Preventive Pediatrics Pt I + Policy Statements (Drowning, MVA, BF) Flashcards
(185 cards)
1
Q
Perfect first food for the newborn
A
Colostrum
2
Q
Latching on and breastfeeding must be initiated during
A
First 30 minutes to 1 hour
3
Q
Follow up of newborns discharged less than 48 hours should be within
A
48 hours of discharge
4
Q
6 key motor development milestones
A
1) Sitting without support 2) Standing with assistance 3) Hand-and-knees crawling 4) Walking with assitance 5) Standing alone 6) Walking alone
5
Q
Most powerful instruments available to the pediatrician in identifying concerns that may need monitoring or referral
A
History, observing the child, and thorough PE
6
Q
Research shows that this helps children develop language and literacy skills, thus making them ready to learn and read in school
A
Reading aloud during the first years of life
7
Q
Milestones of early literacy: Drops, throws book
A
6-12 mos
8
Q
Milestones of early literacy: Turns board book pages
A
12-24 mos
9
Q
Milestones of early literacy: Learns to turn paper pages
A
2-3 years
10
Q
Milestones of early literacy: Starts to scribble
A
2-3 years
11
Q
Milestones of early literacy: Turns pages one at a time
A
3-4 years
12
Q
Milestones of early literacy: Sits still for longer stories
A
3-4 years
13
Q
Milestones of early literacy: Scribbles and draws
A
3-4 years
14
Q
Milestones of early literacy: Starts to copy letters and numbers
A
4-5 years
15
Q
Milestones of early literacy: Likes pictures of baby faces
A
6-12 mos
16
Q
Milestones of early literacy: Responds to own name
A
6-12 mos
17
Q
Milestones of early literacy: Pats picture to show interest
A
6-12 mos
18
Q
Milestones of early literacy: 2- to 4-word phrases
A
12-24 mos
19
Q
Milestones of early literacy: Gives book to adult to read
A
12-24 mos
20
Q
Milestones of early literacy: Points at picturs
A
12-24 mos
21
Q
Milestones of early literacy: Turns book right-side up
A
12-24 mos
22
Q
Milestones of early literacy: Adds 2-4 new words per day
A
2-3 yrs
23
Q
Milestones of early literacy: Likes the same book again and again
A
2-3 yrs
24
Q
Milestones of early literacy: Completes sentences and rhymes in familiar stories
A
2-3 yrs
25
Milestones of early literacy: Recites whole phrases from books
3-4 yrs
26
Milestones of early literacy: Moves toward letter recognition
3-4 yrs
27
Milestones of early literacy: Begins to detect rhyme
3-4 yrs
28
Milestones of early literacy: Pretends to read to dolls and stuffed animals
3-4 yrs
29
Milestones of early literacy: Recognizes numbers and letters
4-5 yrs
30
Milestones of early literacy: Can retell familiar stories
4-5 yrs
31
Milestones of early literacy: Can make rhymes
4-5 yrs
32
Red flag signs for atopy
Family history of atopy + recurrent or persistent symptoms of 1 or more of the ff: Ocular, nasal, respiratory, GI, skin
33
The Phil Society for Adol Med Specialists reccommends screening and preventive services scheduled every
Year/annually
34
T/F In adolescent PE, health care provider is preferably of the same gender as the teen patient
T
35
In addition to routine PE, what should be done
1) Tanner/SMR 2) Breast exam 3) Exam of spine and shoulders for scolio/kyphosis 4) Exam of genitals and anus
36
Adolescent check up schedule: CBC
Every stage of adolescence
37
Adolescent check up schedule: Urinalysis
First encounter
38
Special adolescent labs: Sexually active females
Vaginal wet mount, pap smear
39
Special adolescent labs: Sexually active males
Serologic test for syphilis
40
Special adolescent labs: Sexually active males and females
Non-culture test for gonorrhea and chlamydia
41
Immunization of Teens and Pre-teens: Recommended vaccines (7)
Hep A, Hep B, MMR, Varicella, Flu, Tdap/Td, HPV
42
Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): Hep B
Unvaccinated 7-18; 3; 016 mos; IM; severe allergy to component, mod-severe illness
43
Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): Hep A
Unvaccinated 7-18; 2; 06 mos; IM; severe allergy to component, mod-severe illness
44
Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): MMR
Unvaccinated or incompletely vaccinated 7-18 ; unvacc 2, incom 1; 01; SC; severe allergy to component, mod-severe illness, pregnancy, immunosuppression
45
Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): Varicella
Unvaccinated 7-12, >/13, incom 7-18; unvacc 2, incom 1; 7-12 03, >13 1, SC, severe allergy to component, mod-severe illness, pregnancy, immunosuppression
46
Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): Influenza
9-18; annual, starting Feb; IM/SC; severe allergy to component, mod-severe illness, history of Guillan-Barre following a previous dose
47
Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): HPV Bivalent
9-18 FEMALES; 3; 016; IM; severe allergy to component, mod-severe illness, if found to be pregnant after starting immunization delay remaining doses until completion of pregnancy
48
Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): HPV Quadrivalent
9-18 FEMALES and MALES; 2; 026; IM; severe allergy to component, mod-severe illness, if found to be pregnant after starting immunization delay remaining doses until completion of pregnancy
49
Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): HPV Bivalent alternate sched for females
9-14 FEMALES; 2; 06; IM; severe allergy to component, mod-severe illness, if found to be pregnant after starting immunization delay remaining doses until completion of pregnancy
50
Immunization of Teens and Pre-teens (age-doses-sched-route-precautions/contraindications): Td/Tdap
7-18 unvacc, incom, com; unvacc 3, incom 1-2, com 1; unvac 016, incom 1 Tdap, the rest Td, com 1 dose Tdap then Td every 10 years; IM; severe allergy to component, mod-severe illness
51
When to use recumbent length vs standing height
Recumbent length for <2 y/o, standing height for >/2 y/o (if <2 will not lie down, may measure standing; if >/2 will not stand, may measure recumbent WITH APPROPRIATE ADJUSTMENT IN VALUE MEASURED)
52
Difference between recumbent and standing height
Recumbent length is longer by ~0.7cm
53
Reliable growth indicator even when child's age is not known
Weight for length or height
54
Enable early detection and prevention of overweight and obesity problems
BMI
55
What to do if measurements taken for plotting on WHO growth charts is done in a patient with edema
Note on growth chart that child has edema
56
A child is normotensive if BP is ___
<90percentile for age, height, and gender
57
The Pediatric Nephro Society recommends routine BP measurement for children starting what age
3 y/o; regardless of age on all patients who are ill and and at risk
58
Prehypertension in children is defined as
Average SBP AND/OR DBP >90th but <95th percentile; 120/80 in adolescents
59
Hypertension in children is defined as
SBP AND/OR DBP >/95th pecentile on THREE or more occasions
60
RA 9288
Newborn screening act of 2004
61
Article 3 Section 54 of the Newborn Screening Act of 2004
Obligation to Inform: Any health practitioner who delivers/assists in delivery of a newborn in the PH shall, PRIOR to delivery, inform parents or legal guardian of availability, nature, and benefits of NBS
62
NBS shall be ideally done when
Immediately after 24 hours from birth
63
Expanded NBS has been made available since
December 2014
64
The PPS Policy Statement on National Hearing Screening recommends screening for
All NB, whether high-risk or not
65
RA 9709
Universal NHS and Intervention Act of 2009
66
Section 5 of RA 9709
Obligation to Inform: Any health practitioner who delivers/assists in delivery of a newborn in the PH shall, PRIOR to delivery, inform parents or legal guardian of availability, nature, and benefits of hearing loss screening among NB or children 3 months old and below
67
Section 6 of RA 9709
Obligation to Perform
68
All infants born in hospitals in the PH shall be made to undergo NHS when
Before discharge, UNLESS parents or legal guardians of the newborn object
69
All infants who are not born in hospitals in the PH shall be made to undergo NHS when
Within 3 months after birth
70
In the event of a positive NHS, newborn shall undergo audiologic diagnostic evaluation when
In a timely manner to allow appropriate follow up, recall, and referral for intervention before 6 MONTHS
71
In the event of a positive NHS, newborn shall undergo audiologic diagnostic evaluation where
NHS centers duly CERTIFIED by the DOH
72
Recommended timing of regular eye and vision screening in pediatric patients
From infancy until maturation of their visual system
73
Single most effective way to determining a child's eye health
Non-invasive and simple eye and vision screening test
74
Components of eye and vision screening in pediatric patients (5)
1) History 2) VA 3) External inspection 4) Ocular motility 5) ROR
75
High risk infants who should be referred to an ophtha for comprehensive eye exam
1) Premature infants: 32 weeks, 1500g, any age/weight with a stormy course in the NICU 2) With metab disorders 3) With medical conditions known to have associated eye problems 4) With history of squinting, head tilt, head turn 5) With history of visual difficulties and learning problems 6) Family history of eye problems
76
VA test done for infants and pre-verbal children
Fix and follow test with unoccluded eyes and with 1 eye occluded
77
VA test done for children who can participate in subjective/formal testing and are NOT familiar with letters
LEA pictures chart
78
VA test done for children who can participate in subjective/formal testing and are literate
Sloan chart
79
VA of children 3-3 11/12 y/o
20/50 (10/25) or better
80
VA of children 4-4 11/12 y/o
20/40 (10/20) or better
81
VA of children 5 y/o and older
20/30 (10/15) or better
82
Tests done to assess ocular motility
1) Corneal light reflex 2) Versions and ductions 3) Cross cover test
83
In corneal light reflex test, light reflex should be seen simultaneously at
Center of the pupil of each eye
84
T/F Any limitations or lag in the eye movements in versions and ductions test should warrant a referral
T
85
T/F Any movement noticed during the corss over test warrants a referral
T
86
T/F The ROR test should be done under bright illumination
F, under a darkened surrounding
87
In ROR test, where is light directed?
Through the pupil
88
A normal ROR shows a red orange glow through the ophthalmoscope signifying light was able to enter the eye and reflected back from the
Choroidal blood vessels
89
ROR findings that indicate referral to an ophtha
1) Absence of ROR 2) White reflex pupil
90
LEA chart or its equivalent is preferably done at what age
3 years old
91
Distance for VA should be tested at what distance
6m (20 ft) or 3m (10 ft) and reading distance of 34-40cm (14-16 inches)
92
T/F VA testing in children should start with both eyes open
T, then with one of each eye occluded
93
VA is recorded as
Last line on which 4 of the 5 symbols are read correctly
94
T/F In VA testing in children, a child who wears glasses should wear his/her glasses
T
95
T/F In VA testing in children, examiner pointing at the line to be read is preferable over pointing at a specific symbol
T
96
Most common presenting signs of retinoblastoma
Leukocoria and strabismus
97
RA 9482
Anti Rabies Act of 2007
98
RA 9482 mandates provision of FREE routine immunization and pre exposure prophylaxis for what population
5-14 y/o
99
Iron supplementation: LBW
15mg elemental iron/0.6mL, 0.3mL OD from 2m-6m old
100
Iron supplementation: 6-11 months
15mg/0.6mL, 0.6mL OD x 3 mos
101
Iron supplementation: 1-5 y/o
30mg/5mL, 1 tsp [5mL] OD x 3 mos OR once a week for 6 mos
102
Iron supplementation: Adolescent girls (10-19)
60mg elemental iron with 400mcg folic, 1 tab OD
103
Vitamin A supplementation: 6-11 mos
100,000 IU, 1 dose (capsule) only given at any time but usually at 9 months of age during measles immunization
104
Vitamin A supplementation: 12-59 mos
200,000 IU, 1 cap every 6 months
105
PPS Policy Statement on Zinc Supplementation in Children cites beneficial role in the prevention of
Pneumonia and Diarrhea
106
Deworming should be done among children aged
1-12 y/o
107
Drugs recommended for deworming
1) Albendazole 2) Mebendazole
108
Dose of albendazole for deworming
12-23 mos: 200mg single dose every 6 months; 24 months and above: 400mg single dose every 6 months ON FULL STOMACH
109
Dose of mebendazole for deworming
12 mos and above: 500mg single dose every 6 months ON FULL STOMACH
110
Deworming must not be done in what conditions (6)
1) Severe malnut 2) High-grade fever 3) Profuse diarrhea 4) Abdominal pain 5) Serious illness 6) Previous hypersensitivity to antihelminthic drug
111
Nat'l filariasis elimination program is implemented in municipalities endemic for filariasis and involves mass treatment with
DEC and Albendazole from 2 years and above
112
Recommended first dental visit
Time of eruption of first tooth and no later than 12 mos of age
113
Recommended frequency of use of flouride toothpaste among children
AT LEAST 2x a day
114
T/F Children should be taught to spit out toothpaste and to avoid rinsing after brushing
T
115
Recommended use of fluoride toothpaste in children: 6 mos to <2 y/o
1000ppm AT LEAST 2x a day; 2.5mm SMEAR; 0.125 x 2 = 0.25mg/day
116
Recommended use of fluoride toothpaste in children: 2-6 y/o
1000ppm AT LEAST 2x a day; 5mm PEA-SIZE; 0.25 x 2 = 0.50mg/day
117
Recommended use of fluoride toothpaste in children: 6 y/o and above
1500ppm AT LEAST 2x a day; 10-20mm full length of bristle; 0.50 x 2 = 1mg/day
118
Has been proven to prevent or reverse enamel demineralization
Professionally applied topical fluoride
119
Professionally applied topical fluoride is recommended for
1) Children at moderate risk for caries, at least every 6 months 2) Children at high risk for caries, more frequently
120
T/F Cleansing infant's teeth as soon as they erupt with either a washcloth or soft brush will help reduce bacterial colonization
T
121
T/F Use of dental floss in children is important to reduce interproximal caries
T
122
T/F Factors that impact child's caries rate: Prolonged bottle feeding
T
123
T/F Factors that impact child's caries rate: Bottle feeding while asleep
T
124
T/F Factors that impact child's caries rate: Good oral hygiene in the mother
T
125
Breastfeeding protects mother's health against (3)
Cancer (breast, uterus, ovaries), obesity, post-partum hemorrhage
126
T/F While breastfeeding, head, back, and hips should be aligned in a straight manner
T
127
T/F While breastfeeding, support breast with the hand of the opposite arm in a C-hold position
T
128
T/F While breastfeeding, the chin should touch the breast
T
129
T/F While breastfeeding, ensure that the entire nipples plus 1 inch of the surrounding areola
T
130
While breastfeeding, how long should the baby suck
15-30 mins per breast to extract both foremilk and hindmilk
131
To ensure adequate milk supply, the breast should be emptied how many times per day
8-10x
132
Material recommended for use in milk storage
Polypropylene plastic
133
Recommended breastmilk storage period:
```
>25C - 1 hr
<25C - 4 hrs
Ref (4C) - 8 days
Freezer (1-door ref) - 2 wks
Freezer (2-door ref) - 3 mos
Deep freezer with constant temp -20C - 6 mos
```
134
Complementary food must be PAST
Properly fed, adequate, safe, timely
135
Introducing complementary food: One food at a time to be given for
3 days
136
Introducing complementary food: Start with
Lugaw or cereals, fruits or vegetables; 1-2 tsp a day
137
Introducing complementary food: Start pureed food at
6 mos
138
Introducing complementary food: Start finger foods at
8 mos
139
Introducing complementary food: Start lumpy or chopped food at
10 mos
140
Introducing complementary food: Start table food at
12 mos
141
Introducing complementary food: Feed 6-8 month old ___x a day
2-3
142
Introducing complementary food: Feed 9-24 month old ___x a day
3-4
143
Introducing complementary food: Give additional nutritious snacks ___x a day
1-2
144
Introducing complementary food: Do not add salt before
1 y/o
145
Introducing complementary food: If diet is primarily plant-based, give supplements of (4)
Iron, zinc, calcium, vitamin B12
146
Recommended duration and frequency of age-appropriate physical activities for children and adolescents
60 mins daily or on most days of the week
147
Prolonged periods of sedentary activity is defined as a duration of
2 hours per day
148
LEADING cause of childhood INJURY in the PH
Drowning
149
T/F Drowning rates are higher in low-income countries
T
150
In the Western Pacific Region, ___ is the leading cause of INJURY-RELATED DEATH among children less than 5
Drowning
151
Case fatality rate of drowning is as high as
50%
152
Epidemiologic characteristics and risk of unintentional drowning: 0-4 years
At home while bathing or in open water in urban settings
153
Epidemiologic characteristics and risk of unintentional drowning: >/5 years
Natural bodies of water and public pools
154
Epidemiologic characteristics and risk of unintentional drowning: adolescents 15-19
Associated with alcohol in 15%, majority in swimming pools
155
3rd leading OVERALL cause of MORTALITY in the 5-15 age group
Traffic crashes
156
RA that mandates the installation and use of adult seatbelts in front and rear seats of any private motor vehicle
RA 8750
157
Children below ___ are prohibited from occupying the front seat of any moving motor vehicle
6 y/o
158
T/F According to AAP, child seats provide effective restraint and minimize risk of death and injury during car crashes if used appropriately
T
159
Specialized child seats are REQUIRED for children weighing up to ___ or ___ y/o
60lbs, 8 y/o
160
Built in car seatbelts is mandated for children older than ___ y/o
8
161
3rd leading cause of INJURY among hospitalized motor vehicle injury patients
Jeepney crashes
162
4th leading cause of INJURY among hospitalized motor vehicle injury patients
Passenger tricycle injury
163
T/F Pedestrian injuries account for majority of all road injuries
T, 51%
164
2nd most common type of ACCIDENT in children 1-12 y/o
Traffic accidents
165
Safety equipment that works by dissipating the sharp energy of a blow over a large surface area
Helmet
166
Also known as the Rooming-In and Breastfeeding Act of 1992
RA 7600
167
Studies show strong evidence that breastfeeding protects the infant from (6)
1) UTI 2) OM 3) Bacteremia 4) Bacterial meningitis 5) Botulism 6) Necrotizing enterocolitis
168
T/F Infants who are breastfed have shown to have lowered risk for SIDS
T
169
T/F Infants who are breastfed have shown to have lowered risk for IDDM
T
170
T/F Breastfeeding improves long-term cognitive and motor abilities in term infants especially with prolonged breastfeeding
T
171
Studies done in the PH showed that "not breastfeeding" especially within the first 6 months of life increased the rate of mortality associated with (2)
1) Diarrhea (8-10x) 2) Acute lower respiratory tract infection (6x)
172
It has been shown that bottle feeding increase the risk of what childhood illnesses (2)
1) Otitis media 2) H. influenzae bacteremia and meningitis
173
It has been shown that bottle feeding increase the risk of death from ___ as high as 20x
Diarrhea
174
Absolute contraindications to breastfeeding (2)
1) Galactosemia 2) Maternal use of illicit drugs, anti-neoplastic agents, and radiopharmaceuticals
175
Relative contraindications to breastfeeding
1) Active Tb infection 2) Maternal HIV infection
176
T/F During the 2 weeks of treatment, breast milk can still be given to the infant
T, by cup or dropper
177
T/F In feeding infants of mothers with active Tb in the first 2 weeks of treatment, milk expressed in an aseptic manner should be given to the infant by the mother
F, by a caregiver other than the mother
178
This method has been shown to effectively kill HIV in expressed breast milk from an HIV-positive mother
Heat treatment
179
T/F There are some instances when breastfeeding is preferred even if the mother is HIV-positive
T
180
T/F Exclusive breastfeeding of infants of HIV-positive mothers for 3 months or more had no excess risk of HIV infection over 6 months than those never breastfed
T
181
Feeding practice in the first 6 months of infancy that is proven to be related to higher cumulative probabilities of HIV detection by 6 months
Mixed breastfeeding
182
"The Baby-Friendly Hospital Initiative" in 1992 advocates (10)
1) Written breastfeeding policy that is routinely communicated 2) Train health care staff in implementation 3) Inform pregnant women about benefits and management of BF 4) Help mothers initiate BF within half an hour of birth 5) Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants 6) No food or drink other than BM unless medically indicated 7) Practice rooming-in 8) BF on demand 9) No artificial teats/pacifiers 10) Foster establishment of support groups and refer mothers on discharge
183
In 2003, only ___% of children <6 months are exclusively breastfed
37
184
T/F Incentives for mothers who decide to breastfeed may be provided
T
185
Policy on advertisements for milk formulas in the PH
Should first pass an Advertising board created by the DOH under the Maternal and Child Committee BEFORE ads are aired
