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PHRM 865 > Exam 5: Pediatrics > Flashcards

Exam 5: Pediatrics Flashcards

1
Q

aom incidence

A

incidence highest <2 years old –> tapers gradually with age

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2
Q

aom first episode difference

A

earlier the age = increased recurrence

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3
Q

preventable aom risk factors

A
  1. daycare attendance
  2. smoke exposure
  3. pacifier use
  4. bottle feeding
  5. immunization status
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4
Q

non-preventable aom risk factors

A
  1. male
  2. older siblings
  3. family history
  4. congenital anomalies
  5. immune deficiency
  6. onset < 6 months old
  7. lower socioeconomic status
  8. season
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5
Q

ome characteristics

A

middle ear is sterile, no signs of acute infection

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6
Q

ome treatment

A

antibiotics not indicated and not beneficial

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7
Q

aom characteristics

A

bacterial infection likely

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8
Q

aom treatment

A

antibiotics indicated if symptomatic

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9
Q

eustachian tube purpose

A

drain non-sterile fluid

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10
Q

anatomical differences in eustachian tube purpose

A

infant eustachian tube is shorter, more flexible and more horizontal vs adult

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11
Q

aom pathogenesis

A
  1. ineffective aeration of middle ear space –> eustachian tube dysfunction
  2. inflammation and edema of mucosal linings and narrowing of eustachian tube lumen
  3. trapped air creates vacuum reversing flow of secretions, drawing fluid into middle ear
  4. Bacteria multiply in fluid and stimulate inflammation
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12
Q

most common aom bacterial species

A

strep pneumoniae

h. influenzae

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13
Q

TM in otitis media

A

bulging
immobile
erythematous

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14
Q

diagnostic requirements of AOM

A
  1. acute onset
  2. middle ear effusion
  3. symptoms of middle ear inflammation
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15
Q

non-severe AOM

A

mild otalgia
AND
fever < 39 C

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16
Q

severe AOM

A

moderate/severe otalgia
OR
fever >39C

17
Q

Observe treatment in AOM when…

A

unilateral non-sev 6mo-2yr

nonsevere >2 yr

18
Q

aom first line

A

amoxicillin 80-90 mg/kg/day divided q12h x10

19
Q

when to not use amoxicillin

A
  1. known resistance
  2. treatment failure
  3. amox in last 30 days
  4. allergy
  5. concurrent conjunctivitis
20
Q

AOM amox altenative

A

Augment 600/42.9 /5ml
90mg/kg/day amox divided q 12
goal 10mg/kg/day

21
Q

what to use in AOM if all amoxicillins are a no go

A
  1. cefdinir
  2. cefuroxime
  3. cefpodoxime
22
Q

what to use for severe cases of aom

A

ceftriaxone

23
Q

ceftriaxone dosing

A

50mg/kg IM
one dose as initial therapy
three doses if treatment failure

24
Q

aom adjunctive therapy

A

APAP: 10-15 mg/kg/dose q 4-6h (max 75)
Ibuprofen: 5-10 mg/kg/dose q6-8h

25
Q

female risk factors for UTI

A
  1. white race
  2. age <12 months
  3. temp >39C
  4. Fever >2 days
26
Q

male risk factors for UTI

A
  1. nonblack race
  2. temp >39C
  3. Fever >24 hrs
27
Q

common pathogen for UTI

A

e. coli

28
Q

preferred method of urine collection when <24 months old

A

catheterization

29
Q

first line treatment for uti and duration

A

amoxicillin
7-10 days: 2-24 months
10-14 days: pyelonephritis
3-7 days: cystitis

30
Q

approved medication for complicated e. coli UTIs and pyelonephritis in pts 1-17 yrs

A

cipro
IV: 18-30 mg/kg/day q 8 (1200)
PO: 20-40 mg/kg/day q 12 (1500)

31
Q

what is bronchiolitis

A

viral lower RTI in infants and younger children

acute inflammation, edema, increased mucus

32
Q

RSV symptoms

A

cold-like symptoms with low-grade fever

33
Q

RSV treatment

A

supportive therapy

  • oxygen
  • hydration
  • mechanical ventilation
  • ECMO
34
Q

what is palivizumab

A

humanized murine monoclonal antibody used to prevent RSV

35
Q

can you use palivizumab to treat RSV

A

NO

36
Q

palivizumab dosing

A

15mg/kg IM every month for up to 5 doses/season

37
Q

palivizumab criteria

A
  1. GA <29 weeks
  2. GA <32 weeks with CLD
  3. Hemodynamically significant CHD
  4. Profound immunocompromised

PHRM 865 (59 decks)

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