Approach To Hematuria

Question 1

Group b streptococcus common in and group A streptococcus common in age group ?

Answer 1

Group b -< 3weeks
Group A -4months to 4 years
(<3wk) Group B streptococcus, Escherichia coli, other gram-negative bacilli, Streptococcus pneumoniae, Haemophilus influenzae
(type b,* nontypeable)
3wk-3mo Respiratory syncytial virus, other respiratory viruses (rhinoviruses, parainfluenza viruses, influenza viruses, human
metapneumovirus, adenovirus), enterovirus D68, S. pneumoniae, H. influenzae (type b,* nontypeable); if patient is afebrile,
consider Chlamydia trachomatis
4mo-4yr Respiratory syncytial virus, other respiratory viruses (rhinoviruses, parainfluenza viruses, influenza viruses, human
metapneumovirus, adenovirus), enterovirus D68, S. pneumoniae, H. influenzae (type b,* nontypeable), Mycoplasma
pneumoniae, group A streptococcus
≥5yr M. pneumoniae, S. pneumoniae, Chlamydophila pneumoniae, H. influenzae (type b,* nontypeable), influenza viruses,
adenovirus, COVID-19, other respiratory viruses, Legionella pneumophila

Question 2

In all age groups what organism causes community acquired pneumonia?

Answer 2

H influenza type b non typeable, streptococcus pneumonia

Question 3

Respiratory syncytial virus and enterovirus d 68 causes cap in age group ?

Answer 3

3weeks -3months,4months-4years

Question 4

Respiratory syncytial virus and enterovirus d 68 causes cap in age group ?

Answer 4

3weeks -3months,4months-4years

Question 5

What is recurrent pneumonia? Causes of recurrent pneumonia?

Answer 5

Recurrent pneumonia is defined as two or more episodes in a single
year or three or more episodes ever, with radiographic clearing
Causes:-
Mnemonic-HICA
Hereditary-cystic fibrosis ,sickle cell disease
Immunity:-scid,cvid, lad,cgd,hyper ige,hiv
Cilia disorders:-primary ciliary dyskinesia,kartagener syndrome
Anatomical:-aspiration,bronchiectasis,gerd,foreign body,cpam,pulmonary sequestration,lobar emphysema

Question 6

Causes of recurrent pneumonia
Mnemonic-HICA
Hereditary-[. ? ]
Immunity:-scid,cvid, lad,cgd,hyper ige,hiv
Cilia disorders:-[. ? ]
Anatomical:-aspiration,bronchiectasis,gerd,foreign body,cpam,pulmonary sequestration,lobar emphysema

Answer 6

Mnemonic-HICA
Hereditary-cystic fibrosis ,sickle cell disease
Immunity:-scid,cvid, lad,cgd,hyper ige,hiv
Cilia disorders:-primary ciliary dyskinesia,kartagener syndrome
Anatomical:-aspiration,bronchiectasis,gerd,foreign body,cpam,pulmonary sequestration,lobar emphysema

Question 7

Causes of recurrent pneumonia Mnemonic-HICA
Hereditary-cystic fibrosis ,sickle cell disease
Immunity:-[. ? ]
Cilia disorders:-primary ciliary dyskinesia,kartagener syndrome
Anatomical:-[. ABCDEFG. ]

Answer 7

Mnemonic-HICA
Hereditary-cystic fibrosis ,sickle cell disease
Immunity:-scid,cvid, lad,cgd,hyper ige,hiv
Cilia disorders:-primary ciliary dyskinesia,kartagener syndrome
Anatomical:-aspiration,bronchiectasis,gerd,foreign body,cpam,pulmonary sequestration,lobar emphysema

Question 8

2 or more episodes of pneumonia in a year or 3 or more episodes with radiographic clearing between episodes called?

Answer 8

Recurrent pneumonia

Question 9

Which child with pneumonia needs hospital admission?
Age-
Cyanosis,spo2-
Complicated pneumonia
Distress-
Immunity-

Answer 9

Age <6mo
Immunocompromised state
Toxic appearance
Moderate to severe respiratory distress (retractions, nasal flaring,
grunting)
Cyanosis/hypoxemia (oxygen saturation <90% breathing room air,
sea level)
Shock (tachycardia, hypotension, prolonged capillary refill time)
Complicated pneumonia*
Sickle cell anemia with acute chest syndrome
Vomiting or inability to tolerate oral fluids or medications
Severe dehydration
No response to appropriate oral antibiotic therapy
Social factors (e.g., inability of caregivers to administer medications
at home or follow up appropriately)
High-risk pathogen

Question 10

All children with pneumonia needs admission? Yes or no
If no den the tell who needs admission ?
Age less than 6 months or less than 1year

Answer 10

Age <6mo
Immunocompromised state
Toxic appearance
Moderate to severe respiratory distress (retractions, nasal flaring,
grunting)
Cyanosis/hypoxemia (oxygen saturation <90% breathing room air,
sea level)
Shock (tachycardia, hypotension, prolonged capillary refill time)
Complicated pneumonia*
Sickle cell anemia with acute chest syndrome
Vomiting or inability to tolerate oral fluids or medications
Severe dehydration
No response to appropriate oral antibiotic therapy
Social factors (e.g., inability of caregivers to administer medications
at home or follow up appropriately)
High-risk pathogen
*Pleural effusion, empyema, abscess, bronchopleural fistula, necrotizing pneumoni

Question 11

Pneumonia child admission criteria :- spo2 below?
Age below?
Shock, severe dehydration, sickle cell disease with acute chest syndrome

Answer 11

Age <6mo
Immunocompromised state
Toxic appearance
Moderate to severe respiratory distress (retractions, nasal flaring,
grunting)
Cyanosis/hypoxemia (oxygen saturation <90% breathing room air,
sea level)
Shock (tachycardia, hypotension, prolonged capillary refill time)
Complicated pneumonia*
Sickle cell anemia with acute chest syndrome
Vomiting or inability to tolerate oral fluids or medications
Severe dehydration
No response to appropriate oral antibiotic therapy
Social factors (e.g., inability of caregivers to administer medications
at home or follow up appropriately)
High-risk pathogen
*Pleural effusion, empyema, abscess, bronchopleural fistula, necrotizing pneumoni

Question 12

Complicated pneumonia means?

Answer 12

Pleural effusion, empyema, abscess, bronchopleural fistula, necrotizing pneumonia,
acute respiratory distress syndrome, extrapulmonary infection (meningitis, arthritis,
pericarditis, osteomyelitis, endocarditis), hemolytic uremic syndrome, or sepsis.

Question 13

Extra pulmonary infection in complicated pneumonia?

Meningitis, arthritis,[. ? ],endocarditis,[. Bone. ]

Answer 13

Meningitis, arthritis,pericarditis,endocarditis,osteomyelitis

Question 14

Management of cap in opd:-
Pre school child:-{. ? }90mg/kg/day bd 5 to 7 days or after broke for 3 days.
Alternative drugs:- cefuroxime/amoxylav
School age child:- azithromycin preferred, clarythromyvin, doxycycline
Adolescent:- azithromycin, clarythromycin, doxycycline, respiratory fluoroquinolones:mocifloxacin, levofloxacin

Answer 14

Pre school child:- amoxicillin 90mg/kg/day bd 5 to 7 days or after broke for 3 days.
Alternative drugs:- cefuroxime/amoxylav
School age child:- azithromycin preferred, clarythromyvin, doxycycline
Adolescent:- azithromycin, clarythromycin, doxycycline, respiratory fluoroquinolones:mocifloxacin, levofloxacin

Question 15

Opd management of cap
< 3 months:- ?
3 months-5 years:- 1st line drug and dosage?
> 5 years:- 2nd line drug ? And dosage ?

Answer 15

< 3 months:- admit child
3 months - 5 years:- 1st line drug amoxicillin 40 to 50 mg/ kg/ day in India bd for 5 days / 90 mg/ kg/ day in Nelson book
2 nd line:- amoxyclav as amoxicillin dose or cefpodoxime 10 mg/ kg/ day bd or cefuroxime 30 mg/ kg/ day bd
> 5 years:- 1st line same amoxicillin
2 nd line:- co amoxyclav, cefpodoxime, or azithromycin 10 mg/ lg/ day of 5 days empty stomach

Question 16

Opd mx of cap ?
< 3 months:- admit child
3 months-5 years:- 2 nd line drug and dosage?
> 5 years:-1 st line drug ? And dosage ?

Answer 16

< 3 months:- admit child
3 months - 5 years:- 1st line drug amoxicillin 40 to 50 mg/ kg/ day in India bd for 5 days / 90 mg/ kg/ day in Nelson book
2 nd line:- amoxyclav as amoxicillin dose or cefpodoxime 10 mg/ kg/ day bd or cefuroxime 30 mg/ kg/ day bd
> 5 years:- 1st line same amoxicillin
2 nd line:- co amoxyclav, cefpodoxime, or azithromycin 10 mg/ lg/ day of 5 days empty stomach

Question 17

2months old baby admitted with pneumonia.what drugs u will give? Dosage?

Answer 17

<3 months Cefotaxime ±
gentamicin
(5–7 mg/kg/d, OD)
Or
Amikacin
(15 mg/kg/d, OD)
Or
Ceftriaxone
(75–100 mg/kg/d), BD
Piperacillin-tazobactam ±
gentamicin or amikacin
Or
Cefoperazone-sulbactam ±
gentamicin or amikacin
Ceftriaxone + cloxacillin
(50–100 mg/kg/d, QID)
Or
Cefuroxime/or co-amoxiclav* +
gentamicin or amikacin
Second line
Ceftriaxone + vancomycin
(40–60 mg/kg/d, QID) or linezolid**
(same as oral dose)
3 months
to 5 years
Ampicillin (100 mg/
kg/d, TID or QID)*
Co-amoxiclav*
Or
Cefotaxime
Or
Ceftriaxone
Ceftriaxone + Cloxacillin
Or
Cefuroxime or Co-amoxiclav or
cefazolin (50 mg/kg/d, BD or TID)
Second line
Ceftriaxone + vancomycin or
clindamycin (20 mg/kg/d, TID or QID)
or linezolid (same as oral dose)
>5 years Ampicillin (dose
same as above)
Co-amoxiclav*
Or
Cefotaxime (150 mg/kg/d, TID)
Or
Ceftriaxone
Or
Azithromycin
Same as above
*
Co-amoxiclav injectable dose: 100 mg/kg/d, TID.
**
Linezolid is a reserve drug for tuberculosis (TB), so the National Tuberculosis Elimi