LRT Infections - Pediatrics

Question 1

The younger the child. the higher/lower their respiratory rate?

Answer 1

Higher

Question 2

Normal respiratory rate in age >5 years is ___

Answer 2

> 20 bpm

Question 3

3 typical pathogens in pediatric CAP are:

Answer 3

1. S. pneumoniae
2. H. influenzae
3. M. catarrhalis

Question 4

Atypical CAP usually has an abrupt/gradual presentation and is ___ common in kids <5

Answer 4

abrupt presentation and less common in kids <5

Question 5

Infants and children with CAP should be admitted if their oxygen level is

Answer 5

<90%, considered moderate to severe CAP

Question 6

First line inpatient therapy for FULLY IMMUNIZED children with presumed bacterial CAP

Answer 6

Ampicillin or penicillin G

Question 7

Alternative inpatient therapy for FULLY IMMUNIZED children with presumed bacterial CAP

Answer 7

ceftriaxone or cefotaxime

Question 8

First line inpatient therapy for FULLY IMMUNIZED AND NON FULLY-IMMUNIZED children with presumed atypical CAP

Answer 8

azithromycin

Question 9

First line inpatient therapy for NON FULLY IMMUNIZED children with presumed bacterial CAP

Answer 9

ceftriaxone or cefotaxime

Question 10

What should be added for suspected CA-MRSA for presumed bacterial CAP

Answer 10

vancomycin or clindamycin

Question 11

First line outpatient therapy for presumed bacterial CAP in children <5 years

Answer 11

High-dose amoxicillin (90 mg/kg/day divided q12h)

Question 12

First line outpatient therapy for presumed atypical CAP in all children

Answer 12

azithromycin (10 mg/kg/day x 1 day, then 5 mg/kg/day x 4 days)

Question 13

First line outpatient therapy for presumed bacterial CAP in children ≥5 years

Answer 13

high-dose amoxicillin +/- azithromycin

Question 14

Therapy for influenza CAP (viral)

Answer 14

oseltamivir

Question 15

These two LRI in children are caused by viruses

Answer 15

croup, bronchiolitis

Question 16

Age range for croup

Answer 16

6 months-6 years

Question 17

Episode duration of croup

Answer 17

~1 week

Question 18

Airway management in croup

Answer 18

sitting upright is better than laying down, if severe inflammation in epiglottis, need to get immediate medical attention

Question 19

Supportive care in croup and bronchiolitis

Answer 19

humidified air, hydration, oxygen supplementation (in hospital)

Question 20

Croup therapy

Answer 20

Dexamethasone given IM (NOT INHALED) or epinephrine via nebulizer

Question 21

Acute viral infection causing inflammation, edema, increased mucus production, and bronchospasm of lower respiratory tract

Answer 21

bronchiolitis

Question 22

Age most common for bronchiolitis

Answer 22

Children <1 year

Question 23

For which treatment do physicians perform chest physiotherapy?

Answer 23

bronchiolitis to try and break up mucus in CF patients

Question 24

RSV prevention prophylaxis

Answer 24

palivizumab 15 mg/kg/dose IM qmonth (3-5 total doses during RSV season)

Question 25

Palivizumab can be given to any child for RSV prevention (T/F)

Answer 25

False, only for high risk patients

Question 26

Palivizumab should be given to premature infants born

Answer 26

<29 weeks GA and less than 12 months of age at start of RSV season

Question 27

CF patients are candidates for RSV prevention palivizumab (T/F)

Answer 27

False, only if they have another condition that qualifies them

Question 28

The greatest mortality and complications of pertussis is in infants

Answer 28

<6 months

Question 29

Pertussis treatment

Answer 29

azithromycin 10 mg/kg/day x 5 days for 0-5 months

Question 30

Bactrim is contraindicated in children age ___ for pertussis

Answer 30

<2 months

Question 31

Who are candidates for pertussis post-exposure prophylaxis?

Answer 31

1. Infants and women in 3rd trimester of pregnancy
2. pre-existing health conditions that may be exacerbated by pertussis
3. Persons in close contact with infants <12 months, pregnant women, high risk individuals

Question 32

In CF, you should use a _-drug approach to double cover for pseudomonas

Answer 32

2-drug approach (beta-lactam + aminoglycoside or fluoroquinolone)

Question 33

Outpatient therapy for CF

Answer 33

PO + increased CPT, IV +/- PO + CPT

Question 34

Inpatient therapy for CF

Answer 34

IV +/- PO + increased CPT

Question 35

MRSA coverage in CF

Answer 35

vancomycin (IV) or Bactrim (IV/PO)

Question 36

Pseudomonas coverage in CF

Answer 36

Pip-tazo (IV) + AG, cefepime (IV) + AG