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PHRM 865 > Final - Peds ID > Flashcards

Final - Peds ID Flashcards

1
Q 
Preventable risk factors AOM (acute otitis media): \_\_\_\_\_\_\_ attendance**
\_\_\_\_\_\_ exposure
\_\_\_\_\_\_ use
\_\_\_\_\_\_ feeding
\_\_\_\_\_\_\_\_ status
A 
child care attendance**(semi-preventable, ya know)
smoke exposure
pacifier use
bottle feeding
immunization status
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2
Q 
Non-Preventable risk factors AOM (acute otitis media):
 \_\_\_\_\_ gender
older \_\_\_\_\_\_
\_\_\_\_\_\_ history
\_\_\_\_\_\_\_\_ abnormalities
\_\_\_\_\_\_\_ deficiency
onset of 1st episodes before \_\_\_\_\_\_\_\_ of age
lower \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_ of the year
A 
male gender
older siblings
family hx
congenital abnormalities
immune deficiency
onset of 1st episodes before 6 months of age
lower economic status
season of the year
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3
Q

OME or AOM:

middle ear fluid is STERILE

A

OME

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4
Q

OME or AOM:

abx not indicated/not beneficial

A

OME

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5
Q

OME or AOM:

abx indicated if symptomatic

A

AOM

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6
Q

what does OME stand for

A

otitis media with effusion

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7
Q

Ear Anatomy:

what part is the “barrier to the external ear”

A

tympanic membrane/ear drum

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8
Q

Ear Anatomy:

what tube goes towards the external nose from the ear

A

eustachian tube

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9
Q

Ear Anatomy:

what anatomical difference makes infants/kids more likely to have ear infections

A

their eustachian tube is shorter/more flexible/more horizontal = easier to get infections via eustachian tube

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10
Q

two most common bacteria to cause an ear infection

A

streptococcus pneumoniae

haemophilus influenzae

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11
Q

Clinical Signs/Symptoms of an Ear Infection?

A

Otalgia (ear pain)
Fever
irritability/poor feeding/disrupted sleep/malaise
otorrhea (ear discharge)

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12
Q

The tympanic membrane in an ear infection will look like what?

A

bulging
red/erythematous
immobile = won’t move to pressure because fluid is filling it with fluid

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13
Q

AOM:

acute or prolonged onset?

A

acute

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14
Q

Severe AOM when?

A

when 1 of the 2 factors are present:

  • moderate to severe otalgia
  • or a fever >/= 39 C
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15
Q

2 general options for AOM

A

observe or treat with abx…

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16
Q

Management of AOM:

  • When observation: defer abx for ______
  • watch for resolution of symptoms
  • provide __________
A
  • 48-72 hours

- symptomatic relief (gimme dat APAP or ibuprofen)

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17
Q

decide to observe or treat based on what 4 things?

A

childs age
diagnostic certainty
illness severity
assurance of follow-up

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18
Q

Observe or Treat AOM chart:

Always treat when what symptoms?

A

otorrhea or severe AOM!!!

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19
Q

Observe or Treat AOM chart:

always treat what age?

A

< 6 months

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20
Q

Observe or Treat AOM chart:

when is the “observe option” appropriate?

A

if 6 - 2 yrs and UNILATERAL and non-severe
or
if >/= 2 years old and non-severe

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21
Q

Resistance to strep pneumoniae is due to what mechanism?

A

alterations in PBPs (penicillin binding proteins)

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22
Q

Resistance to Haemophilus influenzae is due to what mechanism?

A

beta lactamase production

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23
Q

1st line abx choice for AOM?

A

Amoxicillin

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24
Q

dose to do for Amoxicillin in AOM?

A

80 - 90 mg/kg/DAY — divide it to Q12H for 10 days

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25
when would you NOT use amoxicillin in AOM?
``` known resistance treatment failure Amoxicillin in the past 30 DAYS allergy (SHOCKING) concurrent conjuctivitis ```
26
AOM treatment: | what abx do you use as 2nd line
AMOX/CLAV 90 mg/kg/day of Amoxicillin divided Q12 (same if conjunctivitis or amox in past 30 days)
27
AOM treatment: | what abx do you use if conjunctivitis
AMOX/CLAV 90 mg/kg/day of Amoxicillin divided Q12 (same as if amox in past 30 days or treatment failure)
28
AOM treatment: | what abx do you use if amoxicillin in last 30 days
AMOX/CLAV 90 mg/kg/day of Amoxicillin divided Q12 (same as if contaminant conjunctivitis or treatment failure)
29
Dose clavulanate at = to ________/day or pt will have wild diarrhea
< 10 mg/kg/DAY
30
what Amox/Clav concen is best at preventing diarrhea side effect?
600 mg/42.9 mg clav/ 5 mL
31
if allergy to amoxicillin 2nd option for AOM?
cephalosporins | Cefdinir, Cefuroxime, Cefpodoxime --- aka the 2nd/3rd gens have much lower cross reaction
32
Ceftriaxone used in AOM when?
when oral treatment is not an option initial oral treatment fails highly resistant s.pneumoniae
33
Dosing of Ceftriaxone for AOM?
50 mg/kg IM - - if initial treatment: just ONE dose - - if treatment failure: 3 doses
34
Avoid Ceftriaxone in what age and why?
avoid in < 1 month of age | because gets to brain and cant get out of BBB = kernicterus aka neurological damage
35
Cautions of ceftriaxone?
avoid co-admin with Ca2+ in the line | and C.Diff risk (?)
36
AOM Follow UP: | when to check in for young infants with severe episode or kids of any age with continuing age
within DAYS
37
AOM Follow UP: | when to check in for infants/kinds with hx of frequent recurrences
within 2 weeks
38
AOM Follow UP: | when to check in for kids with only a sporadic episode of AOM
1 month after initial exam
39
UTIs in Peds: | most common pathogen
E.Coli :0
40
Signs/Sxs of UTI in newborns?
``` Jaundice Sepsis failure to thrive vomiting fever ```
41
Signs/Sxs of UTI in Infants/young kids?
``` fever strong smelling urine hematuria abdominal/flank pain new onset urinary incontinence ```
42
Signs/Sxs of UTI in school-aged children?
Dysuria Frequency urgency (similar to adults!)
43
Urinalysis: | when leukocyte esterase is present ---- it suggests ________ and presence of _____
inflammation; WBCs
44
To have nitrite: | process takes 4Hours -- why is this helpful to know when looking at urinalysis
aka so hard to see nitrite levels in babies because they empty their bladders so often
45
Nitrire is made from dietary nitrates in the presence of most _______ bacteria in urine
gram negative
46
how long to treat kids with UTIs when age 2 - 24 months?
7 - 14 days
47
Treatment options for UTIs: | what is 1st line
amoxicillin
48
Treatment options for UTIs: | what are other options than amoxicillin
cephalexin | SMX-TMP
49
most common cause of bronchiolitis?
RSV (respiratory syncytial virus)
50
risk factors for bronchiolitis?
``` Age < 6 mos pre-term birth cyanotic/complicated CHD Chronic lung disease weakened immune system ```
51
treatment of bronchiolitis?
its just viral...so NO ABX!!! | do supportive care (Oxygen, hydration, mechanical ventilation, ECMO)
52
Yay or Nay: | Use of beta adrenergic agonist in bronchioliotis?
Nay (no data)
53
Yay or Nay: | Use of corticosteroids in bronchioliotis?
Nay (no data)
54
Non-Pharm Prevention options for Bronchioliotis?
hand washing isolation "sick pods"?
55
Pharmacologic Prevention strategies of bronchioliotis?
flu vaccine | Palivizumab (Synagis)
56
Palivizimuab: | what is it?
NOT A VACCINE! | it is a humanized murine monoclonal antibody
57
Palivizimuab: | decreases rate of _________
RSV-associated hospitalization
58
Palivizimuab: | stop it when?
stop prophylaxis if RSV hospitalized
59
Palivizimuab: | not indicated for _______
RSV treatment
60
Dosing of Palivizimuab: | dosed how often?
once a month
61
Dosing of Palivizimuab: | does how many times
max of 5 doses!!!

PHRM 865 (59 decks)

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