Peds ID

Question 1

organisms for meningitis

Answer 1

neonate: GBS, Ecoli, Listeria
90 days: Strep pneumo, N. meningitis, H. influenza
28-90 days: mixed

Question 2

treatment for meningitis

Answer 2

neonate: ampicillin, cefotaxime
older: ceftriaxone, vanco, ampicillin (if atypical)
add dex for HIB to prevent hearing loss
HSV suspicion: Acyclovir

Question 3

What are the criteria for AOM

Answer 3

1. Acute process and onset
2. Middle ear effusion
3. Middle ear inflammation

Question 4

What is the tx of AOM? When do you treat?

Answer 4

Amoxicillin
treat < 6mo
OR older than 6mo with no improvement
OR perforated membrane with drainage
6mo to 2y-10 day course
Over 2y -5 day course

Question 5

Tx of GAS pharyngitis. Why do we treat strep pharyngitis

Answer 5

Amoxicillin for 10 days. It usually gets better on it’s own, but we want to prevent Acute Rheumatic Fever AND suppurative complications.

Question 6

Describe the treatment for pnemonia

Answer 6

severity
is there viral and bacterial
is there pleural fluid present

non-severe: high dose amoxicillin
atypical non-severe: azithromycin, clarithromycin
severe: IV or IM ceftriaxone and azithromycin or clarithromycin

viral non severe: antiviral, amox-clav
pleural effusion: small nothing, large tap

Question 7

What is sinusitis, the complications, and the treatment

Answer 7

inflammation of the sinuses, may be acute, subacute, chronic.

Will usually resolve spontaneously, but can become pre-septal or orbital cellulitis, intracranial infection, potts puffy tumour

Treat with amoxicillin

Question 8

UTI abx

Answer 8

amox clav Oral
ampicillin gentamycin IV

Question 9

How to differentiate periorbital vs orbital cellulitis

Answer 9

Periorbital: usually no fever, lethargy, no proptosis, no EOM limitation/pain, normal vision, PERL
Orbital: fever, lethargy, EOM pain and limitation, decreased visual acuity, abnormal pupil eg. RAPD

Question 10

Tx of orbital and preorbital

Answer 10

ENT ophtho consults, IV ceftiaxone