Emergencies in Children

Question 1

What is a fever treated with?

Answer 1

acetaminophen or ibuprofen

Question 2

fever threshold for neonates & infants < 3 months

Answer 2

38 C (100.4 F)

Question 3

fever threshold for infants 3-36 months

Answer 3

39 C (102.2 F)

Question 4

fever threshold for children > 36 months old

Answer 4

not defined because concern for serious bacterial illness in this age group should be directed by other S/S of underlying cause

Question 5

may not produce symptoms other than fever

Answer 5

UTI

Question 6

Ideally, how do we want to get a urine sample from kids?

Answer 6

urine cath or suprapubic aspiration

Question 7

What’s wrong with bagged specimens for collecting urine in children?

Answer 7

high rate of false positives

Question 8

How is the diagnosis of meningitis made?

Answer 8

CSF by lumbar puncture

Question 9

frequently associated with or following upper respiratory tract symptoms

Answer 9

pneumonia

Question 10

What remains the gold standard for diagnosing pneumonia?

Answer 10

plain chest radiographs

Question 11

due to group A Streptococcus

becomes more common in children > 36 months old

Answer 11

pharyngitis

Question 12

Tx for pharyngitis

Answer 12

amoxicillin or Pen G

Question 13

what is the most common cause of vomiting & diarrhea in children?

Answer 13

acute viral gastroenteritis

Question 14

what remains the gold standard measurement of dehydration in children?

(but is infrequently available in the ED)

Answer 14

precentage of body weight lost

Question 15

what are the 3 clinical signs that have significant positive likelihood ratios for 5% dehydration?

Answer 15

1. prolonged capillary refill time
2. abnormal skin turgor
3. abnormal respiratory pattern

Question 16

management of mild to moderate dehydration

Answer 16

oral or nasogastric dehydration

(nasogastric tx is more cost effective than IV treatment)

Question 17

management of moderate dehydration

Answer 17

no advantage of rapid or ultra rapid hydration over standard hydration

Question 18

management of moderate to severe dehydration

Answer 18

requires prompt fluid resuscitation with large volumes of fluid over a short period of time

use isotonic solution or lactated Ringer’s during resuscitation phase

Question 19

what is the most common cause of neonatal cardiorespiratory distress

Answer 19

neonatal sepsis

Question 20

S/S of neonatal sepsis

Answer 20

temp instability

CNS dysfunction (lethargy, irritability, seizures)

respiratory distress

feeding disturbance

jaundice

rashes

Question 21

what should be suspected in a well-developed neonate who presents w/ unexplained cardiorespiratory collapse, cyanosis, and/or tachypnea, especially without retractions

Answer 21

congenital heart disease

Question 22

when does congenital heart disease usually become symptomatic?

Answer 22

in the first week of life or after the second week of life

Question 23

what is the most common site of infection in neonates?

Answer 23

lungs → pneumonia

Question 24

S/S of bronchilitis

Answer 24

nasal discharge

sneezing

decreased appetite

feeding difficulty

cough, dyspnea

irritability

occasional periods of apnea

Question 25

up to 4% of febrile infants with bronchiolitis have concomitant _____

Answer 25

UTI

Question 26

may manifest as lethargy or respiratory and/or cardiovascular collapse in the neonate

Answer 26

inborn erros of metabolism

Question 27

what is one of the few acute life-threatening endocrine emergencies that present in the neonatal period

Answer 27

congenital adrenal hyperplasia

Question 28

what are some risk factors for intracranial hemorrhage in a neonate?

Answer 28

can result from birth trauma or non-accidental trauma

home delivery without administration of Vit K

traumatic vaginal delivery

Question 29

bilious vomiting

distending rigid abdomen

sepsis

circulatory collapse

Answer 29

abdominal catastrophe-

congeital malrotation can lead to midgut volvulus & intestinal infarction

Question 30

necrotizing enterocolitis is typically a disease affecting what population?

Answer 30

premature infants