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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/CMN 571 FINAL EXAM STUDY GUIDE
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CMN 571 FINAL EXAM STUDY GUIDEReview the types of immunity
(Start Module 1) - correct answer 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 - correct answer 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 - correct answer 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 - correct answer 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. - correct answer
Immunization given @ birth - correct answer Hep B (B=HepB)
Immunizations @ 2 mths - correct answer HepB, DTaP, RV, Hib, IPV, PCV
(2 B Dr Hip)
Immunizations @ 4 mths - correct answer DTaP, RV, HiB, IPV, PCV
(4 Dr Hip)
Immunizations @ 6 mths - correct answer HepB, DTaP, RV, Hib, Influenza (yrly) PCV, IPV
(B Dr Hip In 6mths)
,CMN 571 FINAL EXAM STUDY GUIDE
Immunizations @ 1-1.5 yrs - correct answer MMR, HepA, DTaP, Hib, PCV, Varicella
(1 MAD HPV)
Immunizations @ 4-6 yrs - correct answer 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? - correct answer 3-11 months
What paperwork is required to review with the caregiver/parent before vaccination
administration? - correct answer Vaccine Information Sheets (VIS) for each vaccine given.
Obtain from CDC website. Dr. Lang's notes.
What is the difference between DTap and Tdap? - correct answer . 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? - correct answer 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? - correct answer First, when you enter room. Introduce yourself & ask if it's a good
time to examine baby.
general observation - correct answer -asleep or awake?
-warm or cool?
-VS
If baby is in distress you need to - correct answer notify resident/physician
you can console child by: - correct answer laying hand on head or pacifier if parents ok with it
Examine a newborn head to toe. - correct answer
,CMN 571 FINAL EXAM STUDY GUIDE
Head - correct answer -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)
- correct answer 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 - correct answer 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 - correct answer 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 - correct answer put finger and glide, feel hard palate; should suck on finger relex
-check for cleft lip (REFER) -- common isolated
tongue - correct answer push past lower lips if not may need done
, CMN 571 FINAL EXAM STUDY GUIDE
neck - correct answer check for webbing
-run fingers over clavicle for fx
chest - correct answer inspect: flat, concave, convex
-isolated pectus is considered not a refer
Heart - correct answer HR 120-160 newborn
-continuous mumur from patent ductus but resolve
Assess inpiration. Normal for periodic breathing (pauses)
-lungs should be clear RR 30-60 min
Abdoment - correct answer check for distention, hernia can
-out pouching of skin around umbilical cord- hernia: reduce by gently pushing back towards abd
unless it's firm or stuck in place (REFER)
-palpate w/ one hand on top of other & assess liver (should be by newborns ribs
groin - correct answer -assess femoral pulses by pressing against groin; unable to find pulse
may have aortic coraction (investigate)
-check for inguinal hernia
-check genitalia: labia & clitors may appear engorged from hormones; may have small vagnal
bleeding or fouschette (normal)
-testes: hydrocele: fluid around testes resolve spontaneous
hypospadius; hypospadius -- hooded foreskin ventral dispalcement of the rethral meatus
-check patency of anus
hip dysplasia - correct answer congenital deformation or misalignement. more common if fam
hx of hip dysplaisa or breech presentation in utero
Hips one time using Barlow (moving inward to the knee)
Ortalina (flex knees 90 degrees) if clunk of dislocation (REFER)
If have risk fx assess w/ CT 4-6 wks
Hand - correct answer some may have fifth finger & normal. Look at length, look at place.
Transverse palm crease: common in down syndrom & neuro condition
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