OnlineMedEd: Pediatrics - "Peds ID Review"

Question 1

What is the correct order for managing suspected meningitis?

Answer 1

LP - blood cultures - antibiotics

If they cannot get an LP (due to suspected intracranial hypertension), then you do a CT after the antibiotics.

Question 2

What is one sign of meningitis that only kids have?

Answer 2

Bulging fontanelles

Question 3

What are the recommended meningitis treatments for adults and kids?

Answer 3

•Adults:

• Ceftriaxone
• Vancomycin
• Steroids

• Kids:

• Vancomycin
• Cefotaxime (because ceftriaxone can cause hyperbilirubinemia in neonates)
• Ampicillin
• Steroids

Question 4

True or false: ELISAs can be done after 3 months of age.

Answer 4

False.

Babies can have maternal antibodies up to 18 months.

Do a DNA PCR.

Question 5

To cover prophylactic PCP in a child with AIDS, you can use Bactrim, pentamidine, __________, or _____________.

Answer 5

dapsone; atovaquone

Question 6

The classic bacteria that causes osteomyelitis in those with sickle cell anemia is ____________.

Answer 6

Salmonella

Question 7

True or false: give antibiotics as soon as imaging reveals osteomyelitis.

Answer 7

False (in most cases).

If the child looks acutely toxic and imaging suggests osteomyelitis, then give antibiotics without doing a biopsy. If the child looks stable, then do an x-ray, an MRI (if the x-ray is inconclusive), and then a biopsy. Only when the biopsy is positive should you give antibiotics in a stable child.

Question 8

Greater than __________ WBCs in an arthrocentesis is diagnostic of septic joint.

Answer 8

50,000

Question 9

List the two treatments for scabies.

Answer 9

• Permethrin

* Lindane (do not use in infants because of transcutaneous neurotoxicity)

Question 10

The ___________ in scabies infections causes itching.

Answer 10

poop

Question 11

The further the ____________ in a lice infection, the longer they’ve had it.

Answer 11

nit (along the hair)

Question 12

The tape test can reveal _______________.

Answer 12

pinworm (Enterobius vermicularis)

Question 13

How is latent TB treated?

Answer 13

Isoniazid + B6

Question 14

Go through the three layers of PPD interpretation.

Answer 14

• Greater than 15 mm: people with no risk factors
• Greater than 10 mm: healthcare workers, homeless, immigrants
• Greater than 5 mm: immunosuppressed, people with known contacts