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HEENT Flashcards

1
Q

Which of the following may cause microcephaly?

a) Hypocalcemia
b) Craniosynostosis
c) Skull fracture
d) Seizure disorder

A

b) Craniosynostosis

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2
Q

What finding may accompany macrocephaly?

a) Pulsating anterior fontanel
b) Sunken fontanel
c) Premature closure of suture lines
d) Widened suture lines

A

d) Widened suture lines

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3
Q

Obtaining a CT of the head would be indicated in which of these conditions?

a) Macrocephaly
b) Cephalohematoma
c) Craniosynostosis
d) Caput succedaneum

A

a) Macrocephaly

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4
Q

Which one of the following conditions increases the risk of developing hydrocephalus?

a) Bilateral cephalohematomas
b) Craniosynostosis
c) Prematurity
d) Familial macrocephaly

A

c) Prematurity

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5
Q

A conjunctivitis appearing in a 2 day old newborn is likely due to:

a) chemical irritation from eye drops
b) group B streptocuccus
c) chlamydia
d) gonorrhea

A

a) chemical irritation from eye drops

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6
Q

Confirming the diagnosis of chlamydia conjunctivitis in a newborn would best be done by obtaining which one of the following?

a) cervical swab of the mother
b) urine PCR from the mother
c) culture of the eye discharge
d) culture of the conjunctival scrapings

A

d) culture of the conjunctival scrapings

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7
Q

Which one of the following eye findings would be considered an ophthalmic emergency?

a) unilateral vesicular lesions on the upper eyelid of a 3 week old
b) presence of chemosis in a 5 yo with bilateral upper eyelid edema
c) cobblestone-like appearance along the inner aspect of the upper eyelid in a 15 yo
d) bilateral redness along the eyelid margins with tiny ulcerated areas in a 16 yo

A

a) unilateral vesicular lesions on the upper eyelid of a 3 week old

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8
Q

The most appropriate management of a 5 yo with a firm, nontender nodule in the mid-upper eyelid for 3 weeks would be:

a) cool compresses
b) topical ophthalmic ointment
c) oral antibiotics
d) oral steroids

A

b) topical ophthalmic ointment

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9
Q

Daily eyelid cleansing with diluted baby shampoo and a cotton tipped applicator would be appropriate in the treatment of which one of the following conditions?

a) Dacryostenosis
b) Chalzion
c) Hordeolum
d) Blepharitis

A

d) Blepharitis

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10
Q

A 3 year old has an edematous, mildly erythematous right upper eyelid for one day with a fever of 103. An important eye assessment would be:

a) ocular mobility
b) conjunctival inflammation
c) pupillary reaction
d) optic disk papilledema

A

a) ocular mobility

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11
Q

Concurrent otitis media and conjunctivitis is likely due to which organism?

a) streptococcus pneumoniae
b) haemophilus influenza
c) moraxella catarrhalis
d) staphylococcus aureus

A

b) haemophilus influenza

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12
Q

All but which one of the following is consistent with glaucoma?

a) photophobia
b) epiphora (increased tears)
c) blepharospasm
d) leukocoria

A

d) leukocoria

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13
Q

All but which one of the following assessments is used to determine the presence of a strabismus:

a) Hirschberg test
b) Cover-uncover test
c) Extraocular movements
d) Pupillary response

A

d) Pupillary response

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14
Q

A 3 month old has a mild asymmetrical corneal light reflex on physical exam. What is the next appropriate step?

a) observe and reevaluate at the next well check
b) refer immediately to ophthalmology
c) begin atropine drops or eye patching
d) protect eyes from sunlight

A

a) observe and reevaluate at the next well check

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15
Q

Prematurity increases the risk of developing which one of the following?

a) nystagmus
b) astigmatism
c) myopia
d) glaucoma

A

c) myopia

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16
Q

Fluorescein staining of the eye is used to detect a:

a) keratitis
b) foreign body
c) corneal abrasion
d) hyphema

A

c) corneal abrasion

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17
Q

Trauma to the eye increases the risk of developing all but which one of the following?

a) strabismus
b) glaucoma
c) cataracts
d) hyphema

A

a) strabismus

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18
Q

Corneal abrasions can be managed with topical application of which of the following:

a) anesthetic for pain control
b) steroids to prevent adhesions
c) antibiotics to prevent infection
d) atropine to prevent ciliary spasm

A

c) antibiotics to prevent infection

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19
Q

The greatest risk in a patient with a hyphema is which of the following?

a) glaucoma
b) infection
c) rebleed
d) cataracts

A

c) rebleed

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20
Q

A 16 yo was hit in the eye 1 day ago and now has ecchymoses on the upper and lower lids with 5/10 eye pain. All but which of the following would be appropriate to obtain at this time:

a) visual acuity
b) intraocular pressure
c) CT scan
d) fluorescein stain

A

b) intraocular pressure

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21
Q

A 10 yo has marked ear pain, not wanting anyone to touch his ear. The canal is edematous and exudate is present. TM is normal. How should this be managed?

a) topical fluoroquinolone
b) oral steroids and topical neomycin
c) oral amoxicillin and topical anesthetic
d) oral amoxicillin and topical steroid

A

a) topical fluoroquinolone

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22
Q

Patients with otitis externa should be instructed to do which one of the following:

a) keep ear dry until symptoms improve
b) limit swimming for the remainder of summer
c) wear ear plugs at all times with swimming
d) use alcohol drops before swimming each day

A

a) keep ear dry until symptoms improve

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23
Q

All but which one of the following patients are at an increased risk of developing otitis media?

a) 2 yo with cleft palate repair at 1 year of age
b) 15 mo with down syndrome
c) 9 mo with lactose intolerance
d) 3 yo with IgA immune deficiency

A

c) 9 mo with lactose intolerance

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24
Q

A 15 mo failed treatment with amoxicillin for OM. At his 2 week re-check his TM remained red with distorted landmarks and he persisted with nasal congestion, poor sleep, and fever. The next best step would be to treat with:

a) a 10 day course of augmentin
b) a 3 week course of cephalosporin
c) a higher dose of amoxicillin and topical abx
d) ceftriaxone and an antihistamine

A

a) a 10 day course of augmentin

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25
Q

A 2 yo male with a history of chronic serous OM is noted to have a pearly white opacity in the upper outer quadrant of his TM. He currently has no symptoms and appears to be ok. The most likely diagnosis and appropriate managment would be:

a) tympanosclerosis; no treatment is necessary
b) persistent perforation; prescribe topical antibiotic drops
c) foreign body; perform an ear wash for removal
d) cholesteatoma; refer to otolaryngology

A

d) cholesteatoma; refer to otolaryngology

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26
Q

A 7 yo has experienced recurrent nose bleeds in the past 2 months. What finding on the physical exam would suggest an underlying medical cause for the epistaxis?

a) wheezing
b) grade II murmur
c) petechiae
d) tonsil hypertrophy

A

c) petechiae

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27
Q

An 8 yo has chronic intermittent nasal congestion. All but which of the following would support allergic rhinitis?

a) pale, boggy turbinates
b) darkened areas on lower eyelids
c) increased basophils on cbc
d) itchy, watery eyes

A

c) increased basophils on cbc

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28
Q

Acceptable management options for allergic rhinitis include all of the following except:

a) oral cetirizine
b) oral montelukast
c) nasal beclomethsone
d) nasal neosynephrine

A

d) nasal neosynephrine

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29
Q

Which foreign body in the nose needs immediate removal?

a) bean
b) bead
c) stone
d) battery

A

d) battery

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30
Q

What complication of sinusitis are adolescent males more prone to?

a) intracranial abscess
b) potts puffy tumor
c) orbital cellulitis
d) dental infection

A

a) intracranial abscess

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31
Q

Patients with sinusitis should be instructed not to participate in what activity?

a) swimming/ diving
b) boxing/ wrestling
c) weight lifting
d) cross country running

A

a) swimming/ diving

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32
Q

All of the following may predispose a patient to thrush except:

a) age
b) steroid therapy
c) antibiotics
d) poor oral hygiene

A

d) poor oral hygiene

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33
Q

A 9 month old is noted to have a bifid uvula. This would increase his risk of developing which disorder?

a) otitis media
b) retropharyngeal abscess
c) sinusitis
d) dental malocclusion

A

a) otitis media

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34
Q

A 10 yo has a single painful ulcerated lesion on an erythematous base on the inner buccal mucosa. The most likely diagnosis and treatment would be:

a) herpes simplex stomatitis–oral acyclovir
b) herpangina–viscous xylocaine
c) apthous ulcer–triamcinalone in orabase
d) Hand, foot, mouth syndrome–antibiotic mouthwash

A

c) apthous ulcer–triamcinalone in orabase

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35
Q

Initial exposure to the herpes virus may produce all of the following except:

a) fever and dehydration
b) submandibular lymph nodes
c) vesicular lesions on tonsils
d) friable and edematous gingiva

A

c) vesicular lesions on tonsils

36
Q

The organism that causes hand, foot, mouth syndrome is what virus?

a) cytomegalovirus
b) parainfluenza
c) varicella-zoster
d) coxsakie

A

d) coxsakie

37
Q

Which one of the following complications of strep pharyngitis cannot be prevented with antibiotics?

a) peritonsillar abscess
b) cervical adenitis
c) glomerulonephritis
d) acute rheumatic fever

A

b) cervical adenitis

38
Q

In addition to penicillin, all of the following antibiotics can be used to treat strep pharyngitis except:

a) clindamycin
b) erythromycin
c) bactrim
d) ceftriaxone

A

c) bactrim

39
Q

Retropharyngeal abscess is typically seen in what age group and mainstay treatment includes:

a) neonates; hospitalization for IV abx
b) 2-6 yo; ICU admission and IV abx
c) 6-12 yo; outpatient oral antibiotics
d) Adolescent; ENT drainage of abscess

A

b) 2-6 yo; ICU admission and IV abx

40
Q

Findings consistent of peritonsillar abscess include all of the following except:

a) muffled voice
b) unilateral enlargement of tonsil
c) trismus
d) exudate of tonsil

A

d) exudate of tonsil

41
Q

Appropriate lab tests to obtain in assessment of cervical adenitis include all of the following except:

a) throat culture
b) mono test
c) PPD test
d) blood culture

A

d) blood culture

42
Q

The incidence of epiglottis has decreased because of which vaccine?

a) Hib
b) Prevnar
c) Varicella
d) Meningococcal

A

d) Meningococcal

43
Q

Patients with epiglottis prefer to sit in what position?

a) sitting up and leaning forward
b) left lateral position
c) supine with neck hyperextended
d) 45 degree upright, resting back

A

a) sitting up and leaning forward

44
Q

All but which one of the following conditions requires urgent inpatient admission?

a) cervical adenitis
b) retropharyngeal abscess
c) epiglottis
d) orbital cellulitis

A

a) cervical adenitis

45
Q

Conductive hearing loss can be caused by:

a) brain tumor
b) ototoxic drug exposure
c) loud noises
d) serous otitis

A

d) serous otitis

46
Q

Following an episode of meningitis, it is most important to assess the child for:

a) hearing loss
b) changes in taste
c) cervical lymphadenopathy
d) tinnitus

A

a) hearing loss

Complications of meningitis include hydrocephalus, deafness, and blindness.

47
Q

An 8 yo boy has been brought to the clinic with a chief complaint of ear pain. When you grasp the pinna he says it hurts. These findings are consistent with a diagnosis of:

a) serous otitis media
b) mastoiditis
c) otitis externa
d) cholesteatoma

A

c) otitis externa

Exquisite tenderness is noted when pressure is placed on the tragus or pinna of the ear with OE.

48
Q

A 10 yo has been diagnosed with OE twice this year. Health teaching for him and his mother should include:

a) Emphasis on consistent use of low-dose prophylactic antibiotics
b) sleeping with the affected ear in the dependent position
c) Information on the use of decongestants to open the eustacian tube
d) Information on the use of acetic acid after ear canal contact with water

A

d) Information on the use of acetic acid after ear canal contact with water

OE can be prevented by instilling 2% acetic acid (half-strength vinegar) in the external auditory canal after ear canal contact with water. Half isopropyl alcohol can also be used.

49
Q

Following tympanostomy tube insertion, it is important that the tubes remain patent. Which of the following methods may be used to determine patency?

a) visual inspection
b) impedance tympanometry
c) valsalva maneuver
d) instillation of an ototopical suspension

A

a) visual inspection

50
Q

The diagnosis of acute otitis media in a 1 yo is based on:

a) abnormal finding when pnneumatic otoscopy and hearing test are perormed
b) changes in the tympanic membrane’s contour, color, and mobility
c) presence of fever and color of the tympanic membrane
d) presence of fever, ear pain, and tenderness of the pinna

A

b) changes in the tympanic membrane’s contour, color, and mobility

51
Q

A 12 mo has been treated 5 times for acute OM. When planning his follow up care it is most important to evaluate for which of the following?

a) OE
b) hearing loss
c) enlarged tonsils
d) shotty lymph nodes

A

b) hearing loss

Children who have multiple infections should have their hearing assessed.

52
Q

A 13 yo presents with a sore throat. History reveals he had a sore throat a couple of weeks ago and thought he had gotten well. He now has severe throat pain of 2 days duration, has been sweating, and thinks he has a fever. Temp 102 and red swollen throat and soft palate. The right tonsil is swollen and inflamed without exudate and the uvula is displaced to the left. Right cervical nodes are tender. Lungs are clear to auscultation. Signs and symptoms are suggestive of:

a) Acute uvulitis
b) Viral pharyngitis
c) Epiglottitis
d) Peritonsillar abscess

A

d) Peritonsillar abscess

Usually treated with incision & drainage and antibiotics.

53
Q

Which of the following is an expected finding after treatment of acute suppurative otits media?

a) OE
b) central auditory dysfunction
c) functional hearing loss
d) middle ear effusion

A

d) middle ear effusion

Middle ear effusion (serous otitis media) is frequently seen after acute otitis media.

54
Q

The mother of a 2 yo has brought her to the clinic because she thinks the child is having trouble hearing. Your evaluation of the complaint should start with:

a) asking detailed questions related to her medical history
b) examination of the ear
c) tympanometry and hearing tests
d) assuring the mother that transient hearing loss in childhood is common

A

a) asking detailed questions related to her medical history

The investigation of all complaints begins with exploration of the history.

55
Q

Assessment of the red reflex may be used to rule out which of the following?

a) opacities
b) myopia or hyperopia
c) decreased visual acuity
d) blindness

A

a) opacities

A normal red reflex rules out opacities, intraocular tumor, and coloboma.

56
Q

The mother of a 2 yo has brought her to the clinic because she got bathroom cleanser in her eye 30 minutes ago. Physical exam reveals a reddened right eye with an edematous lid. Initial treatment should include:

a) Allowing the natural tearing process to cleanse the eye
b) performing a retinal fundoscopic examination to assess for burns
c) Irrigating the eye with copious amounts of normal saline
d) Referring her to an ophthalmologist

A

c) Irrigating the eye with copious amounts of normal saline

Acid or alkali chemical eye injuries are acute emergencies and require copious normal saline. Over irrigation is not a problem, but litmus paper can be used to determine when the chemical has been neutralized. The child should be referred to an ophthalmologist after irrigation of the eye.

57
Q

The mother of a 5 yo has brought him to the clinic because she thinks he has pinkeye. Which of the following would lead you to consider a diagnosis other than bacterial conjunctivitis?

a) Hyperemic conjunctiva
b) Scratchy sensation in the eye
c) Decreased corneal clarity
d) Copious tearing

A

c) Decreased corneal clarity

Bacterial conjunctivitis does not affect corneal clarity. A more serious condition should be suspected (such as keratitis, corneal ulcer, or glaucoma) and the child should be referred to an ophthalmologist if the cornea is not clear.

58
Q

An 18 mo has had a cold for the past 4 days. There is no history of cough and the mother is unsure whether she had a fever. Exam reveals greenish, blood-tinged mucus with a strong, foul odor, draining from the right nostril. The clinical picture is most consistent with:

a) allergic rhinitis
b) viral rhinitis
c) acute sinusitis
d) nasal foreign body

A

d) nasal foreign body

Nasal foreign body is characterized by unilateral purulent discharge that may be blood tinged. Nasal discharge is very foul smelling.

59
Q

In a child with chronic sinusitis, the most accurate method of identifying sinus abnormalities is:

a) dark room transillumination of the sinuses
b) percussion of the paranasal sinuses
c) AP, lateral, and occipitomental sinus radiographs
c) CT scan of the sinuses

A

c) CT scan of the sinuses

CT scans are superior to sinus radiographs in the identification of abnormalities. A normal radiograph suggests, but does not prove, that sinuses are free of disease.

60
Q

A 10 you has a cold. History reveals a runny nose and cough for about 10 days. No history of frequent respiratory problems. Temp 100, and edematous cervical lymph nodes. Eyes are without redness/swelling. Nose with mucopurulent drainage from the middle meatus bilaterally. The throat is erythematous without tonsillar enlargement or exudate. Breath is malodorous and lungs are clear. Mikes management should include:

a) culture of the nasal drainage
b) radiograph of the sinuses
c) measurement of erythrocyte sed rate
d) use of an antibiotic

A

d) use of an antibiotic

The signs and symptoms, especially mucopurulent drainage from the middle meatus, are supportive of a diagnosis of acute sinusitis.

61
Q

A 10 you has a cold. History reveals a runny nose and cough for about 10 days. No history of frequent respiratory problems. Temp 100, and edematous cervical lymph nodes. Eyes are without redness/swelling. Nose with mucopurulent drainage from the middle meatus bilaterally. The throat is erythematous without tonsillar enlargement or exudate. Breath is malodorous and lungs are clear. Two days after his first visit his mom brings him back because he has a swollen eye. Observation reveals redness and inflammation of the right eyelid with impaired extraocular movement. Which action is appropriate?

a) reassure the mother that this is a common and usually benign condition
b) treat mike for bacterial conjunctivitis
c) order anti-inflammatory eye drops
d) refer mike immediately to the ED

A

d) refer mike immediately to the ED

History of sinusitis often precedes orbital cellulitis. Examination indicates that pt may have orbital cellulitis, a medical emergency that requires hospitalization and IV antibiotics. He should be referred to the emergency room.

62
Q

12 yo presents with c/o runny nose for 2 weeks. History reveals that pt has had 3 other visits for respiratory complaints this year. Exam reveals slightly edamatous and erythematous eyes, pale nasal mucosa with clear mucous, and pharynx with thin secretions posteriorly. There is no tonsillar swelling or exudate. Lips and nail beds are pink. Lymph node examination is significant for shotty nodes. Lungs are clear. Which action is appropriate?

a) discuss symptomatic relief of the common cold
b) culture nasal drainage and delay treatment until results are known
c) order an antibiotic
d) order an antihystamine

A

d) order an antihystamine

Repeated episodes of upper respiratory illness, clear nasal secretions, and pale nasal mucosa are common in children with allergies. Antihistamines are used to treat seasonal and perennial allergies.

63
Q

A 1 wo infant has been diagnosed with nasolacrimal duct obstruction. A typical initial therapy includes:

a) use of prophylactic oral antibiotics
b) nasolacrimal sac massage
c) surgical opening of obstructed ducts
d) referral to an opthalmologist

A

b) nasolacrimal sac massage

Downward strokes raises the pressure in the nasolacrimal sac and may overcome the obstruction. Referral to an ophthalmologist is indicated if the condition persists beyond 6 months or is frequently purulent.

64
Q

A 4 yo has “something wrong with her eye”. Mom reports that there has been no injury to the eye and it has been red since yesterday. Examination reveals conjunctival hyperemia and a copious amount of purulent discharge bilaterally. Vision, pupillary reflexes, and corneal clarity are all normal. Which treatment should be ordered?

a) sodium sulfacetamide opthalmic solution
b) gentamycin opthalmic solution
c) tobramycin opthalmic solution
d) chromolyn sodium opthalmic solution

A

a) sodium sulfacetamide opthalmic solution

Presentation supports bacterial conjunctivitis. Sodium sulfacetamide, erythromycin, or polymixin B sulfate-trimethoprim sulfate solution are appropriate first-line treatments. Gentamycin and tobramycin should be reserved for suspected gram-negative bacterial conjuctivitis. Cromolyn sodium is used to treat allergic conjunctivitis.

65
Q

During the routine examination of a 12 yo boy, you detect a group of hard, fixed, nontender lymph nodes, each of which measure about 1 cm in the posterior cervical chain. You are unable to detect any signs of infection. Your management should include:

a) Recording the finding and reassessing the nodes in 1 month
b) Ordering a 10 day course of a broad spectrum antibiotic and reevaluating the nodes in 2 weeks
c) Ordering a CBC, erythrocyte sed rate and chest radiograph
d) Referring the child to an allergist

A

c) Ordering a CBC, erythrocyte sed rate and chest radiograph

Nodes that are matted, hard, fixed, and nontender are characteristic of cancer. Lymph nodes associated with Hodgkin’s disease usually begin in the lower cervical area.

66
Q

Which method might be used to assess the vision of a 1 month old child?

a) check the vessel pattern of the fundus of the eye
b) watch to see if the infant turns his or her head towards you when you speak
c) observe the pattern of interaction with the mother
d) perform the titmus test on the infant

A

c) observe the pattern of interaction with the mother

Nonquantitative, but clinically helpful information may be gained about the infant’s vision by observing whether or not the infant fixates on and attempts to follow the mother’s face.

67
Q

First line treatment for gonococcal conjunctivitis of the newborn:

A

Ceftriaxone 25 to 50 mg/kg/day IV or IM not to exceed 125mg as a single dose
Topical treatment is inadequate and is not necessary when systemic therapy is given.
The eyes should also be irrigated frequently with NS to clear purulent discharge

68
Q

First line treatment for chlamydia conjunctivitis (and chlaydial pneumonia):

A

Oral erythromycin 50mg/kg/day in four divided doses for 10-14 days

69
Q

First line treatment for bacterial conjunctivitis:

A 
Topical ophthalmic eye drops: 
tobramycin
erythromycin
sulfacetamide
polymyxin B sulfate-trimethoprim
fluoroquinolone
70
Q

Nasolacrimal duct obstruction should resolve spontaneously by what age?

A

1 year old; may refer to ophthalmology at 6 months if not responding to massage.

71
Q

When do you refer for strabismus?

A

If strabismus is fixed or continuous after 6 month old, or if constant exotropia by 3 months of age.

72
Q

First line treatment for OE:

A

Topical antibiotic otic drops:
neomycin
polymixin
fluoroquinolone
ofloxacin is safe if PE tubes or TM rupture
The addition of hydrocortisone is helpful if canal is edematous.

73
Q

First line treatment for OM:

A

Amoxicillin 80-90 mg/kg/day, twice a day, for 10 days
(if history of a non-anaphylactic reaction may use cefdinir)
Cefdinir 14mg/kg daily for 10 days (can cause red stool)

74
Q

Second line treatment for OM:

A

Augmentin 90 mg/kg/day of amoxicillin, twice a day, for 10 days
If no improvement on amoxicillin after 48-72 hours or recurrence within one month of treatment.

75
Q

Third line treatment for OM:

A

Ceftriaxone 50mg/kg 2 doses IM, 48 hours apart with option for a third dose.

76
Q

Fexofenadine dosing:

A

(Allegra) *nonsedating
6 mo-2 yr: 15mg twice a day
2-11 yr: 30mg twice a day
12 yr+: 60mg twice a day

77
Q

Loratidine dosing:

A

(Claritin) *nonsedating
2-5 yr: 5mg daily
6 yr+: 10mg daily

78
Q

Cetirizine dosing:

A

(Zyrtec)
6 mo-2 yr: 2.5mg daily, may increase to twice daily
2-5 yr: 2.5mg daily, may increase to 5mg in 24 hours
6 yr+: 5-10mg daily

79
Q

Montelukast dosing:

A

(Singulair)
6 mo-5 yr: 4mg at bedtime
6-14 yr: 5mg at bedtime
14 yr+: 10mg at bedtime

80
Q

Diphenhydramine dosing:

A

(Benadryl)

5mg/kg/day every 6 hours as needed

81
Q

First line treatment for sinusitis:

A

Amoxicillin 80-90 mg/kg/day, twice a day, for 10-14 days
(if history of a non-anaphylactic reaction may use cefdinir)
Cefdinir 14mg/kg daily for 10 days (can cause red stool)

82
Q

Second line treatment for sinusitis:

A

Augmentin 90 mg/kg/day of amoxicillin, twice a day, for 10 days
If no improvement on amoxicillin after 48-72 hours or recurrence within one month of treatment.

83
Q

First line treatment for thrush:

A

Nystatin oral suspension applied to oral mucosa 4 times/day for 10 days. Treat nipples if breast feeding.
Assess bottom for candidal diaper rash.

84
Q

Second line treatment for thrush:

A

Fluconazole 6mg/kg once followed by 3mg/kg every 24-72 hours for 7 to 14 days.

85
Q

Treatment for group A strep throat:

A

Penicillin V Potassium 250 ( 27kg) every 8 hours for 10 days

Amoxicillin 50mg/kg once a day for 10 days, maximum daily dose 1000mg.

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