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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?

20
Q

What is the MC co-infection associated with RSV?

21
Q

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

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?

24
Q

How can neonates increase their SV?

A

Tachycardia

SVR (diastolic BP will increase and cause narrowed PP)

25
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?
Still’s murmur Supine, w/fever, exercise, anemia Bell
26
What are some CHDs that require patent ductus arteriosus to survive? Have to give what?
``` ToF Tricuspid Atresia Pulmonary Atresia Hypoplastic RH syndrome Transposition of Great vessels ``` PGE1
27
What rate to give PGE1? MC side effect?
.05 to .1 microgram/kg/min Apnea (30%)
28
How to treat SVT in children w/AMS, poor perfusion, cyanosis, HoTN?
Synchronized cardioversion with 1 J/kg If it doesn’t work then 2 J/kg
29
What medical therapy and dosing to treat SVT?
Adenosine .1 mg/kg w/max of 6mg initially, then .2 mg/kg with max of 12
30
What is the treatment if you give adenosine and then a wide complex tachycardia starts?
Amiodarone load of 5 mg/kg over 60 minutes then continue at 5cg/kg/min
31
What med to avoid in children under 2 bc of profound HoTN and CV collapse?
Verapamil and other CCBs
32
Name the ECG changes in the 4 phases of pericarditis:
1 - diffuse STE 2 - normal ST but T wave is flatter/lower amplitude 3 - diffuse T wave inversion 4 - normal ECG
33
What is a good physical exam finding to eval for pericarditis?
Pericardial friction rub - have patient lean forward and hold their breath (will not be present on pleural friction rub)
34
What children should be investigated further for (incomplete) Kawasaki disease? Do what next? What levels? Then what?
Fever > 5 days with 2-3 inclusive criteria CRP > 3 or ESR > 40 Echocardiogram
35
Treatment and dosing for Kawasaki disease?
IVIG 2 g/kg q12h ASA 80-100 mg/kg/day divided into 4 doses to take q6
36
Big complication of Kawasaki if untreated?
Coronary artery aneurysm
37
How to Dx acute rheumatic fever?
Documented + culture/ASO titer AND | 2 major criteria or 1 major + 2 minor
38
Describe how blood flow changes during Valsalva maneuver
Venous blood return to the heart DECREASES, this reduces LV size
39
How is the murmur in HOCM effected by Valsalva?
Increases bc LV decreases thus increasing the degree of obstruction increasing the murmur
40
What are the 2 congenital long QT syndromes called? How do you distinguish them apart?
Jervell-Lange-Nielsen —> deaf | Roman-Ward is normal
41
DDx of long QT?
``` HypoCa HypoMg HypoK Myocarditis Meds (TCA, erythromycin, procainamide, qunidine) ```
42
What is commotio cordis and who does it happen to? | Treat how?
High impact trauma to chest during Ventricular Repolarization causing VFib MC in kids 5-15 y/o AED but can try chest thump
43
Kid is in pulseless VTach, what do you do? And dosing?
Defibrillate 1st shock: 2 J/kg 2nd: 4 J/kg Any additional: 10 J/kg

A - Rosen Peds (5 decks)

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