Peds ID: BRS

Question 1

What is considered to be a fever in kids?

Answer 1

Rectal temp at least 38 (100.4)

Question 2

Infant <3 mo w/ a fever: labs/studies?

Answer 2

CBC
UA
UCx
CSF analysis
CXR if respiratory distress or tachypnea

Question 3

Infants <29 days old with a fever: management?

Answer 3

Hospitalize all

IV Abx until BCx, UCx, CSF Cx (and stool Cx if diarrhea present) are neg

Question 4

Infant 29 days-3 months old with a fever: management?

Answer 4

If labs are low risk and patient has good follow up, can manage w/ empiric outpatient parenteral Abx while Cx pending.
If not low risk, hospitalize + Abx.

Question 5

0-1 mo: 3 MC bacterial pathogens possibly causing sepsis or meningitis?

Answer 5

GBS
E coli
Listeria

Question 6

0-1 mo: empiric IV abx for suspected sepsis or meningitis?

Answer 6

Amp + gent or cefotaxime

Question 7

1-3 mo: 3 MC bacterial pathogens possibly causing sepsis or meningitis?

Answer 7

GBS
Strep pneumo
Listeria

Question 8

0-1 mo: empiric IV abx for suspected sepsis or meningitis?

Answer 8

Amp + cefotaxime

+ vanc if suspect bac meningitis

Question 9

3 - 36 mo: 3 MC bacterial pathogens possibly causing sepsis or meningitis?

Answer 9

Strep pneumo
HIB
N. meningitidis

Question 10

3- 36 mo: empiric IV abx for suspected sepsis or meningitis?

Answer 10

Cefotaxime

+ vanc if suspect bac meningitis

Question 11

3 yo - adult: 2 MC bacterial pathogens possibly causing sepsis or meningitis?

Answer 11

Strep pneumo

N. meningitidis

Question 12

3 yo - adult: empiric IV abx for suspected sepsis or meningitis?

Answer 12

Cefotaxime

+ vanc if suspect bac meningitis

Question 13

What ratio of CSF: serum glc is especially suspicious for bac meningitis?

Answer 13

<0.40

Question 14

Patient with meningeal signs + focal neuro signs: what imaging test might you get to eval for brain abscess?

Answer 14

CT w/ contrast

Question 15

What drug given with the first dose of Abx has been effective at decreasing the risk of hearing loss in HIB meningitis?

Answer 15

Corticosteroids

Question 16

MC complication of bacterial meningitis in kids?

Answer 16

Heading loss

Question 17

What type of meningitis has super high protein + basilar enhancement?

Answer 17

TB

Question 18

How do you treat TB meningitis?

Answer 18

RIPE

Question 19

Simple URI: at what point should you evaluate for a bacterial superinfection?

Answer 19

Sx or fever >10 days

Question 20

What type of sinusitis has nasal discharge and cough (day and night) for 10 - 30 days +/- HA, malodorous breath, facial pain, and low fever?

Answer 20

Acute persistent sinusitis

Question 21

What type of sinusitis has high fever (>39) with purulent nasal discharge for 3-5 days?

Answer 21

Acute severe sinusitis

Question 22

What type of sinusitis has nasal discharge and cough (day and night) for 30-90 days +/- HA, malodorous breath, facial pain, and low fever?

Answer 22

Subacute sinusitis

Question 23

What type of sinusitis has nasal discharge and cough (day and night) for >90 days +/- HA, malodorous breath, facial pain, and low fever?

Answer 23

Chronic sinusitis

Question 24

What 3 bugs are the MCC of acute persistent, acute severe, and subacute sinusitis?

Answer 24

Strep pneumo
H flu
M. catarrhalis

Question 25

How do you treat acute persistent, acute severe, and subacute sinusitis?

Answer 25

Amoxacillin, amox-clauv, or 2nd gen cephalosporin for 10-14 days

Question 26

What special testing should you do in chronic sinusitis?

Answer 26

CT sinuses