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Peds > management > Flashcards

management Flashcards

1
Q

diphtheria

pharmacologic treatment (2) plus duration

A
  • diphtheria antitoxin x 1 dose to neutralize free toxins
    < 2 days: 40-60k units; > 2 days: 80-120k units
  • antibiotic - to erradicate organism, prevent spread
    erythromycin 50 mkday q6 x 14 days
    aqueous penicillin G 100-150k u/kg/da q6 x 14 days
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2
Q

diphtheria

nonpharmacologic tx

A
  • droplet and contact prec
  • bed rest x 2 weeks
  • immunization upon recovery
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3
Q

diphtheria

asymptomatic case contacts, first & second line

A
  • monitor x 7 days
  • culture nose, throat, cutaneous lesions
  • Erythromycin 40-50 mkda q6 x 10 days OR
  • Benzanthine Pen G 600k to 1.2 M IU x 1 dose
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4
Q

Acute pharyngitis

A
  • Penicillin V 25-50 mkday q6 x 10 days
  • Amoxicillin 50 mkday q8-12 x 10 days

allergic:
azithromycin 12 mkday x 5 days

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5
Q

Peritonsillar abscess

first line IV + stepdown; second line

A
  • IV ampicillin-sulbactam 100 mkday q6
    then coamox 40 mkday q8
  • ceftriaxone 50 mkday + metro 30 mkday
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6
Q

Peritonsillar abscess

indications for tonsillectomy

A
  • no improvement after 24 hrs of abx and drainage
  • recurrent
  • complications from peritonsillar abscess
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7
Q

Retropharyngeal abscess

first line, stepdown

A
  • IV ampicillin-sulbactam 100 mkday q 6 then
  • coamoxiclav 40 mkday q6
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8
Q

EBV

nonpharma, pharma

A
  • rest, supportive, avoid contact sports x 2-3 wks
  • PREDNISONE 1 mkda x 7 days (airway obst, thrombocytopenia, hemorrhage, anemia, seizure, mening)
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9
Q

Croup

A
  • racemic epinephrine 0.5ml in 3ml NSS q 20 mins
  • dexamethasone 0.15 - 0.6 mkdose x 1 dose
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10
Q

Bacterial tracheitis

A
  • ceftriaxone 50-75 mkday q 12-24 PLUS
  • clinda 30-40 mkday q 6-8 or vanco 15 mkdo q 6
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11
Q

Acute epiglotitis

A
  • Ceftriaxone 50-75 mkday q12 x 10 days
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12
Q

Acute epiglottitis

prophylaxis - tx, who

A

Rifampicin 20 mkda x 4 days
- all household members
- < 4 yo, incomplete Hib
- < 12 mos, incomplete primary series
- immunocompromised

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13
Q

PCAP, nonsevere

A

duration of tx - 7 days
- amoxicillin 40-50 mkday q 8
- coamox 80-90 mkday q 12
- cefuroxime 20-30 mkday q 12

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14
Q

PCAP, severe
complete Hib

A

Penicillin G 200k IU q6

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15
Q

PCAP, severe
incomplete/unknown hib

A

Ampicillin 200 mkday q6

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16
Q

PCAP, severe
high level of pcn resistance

A

Cefuroxime 100-150 mkday q8;
ceftriaxone 75-100 mkday q12-24;
ampisul 200 mkday q 6

17
Q

PCAP, influenza severe

A

Oseltamivir within 48 hrs of sx; BID x 5 days
> 1yo, 15 kg: 30 mg
15-23 kg: 45 mg
23-40 kg: 60 mg
>40 kg: 75 mg

18
Q

Pertussis

A

Azithromycin x 5 days
< 6 mos: 10 mkday
> 6 mos: 10 mkday D1, 5 mkday D2-5

19
Q

Hydration for mild to moderate dehdydration

A

rehydration: 75 ml/kg ORS x 4 hrs
replacement:
< 10 kg: 50-100ml/kg per loose stool, max 500
> 10 kg: 100-200 ml/kg; max 1L
adolescents: ad libitum, max 2L

20
Q

Hydration for severe dehydration

A

20-30 ml/kg over 30-60 mins then
70 ml/kg over 2.5-5 hrs

10ml/kg for malnourished

21
Q

tetanus

A
  • human tetanus immunoglobulin 500 U IM x 1 dose to neutralize toxin
  • metronidazole 30 mkday q6 x 7-10 days to decrease organism
  • ms. relaxant: diazepam 0.1-0.2 mkdo
  • dark, quiet, secluded setting
22
Q

botulism

A
  • human botulism immune globulin 50-100 mkdo x 1 dose
  • no antibiotics
23
Q

GBS

A
  • IVIG 0.4 g/kg/day x 5 days or 1 g/kg/day x 2 days for severe or rapidly progressive weakness
  • steroids, narcotic analgesic for pain
24
Q

osteomyelitis

A

clindamycin 30 mkday q8 +/- ceftri 100 mkday
mrsa: vancomycin 20 mkdose q8
* 4-6 wks

25
Q

septic arthritis

A

empiric
- clindamycin 30-40 mkday q6 or vancomycin 20 mkdo q8
- shift to oxacillin 150-200 mkday q6 if mssa
* 3 wks

26
Q

reactive arthritis

A

NSAIDS
- naproxen 10-15 mkda BID RTC x 2 wks
- ibuprofen for younger kids
- treat infection if still ongoing

27
Q

myasthenia gravis

A

pyridostigmine bromide 0.5-1 mkdose q4-6
longterm prednisone treatment

28
Q

MIS-C

A
  • IVIG 2g/kg over 8-12 hrs
  • Methylprednisolone 1-2 mg/kg/day q12 then shift to pred 1-2 mkda once afebrile
  • aspirin 3-5 mkday
29
Q

Kawasaki

A
  • IVIG 2 g/kg over 8-10 hrs within 10 days
  • high dose aspirin 80-100 mg/kg/day q6 until afebrile for 48 hr then reduce to 3-5 mkda x 6-8 wks
30
Q

Kawasaki, IVIG resistant

A
  • 2nd dose IVIG 2g/kg OR
  • methylpred 20-30 mg/kg x 3 days then taper over 2-3 weeks OR
  • infliximab 5 mg/kg x 1 dose
31
Q

COVID, severe to critical

A
  • Dexamethasone 0.15 mkda IV OD up to 10 days OR methylpred 0.8 mg/kg IV OD
  • Remdesivir 5 mg/kg D1 then 2.5 mg/kg D2 onwards x 5-10 days (for O2 requ, not intubated)
32
Q

TTN

A
  • O2 support
  • salbutamol - facilitates fluid clearance by activating NaKATPase and ENaC
33
Q

RDS

prophylaxis, treatment, prevention

A
  • ncpap - prophylactic, or if FiO2 40-70% needed to maintain sats > 90%
  • INSURE
    intubate, surfactant, extubate
    SURFACTANT
    4 ml/kg q6-12 up to 2-4 doses
  • antenatal corticostaroids at 24-36 weeks
34
Q

breast feeding jaundice

A
  • admit
  • ensure adequate breastfeeding at least 10 times per day
  • start intensive phototherapy
  • ensure adequate UO and BM
  • repeat bili after 6 hrs of intensive phototherapy
35
Q

orbital cellulitis

A

IV ampisul 200 mkda q6 or clinda 40 mkda q6-8 PLUS ceftriaxone 100-200 mkda q8 /cefotaxime 75-100 mkda q 12-24

add vancomycin 15 mkdo q6 and metro 30 mkda q8 if with CNS extension

36
Q

ophthalmia neonatorum prophylaxis

all bbs, mom w gonococcal infection

A
  • 0.5% erythromycin ointment, 1 strip to both eyes
  • 1% silver nitrate
  • ceftriaxone 50 mkdo IM for infants born to mothers with untreated gonococcal infection
37
Q

ophthalmia neonatorum N. gonorrhea

A
  • eye irrigation with normal saline q10-30 mins until discharge is clear
  • ceftriaxone 25-50 mkday q24 IM/IV x 1 DOSE

if w sepsis:
cefotaxime 50 mkdo q12 x 7 days

if w meningitis: cefotax 10-14 days

38
Q

ophthalmia neonatorum Chlamydia

A
  • eye irrigation with normal saline q10-30 mins until discharge is clear
  • erythromycin 50 mkday q6 x 14 days
39
Q

acute purulent conjunctivitis

A

tobramycin eye drops, 1-2 drops q4 x 7 days

Peds (3 decks)

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