Pediatrics

Question 1

How to treat sepsis/meningitis in infants?

Answer 1

0-1 month is amp + gent or cefotaxime

1-3 is Amp + Cefotaxime/ceftriaxone or Vanc + cefo/ceftri

> 3 months is Ceftriaxone + Vanc

Question 2

What are RSV risk factors?

Answer 2

Premature birth, CLD, CHD, pulmonary hypertension, immunodeficiency, inability to clear secretions, low socioeconomic status, passive smoking, day care, siblings younger than 5

Question 3

Who gets pavilizumab?

Answer 3

IF gestational age <29 and younger than 1 year, other criteria could be cyanotic heart disease, hemodynamically significant CHD, pulmonary hypertension, congenital abnormalities that impair the ability to clear airway secretions, profoundly immunocompromised

Question 4

How to treat otitis media?

Answer 4

Immediate antibiotics if bulging tympanic membrane, perforation, or otorrhea.

Can defer treatment (watch and wait) if none of the above and older than 2. 6 mo- 2 yrs may defer if mild symptoms and unilateral.

Analgesics more beneficial than antibiotics for relieving otalgia within first 24 hours

Antibiotics not needed for OM with effusion

Persistence of middle ear fluid is likely after treatment of AOM

Question 5

What are CI’s to immunizations?

Answer 5

Anaphylactic reaction, immunodeficiency in live vaccines (MMR, Varicella, oral polio). Pregnancy and recent IVIG is MMR and Varicella, no rotavirus if history of intussusception