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23 Cards in this Set
- Front
- Back
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What important screening should be done for school aged and adolescents?
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h/w/bmi
vision/hearing BP lead anemia dyslipidemia urinalysis PPD scoliosis |
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What is BMI?
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wxh ^2
used from 2 yo to adulthood correlates with risk factors for CVD, dyslipidemia, elevated insulin, and high BP |
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How is BMI interpreted in children?
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age-and sex-specific percentiles.
Underweight- Less than the 5th percentile Healthy weight- 5th percentile to less than the 85th percentile Overweight - 85th to less than the 95th percentile Obese - Equal to or greater than the 95th percentile |
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How is BP assessed?
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BP at every vist
look at chart for height of percentiles with growth charts compare SBP and DBP by age and height with gender specific BP charts |
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How are BP values used to diagnose?
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nomotensive: <90%
>/= 90%, repeat at visit again prehypertensive : 90th - <95th >/= 95% may have HTN. repeat at 2 additional visits |
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How is BP managed in adolescents?
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maintain health body weight
eat healthy dont smoke exercise regularly (20 min > 3 days/wk) limit etoh/drugs antihypertensive meds same as adults |
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How is cholesterol screened?
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it is based on risk assessment during the age of 2-18 years old.
parent total cholesterol - >240 mg/dl family hx of premature CVD <55 years smoke, HTN, obesity, sedentary lifestyle? |
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What ages should cholesterol be screened?
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age 6, 8, 10, 11
12-18 annually; 19-21 (can be provided if wanted) |
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What is the acceptable range of cholesterol?
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Total cholesterol <170 mg/dl
LDL < 110 |
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Abnormal values for cholesterol?
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TC = 170-199: borderline
LDL = 110-129: borderline TC = >200 elevated LDL = >130 elvated |
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What is the recommended tx for high cholesterol?
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AAP recommends giving statin to kids as young as 8 if at risk
change is children 10+ who have weight problems only should get statin pravastatin = 8-13 yo 20 mg po daily 14-18 yo 40 mg po daily |
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How is diabetes risk assessed?
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some states requires certificate of examination.
if overweight and has any of two risk factors below: overwieght BMI > 85% rf: first/second degree relatives; ethnicity (AI, AA, hips, asian); signs of insulin resistance (HTN, dylipidemia, PCOS) |
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What factors are used to assess/diagnose metabolic syndrome?
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Any 3 out of 5!!!
waist circum: >/= 102 m, 88 w lipid levels trig >/= 150 HDL < 40 men < 50 f BP >/= 130/85 fasting glucose >100 |
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What are the physical activity recommendations?
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60 min a day
limit sedentary lifestyle |
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How does one screen for lead in this age group?
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3-6 and never tested:
blood level if live in high risk area, ask risk questions ages 3-6 and had previous lead level < 10, do risk assessment question |
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How is anemia screened?
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Hb/HCT not recommended in school aged children
screen only if history of iron deficiency anemia complete once during menstruation for girls annually if risk for adolescent girls (11-21) risk is: mode/heavy menses, chronic weight loss, nutritional deficit, athletic |
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How is TB screened?
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screen in those high risk, such as certain foreigners, shelters, high risk areas, communities or schools with high prevalence, HIV infection. immigration, exposure.
need xray to verify findings. |
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How do you screen for scoliosis?
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Complete adams test: child bends forward at waist and the examiner checks for asymmetry of posterior chest wall.
lateral progression of curve: sex (female), tanner stages (peaks tween 2 and 3), growth potential (use X-ray) lateral curvature < 30 degrees at bone maturity unlikely to progress. |
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what are the guidelines on scoliosis screenings?
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vary on the organization.
USPSTF = insuff evidence AAOS - screen in adolescence AAP - routine beginning at age 10 |
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what is the female athlete triad?
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eating disorder
amenorrhea bone loss related to high expectation |
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What is the recommended calcium for athletes?
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1300 mg /day
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What is included in the PPE history?
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opportunity fr preventative health care
type of sport extent of participation level of competition training schedule coaching and supervision preparticipation conditioning general PE musculoskeletal exam ( 2 min) CV (auscultate supine, standing, vlasave, plpate femoral pulse) hepatic or splenic enlargement |
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What are the top ten clinical pearls?
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privacy
PE (alone with teen) HEEADSSS obese risk factors pelvic exam testicular exam STIs deafness literacy and learning difficulties sickle cell and thalassemia/CBC musculoskeletal exam ( includes scoliosis, osgood schlatter, slipped capital femoral, leg length disc rep, in toeing, etc) |
