Question 2

Normal vital signs for a toddler age 1-3

Answer 2

RR:24-40
pulse:90-150
SBP: >70

Question 3

Normal vitals for preschool (4-5 yr)

Answer 3

RR:22-34
pulse:80-140
SBP>75

Question 4

Normal Vitals for age 6-12

Answer 4

RR:18-30
pulse: 70-120
SBP:>80

Question 5

adolescent vitals 13-18

Answer 5

RR:12-20
pulse:60-100
SPB:>90

Question 6

Developmental milestones: 2 mo

Answer 6

coos and makes gurgling sounds
can hold head up and begins to push up when laying on tummy
begins to smile at people
pays attention to faces

Question 7

Developmental milestones: 4 mo

Answer 7

holds head steady, unsupported

may be able to roll over from tummy to back

Question 8

Developmental milestones: 6 mo

Answer 8

babbling
responds to own name
rolls over in both directions
knows familiar faces
likes to play with others

Question 9

Developmental milestones: 9 mo

Answer 9

sits without support
crawls
may be afraid of strangers
picks up things between thumbs and index finger

Question 10

Developmental milestones: 12 mo

Answer 10

says “mama” and “dada”

follows simple directions

Question 11

Developmental milestones: 18 mo

Answer 11

says several single words
walks alone
simple pretend play

Question 12

Developmental milestones: 3 years old

Answer 12

can name most familiar objects
talks well enough for strangers to understand most of the time
runs easily

Question 13

Developmental milestones: 4 years old

Answer 13

hops and stands on 1 foot for up to 2 seconds

Question 14

Developmental milestones: 5 years old

Answer 14

speaks very clearly
can use toilet on own
counts 10 or more objects

Question 15

Developmental milestones: 7-8 years old

Answer 15

adult proficiency with language
major improvements in strength and coordination
“concrete operational thinking” (focuses on the present)
moral development is simple (right and wrong)
more independent socially

Question 16

Developmental milestones: Adolescence

Answer 16

formal operational thinking (consider future consequences)
moral thought is more sophisticated
increasing autonomy and peer influences

Question 17

Hepatitis B vaccine

Answer 17

administered in 3 doses
at birth (hospital), at 1-2 mo, and at 6-18 mo

Question 18

Diptheria,Tentanus, and pertussis vaccines (DTaP)

Answer 18

can be given at the same time as other recommended vaccines but should not be mixed in the same syringe
-given at 2 mo, 4 mo, 6 mo, 15-18 mo and 4-6 years of age

Question 19

CI to DTaP

Answer 19

anyphylactic rxn to vaccine or its components
encephalopathy within 7d of previous dose w/o other identifiable cause
progressive neuro disorder

Question 20

when do you give H. influenza serotype b (Hib)?

Answer 20

PedVaxHIB- 2 dose series at 2 and 4 mo and booster at 12-15 mo
ActHIB 3 dose series at 2, 4 and 6 mo and as a booster at 12-15 mo

Question 21

when do you administer poliovirus vaccine?

Answer 21

IPV is administered SQ or IM in 4 doses

2,4,6-18 months and 4-6 years

Question 22

measles, mumps, rubella (MMR) vaccine

Answer 22

live attenuated virus

first dose administered at 12-15 mo of age with second dose at school entry (4-6 yo)

Question 23

True CI’s to MMR vaccine?

Answer 23

pregnancy
known altered immunodeficiency
long term immunosuppressive therapy 
hematologic or solid tumors
* if thrombocytopenia w/i 6 w of prior MMR, do not get another dose b/c increase risk for immune thrombocytopenia purpura

Question 24

Varicella Vaccine (Varivax)

Answer 24

Live attenuated

2 dose series admin SQ or IM at 12-15 mo and 4-6 yr

Question 25

what should you avoid after varicella vaccine?

Answer 25

salicylates for at least 6 weeks due to reye syndrome

Question 26

CI to varicella vaccine?

Answer 26

``` primary or acquired immunocomprimise pregnancy moderate or sever ilnesses previous anaphylactoid rxn reaction to neomycin or gelatin ```

Question 27

when should you give pneumococcal vaccine?

Answer 27

IM at 2,4,6 mo of age and 4th dose b/w 12-15 mo of age

Question 28

when should you get meningococcal vaccine?

Answer 28

children age 2-10 year old who have and indication for vaccination recommended for all adolescents aged 11-18 years of age

Question 29

when in Hep A vaccine suggested and what route?

Answer 29

patient 1-18 yo: 2 IM doses at least 6 mo apart

Question 30

when should an ind get the influenza vaccine?

Answer 30

all children 6 and older given annually in the fall kids 6-8 may need 2 doses give 2 doses of 1rst influenza vaccinr give 2nd dose 28d following intial dose

Question 31

what are the 2 types of flu vaccine?

Answer 31

``` Inactivated vaccine (TIV) administered IM Live attenuated, cold adapted influenza vaccine (LAIV)- administered intranasally *choice of vaccine de[ends upon age and risk factors ```

Question 32

when should rotavirus be given?

Answer 32

live attenuated RV5,PRV, RotaTeq-3 doses at 2,4,6 mo RV1,HRV, rotarux- 2 doses at 2,4 mo

Question 33

When is HPV recommended?

Answer 33

girls beginning at 11-12 (13-26) boys 11-12 (12-21) Gardasil: 3 doses at time 0, 2 and 6 mo Cervarx: 3 doses at time 0, 1 and 6 mo

Question 34

How many criteria do no need to diagnose rheumatic fever?

Answer 34

2 major criteria OR | 1 major and 2 minor criteria

Question 35

What are the major criteria?

Answer 35

``` migratory arthritis primarily involving large joints carditis SQ skin nodules sydenham chorea erythema marginatum ```

Question 36

What are the minor criteria?

Answer 36

fever elevated acute phase reactants arthralgia abnormal EKG-prolonged PR interval