Pediatric Conditions Flashcards
age classification: neonate
0-28 days
age classification: infant
1 month - 12 months
age classification: child
1 - 12 years
age classification: adolescent
13-18 years
When to seek urgent care for a child?
Temperature for <3 month:
Temperature for age 3-6 months:
Age >6 months:
Temperature for <3 month: 100.4F/38C rectal
Temperature for age 3-6 months: 101F/38.3C rectal
Age >6 months: 103F/39.4C rectal
When to seek urgent care for a child?
Inability to sleep or drink, limping, any cough/cold that worsens or does not improve in several days
A newborn’s general condition is assessed using what score?
APGAR score: 7-10 is healthy
What are the standard medications given at birth?
- vitamin K
- opthalmin erythromycin or silver nitration (conjunctivitis)
- hep b
- light therapy for jaundice
Low Apgar scores in pre-term infants are usually due to
immature lung or heart development
Hypotension is tax’s primarily with IV fluids. hypotension can be due to
intraventricular hemorrhage (IVH)
How is patent ductus arteriosus normally treated?
requires medical attention with surgery or drugs: NSAIDS (IV indomethacin or ibuprofen)
How is persistent pulmonary hypertension of the newborn normally treated?
Supportive care & inhaled nitric oxide can help to dilate the pulmonary arterioles is the standard tx
PPHN may be linked to in utero ___ exposure
SSRI
Respiratory Distress Syndrome is caused by
deficiency of surfactant production in lungs that are not fully developed
Most babies born
<35 weeks
Do NOT recommend salicylates to patients that are
16
Acetaminophen infant drops and children’s suspension are
the same concentration to help reduce dosing errors in older children
Avoid what drug in infants <6 months for pain/fever due to the risk of nephrotoxicity
ibuprofen
To prevent dosing errors, Rphs should counsel on what regarding ibuprofen?
these products are supplied in different dosage strengths for infants and children
Acetaminophen or ibuprofen are appropriate for treating pain and fever in what age group?
> 6 months
What drug can provide mild symptom relief of intestinal gas in infants?
simethicone drops (sx normally dissipate when child is around 6-8 months)
The FDA does not recommend OTC cough and cold medications in:
children < 2 years
What are options for >2 years olds who are experiencing constipation?
MiraLax, Prunes, glycerine suppositories
Children experiencing diarrhea is dangerous; fluid and electrolytes should be replaced with:
Pedialyte, enfamil enfalyte
Loperamide is not recommended for OTC use in children under the age of
6
OTC fever options for children
Acetaminophen (10-15mg/kg/dose Q4-6H, max 75mg/kg/day; products are all the same [] = 160mg/5mL)
ibuprofen (5-10mg/kg/dose Q6-8H); >6 months
OTC intestinal gas options for children
Simethicone (Mylicon) QID PRN; take after meals, SHAKE
Bacterial Meningitis: Bulging fontanelles and nuchal rigidity will be present in <25% of cases, most symptoms are non-specific and not present. A definitive dx is made with:
a lumbar puncture
S. agalactiae (group B strep), E.Coli, listeria, klebsiella are common bacterial pathogens in bacterial meningitis in what age group?
<1 month
S. pneumoniae, neisseria, S. agalactiae, H. influenzae, and E. coli are common bacterial pathogens in bacterial meningitis in what age group?
1-23 months
N. meningitis, S. pneumoniae are common bacterial pathogens in bacterial meningitis in what age group?
2+ years
Empiric treatment for bacterial meningitis in those <1 month
Ampicillin + cefotaxime
Ampicillin + gentamicin
Empiric treatment for bacterial meningitis in those 1 month and older
Vancomycin + 3rd gen ceph (ceftriaxone or cefotaxime)
This medication displaces bilirubin from albumin, which can cause bilirubin-induced brain damage (kernicterus), THUS avoided in neonates (<1 month)
Ceftriaxone
A common cause of bronchiolitis (swelling and mucus build up in the bronchioles)
respiratory syncytial virus (RSV)
RSV treatment
supportive care (oxygen, IV fluids, suction of secretions)
In patients with underlying compromising conditions (prematurity, cardiopulmonary dz, or immunosuppression) that contract RSV, what tx can be considered?
INHALED ribavirin (Virazole)
This humanized MAb is indicated for the prevention of serious lower respiratory tract dz caused by RSV in children at high risk of the dz
Palivizumab (Synaqis)
How is Synaqis dosed?
MONTHLY at 15mg/kg per dose by IM injection; and not to receive more than 5 monthly doses during RSV season. If the baby becomes infected with RSV, no further doses should be given
Who should receive palvizumab?
In the first year of life:
- premature infants born <29 weeks gestation
- premature infants born <32 weeks gestation with chronic lung disease who are <12 months of age
- infants <12 months of age with certain heart conditions
_____ is usually due to a viral infection which causes inflammation of the UPPER airway, larynx, trachea, and bronchi
Croup (laryngotracheobronchitis)
Most common in children < 6
How is Croup treated when it is severe?
Dexamethasone 0.6mg/kg
+ a patient having difficulty with breathing will be given the systemic steroid +nebulized racemic epinephrine
How is nocturnal enuresis treated?
First, behavioral approach
Then alarm therapy
Then alarm therapy + drug (desmopressin)
What is the only preferred medication enuresis?
Desmopressin, a synthetic analogue of ADH
What is desmopressin’s boxed warning?
severe, life-threatening hyponatremia
What drugs are contraindicated in peds?
Codeine <12y
Tramadol <12y
Promethazine in age <2y
Ceftriaxone in neonates (1-28 days)
What drugs are not generally recommended in peds?
Quinolones
tetracyclines in age <8y
OTC teething medications containing benzocaine in age <2y
OTC cough and cold preparations in age <6 years
Tetracyclines are not recommended in children <8y of age they stain teeth and deposit into mineralizing bone and cartilage which weakens it. What is the one exception?
Tick-borne Rickettsial diseases (Rocky Mountain spotted fever, ehrlichosis and anaplasmosis). Doxycycline is the most effective treatment and is recommended in peds as the risk of severe illness or death outweighs the roisk of tooth discoloration
Kopek spots in mouth, maculopapular rash. What childhood illness?
Measels (transmission is airborne)
Swollen and tender salivary glands under the ears. What childhood illness?
Mumps (remember “lumps”)
