CPS Review

Question 1

treatment of scabies in > 3 months of age

Answer 1

5% permethrin cream - leave on 12-24 hrs, repeat after 7 days

Question 2

treatment of scabies in infants and pregnant women

Answer 2

sulphur in petroleum jelly daily x 3 days

Question 3

potential benefits of circumcision (lowest NNT)

Answer 3

HPV reduction, HSV reduction, reduced risk of UTI in those with risk factors

Question 4

CPS recommendations re circumcision

Answer 4

not recommended routinely, parents can make choice based on their personal beliefs

Question 5

what is a risk in the first week after rotavirus vaccination?

Answer 5

intussusception

Question 6

when should you give the rotavirus vaccine?

Answer 6

after 6 weeks of age and before 8 months (to reduce risk of intussusception)

Question 7

ankyloglossia - prevalence, incidence, genetics

Answer 7

prevalence 4-10%, typically isolated congenital anomaly, may be genetic predisposition

Question 8

organisms causing neonatal opthalmia

Answer 8

neisseria gonorrhea, chlamydia trachomatis

Question 9

treatment of neonatal opthalmia

Answer 9

erythromycin is NOT recommended (up to 25% of strains of gonorrhea are resistant, not effective against chlamydia)
- should do conjunctival culture, then ceftriaxone 50mg/kg IV/IM

Question 10

what is pediculosis

Answer 10

infestation with head lice

Question 11

treatment of head lice

Answer 11

topical head lice insecticide i.e. 1% permethrin/pyrethrin (2x, 7-10 days apart)
- do not recommend excluding children from school, no environmental decontamination required

Question 12

when to consider UTI abx prophylaxis

Answer 12

grade IV or V VUR or significant urologic abnormality

Question 13

what antibiotic would you use for UTI prophylaxis

Answer 13

septra or nitrofurantoin

Question 14

risk factors for severe bronchiolitis

Answer 14

• preterm < 35 weeks, < 3 months old, hemodynamically sig cardiopulm disease, immunodeficiency

Question 15

consider admission for bronchiolitis when…

Answer 15

• severe resp distress, O2 required to keep sats > 90%, dehydration, cyanosis/apnea, risk factor for severe disease, family unable to cope

Question 16

recommended for management of bronchiolitis

Answer 16

oxygen, hydration

Question 17

equivocal recommendation for management of bronchiolitis

Answer 17

may trial epineb, superficial nasal suctioning, 3% hypertonic saline neb, combined epi/dex

Question 18

early presentation of lyme disease

Answer 18

erythema migrans, presents in 7-14 days, non-pruritis, spontaneously resolves in 4 weeks

Question 19

diagnosis of lyme disease (early vs late)

Answer 19

early: clinical diagnosis, late disease: ELISA screen followed by western blot

Question 20

when is the highest risk of severe bacterial sepsis after splenectomy?

Answer 20

first 3 years post-splenectomy, but risk always present for life

Question 21

vaccinations in splenectomized patient

Answer 21

Pneumococcus (PCV13, PPV23), meningococcus (MCV4, 4CMenB), hemophilus influenza B (primary + booster), influenza (for patient and household contacts)

Question 22

when to consider imaging after concussion

Answer 22

focal neurologic signs, seizures, prolonged LOC