• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/172

Click to flip

172 Cards in this Set

  • Front
  • Back
  • 3rd side (hint)
How often should you check a lead level?
Age 1yo and age 2yo.
What are signs of lead poisoning?
Lead lines on long bones and basophillic stippling on CBC
What are symptoms of lead poisoning?
Headache, irritability, constipation, lethargy, microcytic anemia.
What are symptoms at lead level of 10-20 mcg/dL? What should you do?
Mild cognitive delay. Education on lead exposure, environmental control and continued monitoring.
What are symptoms at lead level > 60 mcg/dL. How should you treat?
Headaches, encephalopathy, lead lines on the gingiva and anemia.

Admit to hospital for chelation
True or False:
Lead levels are helpful in tracking chronic accumulation of lead.
False.
Lead levels are useful in tracking recent exposure to lead, not for chronic accumulation.
True or False:
A fingerstick is sufficient for screening purposes of lead levels.
False. A fingerstick can be used for initial test, but no action can be taken based on this. You must confirm with venous blood level, FEP, abdominal film and x-ray of long bones.
How often do you give DTaP?
2, 4, 6, 15 months and just before kindergarten. The 4th dose can be given at 12 mos if 6 months have elapsed since the 3rd dose was given.
After what age do you not give DTaP?
Age 7yo
A 12 yo comes in for a well visit. You have known her since birth and know that she completed her entire DTaP cycle at age 6yo. What immunization is she due for now?
Tdap
A 16yo boy comes in for his well visit. He had completed his DTaP at age 5yo, but at age 13yo he received Td in the ED after an injury while helping his dad build their jungle gym. When should he receive his Tdap booster?
A) now
B) in 6 months from now
C) in 1 year from now
D) in 2 year from now
E) never, he does not need it, since he got Td.
D. You must wait five years from receiving Td until you receive Tdap.
What are the circumstances that allow you to give Tdap within 18 months of receiving Td.
A pertussis outbreak
Close direct contact with pertussis (household or residential)
Underlying neurologic, muscular, cardiac or pulmonary disease
What is the MCV4 vaccine?
Meningococcal vaccine.
When should MCV4 be given?
At the same time as Tdap or at least 1 month before or after Tdap
A 13yo girl was climbing on a tree and fell, scratching herself on an old rusty nail that her brother had left in the tree when he was hanging a swing off of it.

She comes to the ED. Which immunization should she receive?
What if she has not completed her normal set of vaccines?
Tdap if she has not received Tdap before, or Td is not available or if she received Tdap previously. If she has not completed her normal set of vaccines, she should also receive tetanus immune globulin.
A 7yo child is adopted from Sudan, she has not received any immunizations. What should she receive?

What if she were 10yo or older?
3 doses of Td (2nd dose after 4 weeks of 1st dose and 3rd dose 6 months after 2nd dose.)

She could receive Tdap for one of the doses, so that would count as her adolescent booster.
What should you do if a patient younger than 7yo receives Tdap instead of DTaP during one of the first three doses?
Inform the family of the error, and give DTaP on the same day and resume schedule.
What do you do if a child younger than age 7yo receives Tdap instead of DTaP for the fourth dose?

What about for the fifth dose?
Continue normal schedule and use DTaP for 5th dose.

Continue as usual for adolescent schedule
What are the contraindications to giving Tdap?
Severe allergy. Send to allergist for desensitization.

Encephalopathy within 7 days of DTaP
What do you for the adolescent immunization in a child with past history of encephalopathy within a week of DTaP?
Give Td instead
A 10yo child presents to you after cutting herself on a rusty metal ledge. You advise the family that you she will need tetanus vaccination. The family is concerned because after her last DTaP at age 5yo, she had Guillane Barre Syndrome. What do you do?
Give Tdap instead of Td.
An 8yo autistic child is brought to the ED after stepping on a rusty nail that has penetrated his shoe. The parents do not want immunization but the wound looks dirty, and you feel he needs tetanus vaccination. What do you do?
Give Td, because the pertussis part is likely the most concerning regarding autism.
A 7yo is diagnosed with pertussis. He has a 9yo autistic brother. What do you give for secondary prevention to the brother?
Tdap. Although the pertussis is concern, this patient is in a high risk situation. Tdap is not as concerning as DTaP.
A 16yo is brought to the ED after injuring himself while repairing his motorcycle. He would normally require Tdap because he when he was 10yo they gave him Td, but never Tdap. The family is concerned because when he did receive Td, he developed limb swelling. What do you do?
Give Tdap anyway.
Can you give Tdap to a pregnant teenager?

When?
Yes

2nd or 3rd trimester
Can you give Tdap to immunocompromised kids?
Yes
Can you give Tdap to a child with well-controlled seizure disorder?
Yes
A 14yo teenager comes in for well visit. He is due for Tdap, but his mom asks whether he really needs the pertussis part because he just had pertussis last winter. What do you say?
Yes he still needs Tdap.
For which two diseases has the HiB vaccine made the greatest risk reduction?
Epiglottitis and Meningitis
At what three stages are kids at greatest risk of Hepatitis B?
Intrapartum
Day Care
Adolescence (Sex and IV drugs)
What is the worst outcome of hep B?
Carcinoma
When do you normally give Hep B vaccine?
Birth, 2 mos, 6-18 months after 2nd dose.
A teenager is applying to be a volunteer in the hospital. She has never been immunized for Hep B. What series does she follow?
Now, then 2 months, then 6-18 months
A 16yo pregnant woman who has history of SLE and had an anaphylactic reaction to Hep B vaccine at age 2 months would like to be vaccinated for Hep B. What do you do?
A) Give the vaccine series as usual
B) Give only the final dose
C) Don't give it because she is pregnant
D) Don't give because she had allergic reaction in the past
E) Don't give because she has SLE
D
What are the age restrictions for the DTaP, Hep B, IPV combination vaccine?
After age 7yo
Before age 6weeks
A baby received a monovalent Hep B vaccine at birth. She has been getting the combo vaccine for DTaP and IPV and has now received a total of 3 HepB, 2 DTaP, 2 IPV. Her mom would like to spare her from extra shots, but this would mean a 4th Hep B. Is this okay?
Yes.
Which strains does MCV4 cover?
A, C, Y, W-135
Which is the most common strain of N. Meningitides that causes meningitis in infants?
B
It's Bad and most common in Babies
Which healthy kids should get MCV4?
1) All kids before age 15yo or before high school, whichever is first

2) Kids entering college dormitory
Can kids with HIV get the MCV4?
Yes, but they must be 2yrs old or older
Who are "at risk" kids who should get MCV4?
1) Kids with terminal complement deficiency
2) Kids with asplenia
3) Kids who are traveling to endemic areas
An 16yo is starting college. She received MPSV4 at age 11yo. Should she get MCV4?
Yes. Anyone who is still at risk should get MCV4 if it has been 3 or more years since receiving MPSV4.
How is MCV4 given? IM or IV or PO or SQ

What about MPSV4?
MCV4 is given IM and MPSV4 is given SQ
Who should receive HPV vaccine?
All girls between ages 11-18.
The mother of a 9yo girl is afraid her daughter may be engaging in sexual activity. She would like her daughter to receive the HPV vaccine in lieu of constantly having to take her to the doctor for cervical screening. What do you tell the mother?
You can give the HPV series, but this does not mean she will not require cervical screening. That should continue per the usual schedule.
What is the HPV schedule?
1st dose, then 2nd dose 2 months later, then 3rd dose 4 months later.

0-2-6
When do you give MMR?
At 12-15 mos, then booster before school ideally otherwise anytime after 1 month of first dose and before age 12yo.
I received booster at age 11yo
A 7 month old is brought to your office after being exposed to measles 2 days ago. What do you do?

What if it were 5 days ago?
If within 72 hours, give MMR vaccine.

If greater than 72 hours but less than 6 days, give measles IG, then WAIT 5-6 months before giving MMR.
Passive immunity blocks active immunity
A 1yo was just in your office ten days ago and now returns with fever and rash. The mother is irate and insists that her child is scarred for life. What do you do?
A) Call a psychiatrist for the mother
B) Stop all immunizations of that batch of MMR and send it back to the company.
C) Try to reassure the mother
D) Fire the tech who administered the shot
E) Treat the child for measles
C
Which are contraindications of MMR?

1) Severe Allergy
2) Positive TB skin test
3) Concurrent TB skin test
4) Breast Feeding
5) Pregnancy
6) Pregnancy in the mother or other close contact
7) Immunocompromised
8) Egg allergy
9) Immunodeficiency of relative or household member
10) Asymptomatic HIV
Pregnancy
Immunocompromised
Severe allergy
A child recently had MMR vaccine and needs to have TB skin test as well, but because the MMR was administered on Thursday and the clinic is closed on the weekend, the TB skin test was postponed. How long must the child wait before having the TB skin test?
4-6 weeks after the MMR
A 4yo test positive by PPD. It is confirmed by x-ray and she has positive sputum AFB as well. She has not received her MMR yet. When should she receive her MMR?
You should first start treatment of TB, then give MMR
True or False: MMR and Varicella can not be given together as they are both live vaccines.
False. Both can be given together between 12-15 months.
A 16yo who has not been immunized comes in for her MMR vaccine. She receives the vaccine without complication, but later finds out that she is 2 months pregnant. She is quite upset and anxious and wondering if she needs to have an abortion because of the vaccines effects on her unborn child. What do you tell her?
Reassure her that she does not need a therapeutic abortion.
A 2yo is brought in by her father. Her mother declined vaccination because of the child's known allergy to eggs. The father would like to have the child vaccinated. What would you advise, given the child's egg allergy?
A) Give the MMR
B) Don't give the MMR
C) Do a skin test to assess for allergy to MMR
D) Check if the parents are allergic to the MMR
E) Premedicate with benadryl and zantac, then give the MMR
A) Give the MMR.
The 7yo daughter of the ambassador to China is brought in by her nanny for immunizations. You have given the Hep A, but just as the tech is about to pull the yellow fever and influenzae vaccines, you are told that the child has an egg allergy. What do you do?
A) Give both yellow fever and influenzae vaccines
B) Give yellow fever vaccine only
C) Give influenzae vaccine only
D) Give neither vaccine
E) Premedicate with benadryl and zantac and give both vaccines
D) Give neither vaccine
A 6yo who is allergic to eggs is brought to your office. She is due to get the influennzae vaccine, but you tell her mother that she can not have the flu vaccine. Her mother asks you for an alternative. What can you offer her?
Chemoprophylaxis
Who should receive Prevnar (7 strain pneumococcal vaccine)?
All kids between 2-23 months

Give at 2, 4, 6, and 12 months
Same schedule as DTaP
Who should get the PPV-23 vaccine?
All kids over age 2 who have a chronic illness or asplenia
What is the contraindication to pneumococcal vaccination?
Systemic allergy to vaccine component
When should you give the new Rotavirus vaccine?
2, 4, 6, months of age
True or False: You should not give the first Rotavirus dose after 12 weeks of age.
True, but if given after 12 weeks go ahead and complete the series such that you are done by 32 weeks at latest.
Two twins are brought to the ER because of diarrhea. The sister has mild diarrhea and tolerating po well. The brother has 7-8 stools per day and tolerating po but appearing dehydrated. The father would like the kids to have the Rotavirus vaccine. What do you suggest?
A) Give both kids the vaccine
B) Give the sister the vaccine
C) Give the brother the vaccine
D) Give neither the vaccine
B. Kids with moderate to severe diarrhea should wait until diarrhea improves before receiving rotavirus vaccine
A 4 month old is given the oral rotavirus vaccine, but spits much of it up. Does she need redosing?
No.
A child is brought in for well visit. You would like to give the rotavirus vaccine, but the mom is concerned because her pregnant sister is visiting with her son who has sickle cell disease. What do you advise?
A) You can't give rota vaccine because of the pregnant aunt.
B) You can't gibe rota vaccine because of the sickle cell cousin
C) A and B
D) Give the vaccine
D
Who should get the Varicella vaccine and when?
Give between 12 and 18 months of age to all kids unless they have had chicken pox.
A 15yo is upset because her parents never had her immunized. She would like to have the varicella vaccine today. How would you dose this?
Give the second dose 1 month after the first.

0-1
A woman comes to your office with her two kids aged 10 and 14. Neither have had chicken pox or the vaccine and she would like them both to have it. What would be the administration schedule?
Both kids two vaccines one month apart.
0-1
What are contraindications to the varicella vaccine?
Pregnancy
Immunocompromised
Prior allergy to the vaccine
There are 3
A 1yo child who is HIV positive but growing well and without any AIDS defining illnesses, is due for MMR and Varicella. Do you give them?
A) Measles only
B) Varicella only
C) Give both
D) Give neither
A. Measles: Yes, as long as child has no major symptoms.
Varicella: NO
Can you give chicken pox vaccine to a child who is in remission from ALL?
Yes. There is a special type.
A father brings his 15 month old in for varicella vaccination. The patient's mother is pregnant and the patient's older sister has ALL. The neighbor has chicken pox right now. What would prevent you from giving the vaccine?
A) Mom is pregnant
B) Sister has ALL
C) Neighbor has chicken pox
D) Give the vaccine
D.
Who needs the Hepatitis A vaccine and when?
All kids at age 1 and it is given in 2 doses 6 months apart.
What are the contraindications to Hep A vaccine?
Allergy to aluminum hydroxide or phenoxyethanol, the components of the Hep A vaccine
Who should get the flu vaccine?
1)All kids between 6 months and 60 months (that's age 5yo)
2) Caregivers of kids in this group
3) CAPE kids
Chronic metabolic disorders
Cardiac kids
Asthma
Acquired immunosuppressed kids
Pulmonary kids
Empty Bladder (Renal kids)
Sickle kids
Kids requiring aspirin
Which of the following kids does NOT require the flu vaccine?
A) A child with JRA
B) A child with Addison's Disease
C) A child with history of BPD
D) A child with an asymptomatic heart murmer
E) A child with history of Kawasaki
D. The JRA and Addison's kids need steroids, leaving them immunosuppressed. The BPD has probable long standing pulmonary issues. The Kawasaki kid needs long term aspirin.
CAAAPERS
When does the mother of a BPD baby need to receive the flu vaccine?
Before the baby is 6 month's old.
At what age do you first screen for hypertension?
Age 3
What is the definition of hypertension in pediatrics?
Greater than the 95th percentile for age and gender and taken on three occasions one month apart.
You are seeing a 7yo boy who has elevated blood pressure. What is your 1st step in management?
A) U/A with culture
B) Repeat the blood pressure in a month.
C) Repeat the blood pressure in one month and again in another month
D) Check urine for protein
E) Order a renal ultrasound
F) Check parent's blood pressure
C
Why is newborn hemoglobin/hematocrit so high (19mg/dL and 61% respectively ?
Because the womb is relatively hypoxic. Fetal hemoglobin helps in that it holds on tighter to oxygen, but it in order to accommodate for the low ambient oxygen, there is increased hemoglobin/hct
What is physiologic anemia of the newborn?
Because the external air has much more oxygen than intrauterine air, as adult hemoglobin increases the overall hgb/hct falls down to a nadir of about 9-11 at around 9-12 weeks after birth.
Which of the following causes the most severe degree of conductive hearing loss?
A) Atresia of the ear canal
B) Otitis media
C) Otitis media with effusion
D) Otitis externa
E) Heavy metal concert
A
Which of the following is the most common cause of conductive hearing loss?
A) Atresia of the ear canal
B) Otitis media
C) Otitis media with effusion
D) Otitis externa
E) Heavy metal concert
C
What is a cholesteaoma?
A benign growth in the middle ear that may result in recurrent discharge and also in conductive hearing loss. It may be congenital or acquired.
True or False:
Cholesteatoma often presents without any hearing loss.
True
True or False:
Tympanosclerosis is almost always associated with hearing loss.
False
What is tympanosclerosis?
Submucosal collagenesis and hyalinization, and finally calcification and occassionally ossification as a result of chronic otitis media
True or False:
All children should have a screening cholesterol level prior to age 15yo.
False. There are no universal recommendations for screening cholesterol in pediatrics.
An 8yo child presents to your office with her father. He is concerned because his doctor just informed him that his cholesterol level was 280. Neither the child, nor the parents are diabetic, and the child is in the 50th percentile for weight and 50th for height. What diagnostics steps should you do and why?
Because parent LDL is >240, check a non fasting cholesterol level in the child. If it is >or = to 170, get a fasting LDL
You have screened an 8yo girl for high cholesterol what would your management be in each of the following circumstances?
1) LDL > 130
2) LDL > 190
1) Diet and exercise

2) Diet and exercise and medications
You are treating an 8yo girl for elevated cholesterol. Her initial cholesterol level was 170, so you advised diet and exercise. It is now 8 weeks later and her current LDL is 165. You also come to find out that her father's brother suffered an MI at age 50. What is your next step?
Start anti-lipid medications
A 15yo presents to your office. Her father recently passed away at age 49 of an MI. Which of the following are most important to address to lower her risk for MI? (Pick two)
Hypertension
Cigarette smoking
Elevated cholesterol level
Low HDL
High LDL
Physical inactivity
Inactivity and cigarettes
Which of the following is not a risk factor for hypercholesterolemia?
Steroid medications
Anticonvulsants
Beta blockers
Alcohol
Anorexia Nervosa
Hypothyroidism
Bulemia
Bulemia
Which of the following would be appropriate to screen for hypercholesterolemia?
A) A child whose mother has a cholesterol level of 230 at age 32
B) A child whose grandfather who had an MI at age 63yo
C) A child whose uncle had angina at age 55yo
D) A child whose uncle has a cholesterol level of 600
E) A chain smoking 16yo whose only activity is pushing the buttons on his gameboy
E. The first or second degree relative's age must be less than 55. The parent's cholesterol must be greater than 240.
A 1yo child has a finger stick to check his hemoglobin, lead level, and screen for polycythemia. His results came back positive for polycythemia. What is your next step?
Recheck with venous sample.
Which of the following polycythemic patients are at risk for hyperviscosity syndrome?
A) A child who received twin-twin transfusion.
B) A child who had delayed clamping of the umbilical cord
C) A child with Down Syndrome
D) An infant of a diabetic mother
E) All of the above.
E.
Which of the following is not a complication of polycythemia?
A) hyperglycemia
B) hypoglycemia
C) hyperbilirubinemia
D) hyperviscosity
A
RBCs take up all the rooms.
What is ambylopia?
loss of visual acuity due to active cortical suppression of the vision of one eye
What is deprivation amblyopia?
ambylopia due to ptosis, congenital cataract or extended eye closure
What is esotropia?
inward turning of the eye
What is exotropia?
Outward turning of the eye
What is esophoria?
The tendency of the eye to turn inwards during cover/uncover test
phoria = to like
What is hyperopia?
Eye alignment is difficult when significant focusing effort is required.
Look for a 3 year old.
A 3yo child is brought in for a well visit test. You cover one eye and note that the other one turns outward. What is your diagnosis?
Exotropia
A 3yo child is brought in for a well visit test. You cover one eye and note that the other one turns inward. What is your diagnosis?
Esotropia
A 3yo child is sitting for the cover test. He does fine when you cover his left eye, but fights you when you attempt to cover his right eye. Which eye is likely abnormal?
Left
A 4yo child is brought in by her mother because her mother is concerned that the child keeps running into things, and constantly spilling things. The motor and fine motor skills on exam are normal, but you do find some abnormality on vision exam. What is your most likely diagnosis?
Cataract
How do you screen for cataracts in the newborn?
Red reflex exam
What is optokinetic nystagmus?

When is this present?
The ability to see a moving target, follow it and then return to original gaze.

At birth
When is a child able to visually fixate on an object?
Age 6 weeks
When can a child see in color?
2 months of age
Binocular vision with convergence ability develops at what age?
3 months of age
By what age do kids begin preferring faces and patterns?
4 months of age
What is the visual acuity of a 1 month old?
20/200 to 20/400
A child comes in for pre-kindergarten PPD screening. The induration is 9mm. In which of the following scenerios is this not concerning?
A) Prior TB vaccine
B) Close contact with TB
C) Positive x-ray
D) Patient has HIV
E) Patient is on chronic steroids
A. The only situations in which induration less than 11mm is concerning are: close contact with TB, positive x-ray or immunocompromised patient
A mother who is positive for TB on x-ray delivers a neonate whose x-ray is normal. What do you do for the neonate?
Treat with INH.
A mother who is positive for TB on x-ray delivers a neonate whose x-ray is positive for TB also. What do you do for the neonate?
Treat with triple therapy.
A mother who has a positive PPD but negative CXR delivers a neonate whose PPD is positive but CXR is negative. What do you do for the neonate?
Treat with INH
A mother who has a positive PPD but negative CXR delivers a neonate whose PPD is positive and CXR is positive for TB. What do you do for the neonate?
Treat with triple therapy.
A 4yo girl is diagnosed with meningitis. Who does not need prophylaxis?
A) Her parent and siblings
B) The triage nurse
C) Other kids in the day care
D) The preschool teacher
E) Her nanny
B. Essentially household contacts and Daycare contacts need prophylaxis
A 7yo has meningitis. Do all the kids in her second grade class need prophylaxis?
No. Daycare contacts need prophylaxis, but school contacts do not.
A 4yo who recently immigrated from India. She did not receive prior immunizations. She is diagnosed with H. flu epiglotitis. Who needs prophylaxis?
All household contacts
A physician is exposed by respiratory contact to a patient who has active TB. What prophylaxis, if any, should he receive?
9 months of INH
A patient has positive ppd, but negative x-ray findings. What do you treat the patient with? What do you treat the household contacts with?
9 months of INH for the patient. 3 months of INH.
A patient appears to have TB on x-ray, but acid fast test of sputum is negative. What do you treat this patient with?
Nothing.
A patient returns from India with abdominal cramping. He is diagnosed with Hep A. Who needs prophylactic treatment and with what do you treat?
IgG should be given to household and sexual contacts.
A parent is trying to help with drawing blood from his infant. The nurse accidentally is stuck with the "dirty" needle. What do you treat him with?
HBIG and Hep B series
A neonate is born to a hep b positive mom, what should the neonate receive with regards to hep B prophylaxis?
HBIG and HepB series
A resident is acidentally stuck with a "dirty" needle. She had completed her vaccination series prior to starting work. What should you do?
A) Nothing
B) Check her hep B titers to insure surface antibody is positive, if it is, do nothing
C) Give her hep B series again
D) Give her hep B booster dose
E) Give her hep BIg
B
A resident is acidentally stuck with a "dirty" needle. She had completed her vaccination series prior to starting work, but her surface antibody is negative. What should you do?
A) Nothing
B) Give her hep B series and BIg
C) Give her hep B series again
D) Give her hep B booster dose
E) Give her hep BIg
B
A resident is acidentally stuck with a "dirty" needle. She is not sure she completed her vaccination series prior to starting work because she transferred in from another hospital. What should you do?
Check her hep B titers to insure surface antibody is positive, if it is, do nothing, if it is negative, give HBIG and Hep B series
What are the most common childhood burns?
A) Smoke inhalation
B) Hot iron burn
C) Electrical burn
D) Hot liquid burn
E) Gas stove burn
D
A child is brought in by the babysitter with a well demarcated burn of the entire left hand ending at the wrist. What do you suspect?
Abuse.
When should you discuss "baby-proofing" the house?
At the 6 month well visit. Before the child is mobile.
Which of the following consequences is unique to UVA?
A)Drug induced photosensitivity
B) Skin aging
C) Sunburn
D) Skin Cancer
A
When is the highest risk of UVA exposure?
All day
When is the highest UVB exposure?
10am to 5pm
Boys like to bask during the day.
True or False:
80% of sun exposure occurs in the first 2 decades of life.
True
True or False:
Using sunscreen in the first two decades of life reduces the risk of skin cancer by 20%
False. It reduces it by 80%
True or False:
You should always use sunscreen of spf 30.
False. You should use spf 15
True or False:
Physical sunscreens are effective for UVA and UVB.
True
True or False:
Applying less than the optimal amounts of sunscreen will reduce the SPF rating
True
True or False
You should apply sunscreen 10 minutes before sun exposure.
False. It should be applied 20 minutes before.
A couple has their first child and wants to know how long their infant needs to be facing the rear in her infant car seat. What do you suggest?
Until the child is at least 20 lbs, she should be in an infant seat facing the rear.
A couple comes in with their 6 month old child. She weighs 23lbs today. What can you advise about her car seat today?
She can use a convertible car seat and face forward.
A couple brings their 4 year old child for a well visit. They would like to know if they can switch her to a booster seat because they are about to have another child and would like to use the car seat for their second child. The 4 year-old weighs 35 pounds. What do you advise?
No. The 4 year-old can not use the booster because while she meets the age requirement, she also needs to weigh at least 40 pounds.
A 7 year old has been fighting with his mom because he no longer wants to sit in the booster seat and wants to it in the front seat. The mom has promised that if you, the pediatrician, say it is okay, then he can sit in the front. The child weighs 70 pounds. What do you advise?
Because he is 60-80 pounds, he can sit without a booster, but only in the backseat and with a seatbelt.
Can a 90pound 11yo sit in the front passenger seat?
No he or she must be at least 12 years old, regardless of weight.
At what angle should you position an infant car seat?
45 degrees
Which of the following facts about bicycles is correct?
A) Helmets resduce serious injury by 65%
B) 25% of bike injuries are due to head injuries
C) Reflectors reduce bike injuries by 30%
D) All bikes must have reflectors on them
D. When looking at answer choices where all but one have a specific percentage, consider the one that does not, even if it seems illogical.
Which of the following is false?
A) Most bicycle deaths and injuries occur in kids younger than 15yo
B) Bicycle helmets are worn by less than 10% of kids riding bikes
C) Helmets reduce serious injury by 75%
D) 75% of deaths related to bikes are because of head injuries
E) Reflectors are required on pedals, tire walls, or rims, front and rear of bike
C. Helmets protect by 85%
True or False:
Guns are present in 50% of US households.
True
True or False:
More than 90% of sucide attempts with a gun are fatal.
True
True or False:
More than 75% of adolescent homicides are due to guns
True
True or False:
Having a gun in the home doubles the risk of adolescent suicide
False. It increases it by 5 fold.
True or False:
Handguns can be safely kept in the home as long as a trigger lock is properly in place.
False.
Which of the following people is at highest risk of suicide.
A) A 16yo orphan
B) A 14yo with cancer
C) A 17yo homosexual
D) A 12yo child of a single mom
E) A 12yo child of a single dad
C.
True or False: The AAP recommends a 3 sided fence with around all swimming pools.
False. They recommend a 4 sided fence with a lock.
Determine whether each of the following statements are true or false.
A) Infants are most likely to drown in a bathtub
B) Children younger than age 5yo are most likely to drown in a residential pool
C) Adolescents are most likely to drown in fresh water.
D) Above ground pools are less likely to cause drowning
E) Drowning is higher among african american males
F) Drowning is the most common cause of death in kids with epilepsy
G) Males account for 75% of drowning
H) Ratio of near drowning to drowning is 1:1
All are true.
True or False:
Children tend to lose 1 month of linear grown for every 3 months in an orphanage.
True
What growth marker should you base the milestones of an adopted child?
Linear growth
Can the typical features of fetal alcohol syndrome be used to quantify risk in international adoptees?
No.
A potential international adoptee seems to have microcephaly. What 2 types of abnormalities should you consider?
FAS or perinatal brain injury.
True or False:
25% of LBW infants are due to smoking during pregnancy.
True
Second hand smoke is shown to increase all the following except:
A) SIDS
B) Cancer
C) Otitis Media
D) Asthma
E) Bronchiolitis
F) Pneumonia
B. Cancer
A 15yo with a 5 pack-year smoking history comes to you seeking help with smoking cessation. He has tried to quit on his own and not succeeded, but he says he is determined and his mother and father are also supportive in his efforts to quit. What do you offer?
Nicotine replacement
A 17yo with a 5 pack-year smoking history comes to you seeking help with smoking cessation. He has tried to nicotine replacement and not succeeded, but he says he is determined and his mother and father are also supportive in his efforts to quit. What do you offer?
Buproprion with counseling.
What is the best vision screening test for a preschooler?
Tumbling E or Snellen test. The cover test is good for testing for strabismus, but not a good initial screening test.
A 10year old boy has a reading disability. What would you advise to help this child?
A) specialized optho appt
B) audio books
C) grade retention
D) more reading homework
E) private school
B) audio books. the optho appointment is a possible answer, but not the best answer.
True or False:
Children may be diagnosed with ADHD if the level of inattention and activity is greater than that expected for their MENTAL age as determined by IQ.
True. For example, if a 10-year-old boy has an intelligence quotient of 60, he would be expected to have the attention span and activity level of a 6-year-old.
What is the mechanism of action of prevnar vs. the 23 valent pneumococcal vaccine?
prevnar uses both T and B cells, so it is more effective. This is similar to all childhood vaccines.