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Flashcards in Pediatric Conditions Deck (12)
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1
Q

A 7 year old will receive pediacare Children’s Cough & Runny nose liquid. He is going to take 2 teaspoons 3-4 times a day as needed. The medication contains 160mg of APAP, 1 mg of chlorpheniramine and 5 mg of dextromethorphan per teaspoon. Which of the following statements are correct? Select all that apply

A. The child will get overdosed on dextromethorphan if he is given that dose
B. The child will get overdosed on APAP if he is given that dose
C. The doses are safe as recommended
D. Chlorpheniramine is a decongestant
E. Dextromethorphan by itself comes as the brand name Delsym

A

C and E

2
Q

A 4 y.o. is starting valproic acid. Her parents will sprinkle the depakote sprinkles 125mg capsule on food BID. Which of the following counseling statements should be provided to the parents by the pharmacist? Select all that apply

A. This drug may cause very bad and sometimes deadly liver problems. This most often happens within the first 6 months of using this drug. Call the doctor if the child has dark urine, is feeling tired, is not hungry, has an upset stomach, is throwing up, or has yellowing of the skin or eyes
B. This drug may cause very bad and sometimes deadly pancreas problems (pancreatitis). This could happen in children at any time during care. Symptoms of pancreatitis include tummy pain, upset stomach, throwing up, or not feeling hungry. Call the child’s doctor right away if she has any of these symptoms
C. This drug comes with an extra patient fact sheet called a medication guide. Read it with care. Read it again each time this drug is refilled
D. This drug may cause very bad birth defects if the child takes it pregnant. It can also cause the baby to have a lower IQ. Do not give this drug to prevent migraine headaches if the child is pregnant. If the child is pregnant and takes this drug for seizures or bipolar disorder, talk to the child’s doctor to see if the child needs to keep taking this drug
E. It is important to chew the medicine thoroughly or not enough of the medicine will get into the child’s body and the medicine may not work well

A

A, B and C

3
Q

Which of the following statements are correct? Select all that apply

A. The FDA has warned that APAP has been associated with a risk of rare but serious and potentially fatal skin reactions, including SJS, TEN and acute generalized exanthematous pustulosis (AGEP)
B. Anyone who develops a skin rash or reaction while using APAP or any other pain reliever/fever reducer should stop taking the drug and seek medical attention immediately
C. Patients who have experienced a serious skin reaction with APAP should not take the drug again
D. The FDA recommends that the safe dose of APAP is 325mg or less per dosage unit
E. Keeping the unit dose to less than 325mg reduces the risk of severe skin reactions

A

A, B, C and D

Risk of severe skin reactions is not dose related

4
Q

Which of the following is correct about vaccination to prevent transmission of pertussis?

A. Pregnant women (weeks 27-36) should receive DTaP
B. Children < 7 years of age should receive the DTaP series
C. Infants and children should receive Tdap at 2, 4, 6, and 12-15 months
D. Pregnant women (weeks 27-36) should receive Td
E. Children 7-10 years of age who were not fully vaccinated should receive a one time dose of DTaP

A

B
Pediatric formulations have a D, adult formulations have a d
Pregnant women (weeks 27-37 weeks) should get Tdap

5
Q

Desmopressin is a synthetic form of vasopressin (anti-diuretic hormone), which regulates fluid volume. It is used for patients with inadequate vasopressin (which results in diabetes insipidius), for treating bedwetting in children (enuresis) and for reducing bleeding in hemophilia (Von Willebrand’s disease). Select available formulations for desmopressin. (Select all that apply)

A. Injection
B. Suppository, rectal
C. Nasal spray
D. Topical paste
E. oral tablet
A

A, C, and E

6
Q

A 5 m.o. infant, weight 3.4 kg is treated for her first case of otitis media with amoxicillin at a dose of 150mg BID x 7 days. At 2 week follow up, she has documented fullness in middle ear and a cloudy tympanic membrane. Febrile with temp of 38.7. Which of the following represent preferred options for treatment?

A. High-dose amoxicillin (90 mg/kg/day) for 7 days
B. Augmentin 150mg (of amox component) BID x 7 days
C. Augmentin 300 mg (of amox component) BID x 7 days
D. Cefuroxime 50 mg BID x 7 days
E. Azithromycin 30 mg x 2 days

A

D.
Azithromycin is given as 1, 3 or 5 day dosing regimen, but not preferred in the presence of initial amox treatment failure. It can be used if anaphylaxis to beta-lactam
Treatment failure with amox preferred treatment is augmentin or ceftriaxone injection IM or IV

7
Q

A 7 y.o. patient will receive pediacare children’s cough and runny nose liquid. The medication contains 160mg of APAP, 1 mg of chlorpheniramine and 5 mg of dextromethorphan per teaspoon. Which of the following statements are correct? Select all that apply

A. The FDA recommends that OTC cough and cold products should not be used for infants and children under 6 y.o. due to the risk of serious and potentially life-threatening side effects
B. The pharmacist should recommend that the parents use a standard size teaspoon in order to make sure the child receives an accurate dose; “teaspoons” come in different sizes
C. Chlorpheniramine is an antihistamine that will produce a sedative effect
D. The parents need to be counseled not to over-use APAP by administering it separately for pain or fever
E. Dextromethorphan is used as a mucolytic

A

C and D

FDA recommends that OTC cough & cold products should not be used for infants and children under 2 years of age.

8
Q

What is an OTC anti-gas agent that can be used for a newborn?

A. Advil infant drops
B. Mylicon infant drops
C. APAP infant drops
D. Gaviscon infant drops
E. Phillips infant drops
A

B

Mylicon - simethicone
Gaviscon = aluminum hydroxide + magnesium carbonate

9
Q

If a patient was to develop a severe skin reaction to APAP (or another drug) what are the likely initial symptom that would be seen prior to the onset of rash?

A. Nausea, vomiting
B. Fever and muscle aches
C. Yellowing skin
D. Tingling of the extremities
E. Severe headache, dry mouth, light sensitivity
A

B

10
Q

Based on a diagnosis of severe croup, which of the following drug regimens is warranted?

A. Dexamethasone only
B. Nebulized racemic epinephrine only
C. Dexamethasone and nebulizer racemic epinephrine
D. Nebulized racemic epinephrine, dexamethasone and amoxicillin
E. Dexamethasone and nebulizer budesonide

A

C

11
Q

Fever criteria for urgent care in peds

A

all temps are rectal
< 3 months, temp 100.4
3-6 months 101
> 6 months 103

12
Q

Which of the following statements about croup are correct? Select all that apply

A. Croup is most common in children < 6 y.o.
B. Croup is most commonly caused by a fungal infection
C. Mild cases require admission to the hospital for antibiotics to prevent progression to severe illness
D. Inflammation of the upper airway leads to the symptoms of the croup
E. Epinephrine is used in croup to relax bronchial smooth muscle and cause bronchodilation

A

A, D and E