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CMN 571 FINAL EXAM STUDY GUIDE
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CMN 571 FINAL EXAM STUDY GUIDE CMN 571 FINAL EXAM STUDY GUIDE CMN 571 FINAL EXAM STUDY GUIDE
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CMN 571 FINAL EXAM STUDY GUIDEReview the types of immunity
(Start Module 1) - ANS Innate immunity: Everyone is born with innate (or natural) immunity, a type of
general protection. For example, the skin acts as a barrier to block germs from entering the body. And
the immune system recognizes when certain invaders are foreign and could be dangerous.
Adaptive immunity: Adaptive (or active) immunity develops throughout our lives. We develop adaptive
immunity when we're exposed to diseases or when we're immunized against them with vaccines.
Passive immunity: Passive immunity is "borrowed" from another source and it lasts for a short time. For
example, antibodies in a mother's breast milk give a baby temporary immunity to diseases the mother
has been exposed to
active immunity - ANS Active immunity is usually permanent.Acquired through exposure and infection
with the disease or artificially acquired through immunization.Onset is a few weeks and usually last a
lifetime
passive immunity - ANS A person is given antibodies to a disease rather than produterm-61cing their
own & it is short -term immunity. ( Example Mother to baby).
herd immunity - ANS This occurs when a significant portion of the population is vaccinated and that
provides a portion of immunity for those that have not developed immunity. The population (herd)
helps prevent disease in the unprotected population. The herd protects those who can not safely get
vaccinations. Generally 90 -95% of the population should be vaccinated to haveeffective Herd immunity.
Review the routine immunization required for infant and children 0-6 as found on the CDC immunization
schedule. - ANS
Immunization given @ birth - ANS Hep B (B=HepB)
,Immunizations @ 2 mths - ANS HepB, DTaP, RV, Hib, IPV, PCV
(2 B Dr Hip)
Immunizations @ 4 mths - ANS DTaP, RV, HiB, IPV, PCV
(4 Dr Hip)
Immunizations @ 6 mths - ANS HepB, DTaP, RV, Hib, Influenza (yrly) PCV, IPV
(B Dr Hip In 6mths)
Immunizations @ 1-1.5 yrs - ANS MMR, HepA, DTaP, Hib, PCV, Varicella
(1 MAD HPV)
Immunizations @ 4-6 yrs - ANS Varicella, DTaP, IPV, MMR
(Very Dim 4-6pm)
How long should live-virus vaccination be delayed if an immunoglobulin (1g) or blood product was
given? - ANS 3-11 months
What paperwork is required to review with the caregiver/parent before vaccination administration? -
ANS Vaccine Information Sheets (VIS) for each vaccine given. Obtain from CDC website. Dr. Lang's notes.
What is the difference between DTap and Tdap? - ANS . The pediatric formulation will have about 3-5
times the amount of diphtheria component compared to the adult formulation. Therefore, you will see
it indicated with an upper-case "D" (DTaP) and lower-case "d" in the adult formulation (Tdap, Td).
Think of it like this, DTaP helps young children develop immunity to diphtheria, tetanus, and (whooping
cough) pertussis. Tdap served as a "booster" for continued protection.
,How many HepB doses does a child need before 6yo and which months are they recommended? - ANS 3
doses recommended at birth, 1-2mos & 6-18 mos
Review " Newborn Exam" by Dr. Nina Gold, MD, this is Very important! Video
What first? - ANS First, when you enter room. Introduce yourself & ask if it's a good time to examine
baby.
general observation - ANS -asleep or awake?
-warm or cool?
-VS
If baby is in distress you need to - ANS notify resident/physician
you can console child by: - ANS laying hand on head or pacifier if parents ok with it
Examine a newborn head to toe. - ANS
Head - ANS -hand behind posterior part of head, place measuring tape in cm around head circumferance
to measure
-look at the shape
-Skull design: allow sskull to me malleable which can cause transformation
-cephalhematoma: doesn't cross suture lines. bleeding below periosteium. common after birth using
triceps. increased risk for jaundice
-caput succandanemum: cross suture lines; fluid accumulation above periosteum; results from birth
canal but resolves in few days after birth
, -rarely: subgaleal hemmorhage
-finally, run fingers over back of head scapel to check for cutis aplasia (congenital anomaly where scalp
hasn't formed properly, not dangerous but throrough examination)
- ANS Asses the ears, alignment drawn from the corner of eye to make sure aligned. Atypical ear
displacement isn't dangerous but could be genetic
-check for pits and skin tags
-ear formation: helix, crus, pits, skin tags, variation is normal
eyes - ANS widely spaced? horizontal, upslating, downslating
Look at pupils by cupping hand over eyeballs and quickly shine othalmaslpe
should see a flash of red IN EACH EYE... if asymetric red reflex detected anomaly (CONGENITAL
CATARACT OR RETINAL BLASTOMA)
AND REFER
Coloma-refer
NOSE - ANS most important feature is assessing patency of nares (ability to bbreath)
-- put small french catheter through nares to test
-common to have transient obstruction/edema after birth suctioining
-asses for choanasal atresia (refer!!)
mouth jaw - ANS put finger and glide, feel hard palate; should suck on finger relex
-check for cleft lip (REFER) -- common isolated
tongue - ANS push past lower lips if not may need done
neck - ANS check for webbing
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