11 - Additional Notes For Pedia Handout By Dr.ian De Vera.docx

TOPNOTCH MEDICAL BOARD PREP PEDIATRICS HANDOUT BY RUBY PUNONGBAYAN,MD & COCOY CALDERON,MD For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected]

PPS Recommended Vaccines 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16.

BCG Hep B DPT HiB Polio Pneumococcal Rotavirus Influenza Measles Japanese Encephalitis MMR Varicella MMRV Hepatitis A Td/Tdap HPV

Pneumococcal (PCV)  Min age 6weeks, Intramuscularly (IM), 4weeks apart, 3 doses  Booster 6months after 3rd dose  2-5yo  1 dose of PCV 13 or 2 doses PCV 10 (8weeks apart)  Not recommended for > 5yo Japanese Encephalitis Vaccine (JE)  Subcutaneously  Min age 9months  9months to 17yo – one primary dose plus booster 12-24months after  >18yo – single dose only Td and Tdap  Fully immunized -Td boosters every 10years (single dose of Tdap can be given in replacement of due dose of Td)  Fully immunized pregnant – 1 dose Tdap after 20weeks AOG  UNIMMUNIZED pregnant – 3-dose t-d containing vaccine (Td/Tdap) 0-1-6month. Tdap should replace one dose preferably after 20weeks AOG 

Influenza  Trivalent IM or SQ, Quadrivalent IM  0.25ml for 6mos-35mos, 0.5ml for 36mos18yo  For 6mos to 8yo  2 doses, 4 weeks apart  Then yearly  If only one dose was given the previous year = give 2 doses  If single dose has been given for 2 consecutive years, give annually  For 9-18yo – 1 dose annually Hepatitis A Vaccine  1st dose >12y.o  2nd dose, 6-12months after 1st HPV  Bivalent - 0,1,6months  Quadrivalent – 0,2,6months  Give vaccine to girls age 11-12 yrs old (may be given as early as 9 yrs old) MMRV  1st dose – 1yo  2nd dose – 4-6 years  Minimum of 3months interval from 1st Varicella  Subcutaneously  1st dose – 12-15months  2nd dose -4-6years  3 months interval from first (for children < 13yo)  >13 y.o without evidence of immunity  2 doses, 4 weeks apart Rotavirus  Monovalent (RV1)  2-dose  Earliest 6weeks of age  Not later than 32weeks  Pentavalent (RV5)  3-dose  Earliest 6weeks of age  Not later than 32weeks  May give dose #1 as early as 6 wks  Give final dose no later than age 8 mos 0 days  Do not begin series in infants older than 15 wks 0 days VACCINES FOR HIGH RISK/SPECIAL GROUPS Typhoid  2 years old  Every 2-3 years Rabies  Pre-exposure – IM days 0,7,21or 28  ID: 0,7,21,28 Meningococcal  Tetravalent Conjugate (MCV4-D, MCV4-TT, MCV4-CRM) – IM  Tetravalent Polysaccharide (MPSV4) IM or SQ  High risk : ex complement deficiency, asplenia, HIV  MCV4- D : min age 9mos  9-23mos – 2 doses, 3months apart  2yo and above – one dose  MCV4-TT: 12mos and above, single dose  MCV4-CRM: 2yo and above, single dose  Revaccinate with MCV4 every 5 years as long as pt is high risk

TOPNOTCH MEDICAL BOARD PREP PEDIATRICS HANDOUT BY RUBY PUNONGBAYAN,MD & COCOY CALDERON,MD Page 1 of 2 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected]

TOPNOTCH MEDICAL BOARD PREP PEDIATRICS HANDOUT BY RUBY PUNONGBAYAN,MD & COCOY CALDERON,MD For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected]

MPSV4

SLE  2yo and above as single dose  If MPSV4 used as first dose, MCV4 should be given 2months later  *MCV4-D and PCV13 should be given 4weeks apart

Pnuemococcal for High Risk (PCV + PPSV)  IM  High Risk : Chronic heart, lung, kidney disease, DM, CSF leak, cochlear implant, sickle cell disease and other hemoglobinopathies, anatomic and functional asplenia, HIV and immunodeficiency 2-5yo  One dose PCV 13 if incomplete PCV was given  2 doses of PCV 13 (8weeks apart) if unimmunized  One dose PCV 13 if completely immunized with PCV 7  PPSV at least 8 weeks after the most recent PCV 13 6-18yo  1 dose of PCV 13 then PPSV after 8weeks  Single revaccination of PPSV after 5 years Dengue    

Live Attenuated, SQ Minimum age 9yo Max age 45yo 3 dose series – 0,6,12months

DENGUE

Hepatitis B Tests

CSF FINDINGS IN BRAIN ABSCESS

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