05 emergency

Question 1

Clinical features of looming pediatric arrest: 5

Answer 1

1-Respiratory distress
2-Cyanosis
3-Altered level of consciousness
4-Respiratory rate >60
5- <5 y/o: Heart rate >180 or <80 AND >5 y/o: Heart rate >180 or <60

Question 2

Pathogens that cause epiglottitis: 4

Answer 2

MC: H. Flu
Streptococci
Staphylococci
Candida albicans

Question 3

Objects that may become lodged in distal to the pylorus: 4

Answer 3

Irregular
sharp
wide (>2.5 cm)
long objects (>6 cm)

Question 4

Emergent endoscopy is indicated for the following: 7

Answer 4

1/2-Sharp or elongated objects 			
---Toothpicks, aluminum can tabs
3- Ingestion of multiple foreign bodies
4- Evidence of perforation
5- Button Battery 
---Causes erosion of the esophageal mucosa resulting in a perforation
6- Coins 
---Lodged at the cricopharyngeus muscle causing airway compromise
7- Presence of foreign body > 24 hours

Question 5

Most accurate & definitive diagnostic test

in an appendicitis:

Answer 5

CT scan with IV contrast (sometimes PO & Rectal contrast)

Question 6

Broad spectrum IV antibiotics therapy (options) in acute appendicitis:

Answer 6

1-Mefoxin (Cefoxitin)
2-piperacillin-tazobactam (Zosyn)
3-Rocephin (Ceftriaxone) AND metronidazole (Flagyl)
4-Gentamicin AND either clindamycin OR metronidazole