COMMED FIGURES TO REMEMBER

-If theres a will, theres a way!:)-

=^..^=

Disclaimer: Use at your own risk. It will be appreciated if youll contact me if there
are corrections, nicely please ;).
Sources: rationalized 2018 evals (most of the included values were asked in our
exams)
(mne: mnemonics, pasensya pasenya corny ako at ganito ako mag-aral HAHA)
TIME: WEEKS/DAYS/YEARS

PNEUMONIA
Return immediately: 3 days
DIARRHEA
Follow-up
o dysentery: 3 days ( mne: |3lood)
o Home treatment (Plan A), if not improving: 5 days
Re-assessment
o some dehydration (Plan B): 4 hours
o severe dehydration (IV) for children: 3 hours
o severe dehydration (IV) for infants: 6 hours (mne: 6abies)
o severe dehydration (IV and NGT) for infants: 6 hours
o severe dehydration NOT improving: 1-2 hours

HIV
Post exposure prophylaxis: WITHIN 72 hours after exposure
RABIES
Observation period to determine if the biting animal has rabies: 14 days from
the time of the bite
DENGUE
Dengue IgM (recent infection)
o 3rd day: starts to rise
o 5 days or more after onset of illness: can be detected
o 1-3 weeks: continue to rise
o 2 months after infection: detectable
NUTRITION
Window of opportunity:
o conception to 2 years of age
o 1st 1000 days -300 days of preg + first 700 days of the child
o opportunity to prevent: kasi, nutrition intervention have the potential
to prevent lasting damage
o Stages of nutruition that affect growth during this time (related sa
pagkain sa period na yun) : Maternal nutrition (preg), Exclusive breast
feed (6mos), Complementary feed (6-24 mos)
SARS
CXR
o Initial: 6 days after onset of sx
 o Repeat (initial is negative, SARS is still suspected): 9 days after onset
of sx
Re-evaluation of suspected SARS infected individuals: AFTER 72 hours of
hospitalization

MERS
Monitoring of patients suspected: WITHIN 72 hours of
confinement/hospitalization
ZIKA
Women with ZIKV infection should wait atleast _ weeks after any symptom
onset before attempting to get pregnant: 8 weeks (visual mne: 8 parang
buntis yung number)
Asymptomatic women with possible exposure should wait _ weeks before
attempting pregnancy: 8 weeks (visual mne: 8 parang buntis yung number)
Men should wait at least _ months before having an intercourse and attempt
to have a child: 6 mos

COUNT
HIV
Normal CD4 count: >500 cells/mm3
AIDS CD4 count < 200 cells/mm3
NUTRITION
Minimum diversity score
o 6- 23 mos old
o receive foods from at least 4 groups (mne: anything FOUR(for) FOOD)
seven food groups:
grains, roots, tubers
flesh meat
legumes and nuts
other fruit and veggies
vitamin A rich fruits and veggies
eggs
dairy
(mne: GF LOVE Dairy (grain, flesh, legumes, other fruit, vitamin
A, eggs, dairy))
or 1 kind ng carbo(grains, roots, tubers), 2 kinds ng fruits or
veggie(vit a rich and others) , 1 kind of fat (dairy) , 3 kinds ng
protein ( eggs, flesh and nuts)
MERS COV
36% : MORTALITY RATE

PLACES red: tinanong sa exam

NCR: Region with highest number of HIV-positive reported cases (NCR 41%
Region 4a
17% Region 7 10%, Region 8: 3%)
 Region IV A: Region with highest number of dengue cases (January to July
2015)
27 Malaria-free provinces (2014):
o Cavite, Batangas, Marinduque,
o Catanduanes, Albay, Masbate, Sorsogon, Camarines Sur
o Iloilo, aklan, capiz, guimaras, Bohol, Cebu, Siquijor,
o Northern, Western, Eastern Samar
o Surigao del Norte
o Benguet, Romblon, Batanes, Dinagat Islands
Highest cases of leprosy
o Ilocos Sur
o Davao del Sur
o Tarlac
o Metro manila
o Cebu
o South Cotabato
o Basilan
o Lanao del SUr
DOSES/MEASUREMENTS

DIARRHEA
For dysentery: Ciprofloxacin: 15mg/kg x 3 days
Plan A Extra Fluid after each loose stool
o 0-2 years old: 50-100 mL
o 2 years and above: 100-200mL (mne 2 years and ab00ve)
Zinc 20 mg x 14 days
o 2mos 6mos: tablet daily
o 6 mos and above: 1 tablet daily (mne: pag nagstart na ng
complementary feeding 1 tablet, pag di pa half lang)

RABIES
HRIG: 20 units/kg on day 0 (asked in the exams)
ERIG: 40 units/kg on day 0 (not asked, for the sake of comparison)
NUTRITION
Low birth weight < 2500 g (mne: remember yung normal ay 3000 g nga ba)
PNEUMONIA
Amoxicillin Syrup 125 mg/5ml for 5 days

COMPUTATION (pinacompute sa exam)

ORS
o Some dehydration: weight (kg) x 75 = _ mL
o Severe dehydration (NGT): weight (kg) x 120= _ mL
Severe diarrhea IV fluid time of administration
30 ml/kg 70 ml/kg
< 12 mos 1 hour 5 hours
(mas bata, mas matagal,
mas dahan dahan)
 1 year 5 years 30 minutes 2 hours
(appx. kalahati ng sa
taas)

DEPENDENCY RATIO
o (# persons 0-14 + 65 yrs & over / 15-65 years old) x 100
o Dependent/ Work force
CRUDE DEATH RATE (probability of dying in a population)
o (# of deaths/ Total population) x 100

PROPORTIONATE MORTALITY RATE

o (no of deaths due to a certain cause/ total no of deaths (all
causes)) x 100
o Relative importance of diff FATAL diseases in the population, ages, sex,
occupation
o Ano ang proportion ng certain disease na yun sa lahat ng pagkamatay,
kaya siguro nagkaka top 10 causes of mortality: tandaan ko lang
o Order of importance of cause of death in different age groups
o mne: P= c/all
CAUSE SPECIFIC DEATH RATE
o (# deaths from a particular cause / total population) x 100
o rate of dying from specific causes
o compared to PMR: yung PMR sa lahat ng pagkamatay eto sa total
population (living)
o mne: denominator is total population: living pa: may cause pa
mabuhay
CASE FATALITY RATE
o (# deaths from a particular disease/ # CASES of the same
disease) x 100
o Lethality or risk of dying of a disease/injury
o Case Fatality ilan ang namamatay sa case
MATERNAL MORTALITY RATE (risk of dying causes associated with
childbirth)
o (# deaths among women directly due to pregnancy and
childbirth complications/ TOTAL LIVE BIRTHS) x 100,000
o * note only one na tinimes sa 100,000(accdng sa ratio and lecture),
yung iba x 100 lang (PERO! Sa exam x 100 lang, sigh, sings: dont
know what to do whenever youre nearhaha)
NEONATAL MORTALITY RATE
o (# deaths BELOW 28 days in a given year/ # live births) x 100
o inadequate access to basic medical care
INFANT MORTALITY RATE
o (# deaths BELOW 1 years of age / # live births) x 100
o high IMR= low level of health stds
CHILD MORTALITY RATE
o (# deaths BELOW 5 years of age/ # live births) x 100 (values
from the same year)
SUMMARY PALATANDAAN SA PAGKAMATAY NG MGA BATA
 o ( anong tawag sa ICU nila? NICu @ 28 1 5)
o Neonatal : BELOW 28 DAYS
o Infant: BELOW 1 YEARS OLD
o Child: BELOW 5 years old
SWAROOPS INDEX
o (# deaths 50 y/o and above/ total # of deaths) x 100
o HIGHER the better the health status of population
o Mas madami namatay ng mas matanda (reached age of 50 years bago
namatay)
o Mne: pag 50 years old na madalas me SWERO na,
SWEROOPS=SWAROOPS. kbye:P
o Recall: In contrast to Infant mortality rate na the higher, lower yung
health standards, mas madaming namatay at a younger age)
o Recall again: BETTER HEALTH STATUS kapag higher swaroops index at
higher life expectancy

GENERAL FERTILITY RATE

o (# live births in a year/ # of women 15-44 yrs of age) x 100
o MORE APPROPRIATE MEASURE OF FERTILITY THAN CBR
o Mne: Lahat ba ng fertile nagkaanak??
Di tinanong sa exam
o Fetal death ratio (Stillbirth rate)
(Fetal deaths 28 weeks and Over gestation / Total live births) x
100
o Sex specific death rate
No. of deaths among female/male / Total population female/male
x 100
o Age specific death rate
Deaths from all causes in a particular age group/ Total
population of same age group x 100
o Crude birth rate
# live births/ Total population x 100
DENOMINATORS
o TOTAL BIRTHS/LIVE BIRTHS
MMR, NMR, IMR, CMR,
Mne: anything related sa panganganak at bata
o TOTAL NUMBER OF DEATHS
PMR, Swaroops
o TOTAL POPULATION
Crude death rate, Crude birthrate, cause specific death rate
Mne: the crudes + cause specific death rate

CLASSIFICATIONS AND TREATMENT

DENGUE
PHASES
 FEBRILE PHASE:
o Acute febrile 2-7 days
o Mild hemorhhagic manifestations (petechiae, mucosal membrane
bleeding)
o Progressive decrease in total white cell count
o Clinical problems encountered:
dehydration, high fever, febrile seizures(YOUNG children, note
na yung seizure ay classified under severe sa revised
classification), neuro disturbances
CRITICAL PHASE:
o Defervescence day 3-7 (temp drops 37.5- 38 or less) nagging sinat to
normal
o Improve: without warning signs// deteriorate: with warning signs or
even severe dengue
o Clinical problems encountered:
shock from plasma leak, severe hemorrhage, organ impairment
RECOVERY PHASE
o Next 48-72 hors
o Reabsorption of extravasted fluid, gen well being improves
o Classical rash isles of white in the sea of red
o HCT stabilize or lower (dilution nung reabsorbed fluid)
o WBC rise at mas late si platelet mag normalize
o Clinical problems encountered
Hypervolemia (IV fluid escess &/ extended into this period)
Lab confirmed dengue
o Viral culture isolation
o PCR
REVISED CLASSIFICATION
DENGUE WITHOUT WARNING SIGNS (Probable dengue):
o 1.Endemic area +
o 2.Fever +
o 3. 2 of the ff
headache body malaise arthralgia myalgia, retroorbital pain
anorexia, nausea vomiting diarrhea flushed skin rask (petechial
Hermanns sign)
in other words: trangkaso + rash+abdominal symptoms
o 4. Laboratory test
(at least)CBC: leukopenia w/ w/o thrombocytopenia
(and or )Dengue NS1 antigen
(or optional) Dengue IgM antibody test
DENGUE WITH WARNING SIGNS
o See above: 1. 2. (fever 2-7 days) 3. 4.
o WARNING SIGNS:
Mucosal bleeding
Abdominal pain and tenderness
Lethargy, restlessness
Liver enlargement
 Fluid accumulation clin signs
Laboratory INCREASE HEMATOCRIT, &/ DECREASING PLT COUNT
Persistent vomiting
o Mne MALL FIP (WARNING : MALL THIEF (FIP))
SEVERE DENGUE
o 1.2.
o Any of above clinical manifestations for dengue with or without +
o Severe plasma leakage (leading to shock and fluid accumulation with
respi distress)
o Severe bleeding
o Severe organ impairment (Liver AST ALT >= 1000; CNS seizure
impaired consciousness; Heart myocarditis; Kidney: renal failure)
GROUP A MAY BE SENT HOME
o NO warning signs when fever subsides (WITHOUT WARNING SIGNS)
AND
o Tolerate adequate volumes of oral fluids AND
o Pass urine at least once every 6 hours
GROUP B REFERED FOR IN HOSPITAL MANAGEMENT
o EXISTING WARNING SIGNS (WITH WARNING SIGNS)
o Coexisting conditions (make dse/mgt complicated):
Pregnancy, infancy old age obesity DM renal failure, chronic
hemolytic disease
o Social circumstance
Living alone, living far from health facility without reliable means
of transport
o Mne: warning, condition, mag-isa, malayo, walang paraan para
makapunta (sayo.) kaya magpapaospital na lang ako (haha char)
GROUP C REQUIRE EMERGENCY TREATMENT
o SEVERE DENGUE
Severe plasma leakage (leading to shock and fluid accumulation
with respi distress)
Severe bleeding
Severe organ impairment (Liver AST ALT >= 1000; CNS seizure
impaired consciousness; Heart myocarditis; Kidney: renal failure)
o IN CRITICAL PHASE?
DENGUE TETRAVALENT ( for sero types 1-4) VACCINE
o SQ
o Dose (mne: 0-6-12?)
1st dose: 1st visit (0 mos)
2nd dose: 6 mos after
3rd dose: 6 mos after 2nd dose ; window of 20 days before and
after vaccination date for the third dose
o NOT RECOM
<9 years (kaya sa grade 4 pupils binibigay na free ng DOH),
>45 years (mne: kasi fortified(fourty five) na sila waleyyy:P),
allergic to component of vaccine
immunocompromised (kahit yung nag high dose corticosteroids
at chem w/c suppresses immune system)
 pregnant/ breast feeding
HIV
CLINICAL STAGE 1: persistent generalized lymphadenopathy
CLINICAL STAGE 2:
o MODERATE WEIGHT LOSS(<10 %)
(recall stage 3: severe weight loss)
o RECURRENT RESPI INFECTIONS (lahat ng nasa upper: sinusitis,
tonsillitis, otitis media, pharyngitis)
(recall stage 3: severe bacterial infections, stage 4: recurrent
severe pneumonia)
o herpes ZOSTER
recall stage 4: chronic herpes SIMPLEX infection > 1 month
recall: herpes zoster yung dermatomal distribution, unilateral,
reactivation ng varicella
o angular cheilitis, recyrrent oral ulceration, popular pruritic
eruption,fungal nail infections, seborrheic dermatitis
CLINICAL STAGE 3
o UNEXPLAINED SEVERE WEIGHT LOSS (>10%)
Recall: stage 2: moderate weight loss (<10%)
o UNEXPLAINED CHRONIC DIARRHEA (> 1 MONTH)
o UNEXPLAINED FEVER (INTERM, CONSITENT, > 1 MO)
o PERSISTENT ORAL CANDIDIASIS (visual mne: yung number 3 ay parang
dalawang half circle na magkapatong so oral )
Recall stage 4: Esophageal candidiasis
o ORAL HAIRY LEUKOPLAKIA
o PULMONARY TUBERCULOSIS
Recall stage 4: Extrapulmonary TB
o SEVERE BACTERIA INFECTIONS
(recall stage 2: recurrent respi infections, stage 4: recurrent
severe pneumonia)
o ACUTE NEROTIZING ULCERATIVE stoma, gingi, period
o UNEXPLAINED anemia, neutropenia, chronic thrombocytopenia
CLINICAL STAGE 4
o HIV WASTING SYNDROME
o PNEUMOCYSTIS PNEUMONIA
o RECURRENT SEVERE PNEUMONIA
Recall stage 2 recurrent respi infections, stage 3: severe bacteria
infections
o CHRONIC HERPES SIMPLEX (>1 MO)
Recall stage 2: herpes ZOSTER
Recall HSV 1 and 2 sa oral at genital anorectal na blisters and
ulcers
o ESOPHAGEAL CANDIDIASIS (mne: imagine mo na lang yung E apat
yung horizontal lines)
Recall stage 3: oral candidiasis
o EXTRAPULMONARY TB
Recall stage 3: Pulmo tuberculosis
o at iba pang malalang sakit na mahaba, mahirap ipronounce at ispell
RABIES (mne IPACD)
1. INCUBATION PERIOD:
o virus amplification @ bite site (mne pag nag iincubate ka ng bacteria di
ba dumadami, ditto virus naman)
o only period vaccine is effective
2.PRODROMAL
o 1st rabies specific symptom: PAIN/ PARESTHESIA/ ITCHINESS
3. ACUTE NEUROLOGIC PERIOD
o reaches the BRAIN (kaya neurologic)
o disseminate to rest of the organs notably SALIVARY GLANDS (kaya
nauulol ang term)
o a. Encephalitic/ Furious (80% of cases): hyperactive; HYDROPHOBIA,
AEROPHOBIA
o b. Paralytic/ Dumb (20%): paralysis(bite arealimbsrespi),
PERCUSSION MYOEDEMA (mound muscle at percussion site chest
deltoid thigh disappear over a second)percuss myo/muscle
edema( pinercuss, namaga)
4. COMA
o generally DIE within
7 days: furious rabies
2 weeks: paralytic/dumb
5. DEATH (related sa PUSO)
o myocarditis, cardiac arrhythmia, CHF
o andito na rin naman tayo, kung patay na patay ang puso mo, MR. pa
dFAT ka na baka me rabies ka
o kasiii (seryoso na )
o Post mortem samples may undergo: MIT, RT PCR, and dFAT(gold
standard) to confirm rabies infection
Diagnostics:
Sellers Test: Negri body detection ( mne: DLSHI has a black(color of negri
body) market where we sell stuff)
IFAT: rabies specific antigen
MIT: basta me mouse inoculation (di ko na rin alam tatandaan pa dito)
RFFIT: rabies virus neutralizing antibody (VNA)
RT-PCR: molecular rabies nucleoprotein, must correlate with other diagnostics

MALARIA
MOST COMMON MANIFESTATIONS IN CHILDREN
o Uncomplicated malaria: FEVER
o Severe malaria: SEIZURE
Diagnostics: Blood film microscopy (remember may thick and thin smears pa?
tas nag iimagine ka ng banana, rosette)
o NON SEVERE MALARIA
Upon consultation/ administration
Daily for the next 3 days
Post treatment: days 7, 14, 21, 28
 If patient develops fever: blood is examined in between
scheduled dates
o SEVERE MALARIA
Every 8-12 hours for the first 48 hours
Then, daily until (-) for asexual forms
Mne: in comparison sa non severe daily for 3 days
Then, days 7, 14, 21, 28
UNCOMPLICATED MALARIA (NON SEVERE MALARIA)
o High-grade fever
o Severe headache
o Chills and
o Drenching sweats
o Again fever: may be presenting sign in children
o Neonate: signs of neonatal sepsis
o (-) signs of severe malaria
o 1st objective : CURE THE INFECTION
o 2nd objective: prevent development and spread of antimalaria
resistance
SEVERE MALARIA
o Malaria toxins+sequestration of infected RBCs + anemiadysfunction
of organ systems
o MALARIA PARASITEMIA + any one of these:
Seizures, (recall MCC manifestation in children with severe
malaria)
Impaired consciousness (may present with drowsiness)
Prostration/ weakness
Poor urine output
Signs of pulmonary edema
Signs of DIC (commonly thrombocytopenia, most cases walang
bleeding)
Abnormal, spontaneous bleeding (mne ui same sila ni severe
dengue, at severe malaria pwedeng may ganito)
Signs of organ dysfunction (mne ui same sila ni severe dengue,
at severe malaria pwedeng may ganito)
Jaundice
Hyperparasitemia (>2% parasitized RBC)
Severe anemia (may present with pallor)
Metabolic abnormalities(acidosis ad hypoglycemia(pregnant and
induced))
Hemoglobinuria
o Young children and infants: inability to breast feed, eat/ drink, vomiting
and changes in sensorium
o Objective of treatment: PREVENT DEATH AND PREVENT THE
DEVELOPMENT OF SEQUELA SECONDARY TO ORGAN DYSFUNCTION
MULTIDRUG RESISTANT P FALCIPARUM AND TREATMENT FAILURE
(tinatamad na ko i summarize :P) di to tinanong sa past evals natin pero for
the sake of boardsc eto..
 o Drug resistance in malaria is defined as the ability of a parasite strain
to survive and/or multiply despite the administration and absorption of
a drug given in doses equal to or higher than those usually
recommended but within the limits of tolerance of the subject. This is
detected in vitro and vivo methods. This condition can be manifested
in vivo as failure to respond to a standard dose of antimalarial after
poor drug compliance has been ruled out. Treatment failure is
generally considered when a) there is recrudescence of asexual
parasitemia from the 48th hour after start of treatment; and/or b) no
parasite clearance of reduction. The objective of treatment is to cure
the infection and prevent the development of severe malaria; and
prevent the spread of drug resistant forms of the parasite.

Anti-Malarials

INDICATIONS CONTRAINDICATIO
NS AND S/E
(COARTEM) *FIRST LINE for SEVERE MALARIA *pregnancy
ARTEMETHER (accordng to DOH, 2009 not supported by *lactation
+ FDA) * infants < 5kg
LUMEFANTRIN (mne: pangalan pa lang ng gamot, pang
E severe na)
* Enhanced absorption with fat
CHLOROQUIN *VIVAX MALARIA IN PREGNANT patients
E (visual mne: yung letter C parang tyan ng
buntis, BUT according to IM platinum Quinine
is the DOC for pregnant patients)
*CHEMOPROPHYLAXIS
* treatment relapses for infants
*Administered after a meal

PRIMAQUINE * GAMETOCIDAL: for falciparum *G6PD (can cause

*HYPNOZOITICIDAL: for vivax meth hemo,
(mne: prima na naninilaw ang tagapatay (- hemolytic anemia,
cidal), naninilaw dahil (contraindicated for hemoglobinuria)
g6pd) *Pregnancy
*Administered after a meal (unknown g6pd
status)
QUININE *FALCIPARUM MALARIA TX FAILURE: Quinine
plus (Quinine+ doxycycline, tetracycline and
clindamycin) (recommended for severe
malaria by US FDA)
*PREGNANT (sole tx nakalagay sa handout
enebe.me chloroquine pa na sinabi ,
mnemonic na nga lang, pregnant pts are
queennine; queen for nine months)
*loading dose for hospital admission
*potent insulin secreting drugs (monitor for
induced hypoglycemia)
*for infants <5g
Baka lang lumabas sa boards pero wala sa evals
EPI/NIP
Admin order 39 ser 2003 Expanded program on immunization (EPI)
o FULLY IMMUNIZED CHILD
1 BCG
1 AMV (anti measles) before 12 months or bago mag 1 year old
3 DPT OPV
Hepa B Vaccine
Tetanus toxoid 2+ (TT2+)
Mne: BAD HeT (bad hate)
2016 national immunization program (NIP) (9 to remember) in red tinanong
sa evals
BCG Single dose at birth
Hep B At birth
(monovalent)
3 vaccines given at 3 doses 6 -10-14 weeks of age (mne DOP)
1. DPT Hib-Hep B *
2.OPV (oral polio)*
3. PCV (pneumococcal conjugate)

IPV (inactivated Given with 3rd dose of OPV at 14 weeks

polio vaccine) (mne: si IPV at OPV magkasamasa
valentines (feb 14))
Rotavirus Min age: 6 weeks of age with
Min interval: 4 weeks between doses
Last dose: not later than 32 weeks of
age
Measles containing 9 months of age
 Measles
monovalent
OR
MMR
MMR 12 months of age
Failure to immunize *
o In case of missed succeeding doses (DPT, HiB, OPV and HBV)
No need to repeat prev doses
2nd/ 3rd dose still give AFTER 1 YEAR HAS PASSED SINCE
THE PREVIOUS DOSE
o Two dose measles containing vaccine in 2009
MCV 1(monovalent) : 9-11 months
MCV 2 (MMR) : 12-15 mos
Mandatory Infants and Children Health Immunization Act of 2011
o All children under 5 years old given basic immunization against vaccine
preventable disease
o SPECIFICALLY, BIRTH DOSE OF HEPA B WITHIN 24 HOURS OF BIRTH
o One strategy: integrate administration of Hep B to EINC (Essential
Intrapartum and Newborn Care package)
CONTRAINDICATIONS TO VACCINATION
ABSOLUTE CONTRAINDICATION (mne: PIA only drinks absolute drinking water)
o Pertussis vaccine in child > 6 years (not high risk anymore)
o Immunocompromised (HIV, AIDS)
o Adverse drug rxn to a prev dose (anaphylaxis, seizure)

RELATIVE CONTRAINDICATION
o Fever >39 deg cel (recall pag less 38.5 NOT a contraind)
o Hospitalization

NOT a contraindication
o Fever <38.5 deg cel (recall pag >39, relative contraind)
o Tx. With antibiotics, local steroids, low dose systemic steroids
o Mild respi infections
o Diarrhea and vomiting
o History, incubation and convalescence of infectious dse (example sa
evals: on going anti-Koch medication)
o Malnutrition period
o Several vaccines in the same day (as long as administered preterm
birth at diff sites)
COLD CHAIN (ge na basahin mo na sideline to ng pedia, magtatago ka ng bakuna
)
Ensure potency if a vaccine from manufactureadmin
-15 to -25 deg C (6 mos and 3 mos) (mne MObaba)
o OPV
o Measles
+2 to +8 deg C
o BCG, hep B DP DT TT Diluent
 o OPV and measles (1 month and immunization day)
Live attenuated vaccine kailangan idisinfect muna bago idispose (mne sa
pedia MMR ROV B: mentioned sa commed Measles OPV BCG)
BCG: discard after 4 hrs open
DPT OPV MV TT HBV: after 1 day open
Tip: pag di MMR ROV B(live atten) OR Toxoid(diphtheria or tetanus) killed yun
then identify kung bacteria o virus

LEPROSY
Infiltrates: SKIN, PERIPHERAL NERVES, NASAL OTHER MUCOSA AND EYES
CLASSIFICATION
# SKIN Duration Combination therapy Side effects
LESIONS of
treatent
SINGLE LESION 1 1 time Rifampicin Rifampicin: red
Ofloxacin colored urine
Minocycline Any drug: allergy
(mne: naka single
ROM ka ba sa dorm?)
PAUCIBACILLA 2-5 6 mos Rifampicin Rifampicin: red
RY (mne:2 lang (kalahatin Dapsone colored urine
yung gamot na g taon)
gamit at (mne: RiD Any drug: allergy
hanggang read lang kaya
Payb kaya 2- kalahating taon
5 ) lang:P)
MULTIBACILLA *>5 12 mos Rifampicin Clofazimine:
RY *POSITIVE (isang Dapsone darkening of skin
SKIN taon) Clofazimine Rifampicin: red
SMEAR( kahit colored urine
ilan pa yung (mne: RiD Closely, Any drug: allergy
skin lesions kaya isang taon
and ano pa mobabasahin(1 year
yung clinical treatment) :P)
picture)
*Uncertain
classification

DISABILITY GARDING SYSTEM

o HANDS AND FEET
0: none
1: anesthesia present (mne: a 1st letter)
 2: visible deformity/ damage present
o EYES
0: none
1: EYE PROBLEMS present, vision not severe (better 6/60,
count finger 6 meters)
2: SEVERE VISUAL IMPAIRMENT ( worse than 6/60),
lagophthalmos, iridocyclitis, corneal opacities
o Then kung ano mas mataas(hands and feet vs. eyes) yung yung
grading nya see kuya Renz ratio

INCUBATION PERIODS & DURATION

(mahirap tandaan? gawan natin ng paraan)

Incubation period Duration

Leprosy 2-10 years,
may be as long as 20 years
SARS 5 days (mean incubation)
2-10 days
(mne: 5Ar5, S is like #5)
MERS CoV 2-14 days Hospitalization: 4 days
(mne: love me Feb(2) 14)
Avian Flu 7 days
2-8 days up to 17 days
(mne: parang putol na F(for
flu) yung 7)
Chikungunya 2-6 days
Zika 3-12 days 2-7 days

CASES

PUI SUSPECT PROBABLE CONFIRMED

SARS After Nov 1 suspect case
*Symptoms: 2002 with(lab):
1. myalgia, 1.Fever
headache (12- (high) 1. radiographic
24 hrs before: 2.Exposure infilt consistent
2.fever chills 10 days prior w/ pneumonia or
rigor 3. Cough and RDS
3. repsi illness dyspnea 2. + SARS COV
(2-7 days) in 1 or more
OR asays
Lab: Unexplaines 3. autopsy
*lymphopenia ARI death consistent with
*all others are after nov 1 RDS without
elevated / 2002 No identifiable
prolonged Autopsy cause
done W/
earliest finding: exposures(cl (mne: LABable,
patchy ose contact, Probable)
consolidation travel,
residing)

(mne:FEC
susFEC NA!)

Avian Flu Authoriti *unexplained Def 1: 1.suspected/proba

1. unexplained es ALRI 1.suspect + ble with
ALRI, fever, decided *fever >38 2. infiltrates confirmatory
cough,shortnes to *cough, acute pneu + 2.isolation of
s of breath investiga shortness of evidence of respi H5N1 virus
2. DOB: 5 days te breath, DOB failure OR 2. + H5 PCR
after onset of + 2.+ lab results in 2 diff
symptoms *exposure confirmation of PCR targets
w/in 7 days influenza A but 3.4x rise
*Antigenic (close insufficient to neutralization
shift: NEW contact case, confirm H5N1 antibody titer
influenza A poultry/wild 4.microneut ab
virus subtype birds, Def 2: titer 1:80 or
remains, envi 1. suspect+ greater in DAY 14
*Reassortment: contaminate 2.dying or later after sx
virus from 2 d w. feces, unexplained ARI onset and + result
diff species MIX consume raw epidem linked using diff
and create new undercooked time place serological assay
virus poultry in exposure to
suspected probable/confirm
place, close ed case
contact other
animal, (mne: LABable,
handling Probable and
smaples) EPIDEM linked
by time place
exposure)
MERS COV *Fever See pic Basta test is LAB cnfirmation
Labs: and below unavailable/
1.all respirato inconclusive
low(leukopenia ry
thrombocytope symptom
nia s with
lymphopenia) history of
2.expt close
ELEVATED LDH contact
with
confirme
d ase of
MERS
COV
Avian flu
INTERPANDEMIC: in bet influenza pandemics
ALERT:
o CURRENT WHO phase
o NEW subtype identified in humans
o Increased vigilance, risk assessment
PANDEMIC
o GLOBAL SPREAD
TRANSITION
o DE-ESCALATION, REDUCTION
Chikungunya
VIRAL LOAD: ACUTE PHASE (fever,headache, nausea)

ELEVEN DANGER SIGNS

COUGH for 21 days or more (mne: sings tune of 21 guns onetwenty one
cough haha, waleyyyy)
DIARRHEA 14 days or more (appx. 2 weeks)
DYSENTERY
FEVER 7 days or more (appx 1 week, so 1 week fever, 2 weeks diarrhea)
CONVULSION
 Not able to drink or feed
VOMITS everything
CHEST INDRAWING
UNUSUALLY SLEEPY/ UNCONSCIOUS
RED ON MUAC STRAP
SWELLING OF BOTH FEET

COUGH OR DIFFICULT BREATHING

SEVERE PNEUMONIA/VERY SEVERE DISEASE

Any GENERAL danger sign
Stridor in a calm child
Refer to URGENTLY hospital
First dose of appropriate antibiotics

PNEUMONIA
CHEST INDRAWING
FAST BREATHING
o 2-12 MOS: 50 bpm or more
o 1 year- 5 years: 40 bpm or more
Oral Amoxicillin for 5 days
Wheezing: inhaled bronchodilator for 5 days
Cough more than 14 days or recurrent wheeze: TB or asthma assessment
Advise return immediately
Follow up for 3 days

COUGH OR COLD
No signs of pneumonia or very severe disease
Wheezing: disappeared after rapidly acting bronchodilator; give an inhaled
bronchodilator