PPS Policy Statement Flashcards
1
Q
Q: Is exclusive breastfeeding recommended during the first 6 months of life?
A
A: Yes, exclusive breastfeeding is ideal during the first 6 months of life. This practice is supported by extensive research demonstrating its benefits for infant health, including nutritional adequacy and immune support.
2
Q
Q: Have global attempts to encourage, promote, and support breastfeeding been successful?
A
A: Global efforts, such as the WHO/UNICEF’s “Baby Friendly Hospital Initiative,” have been successfully implemented in 171 countries worldwide, showing good results in encouraging, promoting, and supporting breastfeeding.
3
Q
Q: How has the Philippines supported global efforts to promote breastfeeding?
A
A: The Philippines has supported these efforts by passing Republic Act (RA) 7600, also known as “The Rooming-In and Breastfeeding Act of 1992,” in Congress. This legislation promotes and supports breastfeeding in the country.
4
Q
Q: What are the benefits of breastfeeding?
A
A: Breastfeeding offers numerous benefits, including boosting the infant’s host defense through bioactive components like lysozymes, immunoglobulins, hormones, growth factors, immune function modulators, anti-inflammatory and cellular components not found in infant formula. These components protect the infant from infections, aid in gastrointestinal function, reduce the prevalence and morbidity of respiratory illness and infections, and are associated with a reduction in upper respiratory symptoms among premature infants. Breastfeeding also protects against UTI, otitis media, bacteremia, bacterial meningitis, botulism, NEC, and lowers the risk of SIDS and IDDM. Furthermore, it affords psychological benefits, promotes maternal bonding, and improves long-term cognitive and motor abilities.
5
Q
Q: What are the benefits of breastfeeding for the mother?
A
A: Breastfeeding benefits the mother by promoting better postpartum uterine involution, providing emotional satisfaction from maternal-infant bonding, reducing the risk of developing breast and endometrial cancers, enhancing postpartum weight loss, and resulting in lactational amenorrhea which can act as a form of contraception. Additionally, the risk of death from diarrhea may be significantly higher in bottle-fed infants compared to breastfed infants, which also suggests a lack of adequate stimulation and attention during bottle feeds.
6
Q
Q: What are the contraindications to breastfeeding?
A
A: Absolute contraindications to breastfeeding include galactosemia in the infant and maternal use of illegal drugs, anti-neoplastic agents, and radiopharmaceuticals. Relative contraindications include an active TB infection, where breastfeeding is allowed after 2 weeks of observed treatment with anti-koch’s therapy, and maternal HIV infection, which is also considered a relative contraindication.
7
Q
Q: Can HIV-positive mothers provide breast milk to their infants?
A
A: Yes, HIV-positive mothers may opt to give their infants expressed and heat-treated breastmilk. This approach is recommended when nutritionally adequate breast-milk substitutes are not safely prepared and fed, especially in environments where infectious diseases and malnutrition are prevalent causes of infant mortality.
8
Q
Q: What does the policy statement developed by UNAIDS, WHO, and UNICEF say about breastfeeding and HIV?
A
A: The policy statement by UNAIDS, WHO, and UNICEF highlights that children born to women living with HIV are at less risk of illness and death if they are not breastfed, provided they have uninterrupted access to safely prepared and fed nutritionally adequate breast-milk substitutes. However, in environments where infectious diseases and malnutrition are significant causes of infant death, the use of artificial breast milk substitutes can substantially increase the risk of illness and death.
9
Q
Q: What is the aim of the Baby Friendly Hospital Initiative launched by WHO/UNICEF?
A
A: The Baby Friendly Hospital Initiative, launched in 1992 by WHO/UNICEF, aims to promote and reiterate the importance of breastfeeding through a ten-step program. This program includes having a written breastfeeding policy, training healthcare staff in breastfeeding support, informing pregnant women about breastfeeding benefits, initiating breastfeeding within half an hour of birth, showing mothers how to breastfeed and maintain lactation, and ensuring that newborns receive no food or drink other than breast milk, unless medically indicated. Practice rooming-in- that is, allow mothers and infants to remain together 24 hours a day. Encourage breastfeeding on demand. Give no artificial teats or pacifiers to breastfeeding infants. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.
10
Q
Q: Is exclusive breastfeeding recommended during the first 6 months of life?
A
A: Yes, exclusive breastfeeding is considered ideal during the first 6 months of life to support optimal infant health and development.
11
Q
Q: Have global efforts to promote breastfeeding through initiatives like the WHO/UNICEF’s “Baby Friendly Hospital Initiative” been successful?
A
A: Yes, these efforts have seen good results in encouraging, promoting, and supporting breastfeeding across 171 countries worldwide.
12
Q
Q: How has the Philippines participated in global efforts to encourage breastfeeding?
A
A: The Philippines has supported these efforts by enacting Republic Act (RA) 7600, known as “The Rooming-In and Breastfeeding Act of 1992.”
13
Q
Q: What are the benefits of breastfeeding for the infant?
A
A: Breastfeeding offers numerous benefits to the infant, including enhanced immune defense, protection from infections, and support for healthy development.
14
Q
Q: What are the benefits of breastfeeding for the mother?
A
A: Benefits for the mother include improved postpartum recovery, emotional satisfaction from maternal-infant bonding, reduced risk of certain cancers, and aid in postpartum weight loss.
15
Q
Q: What are the contraindications to breastfeeding?
A
A: Absolute contraindications include conditions like galactosemia in the infant and maternal use of illegal drugs or certain medications, while relative contraindications include maternal infections like active TB and HIV.
16
Q
Q: Can HIV-positive mothers breastfeed their infants?
A
A: HIV-positive mothers may opt to give their infants expressed and heat-treated breastmilk under certain conditions to minimize transmission risks.
17
Q
Q: What does a policy statement developed by UNAIDS, WHO, and UNICEF say about breastfeeding in the context of HIV?
A
A: The statement advises that when safe alternatives to breastfeeding are not available, and in environments where infectious diseases and malnutrition are rampant, breastfeeding may carry less risk compared to artificial substitutes.
18
Q
Q: What is the Baby Friendly Hospital Initiative?
A
A: Launched in 1992 by WHO/UNICEF, it’s a ten-step program designed to support and promote breastfeeding in healthcare settings.
19
Q
Q: What legislation was approved to promote breastfeeding in workplaces in the Philippines?
A
A: House Bill No. 6661, known as the “Breastfeeding Promotion Act,” was approved to establish lactation stations in workplaces.
20
Q
Q: When does the neural tube close in fetal development, and what implications does this have for preventing birth defects?
A
A: The neural tube closes within the first 21 to 28 days of life, highlighting the importance of maternal folic acid intake during early pregnancy to prevent neural tube defects.
21
Q
Q: What are the recommendations for folic acid intake to prevent neural tube defects, and how has the Philippines supported these recommendations through legislation?
A
A: Recommendations include a daily intake of 0.4 mg of folic acid for women of childbearing age, supported in the Philippines by Republic Act 8976, or “The Philippine Food Fortification Act of 2000.”
22
Q
Q: What does the Newborn Screening Act of 2004 entail, and why is newborn screening important?
A
A: This Act requires newborn screening for all babies born in the Philippines to detect and treat congenital metabolic disorders early, crucial for preventing disability or death.
23
Q
Q: What are the incidence rates of bilateral hearing loss at birth, and what are the established risk indicators for hearing loss in neonates and infants?
A
A: The incidence rates range from 1 to 3 per 1000 in well-baby populations, with risk indicators including NICU admission, genetic syndromes, family history of hearing loss, and certain infections.
24
Q
Q: Considering the prevalence of hearing impairment in the Philippines, what is the significance of early detection and intervention?
A
A: Early detection and intervention, ideally by 6 months of age, are critical for preventing or reducing the negative impacts of hearing impairment on a child’s development.
25
Q: What are the key elements of an effective universal newborn hearing screening program according to the AAP?
A: The program should include screening, tracking and follow-up, identification, intervention, and evaluation to effectively detect and manage newborn hearing loss.
26
Q: What are the risk indicators for hearing loss in neonates (birth through age 28 days) as identified by the Joint Committee on Infant Hearing?
A: For neonates, the risk indicators include: 1) An illness or condition requiring admission to a neonatal ICU for 48 hours or more; 2) Stigmata or findings associated with syndromes that include sensorineural or conductive hearing loss; 3) Family history of permanent childhood sensorineural hearing loss (SNHL); 4) Ear and craniofacial abnormalities; 5) In utero infections like toxoplasmosis, rubella, cytomegalovirus, or herpes.
27
Q: What are the risk indicators for progressive or late-onset hearing loss in neonates or infants (29 days through 2 years)?
A: For infants aged 29 days to 2 years, the risk indicators are: 1) Parental or caregiver concern regarding hearing, speech, language, and/or developmental delay; 2) Family history of permanent childhood hearing loss; 3) Stigmata or findings associated with syndromes that include sensorineural or conductive hearing loss or Eustachian tube dysfunction; 4) Postnatal infections associated with SNHL such as bacterial meningitis; 5) In utero infections such as herpes, rubella, syphilis, toxoplasmosis, and cytomegalovirus; 6) Neonatal indicators like hyperbilirubinemia requiring exchange transfusion, persistent pulmonary hypertension of the newborn associated with mechanical ventilation, and conditions requiring the use of ECMO; 7) Syndromes associated with progressive hearing loss such as osteopetrosis, neurofibromatosis, and Usher’s syndrome; 8) Neurodegenerative disorders like Hunter syndrome, or sensorimotor neuropathies such as Charcot-Marie-Tooth syndrome and Friedrich’s ataxia; 9) Head trauma; 10) Recurrence of persistent otitis media with effusion for at least 3 months.
28
Q: What are some of the leading causes of blindness among Filipinos?
A: Poor nutrition, measles, and premature birth are among the leading causes of blindness among Filipinos.
29
Q: How significant is Vitamin A deficiency in the context of childhood blindness?
A: Vitamin A deficiency is reported as a leading cause of childhood blindness, highlighting the importance of adequate Vitamin A intake during early childhood.
30
Q: Who should receive Vitamin A capsules according to health recommendations?
A: Vitamin A capsules should be given to infants aged 9-11 months, children aged 12-59 months, and sick and malnourished children to prevent Vitamin A deficiency and associated vision problems.
31
Q: What is the objective of the “Vision 2020: the Right to Sight” initiative launched by the WHO and its partners?
A: The objective of the “Vision 2020: the Right to Sight” initiative is to eliminate avoidable blindness by 2020 and, thereby, reduce the global burden of blindness.
32
Q: What does the AAP recommend regarding eye examinations for children?
A: The AAP advocates for an eye examination at birth and during well-child visits to ensure early detection and treatment of potential vision problems.
33
Q: At what age can visual acuity measurements first be reliably taken?
A: The earliest possible age for visual acuity measurements is at age 3, when children are typically able to participate in vision screening tests.
34
Q: How does the Seat Belts Use Act of 1999 define private motor vehicles?
A: The Seat Belts Use Act of 1999 defines private motor vehicles as those owned by individuals and juridical persons for private use, any motor vehicle owned by the national government or any of its agencies, and any diplomatic vehicle.
35
Q: In the 5-15 age group, where do traffic crashes rank in terms of causes of mortality?
A: In the 5-15 age group, traffic crashes are the 3rd leading overall cause of mortality.
36
Q: What is the benefit of anti-lock brakes compared to conventional braking systems?
A: Anti-lock brakes reduce the incidence of wheel locking and skidding, which are common in conventional braking systems, thereby enhancing vehicle control during emergency braking.
37
Q: What is the function of the crumple zone in a vehicle?
A: The crumple zone, located at the front of the car, is designed to absorb most of the impact energy in a collision, reducing the force transmitted to the occupants.
38
Q: How do airbags contribute to passenger safety during a crash?
A: Airbags are designed to inflate during a crash in order to cushion the passenger at impact, thereby reducing the risk of serious injuries.
39
Q: What role do side-impact beams play in vehicle safety?
A: Side-impact beams are engineered to cushion the blow of a side impact, enhancing the structural integrity of the vehicle's side and helping to protect the occupants from injury.
40
Q: What is the purpose of head restraints in vehicles?
A: Head restraints are designed to prevent an individual’s head from snapping back in rear-end crashes, thereby reducing the risk of neck injuries.
41
Q: What does Republic Act (RA) 8750 mandate regarding seat belts?
A: Republic Act (RA) 8750 mandates the installation and use of adult seat belts in both front and rear seats of any private motor vehicle to enhance the safety of all occupants.
42
Q: Are children below six years of age allowed to occupy the front seat of moving motor vehicles?
A: Children below six years of age are prohibited from occupying the front seat of any moving motor vehicle, as part of safety regulations to protect young children.
43
Q: How effective are existing child seats according to the AAP?
A: According to the AAP, existing child seats provide effective restraint for young children riding in motor vehicles, minimizing the risk of death and injury during car crashes when used appropriately.
44
Q: What are the requirements for specialized child seats?
A: Specialized child seats are required for children weighing up to 60 lbs. (approximately 8 years old), ensuring that children within this weight range are adequately protected while traveling in motor vehicles.
45
Q: What are the regulations regarding the use of built-in car seat belts for children?
A: The proper use of built-in car seat belts is mandated for children older than 8 years, ensuring they are secured in vehicles using the standard seat belts once they outgrow specialized child seats.
46
Q: What characteristics of adolescents contribute to their increased risk for traffic injuries, according to the AAP?
A: The AAP lists several characteristics that contribute to the increased risk for traffic injuries among adolescents: 1) Lack of driving experience, 2) Risk-taking behavior influenced by emotions, peer group pressure, and other stresses, 3) Use of alcohol and other drugs, 4) Low rate of safety belt use (33%), and 5) Lack of experience in night-time driving. These factors combined significantly heighten adolescents' vulnerability to traffic-related injuries.
47
Q: Why are motorcycles considered the most dangerous form of motorized transport?
A: Motorcycles are considered the most dangerous form of motorized transport because motorcyclists are 3 times more likely than passenger car occupants to be injured in a crash and sixteen times more likely to die, with head injuries accounting for the majority of these deaths.
48
Q: How significant are bicycle injuries in terms of road injury causes?
A: Hospital records indicate that bicycle injuries are the 5th leading cause of road injury, accounting for 3% of all road injuries, highlighting the importance of safety measures for cyclists.
49
Q: What role does wearing a helmet play in preventing bicycle-related head injuries?
A: Encouraging bicycle riders to wear helmets is key in preventing head injuries. A properly worn bicycle helmet can effectively reduce the occurrence of brain injury by 63-88%, offering significant protection against head trauma.
50
Q: How effective are helmets in providing protection from crashes for cyclists?
A: Helmets provide cyclists an equal level of protection from crashes involving motor vehicles (69%) and crashes from all other causes (68%), demonstrating their effectiveness in a wide range of accident scenarios.
51
Q: How do helmets work to prevent injuries during a crash?
A: Helmets work by dissipating the sharp energy of a blow over a larger surface area, thereby reducing the force of impact on the skull and brain, which significantly lowers the risk of serious head injuries.
52
Q: What is the impact of bicycle helmets on the risk of head injury and concussion in the 0-15 year old age group?
A: In the 0-15 year old age group, bicycle helmets decrease the risk of head injury by a factor of 0.4 and the risk of concussion by a factor of 0.6, illustrating their effectiveness in protecting young cyclists.
53
Q: How does the fit of a helmet affect its protective efficacy?
A: The fit of a helmet significantly affects its protective efficacy. Individuals with poorly fitting or improperly worn helmets have a 1.96-fold increased risk of head injury compared to those whose helmets fit well, underscoring the importance of proper helmet fit and wear.
54
Q: How is the risk of pediatric burn injury related to socioeconomic status?
A: The risk of pediatric burn injury is inversely proportional to socioeconomic status, meaning that lower socioeconomic status, characterized by factors such as absence of water supply, low salary, and crowding, increases the likelihood of burn injuries in children.
55
Q: What is the leading mechanism of burn injury in children, and what are other common causes?
A: SCALDING is the leading mechanism of burn injury in children, followed by exposure to a naked flame, electrical injuries, and chemical burns. Additionally, smoking and cigarettes are responsible for 10% of fire deaths worldwide.
56
Q: What is early childhood caries (ECC), and how prevalent is it among Filipino children?
A: Early childhood caries (ECC) is defined as the presence of one or more decayed, missing, or filled tooth surfaces in any primary tooth in a child 71 months of age or younger. It is one of the most common chronic childhood diseases, with Filipino children having the second highest caries prevalence in the Western Pacific Region.
57
Q: What is the recommended preventive measure against early childhood caries?
A: The society recommends the use of fluoride varnish as a preventive measure against early childhood caries. Fluoride varnish can help reduce the incidence of dental caries by strengthening tooth enamel and making teeth more resistant to decay.
58
Q: What ranks as the 4th leading cause of overall mortality in the 10-14 age group according to a DOH statistical entry, and what is the death rate?
A: In the 10-14 age group, "injuries undetermined whether accidental or purposeful inflicted" ranks as the 4th leading cause of overall mortality, with a death rate of 3.10 per 100,000 population.
59
Q: What percentage of young children and adolescents in the Philippines are overweight, and what is the significance of physical activity?
A: In the Philippines, 1% of young children (0-10 years) and 3% of adolescents (11-17 years) are overweight. Regular physical activity is emphasized as a key component to healthy living, providing many well-documented benefits to children, including the development of good exercise habits, particularly through school involvement.
60
Q: What is the leading cause of mortality among Filipino children, and what factors are closely associated with it?
A: Diarrhea is the 2nd leading cause of mortality among Filipino children. It is closely associated with poverty, lack of safe water supply, and poor hygiene practices.
61
Q: What has been the substantial source of municipal water in the Philippines, and what is the most effective means for its disinfection?
A: Groundwater has been a substantial source of municipal water in the Philippines, representing about 45.5% of the supply. Chlorination is highlighted as the most effective means for the disinfection of the public water supply.
62
Q: What major health problem is associated with the disposal of solid wastes in the country, and what are common areas of disposal?
A: The disposal of solid wastes is another major health problem in the Philippines, with common areas of disposal being open dumpsites. This presents significant environmental and health risks, including the potential for water contamination and the spread of disease.
63
Q: What is the average age of first coitus among Filipino adolescents for both genders?
A: The average age of first coitus among Filipino adolescents was 18 for males and 18.3 for females.
64
Q: What type of sexual education has been found to be more effective in helping adolescents make healthy decisions regarding sex?
A: Comprehensive sexuality education, rather than Abstinence-Only sexual education, is more effective in helping adolescents make informed and healthy decisions regarding sex.
65
Q: What percentage of youth had already experienced premarital sex according to the 2002 Young Adolescent Fertility and Sexuality Survey, and how many do not use any form of contraception?
A: According to the 2002 Young Adolescent Fertility and Sexuality Survey, 23% of youth had already experienced premarital sex, and 74% do not use any form of contraception.
66
Q: What proportion of overall fertility do adolescents contribute to?
A: Adolescents contribute to 30% of overall fertility.
67
Q: What are the 4 primary goals of a successful comprehensive sexuality education program?
A: The 4 primary goals of a successful comprehensive sexuality education program are to provide: 1. Information 2. Attitudes, values, and insights 3. Relationships and interpersonal skills 4. Responsibility
68
Q: When does retinal vascular development begin during gestation?
A: Retinal vascular development begins between 15 to 18 weeks of gestation, marked by the critical involvement of undifferentiated endothelial cells in the development of retinal vessels.
69
Q: How does exposure to stressors affect the development of retinal vessels?
A: Exposure to stressors can damage developing retinal vessels and temporarily arrest their development, leading to ischemia and an avascularized periphery. Retinal vessel development then typically resumes between 30 to 34 weeks of gestation.
70
Q: What are the signs of plus disease in the eye?
A: In plus disease, the eye may become inflamed and hazy, with exudates forming along the retinal vessels. This condition is also characterized by engorgement and tortuosity of the posterior pole vessels.
71
Q: How are the zones of the retina defined in the context of retinopathy of prematurity (ROP)?
A: Zone 1 refers to the most posterior area of the retina, an area within twice the distance from the optic nerve head to the fovea. Zone 2 describes ROP located outside of zone 1, and zone 3 is defined as ROP present only on the temporal side of the eye, indicating the spatial categorization used to describe the extent and location of ROP.
72
Q: What are the stages of Retinopathy of Prematurity (ROP)?
A: The stages of ROP are as follows: - **Stage 1**: Demarcation line separates the avascular retina anteriorly from the vascularized retina posteriorly, with abnormal branching of small vessels immediately posterior to this line. - **Stage 2**: Intraretinal ridge where the demarcation line has increased in volume, but the proliferative tissue remains intraretinal. - **Stage 3**: Ridge with extra-retinal fibrovascular proliferation. - **Stage 4**: Partial retinal detachment.
73
Q: What is the primary risk factor for developing ROP?
A: The primary risk factor for developing ROP is prematurity, mainly due to the incomplete vascularization of the retina that occurs in premature infants.
74
Q: What are the treatment options for ROP?
A: Several treatment options for ROP include cryotherapy, photocoagulation, and retinal detachment surgery. - **Cryotherapy**: Aims to prevent further progression of the disease by destroying the cells that may release angiogenic factors. - **Photocoagulation**: Involves using laser therapy to treat the peripheral areas of the retina to reduce oxygen demand and prevent further abnormal vessel growth. - **Retinal Detachment Surgery**: Is performed in more advanced stages to reattach the retina.
75
Q: What are common ocular findings in infants with ROP?
A: Common ocular findings in infants with ROP include myopia, which occurs in about 80% of infants with ROP. Strabismus (crossed eyes) and amblyopia (lazy eyes) are also common findings in these patients, indicating the need for ongoing ophthalmic evaluation and management.
76
Q: How is eye patching used in the treatment of strabismus and amblyopia?
A: Eye patching is commonly prescribed in the treatment of strabismus (crossed eyes) and amblyopia (lazy eye). The method involves covering the stronger eye with a patch to force the weaker eye to work harder, thereby improving its function and vision.
77
Q: What are the phases of pathogenesis in the condition being discussed?
A: The pathogenesis of the condition, likely referring to Retinopathy of Prematurity (ROP), can be divided into two phases: 1. An initial disruption in the arborization of the retinal vasculature, leading to the abnormal development of the blood vessels. 2. Subsequent hyperproliferation of retinal vessels, which can lead to further complications including retinal detachment.
78
Q: What are the consistent risk factors for ROP?
A: The only consistent risk factors for ROP are decreasing gestational age and birth weight, indicating that the more premature and the lower the birth weight of the infant, the higher the risk of developing ROP.
79
Q: What are the screening guidelines for ROP?
A: Screening guidelines for ROP include: - Infants with a birth weight (BW) less than 1500 grams or gestation at birth less than 32 weeks, as well as selected infants between 1500-2000 grams with an unstable course, should be screened. - The first examination should be performed at a minimum age of 4 weeks of chronological age or within the 31st to 33rd weeks post-conceptual age (PCA), whichever comes later.
80
Q: What role does surgical intervention play in the treatment of ROP?
A: Surgical intervention is the mainstay of treatment for advanced stages of ROP. This may include procedures like cryotherapy, laser photocoagulation, or surgery for retinal detachment, aimed at preserving vision and preventing further progression of the disease.
81
Q: What has contributed to the prevalence of poisoning from acids and alkali in the country?
A: The ready availability of acids and alkali as commercial products has made poisoning from these substances among the most common non-accidental poisoning cases in the country. Their widespread use and accessibility contribute significantly to the incidence of such poisonings.
82
Q: In the pediatric age group, what is the most common ingested poison, and what are the second and third most common?
A: In the pediatric age group, the most common ingested poison is household cleaning agents. Hydrocarbons are the second most common, and Jathropa seeds rank as the third most common substance ingested.
83
Q: What factors have led to the decrease of unintentional poisoning in the US?
A: The two most important factors that have led to the decrease of unintentional poisoning in the US are the implementation of child-resistant closures and the development of safer medications. These measures have significantly reduced the risk of accidental poisoning among children by making it more difficult for them to access harmful substances and by improving the safety profile of medications.
84
Q: What are the most common causes of poison exposures in children, and what substances are particularly dangerous?
A: Pain relievers are among the most common causes of poison exposures in children, second only to household products. Specific substances that are particularly dangerous include: - Methylsalicylate, where approximately 1-2 teaspoons (5-10 ml) can be lethal for a young child. - Iron, with toxic effects occurring at doses of 10-20 mg/kg of elemental iron. - Isoniazid, where toxicity can occur with acute ingestion of as little as 1.5 g. Doses larger than 30 mg/kg often produce seizures, and it can be fatal at 80-150 mg/kg.
85
Q: What are the toxic effects of ingesting watusi, and what is the treatment?
A: Watusi, a matchstick-like pyrotechnic device, can cause toxic effects upon ingestion, including hypocalcemia, hypoprothrombinemia, metabolic acidosis, and mucosal injury of the esophagus. The treatment involves the administration of egg whites (4-6 for children and 6-8 for adults) to help bind and neutralize the toxins.
86
Q: How is a confirmed Blood Lead Level defined, and what are the health implications?
A: A confirmed Blood Lead Level is defined as one venous blood specimen > 10 mg/dl or two capillary blood specimens > 10 mg/dl drawn within 12 weeks of each other. Lead can be absorbed either by ingestion or inhalation, with up to 95% of absorbed lead found in erythrocytes and the remainder circulating in the plasma. This circulating lead is responsible for transporting lead to the bones, similarly to calcium. Lead encephalopathy, a severe health implication, can occur at levels >10 mg/dl.
87
Q: What significant milestones mark the history of cloning technology?
A: Significant milestones in cloning technology include the cloning of tadpoles by Briggs and King in 1952 and the birth of Dolly the sheep in 1997, the first mammal to be cloned from an adult somatic cell.
88
Q: What does the term "clone" originate from, and what does it denote?
A: The term "clone" originates from the Greek word "twig," denoting a group of genetically identical entities.
89
Q: What are the three main types of cloning technologies?
A: The three main types of cloning technologies are: 1. Gene Cloning, also known as Recombinant DNA technology, Molecular cloning, or DNA cloning, which involves transferring a DNA fragment of interest into a self-replicating genetic element. 2. Therapeutic Cloning, which sources stem cells from an embryo to produce tissues or organs for transplantation, resulting in the embryo's expiration. 3. Reproductive Cloning, using somatic cell nuclear transfer to develop an embryo into maturity, aiming to create a genetically identical organism, though the clone and donor differ in mitochondrial DNA.
90
Q: What ethical considerations surround human reproductive cloning?
A: Ethical considerations in human reproductive cloning include potential physical harm, research standards, individual autonomy, conflicts of interest, psychological or social harm, and concerns regarding dignity and justice.
91
Q: How many nations have laws against reproductive cloning, and what is the general stance of governments on this issue?
A: Thirty-five nations have enacted national laws that forbid reproductive cloning. The general stance is that governments should support legislation that imposes penalties on those who violate the ban on human reproductive cloning, reflecting a global effort to responsibly manage the implications of cloning technologies.
92
Q: How does the WHO define orphan disorders?
A: The World Health Organization (WHO) defines orphan disorders as conditions that affect less than 1,000 people per million.
93
Q: How many orphan disorders are currently recognized?
A: At present, over 5,000 orphan disorders are recognized.
94
Q: How does the Philippine definition of orphan disorders differ from the WHO's definition?
A: The Philippine definition of orphan disorders specifies conditions affecting 1 in every 20,000 individuals, making it a more specific criterion compared to the WHO's definition.
95
Q: Can you provide examples of orphan disorders?
A: Examples of orphan disorders include Maple Syrup Urine Disease (MSUD), tyrosinemia, methylmalonyl CoA mutase deficiency, Gaucher disease, and Phenylketonuria (PKU).
96
Q: What is the recommended weight limit for children's backpacks?
A: Children should not carry backpacks weighing more than 10% of their body weight and never 4 inches below the waistline.
97
Q: Who is more susceptible to low back pain due to carrying heavy backpacks?
A: Students carrying more than 10-20% of their body weight are more susceptible to low back pain, with females and younger children being at a greater risk.
98
Q: How does carrying a backpack on one shoulder affect a child's posture?
A: Carrying backpacks only by one shoulder makes children bend forward to compensate for the heavy load, throwing off the center of gravity and significantly altering the posture and gait of children.
99
Q: What is considered too much weight for maintaining standing posture in adolescents?
A: Carrying more than 15% of the body weight is too much for adolescents to maintain standing posture.
100
Q: What backpack weight is most effective at maintaining balance?
A: Carrying 5% or less of the body weight is most effective at maintaining balance.
101
Q: What role does sucking play in a child's development, and during what age is it most prevalent?
A: Sucking satisfies both the nutritive and nonnutritive needs of a child, with its greatest occurrence from ages 0 to 18 months. It's a crucial activity for comforting and feeding infants.
102
Q: What are pacifiers commonly used for in relation to a child's sucking needs?
A: Pacifiers are the most common non-nutritive sucking materials used to soothe and calm agitated children, aid in dentition, act as analgesia for very preterm neonates undergoing invasive procedures, and provide protection against sudden infant death syndrome (SIDS).
103
Q: What are the advantages of using pacifiers?
A: Advantages of using pacifiers include their ability to soothe and calm agitated children, aid in dentition, serve as analgesia for preterm neonates during invasive procedures, and offer protective effects against sudden infant death syndrome.
104
Q: What adverse effects can arise from the use of pacifiers?
A: The adverse effects of using pacifiers include shortened duration of breastfeeding, poor development of the latch-on technique, nipple confusion, a higher prevalence of altered dental arches, oral myofunctional structures, malocclusion, open bite, an increased risk of infections such as gastroenteritis, respiratory tract infections, otitis media, oral candida infection, and an increased risk of asphyxia due to the possibility of swallowing the pacifier.
105
Q: How is noise intensity measured and what does a 10-decibel increase signify?
A: Noise intensity is measured in decibels (dB), a logarithmic scale where a 10-decibel increase signifies a tenfold increase in noise intensity.
106
Q: What constitutes community noise, and what is considered a safe level?
A: Community noise, also referred to as residential noise, environmental noise, or domestic noise, is noise emitted from all sources except the industrial workplace. A safe level is considered to be less than 85 dB.
107
Q: Which source of noise is most prevalent and damaging, and what are the noise levels associated with different vehicles?
A: Street traffic is the most prevalent and most damaging source of noise, primarily due to engines, exhaust systems, tires, and horns. Cars produce noise levels in the range of 67-75 dB, motorcycle noise ranges from 72-83 dB (and can reach as high as 120 dB), and tricycles produce noise at 80 dB.
108
Q: What are the adverse effects of noise and the two types of health effects it can have?
A: The adverse effects of noise result in changes to the morphology and physiology of an organism that impair its capacity to compensate for additional stress or increase its susceptibility to harmful effects of other environmental influences. The two types of health effects are non-auditory effects (stress, related physiological and behavioral effects, safety concerns) and auditory effects (acoustic trauma, hearing impairment).
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Q: At what noise level does exposure become harmful, and what is the most common effect of noise on people?
A: Noise level exposure of 85 dB is the minimum set point at which adverse effects can result. The most common effect of noise on people is annoyance.
110
Q: What are the classifications of occupational noise, and what are the recommended exposure limits (REL) by WHO?
A: Occupational noise is classified into continuous type (sound level peaks are 1 second or less apart) and impulsive type (steep rise in sound level to a high peak followed by rapid decay, or sound whose peaks have separation intervals greater than 1 second). The WHO recommended exposure limit for continuous noise in the workplace is 80-85 dB for a maximum of 8 hours, and for impulsive noise, it is 140 dB at any one exposure.
111
Q: What are some effects of excessive occupational noise?
A: Effects of excessive occupational noise include heart disease (increased risk of coronary heart disease, hypertension), lung disease (vibroacoustic disease can cause airway aggression), nervous system and sleep disturbances (cognitive impairment, deficits in performance, attentiveness, and problem-solving skills, nervousness, aggression, annoyance), work-related injuries, and noise-induced hearing loss.
112
Q: What percentage of disabling hearing loss worldwide is accounted for by occupational noise, and what is a transient threshold shift?
A: Occupational noise accounts for more than 16% of disabling hearing loss worldwide. A transient threshold shift is defined as a change in hearing threshold of an average of 10 dB or more at 2000-4000 Hz in either ear, and it's considered a precursor to noise-induced hearing loss.
113
Q: What permissible noise level has the DOH set for an 8-hour period?
A: The Department of Health (DOH) has set a permissible noise level of 90 dB for an 8-hour period.
114
Q: What are the recommended maximum average day-night sound levels (DNL) for fetal and neonatal environments?
A: The maximum average DNL during waking hours is recommended to be 55 dB, and during nighttime, it is 45 dB. For hospitals, the limit is lower: 45 dB during daytime and 35 dB during nighttime.
115
Q: When can a fetus start perceiving, storing, and reacting to auditory information?
A: A fetus can start perceiving, storing, and reacting to auditory information around the 23rd to 26th week of life.
116
Q: Why is the auditory system more vulnerable to insults compared to other older systems?
A: The auditory system is one of the last systems to develop, making it more vulnerable to insults than other, more mature systems. High-frequency hearing, which develops later, is therefore more susceptible to damage.
117
Q: What is the target organ of noise, and what are the potential damages caused by excessive noise exposure?
A: The cochlea is the target organ of noise. Excessive noise exposure can cause direct mechanical damage, metabolic exhaustion of cochlear cells, and changes in the cochlear vascular system.
118
Q: How does sound reach the fetus in the environment?
A: Sound in the environment reaches the fetus through bone conduction.
119
Q: What are the effects of noise exposure at greater than 85-90 dB in pregnant women?
A: Effects of noise exposure at greater than 85-90 dB in pregnant women include birth defects (such as cleft lip and palate, spinal malformations, and urogenital system defects), low birth weight babies, intrauterine growth retardation, premature delivery, small for gestational age (SGA) infants, antepartum fetal death, atypical brain development, and high frequency hearing loss.
120
Q: What are the effects of noise on infants in the NICU?
A: Noise effects on infants in the NICU include increased heart rate, respiratory rate, blood pressure, and intracranial pressure (ICP) with decreased oxygenation level. Infants may become annoyed and confused, experience hearing loss (especially with the use of Continuous Positive Airway Pressure (CPAP) which can result in cochlear damage), and lack adequate and peaceful sleep due to noise amplified inside the incubator.
121
Q: What does the DOH recommend regarding the use of fireworks to prevent injuries?
A: The Department of Health (DOH) encourages the use of noise-making devices as alternatives to firecrackers and attending public fireworks displays rather than personal use of fireworks, aiming to reduce fireworks-related injuries, fire incidents, and cases of tetanus.
122
Q: What additional preventive measures does the PPS adopt to combat childhood obesity in the Philippines?
A: The additional preventive measures adopted by the Philippine Pediatric Society (PPS) to combat childhood obesity include promoting breastfeeding, encouraging home-cooked meals over eating out or consuming fast food, and advocating for regular physical activity. Breastfeeding is highlighted for its potential to lower future obesity risk due to learned self-regulation of energy intake, metabolic programming in early life, and the bioactive factors in breast milk that modulate growth and inhibit adipocyte differentiation.
123
Q: Why is a cooperative effort important in solving the problem of obesity?
A: A cooperative effort among individuals and groups from all segments of society is crucial for solving the problem of obesity because it addresses the multifaceted nature of the issue, encompassing dietary habits, physical activity levels, and societal norms and expectations.
124
Q: What role do physicians play in the prevention and management of childhood obesity?
A: Physicians play a key role in the prevention and management of childhood obesity by obtaining a thorough dietary, psychosocial, and family history; monitoring height, weight, and BMI at every clinic visit; advocating exclusive breastfeeding for at least 6 months and proper complementary feeding; educating families on healthy eating and regular exercise habits; referring patients to registered nutritionist-dieticians for proper dietary management; and refraining from using food as rewards.
125
Q: What rights are children entitled to?
A: Children have the right to life, an adequate standard of living, parental care and support, social security, a name, nationality, and identity, access to information, leisure, recreation, and cultural activities, the right to express their opinion, freedom of thought, conscience, religion, freedom of association, and privacy.
126
Q: Why are girls particularly vulnerable in terms of exploitation and abuse?
A: Girls are especially vulnerable to exploitation and abuse, often working as domestic servants or unpaid household help under horrific circumstances. They may be trafficked, forced into debt bondage or other forms of slavery, prostitution, and pornography, participate in armed conflict, or engage in other illicit activities.
127
Q: How prevalent is child labor in the Asian and Pacific regions?
A: The Asian and Pacific regions have 127.3 million child laborers, representing 19 percent of children, with the largest number in the 5 to 14 age group, indicating a significant issue of child labor within these regions.
128
Q: What did the National Statistics Office’s Survey on Children in 2001 reveal about Filipino children?
A: The National Statistics Office’s Survey on Children in 2001 revealed that out of 24.9 million Filipino children, 4.0 million were economically active, meaning one out of six children worked. Most of these children came from Southern Tagalog, followed by Central Visayas and Eastern Visayas.
129
Q: What hazards are working children in the Philippines exposed to?
A: Sixty percent of working children, or about 2.4 million, were exposed to hazardous environments. Physical environment hazards were the most common, with 44.4 percent exposed. Additionally, one out of five children were exposed to chemical elements (such as silica, sawdust, and mist/fumes), and almost one in five working children were in danger of biological infections, with fungal and bacterial infections being the most common.
130
Q: What does Republic Act (RA) 9231, “Anti-Child Labor Law”, aim to achieve?
A: Republic Act (RA) 9231, known as the “Anti-Child Labor Law,” amends some provisions of RA 7610 and aims to eliminate the worst forms of child labor while providing stronger protection for the working child.
131
Q: What are the salient features of Republic Act (RA) 9231, the "Anti-Child Labor Law"?
A: The salient features of RA 9231 include prohibiting the engagement of children in the worst forms of child labor, specifying working hours for children below 15 and those aged 15 but below 18, determining the ownership, usage, and administration of a working child's income, setting up a trust fund for part of the working child's income, providing stiffer penalties against acts of child labor and penalizing parents and legal guardians who violate the Act, and ensuring the speedy prosecution of child labor cases.
132
Q: What are considered the worst forms of child labor according to RA 9231?
A: The worst forms of child labor, as defined under RA 9231, include all forms of slavery or practices similar to slavery, such as sale and trafficking of children, debt bondage, forced labor, recruitment of children in armed conflict, child prostitution, pornography, illegal activities, and work that is hazardous or harmful to the health, safety, or morals of children.
133
Q: What is the minimum employable age set by the law in the Philippines?
A: The minimum employable age in the Philippines is set at 15 years old.
134
Q: What conditions are set for the employment of children between 15 and 18 years old?
A: Children between 15 and 18 years old may be employed in undertakings not hazardous or deleterious in nature. They are allowed to work in conditions where they are not exposed to any risk that constitutes an imminent danger to their life, limb, safety, and health.
135
Q: How does RA 9231 protect the earnings and ensure the welfare of the working child?
A: RA 9231 mandates that the wages, salaries, earnings, and other income of the working child shall belong to them and be set aside primarily for their support, education, or skills acquisition. It also requires the establishment of a trust fund for at least 30% of the earnings of a child whose annual income is at least P200,000. The child gains full control over the trust fund upon reaching the age of majority.
136
Q: What penalties does RA 9231 impose on parents who violate its provisions?
A: RA 9231 holds parents liable for violations, with penalties including a fine of not less than Ten Thousand Pesos (P 10,000) but not more than One Hundred Thousand Pesos (P 100,000), or community service for not less than thirty (30) days but not more than one (1) year, or both. The maximum length of community service is imposed on parents who have violated the Act three times.
137
Q: What defines child labor according to RA 9231?
A: Child labor is defined as any work performed by a child that subjects the child to economic exploitation, is likely to be hazardous, interferes with the child's education, or is harmful to the child's health or physical, mental, spiritual, moral, or social development.
138
Q: Why are infant walkers considered harmful rather than beneficial?
A: Recent studies have shown that contrary to popular belief, infant walkers do not aid in helping infants walk at an earlier age and can even delay their motor and mental development. Infants using walkers may score lower on developmental assessments, exhibit abnormal gaits when starting to walk independently, and suffer from contractures of the calf muscles and motor development issues mimicking spastic diparesis.
139
Q: What types of injuries are associated with infant walker use?
A: The use of infant walkers is associated with various injuries, including falls, which can occur at speeds too fast for a guardian to intervene, resulting in a high percentage of falls from stairs. Burns and poisoning are also risks due to increased access to kitchens and dangerous areas, with reported injuries including contact and scald burns. There have also been reports of submersion incidents and drowning, even with precautions like fenced-in swimming pools. Minor injuries include pinch injuries, abrasions, contusions, lacerations, extremity fractures, and other soft tissue injuries.
140
Q: What are the recommendations as safer alternatives to mobile infant walkers?
A: Recommendations for safer alternatives include stationary walkers and playpens, which provide a safer environment for infants to explore and play without the risks associated with mobility and access to hazardous areas.
141
Q: What guidelines and regulations have been established to improve the safety of infant walkers?
A: In 1997, the American Society for Testing and Materials (ASTM) created voluntary guidelines and standards for the manufacture of infant walkers, including a braking mechanism and a requirement for the walker's width to be greater than 36 inches to prevent passage through doors. New South Wales, Australia, set baby walker regulations in 2000, requiring a specified level of stability and a gripping mechanism to stop the walker at the edge of a step, aiming to reduce the risk of falls and other injuries.
142
Q: What common beliefs about infant walkers have been contradicted by recent studies?
A: Recent studies have contradicted the common belief that infant walkers aid in helping infants walk at an earlier age, showing instead that they can delay motor and mental development.
143
Q: How do infant walkers impact an infant's development according to studies?
A: Studies indicate that infants using walkers may score lower on developmental scales, such as the Bayley scales of mental and motor development, and exhibit abnormal gait patterns when starting to walk independently.
144
Q: What types of injuries are infants at an increased risk for when using walkers?
A: Infants using walkers are at an increased risk for injuries such as falls, burns, poisoning, submersion incidents, suffocation, and minor injuries like pinch injuries and abrasions.
145
Q: What safer alternatives to mobile infant walkers are recommended?
A: Safer alternatives to mobile infant walkers include stationary walkers and playpens, which minimize risks of injury by limiting infant mobility.
146
Q: What safety guidelines have been created to address the risks associated with infant walkers?
A: Safety guidelines created to address infant walker risks include ASTM's voluntary guidelines, which recommend a braking mechanism and a minimum walker width, and New South Wales, Australia's 2000 regulations requiring stability and a gripping mechanism to prevent walker movement at the edge of steps.
147
Q: What is the most widely consumed psychoactive substance?
A: Caffeine is the most widely consumed psychoactive substance.
148
Q: How are children primarily exposed to caffeine?
A: Children are primarily exposed to caffeine through carbonated drinks, chocolate, tea, and coffee.
149
Q: What are the effects of caffeine on the central nervous system?
A: Caffeine's effects on the CNS include increased alertness, wakefulness, and better general body coordination.
150
Q: At what doses do caffeine's undesirable effects occur?
A: Undesirable effects of caffeine occur at doses greater than 500-600 mg.
151
Q: What are the symptoms of caffeine poisoning in infants?
A: Symptoms include tense and relaxed muscles, rapid breathing, nausea, rapid heartbeat, shock, and tremors.
152
Q: What beneficial effects does coffee have?
A: Coffee may reduce the risk of Parkinson’s disease, type 2 diabetes, colon cancer, liver diseases, and gallstones.
153
Q: What is Health Canada's maximum caffeine intake recommendation for children aged 4-6 years?
A: Health Canada recommends a maximum intake of 45 mg/day for children aged 4-6 years.
154
Q: Are there existing guidelines or laws in the Philippines mandating medical certificates for school entrants?
A: No, there are no existing guidelines/protocols or laws mandating medical certificates for school entrants in the Philippines.
155
Q: Do all private schools in the Philippines require medical certification prior to admission?
A: Not all private schools in the Philippines require such certification prior to admission.
156
Q: What does the pending Magna Carta of Students propose regarding physical check-ups?
A: It requires school authorities to endeavor to provide free annual physical check-ups to students.
157
Q: At what age does the AAP recommend beginning comprehensive periodic health assessments?
A: The AAP recommends beginning at 3 years of age.
158
Q: What are the two main purposes of medical evaluation for school entrants?
A: To identify the high-risk population in the student body and fulfill a public health service role.
159
Q: What are the recommended elements of the medical interview?
A: Medical history, immunization status, and developmental and psychosocial status updates.
160
Q: What should the physical examination include?
A: Height, weight, blood pressure, heart rate, dental check, reflexes, vision and hearing tests, and checks for developmental milestones and scoliosis.
161
Q: What are the roles of the physician in this process?
A: To conduct individual interviews and examinations, refer potential health problems to specialists, and ensure confidentiality and adequate time for evaluations.
162
Q: What is the purpose of pre-operative risk assessment and evaluation in pediatric patients?
A: To minimize surgical complications by thoroughly assessing and evaluating pediatric patients before surgery or procedures requiring anesthesia.
163
Q: Are there exceptions to the requirement for pre-operative evaluations?
A: Yes, exceptions include healthy patients needing nerve blocks, local or topical anesthesia, or sedation analgesia without additional sedative or analgesic agents.
164
Q: What are the greatest surgical risks for the pediatric population?
A: The greatest surgical risks for pediatric patients are pulmonary and airway complications.
165
Q: What are the two categories of high-risk patients in pediatric surgery?
A: Patients at increased risk for cardiovascular complications and those at increased risk for non-cardiovascular complications.
166
Q: What components are included in a pre-operative evaluation?
A: Components include history taking, physical examination, laboratory examination, and patient education.
167
Q: Why is history taking crucial in pediatric pre-operative evaluations?
A: It gathers essential information on medical and surgical history, allergies, known medical problems, and current status from parents or guardians.
168
Q: What is emphasized during the physical examination of pediatric patients?
A: Emphasis is on anthropometrics, vital signs, and thorough examination of major body systems, especially head and neck, cardiac, and pulmonary.
169
Q: What laboratory examinations are recommended for pediatric pre-operative clearance?
A: Recommended lab tests include complete blood count with hematocrit, differential count, quantified platelet count, and a chest X-ray (PAL).
170
Q: What is the primary objective of a preparticipation physical evaluation in pediatric sports participants?
A: To detect medical or musculoskeletal conditions predisposing the child to injury or illness during sports activities.
171
Q: What is the leading cause of sports-related sudden death in the US?
A: Hypertrophic Cardiomyopathy.
172
Q: What benefits does establishing a good sports clearance provide?
A: It allows detection of underlying medical problems that may increase the risk of injury with sports participation.
173
Q: What specific cardiovascular history points are recommended for inclusion by the American Heart Association?
A: Exertional chest pain/discomfort, syncope/near syncope, unexpected shortness of breath or fatigue with exercise, heart murmur, high blood pressure, and family history of premature cardiovascular disease.
174
Q: What should physicians who clear children for sports participation include in the medical history?
A: Prior exertional symptoms, past heart murmurs or high blood pressure, and family history of premature cardiovascular disease or genetic conditions.
175
Q: What key aspects should be included in the physical examination for sports clearance?
A: Precordial auscultation, femoral artery pulses, recognition of Marfan syndrome, and brachial blood pressure measurement.
176
Q: What action must a physician take if an abnormality is detected during the sports clearance evaluation?
A: Refer the child to a qualified specialist for further evaluation.
177
Q: What is the role of the physician who clears a child for sports participation regarding continuing care?
A: To coordinate with the child’s primary physician for ongoing care or assume the role of the primary physician if necessary.
