Ch. 5 Pediatrics

Question 1

In infants <3 months old, what temperature indicates a fever?

Answer 1

100.4°F (38°C)

Question 2

In children >3 months, what temperature indicates a fever?

Answer 2

102.2°F (39°C)

Question 3

What empiric antibiotics should be used in febrile pediatric patients <28 days old?

Answer 3

Ampicillin and Cefotaxime
OR
Ampicillin and Gentamicin

(add IV acyclovir if suspicion for HSV)

Question 4

What organism is most common pathogen implicated in serious bacterial infections (SBIs) in <28 days?

Answer 4

Group B Strep

Question 5

What organism is most common pathogen implicated in serious bacterial infections (SBIs) in 29 days - 3 months old?

Answer 5

S pneumo
then E coli

Question 6

What organism is most common pathogen implicated in serious bacterial infections (SBIs) in 3 months to 3 years old?

Answer 6

usually VIRAL

Question 7

What is the most common serious bacterial infection seen in 3 month to 3 year olds?

Answer 7

UTI

Question 8

How is Colic defined? (Rule of 3s)

Answer 8

Crying at least 3 hours a day, 3 days per week, for 3 weeks (aka Wessel criteria)

Question 9

Why is dicyclomine (Bentyl) contraindicated in infants <6 months?

Answer 9

Increased risk of seizure, apnea, and coma

Question 10

When should phototherapy be considered for jaundice in <24hour old?

Answer 10

If total serum bilirubin is >5x birth weight in kg (usually 15-25 mg/dL)

Question 11

When should exchange transfusion be considered for jaundice in <24hour old?

Answer 11

If total serum bilirubin is >10x birth weight in kg (usually 25-30 mg/dL)

Question 12

What is the most common cause of diarrhea in children <5 years old?

Answer 12

Norovirus

Question 13

How soon after birth should newborns pass meconium?

Answer 13

24-48 hours

Question 14

What is the most common cause of esophageal obstruction in neonates?

Answer 14

tracheoesophageal fistula (TEF)

Question 15

What is included in the VATER complex?

Answer 15

Verterbal abnormalities
Anus (imperforate)
TE fistula
Renal defects

Question 16

What is the etiology of Malrotation with Volvulus?

Answer 16

When malrotation occurs, the small bowel is not anchored in the
LUQ or RLQ as it should be in the first 3 months of gestation. Bands of tissue (Ladd bands) form between the cecum and
duodenum, potentially causing duodenal obstruction.
The malrotation of
the midgut also predisposes the bowel to twisting on itself, leading to bowel
obstruction and vascular compromise.

Question 17

When do symptoms of Malrotation with Volvulus typically occur?

Answer 17

33% present with symptoms within the first week of life, 50% present within the first month, and 85% present within the first year

Bilious emesis in a neonate is malrotation
until proven otherwise

Question 18

How is malrotation with volvulus diagnosed?

Answer 18

Upper GI series
(abdominal XRs are insufficient)