peds 4

Question 1

treatment target in AOM

Answer 1

S.pneumonia least likely to resolve without ABX

Question 2

Diagnosis of AOM in children •moderate or severe bulging of TM OR new onset of otorrhea not related to otitis externa (OE) with otalgia

Answer 2

moderate or severe bulging of TM OR new onset of otorrhea not related to otitis externa (OE) with otalgia

Question 3

Watchful waiting, consisting of analgesia without antimicrobial therapy, is an acceptable treatment option in AOM. In the:

Answer 3

Watchful waiting is only appropriate for the child ≥6 months with non-severeillness based on joint decision-making with parents/caregivers for unilateralAOM

•If watchful waiting is used, follow-up must be ensured with ability to start antibiotic therapy within 48–72 hours if child fails to improve or worsens

Question 4

Recommended treatment in AOM for ABX therapy:

Answer 4

1st line amoxicillin (target is S.pneumonia)
or amox with Clav (covers the main 3 bugs)

if allergic may use Cefdinir (14 mg/kg/d PO in 1 or 2 doses)OrCefuroxime (30 mg/kg/d PO in 2 divided doses)OrCefpodoxime (10 mg/kg/d PO in 2 divided doses

Question 5

Antibiotic treatment after 48–72 h with failure of initial antibiotic treatment

Answer 5

Amoxicillin-clavulanate (90 mg/kg/d PO of amoxicillin, with 6.4 mg/kg/d of clavulanate in 2 divided doses
Ceftriaxone

Question 6

Firsdt ine intervention for OME?

Answer 6

no acute infection

this is a watchful waiting

Question 7

46. Identify the following children with AOM as a candidate for initial antimicrobial therapy or watchful waiting therapy. A. Antimicrobial therapyB. Watchful waiting therapyA
    A.
    B. 3-year-old with bilateral AOM, T=102.4°F (39.1°C), and 8-h history of otalgia complaint
    C. 4-year-old with unilateral AOM, T=100.6°F (38.1°C), and a 12-h history of mild ear discomfort
    D. 2½-year-old with bilateral AOM, T=101.2°F (38.4°C), and a 3-day history of otalgia complaint

Answer 7

ABX due to age he is <6m

ABX due to meeting criteria of fever

Watchful waiting non severe disease

ABX reason due to severe of disease with length of sx > 48 hours

Question 8

what do we avoid giving in kids with gastroenteritis?

Answer 8

any anti-diarrhea meds
want to get it out
ok for zofran

Question 9

Rehydration Therapy

Answer 9

For mild-to-moderate dehydration, oral rehydration therapy (ORT) with oral rehydration solution (ORS) is as effective as parenteral therapy, easier to administer, and more cost-effective. With vomiting, consider premedication with 5-HT3 receptor antagonist such as ondansetron to minimize risk of further upper GI fluid loss

Question 10

true or false
Evaluation of the Acutely Ill Younger Child (≥1 month–3 years)The febrile neonate (<28 days of age) is usually treated with empiric parenteral antimicrobial therapy and admitted to the hospital for evaluation of neonatal sepsis.

Answer 10

true