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91 Cards in this Set
- Front
- Back
Front (Term) |
Apgar score |
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What are two components of the infant mortality rate? |
infant period and the post infant period |
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True or false the perinatal death rate (still births + deaths of live born infants) has decreased since 1980? |
True |
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MCH Bureau |
As the only governmental program responsible for ensuring the health and well-being of the entire population of women, infants, and children, the Title V program plays a critical role in coordination, capacity building, and quality oversight at the community and state levels. By connecting people to services, programs to programs, and agencies to agencies, Title V programs maximize resources and increase quality and effectiveness. |
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Bureau of primary care |
HRSA program to fund primary care health centers for low incomes. |
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Gap health care cover for children ineligible for medicaid? |
SCHIP |
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Time in pregnancy when fetus is most suspect able to teratogen? |
3-8weeks |
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Three components of preconception counseling |
Risk assessment, risk reductuction (e.g. , diseases), pt edu |
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Risk factors for late or no prenatal care? |
age less than 20' not married, low edu |
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best treatment for cervical incompetence.? |
Cervical cerclage |
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What is the only proven risk Factors for preterm birth? |
uti Shorter cervical length |
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What is fundal height use to measure? |
From the Punic bone to the top of the uterus, correlates with weeks gestation |
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Complications of electronic fetal montioring |
High false positive rate of predicting advers events Increased risk of operative interventions. No reduced risk of cerebral palsy. |
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2 most common obstetric procedures |
C section Laceration repairs. |
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True or false women with seizure disorder have a lower risk of an infant with birth defects? |
False. They have a higher risk even when not taking any meds. |
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Third leading cause of maternal death |
Pree |
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Task force recommendation for gestational DM screening? |
Screen asymptomatic women at 24 weeks Grade b |
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Top three cause of maternal death in the us? |
*1. Cardiovascular *2. Non cardiovascular 3. Infection hemorrhage is 4th |
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Most women are recommended to gain how many pounds during there pregnancy? |
25 to 35 lbs. |
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What is the failure rate of the male condom? |
18 % per 100 women per a year |
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Each of the following statements regarding routine circumcision of the male newborn is true except for which one?(A) Circumcised males have fewer urinary tract infections.(B) Phimosis is prevented.(C) Circumcision reduces the chances of carcinomaof the cervix in future female partners.(D) Circumcision is contraindicated in the presenceof hypospadias.(E) Circumcision reduces the lifetime risk of penilecancer. |
C |
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Each of the following statements regarding routine circumcision of the male newborn is true except for which one?(A) Circumcised males have fewer urinary tract infections.(B) Phimosis is prevented.(C) Circumcision reduces the chances of carcinomaof the cervix in future female partners.(D) Circumcision is contraindicated in the presenceof hypospadias.(E) Circumcision reduces the lifetime risk of penilecancer. |
C |
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What is the average daily caloric intake for a newborn? |
120 kcal/day |
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All are risks for syndrome (SIDS) in the United States, except for which one?(A) Low socioeconomic status(B) Minority ethnicity(C) Maternal smoking(D) Sleeping in the prone position (E) Familyhistoryofatopicdisease |
E |
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In counseling a first-time mother regarding normal growth and development of her baby, which of the following do you outline as the normal course of developmental milestones?(A) Head up and controlled at 2 weeks, sit unsupported at 3 months, crawl at 6 months, and walk at 9 months(B) Headupandcontrolledat2months,sit unsupported at 4 months, crawl at 6 months, and walk at 9 months(C) Head up and controlled at 3 months, sit unsupported at 6 months, crawl at 9 months, and walk at 12 months |
C |
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In counseling a first-time mother regarding normal growth and development of her baby, which of the following do you outline as the normal course of developmental milestones?(A) Head up and controlled at 2 weeks, sit unsupported at 3 months, crawl at 6 months, and walk at 9 months(B) Headupandcontrolledat2months,sit unsupported at 4 months, crawl at 6 months, and walk at 9 months(C) Head up and controlled at 3 months, sit unsupported at 6 months, crawl at 9 months, and walk at 12 months |
C |
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What guidance should you provide regarding wt gain in the first year of life |
Double wt by 6 month, triple by 1 year |
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What two child immunization a require a booster!? By what age? |
IPV and DTap 4-6 years |
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In counseling a first-time mother regarding normal growth and development of her baby, which of the following do you outline as the normal course of developmental milestones?(A) Head up and controlled at 2 weeks, sit unsupported at 3 months, crawl at 6 months, and walk at 9 months(B) Headupandcontrolledat2months,sit unsupported at 4 months, crawl at 6 months, and walk at 9 months(C) Head up and controlled at 3 months, sit unsupported at 6 months, crawl at 9 months, and walk at 12 months |
C |
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What guidance should you provide regarding wt gain in the first year of life |
Double wt by 6 month, triple by 1 year |
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What two child immunization a require a booster!? By what age? |
IPV and DTap 4-6 years |
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How my inches in ht should a child gain per year until age 10? |
2-2.5 inches/ year |
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19-year-old sexually active female college student has recently married and has been taking oral contra- ceptive medication for 3 months. She complains of headaches since starting “the pill.” Her blood pres- sure is 132/78; she weighs 120 lb (54.4 kg) at a height of 5 ft, 4 in. (1.63 m). Which of the following altera- tions in her regimen would be the most appropriate?(A) Reduce the estrogen component of her birth control pill (BCP)(B) Reduce the progestational component of her BCP(C) Investigate the androgenic effects of her BCP(D) Prescribe a 5-hydroxytryptamine agonist(e.g., sumatriptan)(E) DiscontinuetheBCP |
9. The answer is B. Reduce the progestational compo- nent of her BCP. Progestational agents in BCPs may cause side effects consisting of breast tenderness, hypertension, headaches, and, rarely, myocardial infarction (the latter presumably related to the androgenic effects of progesta- tional agents that include reduced high-density lipopro- tein cholesterol and elevated low-density lipoprotein cholesterol and increased insulin resistance). This patient’s blood pressure appears to be elevated for her age. Although it is true that many people experience migraine headaches when they begin oral birth control medications, manipu- lating the progesterone agent may address both the head- aches and the possible hypertension lurking in the wings with this patient, although hypertension may be caused by the estrogenic effects as well. |
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Is gestational DM a clear cause of birth defects? |
Unlike pre-gestational diabetes, gestational diabetes has not been clearly shown to be an independent risk factor for birth defects. Birth defects usually originate sometime during the first trimester (before the 13th week) of pregnancy, whereas GDM gradually develops and is least pronounced during the first and early second trimester |
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Screening for Hyperbilirubinemia in infants? Grade? What are the risk factors? |
Grade I Risks; family hx, excl breast feeding, asian/black, maternal age >25, male, gestational age <36 week |
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What test are used to screen for PKU? |
Guthie Bacterial inhibition Assay Automated flurometric assay tandem mass spec Note optium timing well infant 24 hrs then 2 weeks. |
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Criteria for DM in children? |
• Overweight (BMI >85th percentile for age and sex, weight for height >85th percentile, or weight >120% of ideal for height)Plus any two of the following risk factors:• Family history of type 2 diabetes in first- or second-degree relative• Race/ethnicity (Native American, African American, Latino, Asian American, Pacific Islander)• Signs of insulin resistance or conditions associated with insulin resistance (acanthosis nigricans, hypertension, dyslipidemia, polycystic ovary syndrome, or small-for-gestational-age birth weight)• Maternal history of diabetes or GDM during the child’s gestationAge of initiation: Age 10 years or at onset of puberty, if puberty occurs at a younger age Frequency: Every 3 years |
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What are the risks for fetal loss and limb deficiency with aminocentesis? CVS? |
1st trimester:
CVS: 1-1.5% fetal loss, <0.1 fetal loss CVS: fetal loss 0.5% 1st trimester amino: 6% fetal loss |
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What are the risks for fetal loss and limb deficiency with aminocentesis? CVS? |
1st trimester:
CVS: 1-1.5% fetal loss, <0.1 fetal loss CVS: fetal loss 0.5% 1st trimester amino: 6% fetal loss |
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Profile of downs in the triple screen |
HcG up, MAFP down, esteriol down |
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Top three most high impact (increase QALYs) services? |
aspirin counseling, immunizing children, tobacco-screening and brief counseling |
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What are the risks for fetal loss and limb deficiency with aminocentesis? CVS? |
1st trimester:
CVS: 1-1.5% fetal loss, <0.1 fetal loss CVS: fetal loss 0.5% 1st trimester amino: 6% fetal loss |
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Profile of downs in the triple screen |
HcG up, MAFP down, esteriol down |
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Top three most high impact (increase QALYs) services? |
aspirin counseling, immunizing children, tobacco-screening and brief counseling |
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A women test positive for GBS. In what case does she NOT need prophylatic ABX |
Elective C-Section |
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Top three causes of neonatal death worldwide (2012), WHO? How does this contrast with US statistics? |
1) Prematurity 15% (2nd in US) 2) Birth asphyxia, 11% (4th) 3) Sepsis (not in top 6) |
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What are the risks for fetal loss and limb deficiency with aminocentesis? CVS? |
1st trimester:
CVS: 1-1.5% fetal loss, <0.1 fetal loss CVS: fetal loss 0.5% 1st trimester amino: 6% fetal loss |
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Profile of downs in the triple screen |
HcG up, MAFP down, esteriol down |
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Top three most high impact (increase QALYs) services? |
aspirin counseling, immunizing children, tobacco-screening and brief counseling |
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A women test positive for GBS. In what case does she NOT need prophylatic ABX |
Elective C-Section |
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Top three causes of neonatal death worldwide (2012), WHO? How does this contrast with US statistics? |
1) Prematurity 15% (2nd in US) 2) Birth asphyxia, 11% (4th) 3) Sepsis (not in top 6) |
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According to the WHO, what are the top 4 causes of death 1-59? Who does this compare with the US? |
1) PNA, 13% 2) Group 1 conditions , 10% 3) Diarrnea 4) Malaria |
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What are the risks for fetal loss and limb deficiency with aminocentesis? CVS? |
1st trimester:
CVS: 1-1.5% fetal loss, <0.1 fetal loss CVS: fetal loss 0.5% 1st trimester amino: 6% fetal loss |
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Profile of downs in the triple screen |
HcG up, MAFP down, esteriol down |
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Top three most high impact (increase QALYs) services? |
aspirin counseling, immunizing children, tobacco-screening and brief counseling |
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A women test positive for GBS. In what case does she NOT need prophylatic ABX |
Elective C-Section |
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Top three causes of neonatal death worldwide (2012), WHO? How does this contrast with US statistics? |
1) Prematurity 15% (2nd in US) 2) Birth asphyxia, 11% (4th) 3) Sepsis (not in top 6) |
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According to the WHO, what are the top 4 causes of death 1-59? Who does this compare with the US? |
1) PNA, 13% 2) Group 1 conditions , 10% 3) Diarrnea 4) Malaria |
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According to WHO, what were the top 5 causes of under 5 deaths? |
1)PNA 2) Diarrhea 3)Preterm birth 4) Aphysia 5) Malaria 6) Mealses 7 HIV 59% of 1-59 mo deaths are from PNA and diarrhea 41% of Infant deaths are from preterm birth or aphysia |
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What is the demographic gap? |
The difference between the birth and death rate. Shows the natural increase in population size |
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What is the lifetime risk of cervical cancer in the us? |
1% |
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True or false. SIDS affects males to females in a 1 to 3 ratio. |
False three times as many males are affected than females |
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True or false. SIDS affects males to females in a 1 to 3 ratio. |
False three times as many males are affected than females |
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True or false. Asians are effected by SIDS at a higher rate than blacks. |
False. It's highest in blacks |
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How does the US definition of still birth compare with the WHO (used for international comparison)? |
CDC: Fetal death in utero after gestation => 20 wks WHO=> 28 weeks or 1000 g |
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How does the US definition of still birth compare with the WHO (used for international comparison)? |
CDC: Fetal death in utero after gestation => 20 wks WHO=> 28 weeks or 1000 g |
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What percent of still births in high income countries are preterm? |
1% of all still births occur in high income countries. Of these, 80% are still births. Note that in developing countries %50 of preterm birth occur intrapartum |
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In 2010, how did intrapartum maternal deaths compare to intrapartum neonatal deaths (Jekel?) |
1/4 th of neonatal death occured intrapartum vs 3/4 of maternal deaths |
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Globally, what of live birth had a birth certificate? |
60% (J.Jekel) |
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Globally, what of live birth had a birth certificate? |
60% (J.Jekel) |
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What is Millenium Development Goal number 4? |
Reduced child mortality by 2/3 rds |
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According to the WHO, what are the top three causes for 2010 of neonatal and child death? |
Neonates: 1) Preterm-12%, 2) Asphysxia-9% 3) Sepsis (6%) 1-5: Diarrhea (14%) & PNA (14%); Other infections (9%), Malaria (8%) |
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What is the ten year false positive and biospy rate for women being screened with mammography? |
23% false positive rate over 10 years 10% biopsy rate over ten years After 10 mammograms, the false positive rate increases to nearly 50% |
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What are the benefits and dangers of hormone replacement therapy as shown in the women's health study? |
Benefits: post-men symptom reduction, increase bone mineral density, decrease colon cancer incidence Risks: inc breast cancer, MI, blood clots, and Alzheimer's |
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What is the anticipated one year pregnancy rate using withdraw or the natural family planning method? |
*Withdrawl = 22% *Natural method =24% |
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True or false. Having a sibling with SIDS increases the infants risk by 2-3 x |
True |
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Treatment options for Ito during pregnancy? |
Cephalexin 500mg QID Ampicillin 500mg QID Nitrofurantion 100 mg BID Sulfisasoxazole - amp/amox 20-40% resistance Avoid trimethoprim: cardiac and facial defects |
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Treatment options for Ito during pregnancy? |
Cephalexin 500mg QID Ampicillin 500mg QID Nitrofurantion 100 mg BID Sulfisasoxazole - amp/amox 20-40% resistance Avoid trimethoprim: cardiac and facial defects |
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How many dosages? Childhood vaccines. hep A & B;roto,DTAP, HIP, PCV13, MMR, menactra, varicella, HPV |
birth- hep B 2 B DR HIP 4 DR HIP b in 6 mo DR HIP 1 MAV 12 Tada boys become men 18 men get boosted hep b 3 Hep a 2 Roto 3 hip 2/3 IPV 4 MMR 2 Varicella 2 Hep 3 |
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What is the anticipated one year pregnancy rate using withdraw or the natural family planning method? |
*Withdrawl = 22% *Natural method =24% |
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According to the World Health Organization (WHO), in children under age 5 years (except the neonatal period), acute respiratory disease is the greatest cause of death. What is the next most common global cause of death in this group Correct answerA) Diarrheal diseases B) HIV/AIDS C) Injuries D) Malaria |
Answer: A. The proportion of global disease mortality for children under age 5 years in descending order for each category is: respiratory disease (17%), diarrheal disease (16%), malaria (7%), injuries (4%), HIV/AIDS (2% |
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For which serologic status would a mother be most likely to transmit Hepatitis B vertically to her infant at birth? Hepatitis B surface antigen positive Correct answerB) Hepatitis B surface and “e” antigen positive C) Hepatitis B surface antibody positive D) Hepatitis B core antibody and surface antibody positive |
Answer: B. Mothers who are both Hepatitis B surface and “e” antigen positive have the highest viral loads. About 70%-90% of infants born to these mothers become infected without intervention. Of those who are only surface antigen positive, about 20% of infants become infected. In either case, 90% of infected infants will become a lifetime carrier of Hepatitis B. Presence of antibody to either core or surface antigen reflects recovery and immunity to infection. No transmission to an infant would be expected in these scenarios. |
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Up or down in down syndrome: AFP, esterdiol. HCG, inhibit A? Trisomy 18? |
hCG and inhibin A up eE3, PAPA, and alpha fetal protein down (Inhibit A down in trisomy) mnemonic: PEA down the stream |
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Up or down in down syndrome: AFP, esterdiol. HCG, inhibit A? Trisomy 18? |
hCG and inhibin A up eE3, PAPA, and alpha fetal protein down (Inhibit A down in trisomy) mnemonic: PEA down the stream |
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Single most accurate biomarker of down syndrome |
Pregnancy associated plasma protein A |
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Disadvantage of first trimester screening? |
Does not test for neural tube defects |
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. Some agents have been found to be neurotoxic to the fetus and af- fect pregnancy outcomes. At which of the following periods will the fetus be particularly susceptible to neurotoxic substances? a. 3 to 16 weeksb. 6to9weeksc. 4to8weeksd. 3to6weekse. 7to9weeks |
a. 3 to 16 weeksThe answer is a. (LaDou, 2/e, p 380.) Susceptibility of the central nervous system extends beyond 8 weeks, contrary to most other organ development. The eyes and the ears are usually not susceptible to terato- gens. Enhanced susceptibility of the external genitalia starts at a later period than most other organs (about 7 weeks) and extends to 9 weeks. The heart is more susceptible between 3 to 6 weeks. |
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Ban of the use of PCBs for all but emergencies |
National Environmental ProtectionAct 1970 |
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Plotting height and weight on a growth chart would be considered: primary, secondary, or tertiary prevention? |
Secondary prevention: A pediatrician could modify their risk for obesity (assuming that they are overweight) |
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Plotting height and weight on a growth chart would be considered: primary, secondary, or tertiary prevention? |
Secondary prevention: A pediatrician could modify their risk for obesity (assuming that they are overweight) |
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Plotting height and weight on a growth chart would be considered: primary, secondary, or tertiary prevention? |
Secondary prevention: A pediatrician could modify their risk for obesity (assuming that they are overweight) |
