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Questions and Answers
What is the primary purpose of a DEXA scan?
What is the primary purpose of a DEXA scan?
What is a common treatment option for a cystocele if surgery is not recommended?
What is a common treatment option for a cystocele if surgery is not recommended?
Which symptom is characteristic of primary syphilis?
Which symptom is characteristic of primary syphilis?
When should women under 65 be screened for osteoporosis with a DEXA scan?
When should women under 65 be screened for osteoporosis with a DEXA scan?
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Which vitamin is essential in food sources such as dairy products and eggs for preventing deficiencies during pregnancy?
Which vitamin is essential in food sources such as dairy products and eggs for preventing deficiencies during pregnancy?
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Which of the following is an example of tertiary prevention in healthcare?
Which of the following is an example of tertiary prevention in healthcare?
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At which Tanner stage does puberty typically begin?
At which Tanner stage does puberty typically begin?
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What is a key characteristic of iron deficiency anemia in children?
What is a key characteristic of iron deficiency anemia in children?
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What common condition is associated with secondary amenorrhea?
What common condition is associated with secondary amenorrhea?
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When do luteinizing hormone and follicle-stimulating hormone levels peak in the menstrual cycle?
When do luteinizing hormone and follicle-stimulating hormone levels peak in the menstrual cycle?
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In relation to lead poisoning in children, which group is at higher risk?
In relation to lead poisoning in children, which group is at higher risk?
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What is the recommended iron supplement dosage for children experiencing anemia?
What is the recommended iron supplement dosage for children experiencing anemia?
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Which sexually transmitted disease is known to require partner treatment?
Which sexually transmitted disease is known to require partner treatment?
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What is the recommended method for taking iron supplements for optimal absorption?
What is the recommended method for taking iron supplements for optimal absorption?
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What should be avoided when taking iron supplements to reduce the risk of decreased absorption?
What should be avoided when taking iron supplements to reduce the risk of decreased absorption?
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What is a common side effect associated with the use of the progestin-based Depo-Provera injection?
What is a common side effect associated with the use of the progestin-based Depo-Provera injection?
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Which strain of HPV is considered high risk for cervical cancer?
Which strain of HPV is considered high risk for cervical cancer?
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In lactating mothers, which dietary change is encouraged for better nutrition?
In lactating mothers, which dietary change is encouraged for better nutrition?
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What often accompanies oligomenorrhea in individuals with Polycystic Ovarian Syndrome?
What often accompanies oligomenorrhea in individuals with Polycystic Ovarian Syndrome?
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What is the primary cause of hirsutism in Polycystic Ovarian Syndrome?
What is the primary cause of hirsutism in Polycystic Ovarian Syndrome?
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What is the advised method to administer iron drops to infants and young children to reduce tooth staining?
What is the advised method to administer iron drops to infants and young children to reduce tooth staining?
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What characterizes the latent stage of a condition?
What characterizes the latent stage of a condition?
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Which outcomes can occur during the tertiary stage of a condition?
Which outcomes can occur during the tertiary stage of a condition?
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At what age does Tanner stage 2 typically begin for females?
At what age does Tanner stage 2 typically begin for females?
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What is the first visible sign of puberty in females according to Tanner staging?
What is the first visible sign of puberty in females according to Tanner staging?
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What can vary in the duration during the latent period?
What can vary in the duration during the latent period?
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What is the most common genetic condition related to an autosomal trisomy?
What is the most common genetic condition related to an autosomal trisomy?
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Which of the following is NOT considered a core focus of anticipatory guidance during childhood wellness exams?
Which of the following is NOT considered a core focus of anticipatory guidance during childhood wellness exams?
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What percentage of children are reported to be obese?
What percentage of children are reported to be obese?
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Which eating disorder is characterized by binge-eating followed by inappropriate compensatory behaviors?
Which eating disorder is characterized by binge-eating followed by inappropriate compensatory behaviors?
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What is a common risk factor for substance use disorder in adolescents?
What is a common risk factor for substance use disorder in adolescents?
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What is the recommended type of car seat for infants until they are at least two years old?
What is the recommended type of car seat for infants until they are at least two years old?
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Which substance is most commonly used by adolescents according to prevalence rates by the end of 12th grade?
Which substance is most commonly used by adolescents according to prevalence rates by the end of 12th grade?
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What characterization describes anorexia nervosa?
What characterization describes anorexia nervosa?
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What condition is indicated by weakened tissues causing the rectum to sag onto the vaginal wall?
What condition is indicated by weakened tissues causing the rectum to sag onto the vaginal wall?
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Which of the following symptoms is associated with secondary syphilis?
Which of the following symptoms is associated with secondary syphilis?
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Which group of women is recommended for osteoporosis screening using a DEXA scan?
Which group of women is recommended for osteoporosis screening using a DEXA scan?
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What is commonly used to support women experiencing a cystocele when surgery is not recommended?
What is commonly used to support women experiencing a cystocele when surgery is not recommended?
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Which nutrient is crucial during pregnancy and is found in dark green vegetables and dairy products?
Which nutrient is crucial during pregnancy and is found in dark green vegetables and dairy products?
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What characterizes the latent stage of a condition?
What characterizes the latent stage of a condition?
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Which outcomes can occur during the tertiary stage of a condition?
Which outcomes can occur during the tertiary stage of a condition?
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What is the duration range for the tertiary stage of a condition?
What is the duration range for the tertiary stage of a condition?
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At what Tanner stage do females first start showing the physical signs of puberty?
At what Tanner stage do females first start showing the physical signs of puberty?
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In females, what is the first visible sign of puberty during Tanner staging?
In females, what is the first visible sign of puberty during Tanner staging?
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What is the main objective of tertiary care in healthcare?
What is the main objective of tertiary care in healthcare?
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What is the required daily iron intake for adults experiencing iron deficiency anemia?
What is the required daily iron intake for adults experiencing iron deficiency anemia?
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At which Tanner stage is puberty typically expected to occur?
At which Tanner stage is puberty typically expected to occur?
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Which condition can lead to secondary amenorrhea?
Which condition can lead to secondary amenorrhea?
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When does a patient typically experience premenstrual syndrome in relation to her menstrual cycle?
When does a patient typically experience premenstrual syndrome in relation to her menstrual cycle?
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What is a common feature of iron deficiency anemia as it relates to blood cell characteristics?
What is a common feature of iron deficiency anemia as it relates to blood cell characteristics?
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Which sexually transmitted disease requires treating the partner as part of its management?
Which sexually transmitted disease requires treating the partner as part of its management?
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What is considered a key element of primary prevention in pediatrics?
What is considered a key element of primary prevention in pediatrics?
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What measure is most effective in preventing infants from falling off high surfaces?
What measure is most effective in preventing infants from falling off high surfaces?
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Which of the following statements about bicycle safety for young children is true?
Which of the following statements about bicycle safety for young children is true?
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What is the recommended maximum temperature for water heaters to prevent scald burns in children?
What is the recommended maximum temperature for water heaters to prevent scald burns in children?
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Which of the following actions is NOT recommended for preventing choking hazards in young children?
Which of the following actions is NOT recommended for preventing choking hazards in young children?
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Which safety measure helps decrease the risk of injury from falls in young children at home?
Which safety measure helps decrease the risk of injury from falls in young children at home?
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What is one of the primary characteristics of bulimia nervosa?
What is one of the primary characteristics of bulimia nervosa?
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Which immunization strategy is recommended for newborns?
Which immunization strategy is recommended for newborns?
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Which of the following statements about injury prevention in infants is accurate?
Which of the following statements about injury prevention in infants is accurate?
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What is a common consequence associated with overweight and obesity in children?
What is a common consequence associated with overweight and obesity in children?
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Which factor does NOT contribute to the risk of substance use disorder in adolescents?
Which factor does NOT contribute to the risk of substance use disorder in adolescents?
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In newborn screenings, which of the following conditions is typically NOT screened?
In newborn screenings, which of the following conditions is typically NOT screened?
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What constitutes a significant challenge for children with Down syndrome?
What constitutes a significant challenge for children with Down syndrome?
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Which dietary recommendation is made for children regarding juice consumption?
Which dietary recommendation is made for children regarding juice consumption?
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Study Notes
Pediatrics
- Primary prevention: Immunizations, education, nutrition, exercise, weight control
- Secondary prevention: Screening for conditions like cancer, type 2 diabetes, hypertension. Referral to specialist.
- Tertiary prevention: Treatment to prevent further sequelae of diseases.
- Pediatric immunizations: Refer to CDC schedule for recommendations on vaccines like Hep B, Tdap.
- Tanner stages of development: Puberty typically occurs during Tanner stage III.
- Common pediatric milestones: Refer to the Bright Futures - Pocket Guide.
- Lead poisoning in children: Be aware of high-prevalence areas and Medicaid patients.
Common Sexually Transmitted Diseases and Treatment
- Gonorrhea: Treat with antibiotics. Treat the partner to prevent re-infection.
- Chlamydia: Treat with antibiotics. Treat the partner to prevent re-infection.
- Herpes: Antiviral medications for management. Treat the partner to prevent re-infection.
- Syphilis: Treat with penicillin. Treat the partner to prevent re-infection.
- Genital warts: Treatments include topical medications and cryotherapy. Treat the partner to prevent re-infection.
- Trichomonas: Treat with antibiotics. Treat the partner to prevent re-infection.
Menstrual Cycle
- Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) peak: During ovulation, typically around day 14 of the menstrual cycle.
- Ovulation: Occurs when the mature egg is released from the ovary.
- Premenstrual Syndrome (PMS): Occurs in the days or weeks leading up to menstruation. Symptoms include mood swings, bloating, and breast tenderness.
Amenorrhea
- Primary amenorrhea: The absence of menstruation by age 15.
- Secondary amenorrhea: The absence of menstruation for 3 months or more in a woman who previously had regular periods.
Iron Deficiency Anemia
- Causes: Low iron intake, inefficient iron absorption, or chronic blood loss.
- Symptoms: Fatigue, weakness, shortness of breath, pale skin, and headaches.
- Treatment: Iron supplements.
- Iron supplement tips: Take 1-2 hours before meals on an empty stomach. Take with meals if GI upset occurs. Do not take with antacids, tetracycline, or dairy products. Bowel movements will be dark in color. Keep out of reach of children. Place iron drops in the back of the mouth to reduce staining of teeth in infants and young children. Vitamin C enhances iron absorption.
Contraception
- Breastfeeding: Minipill (progesterone-only pills) are safe for breastfeeding mothers.
- Smoking: Smoking significantly increases the risk of blood clots and other complications from combined hormonal contraceptives.
- Postpartum: Progesterone-only contraceptive methods are generally recommended for new mothers.
Depo-Provera (Medroxyprogesterone Acetate)
- Common side effects: Irregular or no periods, bone thinning, weight gain, delayed ovulation, injection site reactions, depression.
Pap Smear Reports
- ASCUS: Atypical squamous cells of undetermined significance.
- LSIL: Low-grade squamous intraepithelial lesion: Indicative of mild dysplasia.
- High-risk HPV strains: HPV 16, 18, 31, 33, and 42.
Polycystic Ovarian Syndrome (PCOS)
- Pathology: Too much androgen production causes hirsutism (excess hair growth), acne, alopecia, and menstrual irregularities.
Lactating Mother Nutrition Counsel
Increasing vegetables, fruits, whole grains, and dairy. Decreasing added sugars, saturated fat, and sodium.
- Essential nutrients: Calcium, Vitamin D, Potassium, Dietary Fiber.
- Other important nutrients: Folate, iodine, and choline: found in dark green vegetables, beans, peas, lentils, dairy products, eggs, seafood, meats.
- Supplementation: Continue pre-natal vitamins.
Osteoporosis
- DEXA Scan: Recommended for women over 65 or younger with one or more risk factors, to assess bone density.
- Calcium and Vitamin D supplementation: Consult with a healthcare provider for dosage recommendations.
Rectocele and Cystocele
- Rectocele: A bulge of the rectum into the vagina, diagnosed by pelvic exam.
- Cystocele: A bulge of the bladder into the vagina, diagnosed by anterior vaginal exam and pelvic exam.
Stages of Syphilis
- Primary Syphilis: Characterized by a painless chancre (sore) at the site of infection.
- Secondary Syphilis: Occurs 2-12 weeks after the initial infection, with symptoms like fever, headaches, swelling, and a rash.
- Latent Syphilis: Period between secondary and tertiary syphilis. Can last less than or more than a year.
- Tertiary Syphilis: Occurs 1-30 years after infection, potentially leading to neurosyphilis (meningitis), cardiovascular syphilis, etc.
Developmental Milestones
- Infant, Children, and Adolescents: Refer to the Bright Futures - Pocket Guide for normal developmental milestones.
Developmental Stages for Children
- Infancy (birth to 1 year): Rapid physical and cognitive growth.
- Toddlerhood (1 to 3 years): Learning to walk, talk, and explore.
- Preschool (3 to 5 years): Developing social skills and language abilities.
- School age (5 to 12 years): Focusing on academics and social interactions.
Developmental Stages for Children and Adolescents
- Adolescence (12 to 18 years): Puberty, identity development, and increased independence.
Tanner Staging
-
Females:
- Tanner Stage 1 (Prepubertal): Villus hair only, breast elevation of papilla.
- Tanner Stage 2 (Adrenarche and ovarian growth): Sparse pubic hair along the labia, breast buds are palpable.
Mental Health
- Depression Screening: Utilize standardized depression screening tools.
Genetic Screening in Pregnancy
- Trisomy 21 (Down Syndrome): Autosomal trisomy of chromosome 21. Features include dysmorphic features, and increased risk of congenital heart defects, gastrointestinal issues, and developmental delays.
Annual Childhood Wellness Exams
- Social, Behavioral, and Developmental Milestones: Focus on social skills, behavioral issues, and monitoring developmental milestones.
Newborn Screenings
- Screenings: Bilirubin, blood, critical congenital diseases.
Newborn Assessment
- Vitals: Temperature, heart rate, respiratory rate, oxygen saturation, weight, and head circumference.
Immunizations
- CDC Schedule: Refer to CDC for recommended immunization schedules and booster shots.
Anticipatory Guidance
- Parenting Concerns: Address parental concerns during wellness visits.
- Injury Prevention: Advocate for safe environments and accident prevention strategies.
- Violence Prevention: Educate on child safety and prevention of violence.
- Nutritional Counseling: Promote healthy eating habits.
- Fostering Optimal Development: Encourage parental participation in promoting healthy development.
Overweight and Obesity
-
Prevention Strategies:
- Limit juice intake before one year of age.
- Provide only 100% fruit juice in limited quantities to older children.
Eating Disorders
- Anorexia Nervosa: Restriction of nutrient intake, low body weight, fear of gaining weight, distorted body image.
- Bulimia Nervosa: Binge eating followed by inappropriate compensatory behaviors (vomiting, excessive exercise, fasting, laxatives/diuretics).
Sexuality
- Substance Use: Can negatively impact pleasure and increase risky sexual behaviors.
Addiction (Substance Use Disorder)
- Risk Factors: Family history of substance use disorder, family rejection of sexual orientation, history of childhood sexual abuse, low school connectedness, peers with delinquent behavior.
Infant, Children, and Adolescent Injuries
- Leading Cause of Death: Injuries are the leading cause of death among children.
- Car Seat Safety: Infants in rear-facing car seats until two years old or until they reach weight and height restrictions. Children transition to forward-facing car seats as long as possible.
- Water Safety: Supervise children around water and teach water safety skills.
Primary, Secondary and Tertiary Prevention
- Immunizations, education, nutrition, exercise, weight control are considered primary prevention.
- Referral to a specialist for screening of cancer, type II diabetes, hypertension, is considered secondary prevention.
- Treatment to prevent further sequelae of multiple diseases is considered tertiary prevention.
Common Pediatric Immunizations
- Consult the CDC immunization schedule for the recommended timing of common pediatric immunizations like Hepatitis B and Tdap.
Tanner Stages of Development
- Puberty typically occurs during Tanner Stage III.
Common Pediatric Milestones
- Consult the Bright Futures - Pocket Guide for common pediatric milestones.
Lead Poisoning in Children
- High prevalence areas or Medicaid recipients should be screened for lead poisoning in children.
Common Sexually Transmitted Diseases
- Treat the partner for all sexually transmitted diseases, including gonorrhea, chlamydia, herpes, syphilis, genital warts, and trichomonas.
The Menstrual Cycle
- Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) peak during the menstrual cycle.
- Ovulation occurs after LH peaks.
- Premenstrual syndrome (PMS) occurs before menstruation.
Primary and Secondary Amenorrhea
- Primary amenorrhea is the absence of menstrual cycles in adolescents who have reached puberty.
- Secondary amenorrhea is the absence of menstrual cycles in women who have previously had regular cycles and is often caused by pelvic pathology or a recognized medical condition.
Iron Deficiency Anemia
- Iron deficiency anemia is caused by low iron intake, inefficient iron absorption in the gastrointestinal tract, or chronic blood loss.
- It is characterized by decreased or absent iron stores, low serum iron concentrations, low transferrin saturation, and low hemoglobin concentration.
- Adults need about 180 mg of elemental iron daily during anemic states.
- Children need about 3 mg/kg/day during anemic states.
Osteoporosis
- Osteopenia is a precursor to osteoporosis.
- Women over 65 or under with one or more risk factors should be screened with a DEXA scan.
- Consult medical professionals for recommended calcium and vitamin D supplementation.
Rectocele and Cystocele
- A rectocele occurs when weakened tissues in the pelvis cause the rectum to sag into the vaginal wall.
- A cystocele occurs when weakened tissues in the pelvis cause the bladder to sag into the vaginal wall.
- A pelvic exam is used to diagnose both conditions.
- A pessary may be recommended if surgery is not suitable for a cystocele.
Syphilis
- The primary stage of syphilis is characterized by a chancre, a painless local infection.
- The secondary stage of syphilis appears 2-12 weeks after the initial infection and involves fever, headaches, swelling, rash, and potential full-body involvement.
- The latent stage of syphilis occurs between the secondary and tertiary stages.
- The tertiary stage of syphilis can lead to neurosyphilis, cardiosyhpilis, and other complications 1-30 years after the initial infection.
Developmental Stages for Children
- Refer to Bright Futures guidelines for developmental milestones and anticipatory guidance.
- Refer to Bright Futures guidance for developmental stages for children and adolescents.
Genetic Screening in Pregnancy
- Trisomy 21, also known as Down syndrome, is an autosomal trisomy of chromosome 21.
- Individuals with Down syndrome often have dysmorphic features, and the condition is associated with a range of developmental and health issues.
Annual Childhood Wellness Exams
- Annual childhood wellness exams should include assessment of social, behavioral, and developmental milestones.
Newborn Screenings
- Newborn screenings are performed for bilirubin, blood, and critical congenital disease.
- Refer to the CDC guidelines
Newborn Assessment
- Refer to the CDC guidelines
Immunizations
- Consult the CDC guidelines and Hollier page 121-123 for recommended immunization schedules.
Anticipatory Guidance
- The primary focus of anticipatory guidance should be addressing the concerns of the parents.
- Key priorities include: injury prevention, violence prevention, nutritional counseling, and fostering optimal development.
Overweight and Obesity
- Drinking commercial juice should be avoided before infancy.
- For older ages, encourage limited intake of 100% fruit juice.
Eating Disorders
- Anorexia nervosa is characterized by restriction of nutrient intake relative to requirements, leading to significantly low body weight.
- Individuals with anorexia nervosa have a fear of gaining weight, a distorted body image, and an inability to recognize the seriousness of their condition.
- Bulimia nervosa is characterized by episodes of binge-eating followed by inappropriate compensatory behaviors such as self-induced vomiting, excessive exercise, fasting, or laxative/diuretic abuse to prevent weight gain.
Sexuality & Substance Use Disorder
- Substance use can decrease the ability to experience pleasure and increase the risk of risky sexual behaviors.
- Adolescents are at particular risk for substance use disorder with risk factors including a family history of substance use disorder, family rejection of sexual orientation, history of childhood sexual abuse, low school connectedness, and peers with a history of delinquent behavior.
Infant, Children, and Adolescent Injuries
- Infants should be in a rear-facing car safety seat until they reach the height or weight limit of the seat, or until they are two years old.
- Children should remain in a forward-facing car seat until they reach the height or weight limit of the seat.
- Infants should not be left alone on any elevated surface, and stairs should be secured with gates.
- Infant walkers should be discouraged as they increase the risk of falls.
- Children should never be unsupervised around cars, driveways, or streets.
- Young children should wear helmets while riding tricycles or bicycles.
- Smoke detectors should be installed and maintained in homes.
- Water heaters should be set to 120°F (49°C) to minimize scalding hazards.
- Children should be closely supervised when around any bodies of water, including bathtubs, toilets, pools, spas, and other water sources.
- Window locks, screens, or limited-opening windows should be installed to prevent falls from windows.
- Furniture should be anchored to the wall to prevent it from being tipped over.
- Children should be closely supervised as small objects are a choking hazard.
- Firearms should be kept unloaded and locked away.
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Description
This quiz covers essential concepts in pediatrics, including prevention methods, immunizations, developmental milestones, and lead poisoning awareness. It also addresses common sexually transmitted diseases and their treatments, emphasizing the importance of partner care to prevent re-infections.
