Reference Manual Flashcards

Question

CPR: Compression depth for adults + adolescents

Answer 1

At least **2 in (5cm)**

Answer 2

At least **⅓ AP diameter of chest, ~2in (5cm)**

Answer 3

At least **⅓ AP diameter of chest, ~1.5in (4cm)**

Answer 4

2 hands on the lower half of the breastbone (sternum)

Answer 5

2 hands on the lower half of the breastbone (sternum)

Answer 6

2 hands or 1 hand (optional for very small children) on the lower half of the breastbone (sternum)

Answer 7

* 1 rescuer: * 2 fingers or 2 thumbs in the center of the chest, just below the nipple line * 2 rescuers: * 2 thumb-circling hands in the center of the chest, just below the nipple line * If the rescuer is unable to achieve the recommended depth, it may be reasonable to use the heel of one hand

Answer 8

Limit interruptions in chest compressions to **_\<10 sec**_ w/ a CCF (chest compression fraction) goal of _**80%_**

Answer 9

2.4 inches (6cm)

Answer 10

Weight (kg) ÷ Stature (cm) ÷ Stature (cm) x 10,000 **OR** Weight (lb) ÷ Stature (in) ÷ Stature (in) x 703

Answer 11

x = age (years) y = BMI (kg/m³)

Answer 12

* Birth - 6wks * Hep B * Rotavirus (RV) * Diphtheria, tetanus, and acellular pertussis (DTaP) * Haemophilus influenzae type B (Hib) * Pneumococcal conjugate (PCV13) * Inactivated poliovirus (IPV \<18yrs) * 12mo * Measles, mumps rubella (MMR) * Varicella (VAR) * Hep A

Answer 13

* 7yo * Tetanus, diphtheria, acellular pertussis (Tdap ≥7yrs) * 9yo * Human papillomavirus * Meningococcal ACWY * Hep A * Hep B * Inactivated polio * MMR * Varicella * Dengue

Answer 14

≥5 days The repeat dose should be spaced after the **_invalid_** dose by the recommended minimum interval

Answer 15

Pneumococcal polysaccharide vaccine (PPSV23)

Answer 16

Emergency Use Authorization or Biologics License Application for the particular vaccine

Answer 17

* Minimum age: **6wks** * Routine vax: 5 dose series at **2, 4, 6, 15-18mo, 4-6yr** * Prospectively: Dose 4 may be administered as early as 12mo if at least 6mo have elapsed since dose 3. * Retrospectively: A 4th dose that was inadvertently administered as early as age 12mo may be counted if at least 4mo have elapsed since dose 3. * Catch up vax * Dose 5 is not necessary if dose 4 was administered at 4yo+ and at least 6mo after dose 3. * *Wound management in children \<7yo** **w/ h/o 3+ doses of tetanus-toxoid-containing vaccine:** * *For all wounds except clean + minor wounds, administer DTaP if \>5yr since last dose.**

Answer 18

* Minimum age: **6wks** * Routine vax: * 4 dose series at **2, 4, 6mo, booster at 12-15mo** * Vaxelis is not recommended for booster * 3 dose series at **2, 4mo, booster at 12-15mo** * Catch up vax * **Unvaccinated at age 15–59mo: Administer 1 dose.** * **Previously unvaccinated children age 60mo+ who are not considered high risk: Do not require catch-up vaccination**

Answer 19

* Minimum age: **9yo** * Routine vax: **9-16yo** **living in dengue endemic areas** + have lab confirmation of previous dengue infection * 3 dose series: **0, 6, 12mo** Endemic areas: **Puerto Rico, American Samoa, US Virgin Islands, Federated States of Micronesia, Republic of Marshall Islands, + Republic of Palau**

Answer 20

* Chemotherapy/radiation tx: **Doses administered w/in 14 days of starting therapy or during therapy should be repeated at least 3mo after therapy completion** * Hematopoietic stem cell transplant (HSCT): **4 dose series 6-12mo after successful transplant, regardless of Hib vax hx** * Anatomic/functional asplenia (including sickle cell disease): **Unvaccinated 5yr+ 1 dose** * Elective splenectomy: **Unvaccinated 15mo+ 1 dose (preferably at least 14 days preop)** * HIV infection: **Unvaccinated 5-18yo 1 dose** * Immunoglobulin deficiency, early component complement deficiency:

Answer 21

* Minimum age: 12mo for routine vaccination

Answer 22

* Birth dose: monovalent HepB vaccine only * **Mother is HBsAg negative** * All medically stable **infants ≥2000 g**: 1 dose within 24hr of birth * **Infants \<2000 g**: Administer 1 dose at chronological age 1mo or hospital discharge (whichever is earlier and even if weight is still \<2000 g) * **Mother is HBsAg positive** * Give HepB vaccine + hepatitis B immune globulin (HBIG) (in separate limbs) within 12hr of birth, regardless of birth weight * Infants **\<2000 g**: Give 3 additional doses of vaccine (total of 4 doses) beginning at 1mo * Determine mother's HBsAg status ASAP. **If mother is HBsAg positive, give HBIG to infants ≥2000 g as soon as possible, but no later than 7 days old** * Minimum age for final dose: **24weeks** * Revaccination not typically recommended for those w/ normal immune status who were vaccinated as infants, children, adolescents or adults. * Post-vaccination serology testing + revaccination (if anti-HBs \< 10mlU/mL) recommended in certain populations: * **Infants born to HBsAg positive mothers** * **Hemodialysis patients** * **Immunocompromised**

Answer 23

* Minimum: HPV vaccine **@11-12yo (can start @9yo)** * Age 9-14yo - 2 doses * Age 15yo+ - 3 doses * Not recommended until after pregnancy * No intervention needed if vaccinated during pregnancy

Answer 24

* Minimum age: 6mo, 2yr, 18yo * Age 6mo-8yr: 2 doses for those how have received fewer than 2 flu vaccines before July 1, 2021 or whose flu vaccine history is unknown * Children 6mo-8yr: 1 dose for those who have received at least 2 flu vaccines before July 1, 2021 * 1 dose for all patients 9yo and younger

Answer 25

* Minimum age: 12mo * For dose 1 in children 12-47mo, it is recommended to administer MMR + varicella vaccines separately. MMRV may be used if parents have a preference.

Answer 26

* Minimum age: 2mo, 9mo, 2yo * Anatomic or functional asplenia (included sickle cell disease): * Menveo * Menactra * W/ persistent complement component deficiency or complement inhibitor use * Anatomic or functional asplenia, sickle cell disease, or HIV * MenQuadfi * Travel in countries w/ hyperendemic or epidemic meningococcal disease, including countries in the African meningitis belt or during the Hajj * Menveo * Menactra * First year college students living in residential housing (if not vaccinated at 16yo) or military recruits * Menveo * Menactra * MenQuadfi *

Answer 27

* 7yo+ w/ h/o 3 or more doses of tetanus toxoid containing vaccine: * Clean + minor wounds: Tdap or Td if \>10yr since last dose * All other wounds: Tdap or Td if \>5yr since last dose * Tdap is preferred for persons 11yo+ who have not previously received Tdap or whose Tdap hx is unknown * If tetanus-toxoid containing vaccine is indicated for pregnant adolsecent, use Tdap

Answer 28

* Severe allergic rxn previously w/ any egg-based flu vaccine * Severe allergic rxn to any vaccine component * Children 2-4yo w/ h/o asthma or wheezing * Anatomic or functional asplenia * Immunocompromised (may be due to meds + HIV infection) * Close contacts of severely immunosuppressed who require a protected envt * Pregnancy * Cochlear implant * Active communication between CSF + oropharynx, nasopharynx, nose, ear or any other cranial CSF leak * Children + adolescents receiving aspirin or salicylate-containing meds * Received influenza antiviral meds oseltamivir or zanamivir w/in previous 48hr, peramivir w/in previous 5 days, or baloxavir w/in previous 17 days

Answer 29

* Precautions * Dengue * Meningococcal B * Poliovirus, inactivated * Contraindicated * Influenza, live attenuated * Heplisav-B (hepB) * MMR * Varicella

Answer 30

2-8yo children

Answer 31

Children 9yo+ and adults

Answer 32

If a child 4-8yo needs more calories and is following a pattern at 1600 calories or more, recommended amount from **dairy** group should be **2.5 cups** per day.

Answer 33

All seafood, meats, poultry, eggs, soy products, nuts, seeds. Meats + poultry should be lean or low-fat and nuts should be unsalted. Legumes (beans + peas) can be considered part of this group as well as the vegetable group but should be counted in one group only

Answer 34

All milk, including lactose-free and lactose-reduced products + fortified soy beverages (soymilk), yogurt, frozen yogurt, dairy desserts, cheeses. Most choices should be fat-free or low-fat. Cream, sour cream, cream cheese are not included due to their low calcium content

Answer 35

* Fruits + vegetables, 1 cup = 1 cup raw or cooked fruit or vegetable, 1 cup fruit or vegetable juice, 2 cups leafy salad greens, ½ cup dried fruit or vegetable * Grains, 1oz = ½ cup cooked rice, pasta or cereal, 1oz dry pasta or rice, 1 medium (1oz) slice bread, 1oz of ready to eat cereal (~1cup of flaked cereal) * Protein foods, 1oz = 1oz lean meat, poultry or seafood, 1 egg, ¼ cup cooked beans/tofu, 1Tbsp peanut butter, ½oz nuts/seeds * Dairy, 1 cup = 1 cup milk, yogurt, or fortified soymilk, 1½oz natural cheese or 2 oz of processed cheese All foods are assumed to be in nutrient-dense forms, lean or low-fat + prepared w/o added fats, sugars, refined starches or salt. The overall eating pattern should not exceed the limits of \<10% of calories from added sugars + \<10% of calories from saturated fats

Answer 36

Limit of up to 1 drink/day for women, 2 drinks/day for men

Answer 37

* Hearing + Understanding * Startles at loud sounds * Quiets or smiles when you talk * Seems to recognize your voice; quiets if crying * Talking * Makes cooing sounds * Cries change for different needs * Smiles at people

Answer 38

* Hearing + Understanding * Moves eyes in the direction of sounds * Responds to changes in your tone of voice * Notices toys that make sounds * Pays attention to music * Talking * Coos + babbles when playing alone or with you * Makes speech-like babbling sounds, like pa, ba, mi * Giggles + laughs * Makes sounds when happy or upset

Answer 39

* Hearing + Understanding * Turns + looks in direction of sounds * Looks when you point * Turn when you call his/her name * Understands words for common items + people - “cup, truck, juice, daddy” * Starts to respond to simple words + phrases, like “no, come here, want more” * Plays games w/ you, like peek-a-boo + pat-a-cake * Listens to songs + stories for a short time * Talking * Babbles long strings of sounds, like mimi, upup, bababa * Uses sounds + gestures to get + keep attention * Points to objects + shows them to others * Uses gestures like waving bye, reaching for “up”, shaking head no * Imitates different speech sounds * Says 1 or 2 words, like “hi, dog, dada, mama, uh oh.” This will happen around 1st birthday but sounds may not be clear

Answer 40

* Hearing + Understanding * Understands differences in meaning go-stop, big-little, up-down * Follows 2-part directions like “get the spoon and put it on the table” * Understands new words quickly * Talking * Has a word for almost everything * Talks about things that are not in the room * Uses k, g, f, t, d, n in words * Uses words like in, on, under * Uses two- or three-words to talk about + ask for things * People who know your child can understand him/her * Asks “why”? * Puts 3 words together to talk about things. May repeat some words + sounds

Answer 41

* Hearing + Understanding * Responds when you call from another room * Understands words for some colors * Understands words for some shapes * Understands words for family * Talking * Answers simple who, what, where questions * Says rhyming words * Uses pronouns like I, you, me, we, they * Uses some plural words * Most people understand what your child says * Asks when and how questions * Puts 4 words together. May make some mistakes * Talks about what happened during the day. Uses 4 sentences at a time

Answer 42

* Hearing + Understanding * Understands words for order “first, next, last” * Understands words for time “yesterday, today, tomorrow” * Follows longer directions * Follows classroom directions * Hears + understands most of what she hears at home + in school * Talking * Says all speech sounds in words. May make mistakes on sounds that are harder to say like l, s, r, v, z, ch, sh, th * Responds to “What did you say?” * Talks w/o repeating sounds or words most of the time * Names letters + numbers * Uses sentences that have more than 1 action word, like jump, play, get. May make some mistakes * Tells a short story * Keeps a conversation going * Talks in different ways, depending on the listener + place. Your child may use short sentences w/ younger children. Make talk louder outside than inside

Answer 43

* Patients who may benefit * High caries risk who have active cavitated caries in anterior or posterior teeth * Presenting w/ behavioral or medical management challenges + cavitate caries lesions * W/ multiple cavitated caries lesions that may not all be treated in one visit * W/ dental caries that are difficult to tx * W/o access to or w/ difficulty accessing dental care * Tooth selection * No clinical signs of pulpal inflammation or reports of unsolicited/spontaneous pain * Cavitated caries lesions that are not encroaching on the pulp; radiographs should be taken to assess depth of caries if possible * Cavitated lesions on any surface as long as they are accessible w/ a brush for applying SDF (ortho separators may be used)

Answer 44

As long as 3 minutes

Answer 45

2-4 weeks after initial tx to check the arrest of the lesions treated.

Answer 46

* Hemoglobin * Hematocrit * RBC * WBC

Answer 47

* Normal value: **10.5-18 g/dL** * Function: **Measures oxygen carrying capacity of blood** * Significance: * **Low: Hemorrhage, anemia** * **High: Polycythemia**

Answer 48

* Normal value: **32-52%** * Function: **Measures relative value of cells + plasma in blood** * Significance: * **Low: Hemorrhage, anemia** * **High: Polycythemia, dehydration**

Answer 49

* Normal value: **4-6 million/mm³** * Function: **Measures oxygen-carrying capacity of blood** * Significance: * **Low: Hemorrhage, anemia** * **High: Polycythemia, heart disease, pulmonary disease**

Answer 50

* Normal value: * **1-23mo: 6,000-14,000/mm³** * **2-9yo: 4,000-12,000/mm³** * **10-18yo: 4,000-10,500/mm³** * Function: **Measures host defense against inflammatory agents** * Significance: * **Low: Aplastic anemia, drug toxicity, specific infections** * **High: Inflammation, trauma, toxicity, leukemia**

Answer 51

* Neutrophils * Lymphocytes * Eosinophils * Basophils * Monocytes

Answer 52

* Absolute counts: **1,500-8,000/mm³** * Significance: * **Increase in bacterial infections, hemorrhage, diabetic acidosis** * **Absolute Neutrophil Count (ANC) \<1,000/mm³: Patient at increased risk for infection; defer elective dental treatment**

Answer 53

* Absolute counts: **1,500-3,000/mm³** * Significance: * **Viral + bacterial infections** * **Acute + chronic lymphocytic leukemia** * **Antigen reaction**

Answer 54

* Absolute counts: **50-250/mm³** * Significance: **Increase in parasitic + allergic conditions, blood dyscrasias, pernicious anemia**

Answer 55

* Absolute counts: **15-50/mm³** * Significance: **Increase in types of blood dyscrasias**

Answer 56

* Absolute counts: **285-500/mm³** * Significance: **Hodgkin's disease, lipid storage disease, recovery from severe infections, monocytic leukemia**

Answer 57

ANC **\<1,000/mm³:** Patient at increased risk for infection. Defer elective dental treatment

Answer 58

* Prothrombin time * Partial thromboplastin time * Platelets * Bleeding time (adult) * INR

Answer 59

* Normal lab value: **12.7-15.4 seconds** * Function: **Measures extrinsic clotting of blood.** * Significance: * **Prolonged in liver disease** * **Impaired Vitamin K production** * **Surgical trauma w/ blood loss**

Answer 60

* Normal lab value: **By laboratory control** * Function: **Measures intrinsic clotting of blood, congenital clotting disorders.** * Significance: **Prolonged in hemophilia A, B, and C + Von Willebrand's disease**

Answer 61

* Normal lab value: **150,000-400,000/mm³** * Function: **Measures clotting potential.** * Significance: * **Increased in polycythemia, leukemia, severe hemorrhage** * **Decreased in thrombocytopenia purpura**

Answer 62

* Normal lab value: **\<7.1 minutes** * Function: **Measures quality of platelets.** * Significance: **Prolonged in thrombocytopenia.**

Answer 63

* Normal lab value: * **W/o anticoagulant therapy: 1** * **W/ anticoagulant therapeutic range: 2-3** * Function: **Measures extrinsic clotting function.** * Significance: **Increased w/ anticoagulant therapy.**

Answer 64

* Volume * Specific gravity * pH * Casts

Answer 65

* Normal lab value: **1,000-2,000 mL/day** * Function: -- * Significance: **Increased in diabetes mellitus, chronic nephritis**

Answer 66

* Normal lab value: **1.015-1.025** * Function: **Measures the degree of tubular reabsorption + dehydration.** * Significance: * **Increased in diabetes mellitus.** * **Decreased in acute nephritis, diabetes insipidus, aldosteronism.**

Answer 67

* Normal lab value: **5.0-9.0** * Function: **Reflects acidosis + alkalosis.** * Significance: * **Acidic: Diabetes, acidosis, prolonged fever.** * **Alkaline: Urinary tract infection, alkalosis.**

Answer 68

* Normal lab value: **1-2 per high power field.** * Function: -- * Significance: **Renal tubule degeneration occurring in cardiac failure, pregnancy, and hemogobinuric-nephrosis.**

Answer 69

* Sodium * Potassium * Bicarbonate * Chloride

Answer 70

* Normal lab value: **134-143 mmol/L** * Function: -- * Significance: **Increased in Cushing's syndrome**

Answer 71

* Normal lab value: **3.3-4.6 mmol/L** * Function: -- * Significance: **Increased in tissue breakdown**

Answer 72

* Normal lab value: * **Venous: 22-29 mmol/L** * **Arterial: 21-28 mmol/L** * Function: **Reflects acid-base balance** * Significance: --

Answer 73

* Normal lab value: **98-106 mmol/L** * Function: -- * Significance: **Increased in renal disease + hypertension**

Answer 74

* Normal lab value: **0.08-1.58 mg/dL** * ***\*\*Range is _age dependent_\*\**** * Significance: * **Increase in infection** * **Indicates an acute phase of the inflammatory metabolic response**

Answer 75

* Forms: **Liquid, tablet, oral disintegrating tablet, caplet, rectal suppository, injectable** * Usual oral dosage: * Children \<12yo: **10-15 mg/kg/dose every 4-6hr as needed (max 75 mg/kg/24hr, but not to exceed 4g/24hr)** * Children ≥12yo + adults: **325-650 mg every 4-6hr** ***_OR_*** **1,000 mg 3-4x daily as needed (max 4g/24hr)**

Answer 76

* Sedation, GA, utilization of surgical facilities. * Includes all supportive health care services that are necessary for the optimal quality therapeutic + preventive oral care * Take into account the patient's age, developmental status, psychosocial well-being, in addition to the clinical setting appropriate to meet the needs of the patient + family

Answer 77

Caries is the most common chronic disease of childhood. ## Footnote **~60% of children experience cares in primary teeth by 5yo.**

Answer 78

A child who receives sealants is **72% less likely** to receive restorative services over the next **3** years than children who do not

Answer 79

80-90% - even after a decade

Answer 80

* ADHD * \>6 million children under 18yo * Behavioral problems * Anxiety * 4.4 million * Depression * 1.9 million