Pediatrics

Question 1

What does BRUE stand for ?

Answer 1

brief resolved unexplained event

Question 2

What is the BRUE criteria ?

Answer 2

• Child < 1 yr
• NO clear explanation of sx
• Resolved event of 1+ of the folling
  1. Cyanosis/pallor
  2. Absent, irregular, or decreased rate of breathing
  3. Hypertonia or hypotonia
  4. Altered level of consciousness

Question 3

What criteria would make the situation high risk?

Answer 3

any one of the following present
<60 days old 
-Born  <32 weeks gestation with corrected gestational age <45 weeks
-CPR needed by trained professional
-Event lasted > 1 minute
-not first event

Not first Event

Question 4

What criteria would make the situation low risk ?

Answer 4

> 60 days old

• born >32 weeks gestation, with corrected gestational age >45 weeks
• no CPR needed
• less than 1 min
• first event

Question 5

What is the treatment for high risk ?

Answer 5

admit for obs, work up (CBC w diff, blood cx, LP, electorlytes, CMP, blood gas, UA/Ucx, CXR, echo, EKG, EEG, etc

Question 6

Treatment for low risk :

Answer 6

eduate pts in CPR, pertussiss testing, EKG, brief obs, no admission

Question 7

Typical age range for nurse-maids elbow ?

Answer 7

15 months to 3 years of age

Question 8

Nurse-maids elbow is what type of dislocation ?

Answer 8

Partial dislocation : RADIAL HEAD SUBLUXATION

Question 9

Physical exam finding of nursemaids elbow ?

Answer 9

Arm held down by the side with slight elbow flexion 130-150 degrees and self splinted

Question 10

True or false : the child can easily pinpoint a specific area causing tenderness when they have nursemaids elbow.

Answer 10

False. No area of true tenderness.

Question 11

What diagnostic testing is needed for nursemaids elbow?

Answer 11

NONE

Question 12

What is the treatment for nursemaids elbow ?

Answer 12

Simple reduction

Question 13

What is involved in a simple reduction of the elbow ?

Answer 13

1) flexion
2) flexion with hand externally rotated
3) extension with hyperpronation.

Question 14

What is professor Hurwitz favorite reduction technique for nursemaids elbow?

Answer 14

Palm up, patient touches hand to shoulder, then rotates the thumb.

Question 15

What is meant by the word LETHARGIC in a medical pediatric setting ?

Answer 15

When child is almost comatose.

Question 16

If child is less than 28 days old and has a fever of 100.4 with a source then you must do what ?

Answer 16

Do a full work up

Question 17

If the child is 3m - 1 year with a fever and known source consider what ?

Answer 17

Consider CBC with diff, blood culture, Ua ( chest xray if cough)

Question 18

If they are >3 with a known source of fever then do what ?

Answer 18

No further work up

Question 19

If unknown source and < 28 days old then do what ?

Answer 19

Full work up

Question 20

If 1-3m and fever with unknown source then do what ?

Answer 20

Full workup plus or minus lumbar puncture

Question 21

3 month and older with unknown fever source:

Answer 21

CBC with diff, UA, Urine culture, ( blood culture if sick appearing and chest X-ray if cough)

Question 22

If a neonate is ill-appearing then they are….

Answer 22

SEPTIC until proven otherwise.

Question 23

Normal pediatric growth follows what ?

Answer 23

The growth curve

Question 24

If the child is following their own growth curve then that is what ?

Answer 24

Normal variant .