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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
Q

when would you NOT use amoxicillin in AOM?

A 
known resistance
treatment failure
Amoxicillin in the past 30 DAYS
allergy (SHOCKING)
concurrent conjuctivitis
26
Q

AOM treatment:

what abx do you use as 2nd line

A

AMOX/CLAV
90 mg/kg/day of Amoxicillin divided Q12

(same if conjunctivitis or amox in past 30 days)

27
Q

AOM treatment:

what abx do you use if conjunctivitis

A

AMOX/CLAV
90 mg/kg/day of Amoxicillin divided Q12

(same as if amox in past 30 days or treatment failure)

28
Q

AOM treatment:

what abx do you use if amoxicillin in last 30 days

A

AMOX/CLAV
90 mg/kg/day of Amoxicillin divided Q12

(same as if contaminant conjunctivitis or treatment failure)

29
Q

Dose clavulanate at = to ________/day or pt will have wild diarrhea

A

< 10 mg/kg/DAY

30
Q

what Amox/Clav concen is best at preventing diarrhea side effect?

A

600 mg/42.9 mg clav/ 5 mL

31
Q

if allergy to amoxicillin 2nd option for AOM?

A

cephalosporins

Cefdinir, Cefuroxime, Cefpodoxime — aka the 2nd/3rd gens have much lower cross reaction

32
Q

Ceftriaxone used in AOM when?

A

when oral treatment is not an option
initial oral treatment fails
highly resistant s.pneumoniae

33
Q

Dosing of Ceftriaxone for AOM?

A

50 mg/kg IM

    • if initial treatment: just ONE dose
    • if treatment failure: 3 doses
34
Q

Avoid Ceftriaxone in what age and why?

A

avoid in < 1 month of age

because gets to brain and cant get out of BBB = kernicterus aka neurological damage

35
Q

Cautions of ceftriaxone?

A

avoid co-admin with Ca2+ in the line

and C.Diff risk (?)

36
Q

AOM Follow UP:

when to check in for young infants with severe episode or kids of any age with continuing age

A

within DAYS

37
Q

AOM Follow UP:

when to check in for infants/kinds with hx of frequent recurrences

A

within 2 weeks

38
Q

AOM Follow UP:

when to check in for kids with only a sporadic episode of AOM

A

1 month after initial exam

39
Q

UTIs in Peds:

most common pathogen

A

E.Coli :0

40
Q

Signs/Sxs of UTI in newborns?

A 
Jaundice
Sepsis
failure to thrive
vomiting 
fever
41
Q

Signs/Sxs of UTI in Infants/young kids?

A 
fever
strong smelling urine
hematuria
abdominal/flank pain
new onset urinary incontinence
42
Q

Signs/Sxs of UTI in school-aged children?

A

Dysuria
Frequency
urgency
(similar to adults!)

43
Q

Urinalysis:

when leukocyte esterase is present —- it suggests ________ and presence of _____

A

inflammation; WBCs

44
Q

To have nitrite:

process takes 4Hours – why is this helpful to know when looking at urinalysis

A

aka so hard to see nitrite levels in babies because they empty their bladders so often

45
Q

Nitrire is made from dietary nitrates in the presence of most _______ bacteria in urine

A

gram negative

46
Q

how long to treat kids with UTIs when age 2 - 24 months?

A

7 - 14 days

47
Q

Treatment options for UTIs:

what is 1st line

A

amoxicillin

48
Q

Treatment options for UTIs:

what are other options than amoxicillin

A

cephalexin

SMX-TMP

49
Q

most common cause of bronchiolitis?

A

RSV (respiratory syncytial virus)

50
Q

risk factors for bronchiolitis?

A 
Age < 6 mos
pre-term birth
cyanotic/complicated CHD
Chronic lung disease
weakened immune system
51
Q

treatment of bronchiolitis?

A

its just viral…so NO ABX!!!

do supportive care (Oxygen, hydration, mechanical ventilation, ECMO)

52
Q

Yay or Nay:

Use of beta adrenergic agonist in bronchioliotis?

A

Nay (no data)

53
Q

Yay or Nay:

Use of corticosteroids in bronchioliotis?

A

Nay (no data)

54
Q

Non-Pharm Prevention options for Bronchioliotis?

A

hand washing
isolation
“sick pods”?

55
Q

Pharmacologic Prevention strategies of bronchioliotis?

A

flu vaccine

Palivizumab (Synagis)

56
Q

Palivizimuab:

what is it?

A

NOT A VACCINE!

it is a humanized murine monoclonal antibody

57
Q

Palivizimuab:

decreases rate of _________

A

RSV-associated hospitalization

58
Q

Palivizimuab:

stop it when?

A

stop prophylaxis if RSV hospitalized

59
Q

Palivizimuab:

not indicated for _______

A

RSV treatment

60
Q

Dosing of Palivizimuab:

dosed how often?

A

once a month

61
Q

Dosing of Palivizimuab:

does how many times

A

max of 5 doses!!!

PHRM 865 (59 decks)

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