Section 9 - Pediatrics Flashcards
Temperature threshold infant
Neonate: 100.4
Infants/children: 102.2
Tx for 0-28 day old infants?
Full sepsis testing (CBC, all the cultures, UA, CXR, LP), admission, empiric abx
Abx tx for neonate 0 to 28 days sepsis? Meningitis?
Sepsis: amp plus cefotaxime, meningitis: amp plus cefotaxime
Abx tx for infants 29-90 days bacteremic? Septic? Meningitic?
Bacteremia: ceftriaxone, sepsis: amp plus cefotaxime or ceftriaxone plus vanc, meningitis: amp plus cefotaxime or ceftriaxone plus vanc
Abx tx for children >90 days bacteremic? Septic? Meningitic?
Bacteremia: ceftriaxone, sepsis: cefotaxime or ceftriaxone plus vanc, meningitis: cefotaxime or ceftriaxone plus vanc
Age group and sex of children with UTI?
Females prior to toilet training, circumcised boys younger than 6 months, uncircumcised boys under 1 year
Tx of fever?
Give acetaminophen every 4-6 hours and ibuprofen in children older than 1 year every 6-8 hours
Tx of septic shock in children?
20 ml/kg bolus of NS, repeat as needed until 100 ml/kg total; give abx; refractory give dopamine or norepi
Sx of sepsis in young children? Sx of meningitis in young children?
Lethargy, poor feeding, irritability, or hypotonia
Frequency of feedings for bottle fed infants? Breast fed infants?
Bottle fed: 6-9; breast fed: every 1-3 hours
What are the weight changes of infants?
Lose 12% body weight in first 3-7 days, gain 1 oz/d afterwards
What are the stooling habits of infants?
Can go 5-7 days without stooling or 6-7 stools a day and be normal
Definition of colic?
Excessive crying at least 3 hours per day for at least 3 days per week over a 3 week period, should be done by 3 months
Most common cause of bloody diarrhea in infants younger than 6 months?
Cow’s milk intolerance and anal fissures; NEC can present with other signs of sepsis with bloody diarrhea
What age is developing jaundice in infants an issue?
Under 24 hours, after 3rd day of life
Diff dx for jaundice after 3rd day of life?
Sepsis, UTI, congenital TORCH infxn, hemolytic anemia, biliary atresia, breast milk jaundice, hypothyroidism
Workup for jaundice after 3rd day of life?
Look for sepsis, peripheral blood smear CBC, total and direct bili, liver function tests, retic count, coombs test
Diaper rash that is macular, erythematous, sharply demarcated edges? Tx?
Contact dermatitis, air drying, diaper changes, barrier cream such as zinc oxide.
Diaper rash that has erythematous plaques with a scalloped border and satellite lesions? Tx?
Candida dermatitis, frequent diaper changes and nystatin.
Most common bacterial AOM?
Strep pneumo and h influ
Complication of AOM?
Mastoiditis most common
Sx of mastoiditis?
Fever, protrusion of auricle, tenderness over mastoid.
Diff dx of AOM?
Acute onset of sx, middle ear effusion, signs and sx of middle ear inflammation.
Tx of AOM?
Wait and see, amox 40-50 mg/kg/dose PO BID, augmentin, cef, azithro
Bacterial cause of otitis externa?
Pseudomonas, staph epi, staph aureus
Tx of otitis externa?
Cipro with hydrocortisone
Causes of stomatitis in children?
Hand foot mouth and herpes simplex
Causes of pharyngitis?
Viral, GABHS and gonorrhea
Centor criteria: what is it? What is it used for?
Diagnose GABHS: tonsillar exudates, tender anterior cervical LAD, absence of cough, history of fever
Cause of unilateral acute LAD?
Staph aureus or strep pyogenes
Most common cause of stridor after neonatal period?
Viral croup
Neck and CXR findings of croup?
Steeple sign
Dx of croup?
Clinical: barking seal like cough or stridor
Tx of croup?
Dex, racemic epi, heliox
Sx of epiglottitis?
High fever, sore throat, drooling, strider, respiratory distress, tripod position
Dx of epiglottitis?
Clinical diagnosis, thumb sign on CXR
Tx of epiglottitis?
Racemic epi, heliox, BVM, intubation/definitive management by most experienced person, cefuroxime, cefotaxime, ceftriaxone
Cause of bacterial tracheitis?
Staph aureus, strep pneumo, gram neg (H flu, Moraxella)
Tx of bacterial tracheitis?
Intubate, ceftriaxone plus clinda, consider vanc
Sx of retropharyngeal abscess? Age group?
Children 6 month – 4 years, toxic and present with fever, drooling, dysphagia, inspiratory stridor
Tx of retropharyngeal abscess?
Airway stabilization/intubate, amp/sulbactam and/or clinda, steroids, ENT for drainage
Sx of peritonsillar abscess?
Fevers, chills, dysphagia/odynophagia, trismus, drooling, muffled hot potato voice, uvula displaced away from side
Tx of peritonsillar abscess?
Aspiration, abx, pain control; clinda or amp/sulbactam
