Pediatrics Flashcards
What are common pathogens for bacterial meningitis in a 0-1 month old?
Group B Streptococcus
Escherichia coli
Listeria monocytogenes
Viral (e.g., herpes simplex virus)
Coagulase-negative staphylococcus (nosocomial)
Gram-negative bacteria (e.g., Pseudomonas spp., Enterobacter spp.; nosocomial)
What is a potential abx regimen for a 0-1 OR 1-3 mo bacterial meningitis patient?
Ampicillin + gentamicin or ampicillin + cefotaxime
What is a potential abx regimen for a 3-12 yo mo bacterial meningitis patient?
Ceftriaxone ± vancomycin
- Vancomycin to cover resistant Strep pneumo
- *Less neonatal pathogens, less risk of listeria
Which bacteria are most likely to cause spreading of bacterial meningitis?
H. influenzae and Neisseria meningitidis
What regimens can you give for chemoprophylaxis for bacterial meningitis due to neisseria meningitidis?
Rifampin (1 month old), CTX (< 15 yo, > 15 yo)
What regimens can you give for chemoprophylaxis for bacterial meningitis due to H. influenzae?
Rifampin 20 mg/kg/dose PO daily x 4 days
When is it appropriate to use palivizumab for RSV ppx?
<29 weeks
29-32 weeks: Chronic lung disease necessitating more than
21% oxygen for at least the first 28 days of life
< 32 weeks: Consider prophylaxis for a second RSV season if chronic lung disease necessitating medical therapy within the 6 months preceding the start of RSV season
Any age:
- hemodynamically significant acyanotic congenital heart disease receiving medication of congestive HF and will need cardiac surgery
- Moderate-severe pulmonary HTN
- Congenital abnormalities of airway or neuromuscular disease
- Profound immunocompromise
What is the indication to treat otitis media with antibiotics?
- Bulging tympanic membrane, perforation, or otorrhea
- > 2, otalgia for more than 48-72 hours or T > 39C in past 48 hours without severe symptoms
- NOT recommended < 6 mo old
Which vaccines contain a risk for allergy towards neomycin?
Inactivated polio vaccine, MMR, varicella
When must you delay giving live vaccines for patients taking steroids?
Delay by at least 1 mo if taking more than 2 mg/kg/day or more of prednisone for more than 14 days
What are first line agents for focal and tonic clonic seizures in children?
VPA, CBZ, PHT
What is the first line agent for myoclonic seizure in children?
VPA
What is the first line agents for Lennox-Gastaut?
VPA, topiramate, lamotrigine
What ADHD drug should be avoided in patients with structural heart defects?
Amphetamines (adderall)
What ADHD med has less abuse potential than amphetamine?
Lisdexamfetamine (Vyvanse)
