PAEA Pediatrics Questions and Answers|
Latest Update
Constitutional growth delay "late bloomer" - may have fam hx of delayed growth
family members normal height
skeletal bone age will lag behind chronological age
puberty may be delayed
GH deficiency ant pituitary produces GH under stimulation from GNRH and suppression
of somatostatin
cause - idiopathic
Laron syndrome dwarfism that results from mutation in GH receptor
PE for GH deficiency decline in groth velocity or subnormal growth
truncal obesity
impaired peripheral vision w optic chiasm tumors
delayed pubertyand webbed neck - turner syndrome
Tx for GH deficiency Human GH
referral to pediatric endocrinologist
,ideal source of infant nutrition breast milk bc it contains a perfect mix of nutrients as well
as protein, lipids, and carbs; promotes bonding; and strengthens the infant's immune system.
Infant formulas today come very close to matching breast milk in terms of providing energy and
nutrition
Typical infant diet breast milk or formula until 6 mos. Cereal may be introduced at 4 mos,
fruit at 5 mos, veggies at 6 mos and complex proteins in the months that follow.
When should cow's milk be initiated? no earlier than 1 yr of age
An exception to hep B vaccine for infants... only for premature infants weighing 2 kg or
more
CIs to vaccines Anaphylactic rxn to previous vaccine or component
Hx of encepahlopathy after 7 days of giving DTAP
Pregnancy
Immunocomprised
Common preservatives in MMR and IPV neomycin and streptomycin
Avoid hep B if pt has an allergy to Baker's yeast
Avoid influenza vaccine if pt has an allergy to eggs
, Avoid varicella vaccine if pt has an allergy to gelatin
Which vaccines should pregos avoid? live vaccines: MMR and varicella, and live
attenuated influenza vaccine, HPV, polio
Thimerosal routine childhood vaccines are now manufactured w/o the mercury based
perservative; numerous large studies have failed to link thimerosal or vaccines to autism
Primary source of lead exposure in US lead based paint
Universal screening for lead 1 and 2 yo. Targeted screening at older ages is recommended
for communities w greater prevalence of elevated lead levels or communities w higher
proportion of older homes
Lead screening results venous sample preferred over capillary blood. <10 requires no
action. higher than 14 should prompt close developmental and cognitive monitoring, ID of
possible sources and removal of the child from exposure. >45 should be treated w chelation;
higher than 70 results in severe health problems, seizure and coma
PE for pediatric poisoning unusual breath odors
skin: excessive dryness, sweating, discoloration, and fever
pupillary size as well as lacrimation
vomiting or excessive salivation
Latest Update
Constitutional growth delay "late bloomer" - may have fam hx of delayed growth
family members normal height
skeletal bone age will lag behind chronological age
puberty may be delayed
GH deficiency ant pituitary produces GH under stimulation from GNRH and suppression
of somatostatin
cause - idiopathic
Laron syndrome dwarfism that results from mutation in GH receptor
PE for GH deficiency decline in groth velocity or subnormal growth
truncal obesity
impaired peripheral vision w optic chiasm tumors
delayed pubertyand webbed neck - turner syndrome
Tx for GH deficiency Human GH
referral to pediatric endocrinologist
,ideal source of infant nutrition breast milk bc it contains a perfect mix of nutrients as well
as protein, lipids, and carbs; promotes bonding; and strengthens the infant's immune system.
Infant formulas today come very close to matching breast milk in terms of providing energy and
nutrition
Typical infant diet breast milk or formula until 6 mos. Cereal may be introduced at 4 mos,
fruit at 5 mos, veggies at 6 mos and complex proteins in the months that follow.
When should cow's milk be initiated? no earlier than 1 yr of age
An exception to hep B vaccine for infants... only for premature infants weighing 2 kg or
more
CIs to vaccines Anaphylactic rxn to previous vaccine or component
Hx of encepahlopathy after 7 days of giving DTAP
Pregnancy
Immunocomprised
Common preservatives in MMR and IPV neomycin and streptomycin
Avoid hep B if pt has an allergy to Baker's yeast
Avoid influenza vaccine if pt has an allergy to eggs
, Avoid varicella vaccine if pt has an allergy to gelatin
Which vaccines should pregos avoid? live vaccines: MMR and varicella, and live
attenuated influenza vaccine, HPV, polio
Thimerosal routine childhood vaccines are now manufactured w/o the mercury based
perservative; numerous large studies have failed to link thimerosal or vaccines to autism
Primary source of lead exposure in US lead based paint
Universal screening for lead 1 and 2 yo. Targeted screening at older ages is recommended
for communities w greater prevalence of elevated lead levels or communities w higher
proportion of older homes
Lead screening results venous sample preferred over capillary blood. <10 requires no
action. higher than 14 should prompt close developmental and cognitive monitoring, ID of
possible sources and removal of the child from exposure. >45 should be treated w chelation;
higher than 70 results in severe health problems, seizure and coma
PE for pediatric poisoning unusual breath odors
skin: excessive dryness, sweating, discoloration, and fever
pupillary size as well as lacrimation
vomiting or excessive salivation
