Flashcards in Primary Care Medicine Deck (43):
At what level can lead poisoning cause cognitive damage?
10-20 = mild cognitive delay, >60 = severe headaches/toxicity/encephalopathy anemia ; needs chelation at 45
When are the Dtap and Tdap vaccines given?
Dtap = 2,4,6,15mo and 4-6 years (kindergarten visit). Cannot give to anyone over 7 years. Tdap should be given at 11, then every 10 years
Wound management and tetanus prophy/imm?? Clean vs. dirty wounds
Clean wounds = never need Tetanus IG. If imm status unknown or has gotten
When is hep B vaccine given?
0, 2, 6 months - usually get an extra dose at 4 months if use combo vaccine, if vaccinating after newborn peropd or not completely immunized as a baby, begin the complete 3 part series
When do you give MMR?
12 mos, 4-6 years. MMR can be given at any visit as long as at least 4 weeks have elapsed
What should you do if a child under a year has been exposed to the measles?
If less than 6 mos, give measles IgG, if >6mos and within 72 hours of exposure, give MMR, if >72hours,
What if a child is traveling to a measles endemic area before age 1
give MMR (but this is short term and still needs 12 month dose)
What percent of kids get fever after MMR?
15% within 12 days of vaccination last 1-2 days
What is the relationship between MMR and Tb?
Can place a PPD with MMR (no mitigation of PPD effect). A PPD should not be placed 4-6 weeks after MMR has been given. A positve PPD is not a contraindication to getting MMR, however, if TB is confirmed, start treatment before giving MMR (vaccine can worsen Tb)
Which vaccines have enough egg protein to worry about concurrent egg allergy?
Yellow fever and influenza vaccines. Any kid with egg allergy/reaction should be skin tested to confirm since will affect receiving vaccines
Who do you use epipen Jr for?
Which ages is prevnar indicated?
When is rotavirus given?
2, 4, 6 mos
Must give first dose of rota at what age?
between 6 and 14 weeks (not after 15 weeks), the series must be complete by 8 months, have to give 4 weeks in between doses. If give first dose after 15 weeks, still complete course
If an infant gets rotavirus, do they still need immunization?
yes because only infers partial immunity
What is spit up the rotavirus vaccine?
Do not redose, continue with series
If fail the hearing screen, hen do newborns need to be referred to audiologist?
before 3 months of age
What is Myositis ossificans traumatica?
Ectopic bone formation in a muscle group following trauma to the muscle. Myositis ossificans traumatica should be considered in a patient with a history of a direct blow to a muscle that exhibits persistent pain or worsening several weeks after injury
Below what age should not use monospot?
above which age do babies need sedation for ABR testing?
Catch up vaccine for Dtap:
If got one dose before 12 months, need 4 total doses. If first dose is after 12 months, need 3 total doses. Need 4 weeks between dose 1 and 2, and 6 months between second to last dose and last dose.
What if mother is hep B pos or unknown Hep B status?
Newborn needs hep B vaccine and Hep B Ig, give normal vaccine schedule, 2 and 6 months, but then check titers around 9 months
If have had anaphylaxis to streptomycin, neomycin or polymixin do not give which vaccine?
If have had anaphylaxis to neomycin, do not give which vaccine?
MMR and VZV
If have had anaphylaxis to gelatin, do not give:
MMR, VZV, Yellow fever
Definition of colic
excessive, unexplained crying is an otherwise well-nourished, normal infant lasting >3 hours per day and occuring >3 days a week for at least 3 weeks. 30-50% of infants have colic. Usually occurs in first week of life and resolves at 3-4 months
Disciple strategies age 1-5 then 5 and above
age 1-5 time out. >5 - loss of priveleges
When can kids sit in front seat
How long after diagnosis of CT or GC should patients be tested for repeat infection?
Which drugs cannot be tested in urine
LSD, bath salts.
How long can drugs be tested in urine?
Most 24-48 hours, except PCP is 8-10days and MJ is 4-6 weeks
Which drug is approved for adolescent/child depression
fluoxetine in patients >8
Which SSRI is best for bulimia?
lack of menstruation by age 16
Most common cause of secondary amenorrhea
What tanner stage does menstruation usually happen?
How long after starting menstruation on average do cycles consistently become ovulatory?
Vaginal PH of BV infection
vaginal pH of candida
Treatment of inpatient PID
cefotetan or cefoxitin plus doxycycline
Inpatient treatment of PID if PCN all
Clinda plus gentamicin
Outpatient treatment of PID
rocephin 250mg IM or Cefoxitin2GM IM +Probenecid PLUS doxy and flagyl