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A - Rosen Peds > Fever, Airway Obstruction, Cards > Flashcards

Fever, Airway Obstruction, Cards Flashcards

1
Q

Febrile infants aged 2-24 months should get what if they have a UTI?

Then what?

A

Renal US

VCUG if the US shows high-grade VU reflux or scarring

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2
Q

What defines a positive urine?

Positive culture?

A

Bacteria and wbc’s

> 50,000 CFU

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3
Q

What Vasopressors to start in young kids?

A

Dopamine 1-20 microgram/kg/min
Or
Norepinephrine .1-.3 microgram/kg/min

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4
Q

Dosing of amp/gent/cefotaxime/acyclovir for suspected meningitis in infants < 28 days old?

A

Ampicillin: 100 mg/kg/24 hours divided q6
Gentamicin: 5 mg/kg/ 24 hours divided q8-12
Cefotaxime: 150 mg/kg/24 hours divided q8
Acyclovir: 60 mg/kg/24 hours divided q8

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5
Q

Baraff analyzed data of the Philadelphia, Boston, Rochester criteria for febrile infant 1-3 months, what makes them low risk?

A

Wbc bw 5-15k
< 1500 bands
Normal UA w/< 5 wbc’s
Negative CSF, < 8 wbcs

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6
Q

If a child is determined to be low risk, what are the 2 options?

A

Option 1 via Boston/Philadelphia criteria says if CBC, blood Cx, UA normal then no LP and dc home w/NO Abx

Option 2 based on Boston: full wu w/LP, give Ceftriaxone at 50 mg/kg/IV and re-eval in 24 hours

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7
Q

Initial therapy for suspected meningococcal infection in pediatric pt?

A

Ceftriaxone 100 mg/kg IV

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8
Q

How to treat Kawasaki diseases pts?

A

IVIG 2 g/kg infusion over 10-12 hours
ASA 80-100 mg/kg daily divided q6
Cardio consult

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9
Q

How to treat Toxic shock syndrome?

A

Clindamycin 25-40 mg/kg/day split into 3 doses
+
Vancomycin 40 mg/kg/day split into 4 doses

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10
Q

How often should sickle cell pts take PCN? What doses?

A

Under 3 y/o: 125mg bid

3-5 y/o: 250mg bid

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11
Q

How to wu sickle cell peds?

How to treat?

A

CBC, ESR, blood Cx, Retic count

1 dose Ceftriaxone 50 mg/kg IV or IM

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12
Q

MC pathogen for VP shunt infection?

A

S. Epidermidis

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13
Q

How to dx Retropharyngeal abscess on Xray?

A

At C2, width > 6-7mm

C6 width > 14mm

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14
Q

What is the dosing of IM epinephrine in peds for analphylaxis?

A

0.01 mg/kg up to make of .3mg

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15
Q

What meds for managing croup and what meds?

A 
Inhaled budesonide (2 mg/dose)
Decadron (0.6 mg/kg)
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16
Q

MC cause of bacterial tracheitis?

What is diagnostic?

A

MRSA

Bronchoscopy (also therapeutic)

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17
Q

Dosing of Magnesium sulfate for Asthma exacerbation?

Ipratropium bromide?

A

50-75 mg/kg w/max of 2.5g

< 20kg you get 250 mcg/dose
> 20kg you get 500 mcg

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18
Q

Infant between 1-2 months that is FEBRILE and RSV+, what other tests should you get?

A

UA/UCx bc 7% co-infection rate and (82% of those 7% d/t UTI)

19
Q

MC SE of treating asthma with IV mag?

A

HoTN

20
Q

What is the MC co-infection associated with RSV?

A

OM

21
Q

What is the most sensitive indicator or PNA in young child?

A

Tachypnea

22
Q

Tachypnea is defined by the WHO in children < 1 how?

1-5?

> 5?

A

RR > 50

> 40

> 30

23
Q

Patients with CF can be treated with what mucolytics?

A

NAC

24
Q

How can neonates increase their SV?

A

Tachycardia

SVR (diastolic BP will increase and cause narrowed PP)

25
Q

What murmur is heard in kids 2-6 along the left mid sternal border and has a vibratory musical or twanging quality?

Increases when?

Best heard how?

A

Still’s murmur

Supine, w/fever, exercise, anemia

Bell

26
Q

What are some CHDs that require patent ductus arteriosus to survive?

Have to give what?

A 
ToF
Tricuspid Atresia
Pulmonary Atresia
Hypoplastic RH syndrome
Transposition of Great vessels

PGE1

27
Q

What rate to give PGE1?

MC side effect?

A

.05 to .1 microgram/kg/min

Apnea (30%)

28
Q

How to treat SVT in children w/AMS, poor perfusion, cyanosis, HoTN?

A

Synchronized cardioversion with 1 J/kg

If it doesn’t work then 2 J/kg

29
Q

What medical therapy and dosing to treat SVT?

A

Adenosine .1 mg/kg w/max of 6mg initially, then .2 mg/kg with max of 12

30
Q

What is the treatment if you give adenosine and then a wide complex tachycardia starts?

A

Amiodarone load of 5 mg/kg over 60 minutes then continue at 5cg/kg/min

31
Q

What med to avoid in children under 2 bc of profound HoTN and CV collapse?

A

Verapamil and other CCBs

32
Q

Name the ECG changes in the 4 phases of pericarditis:

A

1 - diffuse STE
2 - normal ST but T wave is flatter/lower amplitude
3 - diffuse T wave inversion
4 - normal ECG

33
Q

What is a good physical exam finding to eval for pericarditis?

A

Pericardial friction rub - have patient lean forward and hold their breath (will not be present on pleural friction rub)

34
Q

What children should be investigated further for (incomplete) Kawasaki disease?

Do what next? What levels?

Then what?

A

Fever > 5 days with 2-3 inclusive criteria

CRP > 3 or ESR > 40

Echocardiogram

35
Q

Treatment and dosing for Kawasaki disease?

A

IVIG 2 g/kg q12h

ASA 80-100 mg/kg/day divided into 4 doses to take q6

36
Q

Big complication of Kawasaki if untreated?

A

Coronary artery aneurysm

37
Q

How to Dx acute rheumatic fever?

A

Documented + culture/ASO titer AND

2 major criteria or 1 major + 2 minor

38
Q

Describe how blood flow changes during Valsalva maneuver

A

Venous blood return to the heart DECREASES, this reduces LV size

39
Q

How is the murmur in HOCM effected by Valsalva?

A

Increases bc LV decreases thus increasing the degree of obstruction increasing the murmur

40
Q

What are the 2 congenital long QT syndromes called? How do you distinguish them apart?

A

Jervell-Lange-Nielsen —> deaf

Roman-Ward is normal

41
Q

DDx of long QT?

A 
HypoCa
HypoMg
HypoK
Myocarditis
Meds (TCA, erythromycin, procainamide, qunidine)
42
Q

What is commotio cordis and who does it happen to?

Treat how?

A

High impact trauma to chest during Ventricular Repolarization causing VFib
MC in kids 5-15 y/o
AED but can try chest thump

43
Q

Kid is in pulseless VTach, what do you do?

And dosing?

A

Defibrillate
1st shock: 2 J/kg
2nd: 4 J/kg
Any additional: 10 J/kg

A - Rosen Peds (5 decks)

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