Peds Exam 1

Question 1

A fever is a rectal temperature that exceeds

Answer 1

38 degrees C (100.4 F)

Question 2

Fever has the GREATEST RISK among infants and children younger than

Answer 2

36 months

Question 3

Most common eye disorder in children is

Answer 3

Conjunctivitis

Question 4

Most common bacterial cause of conjunctivitis is

Answer 4

H. influenza

Question 5

Most common viral cause of conjunctivitis is

Answer 5

Adneoviruses

Question 6

Treatment of suspected bacterial conjunctivitis is

Answer 6

1. Trimethoprim-polymyxin B solution (polytrim) topical drops; 1 drop 4x daily for 7 days

Question 7

Treatment of suspected bacterial conjunctivitis in babies is

Answer 7

Erythromycin ointment

Question 8

Blepharitis is treated with

Answer 8

1. Cleansing the lid well / warm compresses
2. Erythromycin ointment OR Azithromycin drops

Question 9

______ rhinosinusitis is most common

Answer 9

Viral

Question 10

diagnosis of acute bacterial rhino sinusitis is made

Answer 10

when a cold does not improve by 10-14 days or worsens at day 5-7

Question 11

Gold standard diagnostic testing for rhino sinusitis is

Answer 11

Nasal endoscopy (done by ENT and rarely done)

Question 12

First line treatment of acute bacterial rhinosinusitits is

Answer 12

1st Amoxicillin 80-90 mg/kg/day for 10 days
Second line is Augmentin

Question 13

The TWO most common causes of periorbital (preseptal) cellulitis is

Answer 13

• Group A strep
• Staph aureus

Question 14

How does periorbital cellulitis differ in presentation from orbital cellulitis

Answer 14

Periorbital: Visual acuity, eye motility, and pupillary reaction are normal. No pain on eye movement and no proptosis.
Orbital cellulitis: Poor vision, proptosis, poor motility, double and blurry vision, very painful.

Question 15

Treatment of periorbital cellulitis includes

Answer 15

• PO or IV antibiotics
• Amoxicillin-clavulanate (Augmentin) 80-90 mg/kg/day for 10 days

Question 16

Orbital cellulitis is more commonly associated with

Answer 16

Rhinosinusitis

Question 17

the most common cause of URI (common cold) 30-40% of the time is

Answer 17

Rhinovirus

Question 18

most common viral cause of pharyngitis is

Answer 18

Rhinovirus

Question 19

Most common bacterial cause of pharyngitis is

Answer 19

Group A strep

Question 20

Although this is usually not first line dx test, what is the gold standard test to distinguish group A strep pharyngitis from other organisms?

Answer 20

Throat culture

Question 21

Treatment for Group A beta-hemolytic streptococcal pharyngitis strep throat is

Answer 21

Amoxicillin 50 mg/kg/day once daily for 10 days

Question 22

if attempting to eradicate strep carrier state, how could you do that?

Answer 22

• Clindamycin for 10 days OR
• Rifampin for 5 days

Question 23

What vaccination has reduced the incidence of Epiglottis?

Answer 23

H Flu type B (HIB) vaccination

Question 24

A thumb print sign on X-ray Indicates

Answer 24

Epiglottitis

Question 25

Definitive dx of epiglottitis is

Answer 25

Nasal fiberoptic endoscope performed in the OR; can see "Cherry red" erythematous and edematous epiglottitis

Question 26

Treatment of epiglottitis includes

Answer 26

IV antibiotics: Ampicillin/sulbactam, cefotaxime or ceftriaxone for 2-3 days and then change to oral meds to complete a 10 day course

Question 27

Infectious Mononucleosis is caused by

Answer 27

Epstein-Barr (EBV) virus infection

Question 28

Diagnosis of Mono can be done via

Answer 28

Serum Monospot test (90% sensitive)

Question 29

A "hot potato voice", deviated uvula and soft palate to the contralateral side, and a severe sore throat that is out of proportion to physical findings may suggest

Answer 29

Peritonsillar abscess

Question 30

Tx of a peritonsillar abscess includes

Answer 30

Referring pt to ENT for incision and drainage and antibiotics

Question 31

what is type I hypersensitivity

Answer 31

Immediate hypersensitivity (systemic or localized)

Question 32

what is type II hypersensitivity

Answer 32

Cytotoxic (antibody-dependent)

Question 33

what is type III hypersensitivity

Answer 33

Immune complex (inflammatory reaction)

Question 34

what is type IV hypersensitivity

Answer 34

Delayed (cell mediated)

Question 35

Allergic rhinitis is a type ____ mediated allergic response?

Answer 35

Type I IgE

Question 36

What is the atopic triad?

Answer 36

Allergic rhinitis, asthma, and atopic dermatitis

Question 37

The best wat to test for allergies is

Answer 37

Skin testing

Question 38

Skin testing works by

Answer 38

bioassay that detects the presence of allergen-specific IgE on a pt's mast cells

Question 39

Severity classification of allergic rhinitis: Sx present < 4 days a week or for < 4 weeks

Answer 39

intermittent

Question 40

Severity classification of allergic rhinitis: Sx present > 4 days a week and for > 4 weeks

Answer 40

Persistent

Question 41

Severity classification of allergic rhinitis: Without impairment or disturbance of sleep, daily activities, work, school, or without troublesome sx

Answer 41

Mild

Question 42

Severity classification of allergic rhinitis: Disturbance of sleep, daily activities, leisure, sports, school or work

Answer 42

Moderate-severe

Question 43

In infancy, atopic dermatitis is found on

Answer 43

Face, scalp, and extensor surfaces

Question 44

what are Dennie-Morgan folds and what condition are they associated with?

Answer 44

(aka infraorbital folds) Occurs in 25% of patients with atopic dermatitis

Question 45

Benign dry rough patches / tiny bumps found on the upper arms, thighs, cheeks or buttocks that are NOT painful or itchy is known as

Answer 45

Keratosis Pilaris

Question 46

First line pharmacologic therapy for atopic dermatitis is

Answer 46

Topical corticosteroids

Question 47

what type of hypersensitivity reaction is contact dermatitis

Answer 47

Type IV - delayed (cell mediated)

Question 48

Urticaria and angioedema are caused by

Answer 48

mast cell deregulation in the skin

Question 49

there are many causes of urticaria and angioedema some examples include

Answer 49

- VIRAL infections - Foods/drugs - Latex - Serum sickness - Autoimmunity

Question 50

Treatment of urticaria/angioedema is

Answer 50

2nd generation H1 antihistamines; Cetirizine is first line

Question 51

Cetirizine dose to tx urticaria / angioedema in a pt: 6mo-2yrs

Answer 51

2.5 mg

Question 52

Cetirizine dose to tx urticaria / angioedema in a pt: 2y-5y

Answer 52

5 mg

Question 53

Cetirizine dose to tx urticaria / angioedema in a pt: 6y-12y

Answer 53

5-10 mg

Question 54

Cetirizine dose to tx urticaria / angioedema in a pt: > 12 yrs

Answer 54

10 mg

Question 55

what type of hypersensitivity reaction is serum sickness

Answer 55

Type III - immune complex

Question 56

rash, fever, and polyarthralgias or poly arthritis that begin 1-2 wks after the 1st exposure and resolve within a few weeks of discontinuation is cardinal features of

Answer 56

Serum sickness

Question 57

Anaphylactic reactions are what type of hypersensitivity reaction?

Answer 57

Type I - IgE mediated reaction

Question 58

Medical management of anaphylaxis includes

Answer 58

Epinephrine 0.01 mg/kg IM repeat q 20 mins prn

Question 59

medication allergies can occur within

Answer 59

1 hour and up to 72 hrs from the last dose

Question 60

The most frequent cause of medication allergies are

Answer 60

Antibiotics (amoxicillin, bacterium, and ampicillin)

Question 61

Treatment of insect bites includes

Answer 61

- Local therapy with cool compress, steroids, NSAIDs, and antihistamine cream - Epinephrine if needed - IV antihistamines / corticosteroids if needed

Question 62

Complications of insect allergies includes

Answer 62

Anaphylaxis

Question 63

food allergies can occur

Answer 63

minutes up to four hours after ingestion