Community CPS

Question 1

Management of ankyloglossia

Answer 1

Usually conservative - parental education, lactation support, and reassurance
Frenotomy can improve feeding with significant breastfeeding difficulties

Question 2

4 complications from a frenotomy

Answer 2

Bleeding
Infection
Injury to Wharton’s duct
Post operative scarring that limits tongue movement, requiring reoperation

Question 3

3 non pharm therapies for GERD

Answer 3

Thickened feeds
Avoiding cow’s milk (2-4 week trial)
Infant positioning (discourage)

Question 4

What type of bacteria produce nitrites?

Answer 4

Gram negative

Question 5

6 common bacteria causing UTIs

Answer 5

E coli
Klebsiella pneumoniae
Enterobacter
Citrobacter
Serratia
Staph saphrophyticus (adolescent females)

Question 6

How long should febrile UTIs be treated for?

Answer 6

7 to 10 days

Question 7

How long does cystitis need to be treated for

Answer 7

2 to 4 days

Question 8

Signs of a complicated UTI

Answer 8

Hemodynamically unstable
Elevated creatinine
Bladder or abdominal mass
Poor urine flow
Not improving clinically within 24 hours
Fever not decreasing within 48 hours of abx

Question 9

Which children need a RBUS for UTI

Answer 9

Children <2 with first febrile UTI
During or within 2 weeks of their acute illness

Question 10

What grades of VUR need antibiotic prophylaxis

Answer 10

Grade 4 and 5
And see uro or nephro

Question 11

What are the issues with a nuclear cystogram for UTI

Answer 11

Less radiation than VCUG but less available
Poor anatomic details for male urethra (can miss posterior urethral valves)

Question 12

Red flags for specific learning disorders on history

Answer 12

school avoidance
mood disorder symptoms anxiety about attending school
discrepancy between effort into work and objective achievement

Question 13

Vascular tumors vs malformations

Answer 13

Tumors are prolferative
Malformations are defined by anomalous vessels
Hemangiomas and granulomas are tumors
Capillary/venous/lymphatic/arterial malformations

Question 14

Complications from hemangiomas

Answer 14

Ulceration
Pain
Permanent functional impairment
Negative cosmetic outcome
Untreated hemangiomas can leave residual fibro-fatty tissue, atrophy, scars, and telangiectasia

Question 15

Phases of infantile hemangioma growth and how long they last

Answer 15

Proliferative phase: usually begins in first 4 weeks of life, grows rapidly for first 1-3 months
Plateau phase: occurs between 12-18 months
Involution phase: occurs between 1-7 years

Question 16

Main treatment and dose for infantile hemangiomas

Answer 16

Propranolol
1 mg/kg start, titrate up to 3 mg/kg/day
Typically continued for 6 months

Question 17

Congenital hemangiomas vs infantile hemangiomas

Answer 17

Congenital version are present at birth, do not show early proliferation, do not respond to beta blockers