Council on Medical Student Education in Pediatrics

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COMSEP Clinical Cases

HEALTH SUPERVISION

  1. What topics are important to cover in a prenatal visit?
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  2. List and discuss safety issues that should be discussed with parents at the newborn visit, 9 month visit, 2 year visit and 6 year visit.
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  3. A twelve month-old child is seen for a health maintenance visit He is due to receive his vaccines. On exam he has a temperature of 100.4° F and a runny nose. Should he still be immunized? What are the absolute contraindications to immunizations?
  4. A twelve-month-old child has been taking 2 mg/kg/day of oral prednisone for the past three days for asthma. He is due for his routine immunizations. Would you modify his immunization schedule? What if he had been taking 2 mg./kg./day for the past three weeks?
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  5. In the nursery, parents are informed that blood needs to be drawn from their newborn for "screening tests". Describe to the parents what these are and why they are performed. What tests are routinely performed in your state? How are the results transmitted to the parents?
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  6. A two-month old girl is brought to the office for a well child examination. The mother is concerned about the potential complications of immunizing her child. How would you address this issue? What if the mother refused immunizing her child?
  7. A four-month old boy is seen for a well child examination. Following his first set of immunizations he had a temperature of 103° for 12 hours and was extremely irritability. The parents are concerned about giving the next set of immunizations. How would you address their concerns?
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  8. The parents of a previously healthy nine-month-old girl want to know why a hemoglobin was checked. How would you answer their concern? What are the common etiologies of anemia at this age? How would you evaluate an abnormal hemoglobin level?
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  9. The parents of a previously healthy three-year-old boy would like their son tested for tuberculosis. What are the indications for tuberculosis testing? What are the measurements of a positive PPD? How do you interpret a positive PPD in children who had a BCG vaccine?
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  10. The parents of a 14-month-old girl feel that she is not developing at the same pace her older brother did. How would you evaluate her development? What tools are available for developmental screening?
  11. The mother of a twelve-month-old girl, living in a house built four years ago, wants to know why her daughter should undergo lead testing. How would you respond to her concerns? What are the risk factors for lead poisoning? How do you treat an elevated lead level?
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