Peds

Question 1

ETT Size in Peds

Answer 1

Cuffed = age/4 + 3.5

Uncuffed = age/4 + 4

Question 2

Mgt of Varicella

Answer 2

No school until lesions crusted over

Oral acyclovir if within 24 hrs of rash

If immunocomp or pregnant give immunoglobulin up to 10 days after exposure

If normal immune system, unvaccinated, > 1 yo then give vaccine up to 5 days after exposure

Question 3

U/S Measurements in Pyloric Stenosis

Answer 3

3 mm wide
14 mm long

“Pi” 3.14

Question 4

How do you treat ductal dep congenital heart lesions? What is the main side effect?

Answer 4

prostaglandin E2

main side effect to look for is apnea

Question 5

What is the worst complication of measles?

Answer 5

SSPE (subacute, sclerosing pan-encephalitis) - 10 yrs later present with seizures, myoclonus, dementia

Question 6

What are the symptoms of congenital hypothyroidism? (7)

Answer 6

Large fontanel and tongue
Hoarse cry
Poor tone
Hypothermia
Peripheral edema
Coarse facial features
Constipation

Question 7

Juvenile Dermatomyositis (sx, labs and tx)

Answer 7

Sx - 
Symmetric proximal muscle weakness
Heliotrope rash 
Gottron papules over extensors of fingers 
Arthritis 

Labs - Inc aldolase, CK, AST and LDH (all found in muscle)

Tx - steroids x 2 yrs +/- plaquenil for rash

Question 8

Still’s Disease

Answer 8

Sx
ARTHRITIS and …
Fever, lymphadenopathy, hepatosplenomegaly, fatigue, wt loss
Salmon rash

Tx - NSAIDs and steroids

Question 9

When do you refer to urology for un-descended testis?

Answer 9

If still present at 1 yo

Question 10

Period Breathing

BRUE

Breath Holding Spells

Answer 10

Periodic breathing = NORMAL in babies, alternate between fast and slow RR with up to 10 sec pauses, NO bradycardia or cyanosis

Apnea/ BRUE = apnea > 20 sec or if shorter but with bradycardia or cyanosis, work-up based on H&P

Breath Holding Spells = 6 mo to toddlers, after upset or crying –> color change, LOC, loss of tone, myoclonic jerks, NO work-up needed

Question 11

When do you give epi in croup? What do you do after?

Answer 11

Indicated if stridor or respiratory distress at REST

Then observe 3 hours

Question 12

PNA Tx by Age

Answer 12

Infant - GBS, E Coli, Staph
Tx = amp + cefotaxime

Young Kid - strep pneumo, strep pyogenes, H flu, staph aureus
Tx = amox

Older Kid - mycoplasma
Tx = azithromycin

Question 13

What is the definition of FTT? What is the #1 cause?

Answer 13

1 cause = neglect

wt < 3rd percentile, height < 5th percentile, growth decreases by 2 percentile curves

Question 14

PALS Dosing

Lidocaine
Amiodarone
Epinephrine
Shock

Answer 14

Defibrillation is 2J/kg

v. synchronized cardioversion is .5J/kg

Epi dosing .01mg/kg 1:10,000 (use 1:1000 if down ETT)

Amio 5 mg/kg in stable VT

Lidocaine 1 mg/kg in stable VT