8

Question 1

Why not use ceftriaxone in pediatrics?

Answer 1

Can cause hyperbilirubinemia

Question 2

Empiric tx of meningitis?

Answer 2

cofexetime, ampicillin and steroids

Question 3

How test <18 mo child for HIV?

Answer 3

DNA PCR; Ab test won’t tell you anything since mom’s hang around for awhile

Question 4

What infection do you want protect against in HIV pt with CD4 < 200?

Answer 4

PCP

Question 5

What infection do you want protect against in HIV pt with CD4 < 100?

Answer 5

TOXO

Question 6

What infection do you want protect against in HIV pt with CD4 < 50?

Answer 6

MAC

Question 7

A child is diagnosed with osteomyelitis. Cultures show infection with salmonella. What do you need to do further?

Answer 7

Osteo is typically s. aureus; salmonella indicates patient likely has SCD.

Question 8

2 common bugs in septic joints

Answer 8

Gonorrohea and S. aureus

Question 9

How many WBC of joint aspirate indicate septic joint?

Answer 9

> 50,000

Question 10

Itchy fingers

Answer 10

Scabies

Question 11

Tx for scabies

Answer 11

Permethrin, lLindane

Question 12

itchy butt and tape test

Answer 12

pinworm

Question 13

tx for pinworm

Answer 13

Albendazole

Question 14

tx for scabies and lice

Answer 14

Permethrin

Question 15

Pneumonia in < 5 y/o is likely

Answer 15

viral

Question 16

In who would 5 mm induration with PPD be concerning for TB?

Answer 16

Immunocompromised and close contact

Question 17

Insidious onset, antalgic gate, protecting joint

Answer 17

Get XR - likely Legg-Calve-Perthes; will need cast

Question 18

Joint pain in fat kid in puberty with no history of trauma

Answer 18

Get XR - likely SCFE; will need surgery

Question 19

Protecting joint and looks sick

Answer 19

Septic joint

Question 20

Joint pain, no trauma, recent viral URI

Answer 20

Likely transient synovitis, but consider septic joint and whether you need to tap and rule out; otherwise reassure and supportive care

Question 21

Teenage athlete, enlargement of tibial tuberosity, knee pain

Answer 21

Osgood Schlatters; refrain from exercise and give time to heal

Question 22

Two bone cancers

Answer 22

Ewing sarcoma, osteosarcoma

Question 23

Bone tumor with onion skin appearance, mid shaft of long bone

Answer 23

Ewing sarcoma

Question 24

Retinoblastoma, sunburst pattern, distal femur

Answer 24

Osteosarcoma

Question 25

Where should fractures of growth plate be taken?

Answer 25

OR, if not addressed can impede growth

Question 26

Urine sample has RBCs with casts. Where is blood from?

Answer 26

Kidney

Question 27

Just like BPH in old men, ______ in children can lead to obstruction and hydronephropathy

Answer 27

posterior urethral valves

Question 28

What will PUV lead to in utero?

Answer 28

oligohydraminos

Question 29

What is use of voiding cystourethrogram?

Answer 29

rule out reflux

Question 30

What is a CI to circumcision?

Answer 30

Hypo and Epispadias

Question 31

What can renal US tell you?

Answer 31

Mass, hydronephrosis

Question 32

First line tx for AOM?

Answer 32

Amoxicillin

Question 33

Common bugs in otitis externa?

Answer 33

S. aureus, pseudamonas

Question 34

What to do for mastoiditis?

Answer 34

Surgical decompression of fluid

Question 35

When to treat sinusitis?

Answer 35

> 10 days sx, worsening, temp > 38 (100.4)

Question 36

Recurrent sinusitis. Imaging?

Answer 36

Yes, more likely anatomic defect.

Question 37

Does treatment of GAS pharyngitis prevent future rheumatic fever?

Answer 37

YES

Question 38

Does treatment of GAS pharyngitis prevent PSGN?

Answer 38

NO

Question 39

What are the four symptoms of the modified centor criteria for GAS pharyngitis?

Answer 39

Cough Exudates Cervical LAD Temperature > 38

Question 40

When to treat strep without rapid strep test?

Answer 40

Centor > 4

Question 41

When to run rapid strep test?

Answer 41

Centor > 2

Question 42

What to do for nose bleeds?

Answer 42

Lean forward, apply pressure, cauterize (if anterior bleed), patching (if posterior bleed, risk of TSS so may want ppx abx)

Question 43

In nursery, baby appears blue, but quickly pinks up with crying. What is up?

Answer 43

Choanal atresia - crying forces to breath through mouth. Test with catheter through nose.

Question 44

You suspect a kid has swallowed a foreign body. There is an inspiratory wheeze on exam. Where is the FB?

Answer 44

Extrathroacid

Question 45

Wheeze on exhalation means FB ____

Answer 45

Intrathoracic, call pulm for bronchoscopy to remove

Question 46

You have a kid with asthma currently on albuterol. You want to add a LABA. What must you do first?

Answer 46

Must start both LABA and ICS! If LABA alone, increases mortality.

Question 47

A child with CF is diagnosed with pneumonia. What is likely bug?

Answer 47

Pseudomonas, common in CF

Question 48

What differentiates simple vs complex seizure.

Answer 48

LOC (complex)

Question 49

Another name for a complex generalized sizure

Answer 49

Grand mal

Question 50

Commonly used antiseizure med for kids

Answer 50

Keppra/Leviteracetam

Question 51

Ethosuximide

Answer 51

Used for absance seizures

Question 52

What medication to abort febrile seizure?

Answer 52

Benzos

Question 53

What to use to control fever?

Answer 53

Acetaminophen

Question 54

What is west syndrome?

Answer 54

Infantile spasm

Question 55

Interictal EEG, hysparrhythmia

Answer 55

infantile spasm/west syndrome -- associated with tuberous sclerosis

Question 56

Ash-leaf spots, angiofibromas, infantile spasm

Answer 56

tuberous sclerosis