Peds

Question 1

newborn <30 days with fever warrants

Answer 1

sepsis workup
(CBC, blood culture, urinalysis, urine culture, CXR, and LP), admission, and empiric abx treatment (usually ampicillin plus cefotaxime)

Question 2

what constitutes a fever

Answer 2

rectal temp >38/100.4

Question 3

fever 3-36 months is usually

Answer 3

viral

Question 4

how to tx fever in kids

Answer 4

Acetaminophen 15mg/kg Q4H
Ibuprofen 10mg/kg
Ensure close follow up, Educate your parents

Question 5

Period of apnea, transient color change (usually pale or cyanotic) &transient change in tone (limp or stiff)

Answer 5

apparent life threatening injury

Question 6

factors involved with SIDS

Answer 6

Brain defects
Low birth weight
Respiratory infection

Question 7

sleep related SIDS factors

Answer 7

Sleeping on the stomach or side…should sleep on back!!
Sleeping on a soft surface
Sharing a bed
Overheating

Question 8

SIDS risk factors

Answer 8

Sex
Age (most vulnerable 2-4th months)
Race (nonwhite infants are more likely to develop SIDS)
Family history.Babies who’ve had siblings or cousins die of SIDS are at higher risk of SIDS.
Secondhand smoke
Being premature

Question 9

MCC complication of AOM

Answer 9

mastoiditis

Question 10

how to tx AOM

Answer 10

amoxicillin

Question 11

when to suspect acute bacterial sinusitis

Answer 11

if symptoms persist or are severe: fever > 39*C, purulent nasal drainage for > 3 days & ill appearance

Question 12

Cyanosis, AMS, somnolence, bradycardia and shock often indicate

Answer 12

impending respiratory failure and cardiac arrest

Question 13

steeple sign

Answer 13

croup

Empiric abx: ampicillin/sulbactam or ceftriaxone

Question 14

Consider in all children w/ unilateral wheezing

Answer 14

foreign body aspiration

definitive tx is bronchoscopy

Question 15

how to tx peritonsilar abscess

Answer 15

clindamycin

Question 16

how to tx retropharyngeal abscess

Answer 16

Antibiotics: BROAD (ampi/sulbactam or Clinda & 3rd gen cephalosporin)

Question 17

viral vs bacterial pneumo on xray

Answer 17

Viral – diffuse interstitial infiltrates, hyperinflation, atelectasis, peribronchial thickening
Bacterial – lobar or segmental infiltrate

Question 18

how to tx dehydration

Answer 18

oral fluids
NS 20ml/kg Bolus
Ondansetron .15mg/kg/dose
maintenance are 4/2/1 (4 mg for first 10 k, 2 mg for 2nd 10 kg, 1 thereafter)

Question 19

when to give antibiotics for gastroenteritis

Answer 19

significant fever, diarrhea > 10-14 days, blood or pus in stool

Question 20

Non-bilious projectile vomiting right after feeding

Diagnosis:May feel “olive pit” in RUQ

Answer 20

pyloric stenosis

Question 21

hwo to dx appendicitis

Answer 21

Ultrasound now more often used for children

CT if US nondefinitive and concern is high

Question 22

Classic triad = vomiting, abd pain & current jelly stool
Sudden colicky epigastric pain; sausage shaped mass in R abdomen (Dance sign); Lethargy
Diagnosis:

Answer 22

intussusception