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Flashcards in Community Pediatrics Deck (17)
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1
Q

Prophylactic Antibiotics in UTI

A

This is no longer recommended.
The only time you would is there is reflux Grade IV or V.
If so you can use septra or macrobid.
Treatment for 3-6 months.

2
Q

UTI Diagnosis and Mangement

A

Leuk Esterase: Sensitive
Nitrites: Specific
LE/N/WBC = very high specificity and sensitivity

Minimum Colony Counts:
Suprapubic aspiration: any amount
Catheter: >5 x 10^7
Clean catch: >10^8

3
Q

When do you think of a UTI in infant?

A

Infants 2-36 months with high fever (>39) and no other reason may have fever.

4
Q

U/S?

A

Ultrasound all children <2 years of age with their first febrile UTI. Do not all need VCUG, only if abnormal

5
Q

When can you start using a cup in an infant?

A

6 months

6
Q

When should you start introducing Iron?

A

6 months

7
Q

When should you screen children for hearing abnormalities and with what?
Risk factors for hearing loss (5)

A

1 month of age with otoacoustic emission.
If they fail you follow up by 3 months with brainstem evoked potentials.
Repeat at 6 months and treat then if required.

Risk factors: Hyper billi; , NICU, Torch, craniofacial abnormalities, meningitis

8
Q

What deficiencies are children at risk for with vegetarian diets?

A

Iron (biggest)
Vitamin B 12 (if mom is vegan and breastfeeding)
Calcium and Vitamin D
Zinc

9
Q

Day Care Exclusion Criteria:

Diarrhea, Conjunctivitis, Scabies, Impetigo, Varicella, pertussis, measles, rubella and Hep A

A
Diarrhea: if culture + then 2 negative cultures (salmonella is 3 cultures)
Conjunctivitis: Treatment initiation
Scabies: Treatment 5% permetherin
Impetigo and GAS: 24 hours of treatment 
Varicella: crusted lesions
pertussis: 5 days of treatment 
Measles: 3 days from rash, Mumps: 9 days from welling Rubella 6 days from rash 
Hep A: 7 days from jaundice
10
Q

What are the contraindications to flying?

A

Eisenmeingers, uncontrolled SVT, uncontrolled htn

Should provide O2 for sickle cell and cardiopulmonary disease.

11
Q

Toilet training: when will kids have daytime continence?

A

98% of children will have daytime continence by the age of 3 years.

12
Q

What signs to children need for toilet readieness

A
Neurologically ready - sphincter control 18 months
Developmentally ready:
Will please family
Can follow a 2 step command
Asking too or showing readiness
13
Q

Head Lice

A

Pediculus humarus capitus. the actual diagnosis requires the presence of a live louse.
They can live away from the scalp for about 2 days.
Treatment: Permetherin
Ivermectin can not be used in children <15 kg.

14
Q

Early Onset Sepsis Guidelines - Risk factors

A
Prolonged rupture of membranes >18 hours
Previous diagnosis of GBS
GBS Uria
GBS + 
Maternal Fever 
Chorio
15
Q

Early onset sepsis - evaluation

A
  1. If baby is unwell - full work up and initiate antibiotics
  2. Multiple risk factors - CBC in 4 hours; monitor every 4 hours; keep in hospital 48 hours
  3. GBS Status:
    +/- Adequate antibiotics: Monitor for 24 hours then d/c.
    +/- Inadequate: Birth until 4 hours close monitoring; may d/c at 24 hours.

ONLY WBC and Neut can predict infection as compared to CRP.

16
Q

Transfusion Requirements

A

Note: EPO is not recommended due to the increased risk of ROP; unclear if transfusion increases risk for NEC.
Infants on support: 115, 100, 85
Infants not on support: 100, 85, 75

17
Q

Risks associated with Transfusions

A
  1. Anaphylaxis - ABO Incompatibility
  2. Graft Vs. Host
  3. Infection - CMV is the most common
  4. Fluid Overload
  5. Electrolyte abnormalities