Pediatrics

Question 1

What is correct gestational age?

Answer 1

age since conception
= GA+PNA

Question 2

What is a premature neonate?

Answer 2

born <37 weeks gestational age

Question 3

What is a full term baby?

Answer 3

37-41 weeks +28 days PNA

Question 4

What is an infant, child, adolescent?

Answer 4

infant= 1m-1y
child 1-12y
Adolescent 12-18y

Question 5

What is a Childs gastric pH? At what age does it make it about to adult?

Answer 5

higher=more basic

> 5

Question 6

Due to a child (<5)’s stomach, how would absorption of a basic and acidic drug change?

Answer 6

acidic= less
basic= more

Question 7

When a kid is <4 months how does their motility change?

Answer 7

gastric motility very slow= slower absorption or Tmax higher
normalizes at 4 months

Question 8

Do kids have more or less topical absorption?

Answer 8

thing skin= increased

Question 9

In regards to water do they have more or less than adults?

Answer 9

more body % water in babies

Question 10

If more water how does this affect Vd?

Answer 10

higher Vd for hydrophilic drugs

Question 11

Do babies have more or less albumin?

Answer 11

LESS= more unbound

Question 12

What other factor of babies affects fraction unbound?

Answer 12

MORE endogenous products to displace drugs from albumin= more unbound

Question 13

In regards to liver enzymes how is this different for kids?

Answer 13

less enzymes and increases as we age

Question 14

When does kids reach adult GFR? When does rapid renal function increases happen?

Answer 14

8-12 months
first few weeks of life

Question 15

Formula for estimating renal function in kids?

Answer 15

bedside Schwartz equation

Question 16

Limitations of Schwartz equation?

Answer 16

if Sir rapidly changing, bad CKD, obese, malnourished, muscle wasting

Question 17

What should a kid daily dose not exceed?

Answer 17

adult dose

Question 18

What is the aliquot method?

Answer 18

make a larger volume and take a portion
EX: 5 mg/ml if need 3 mg you need 0.6 ml

Question 19

What if a child throws up (not just a spit up) dose?

Answer 19

<30 min= dose again DO NOT REPEAT if vomit again
>30 do not repeat

Question 20

Which form of tube feeding has less absorption?

Answer 20

NJ

Question 21

What does number of lumens mean for IV access?

Answer 21

how many ‘holes’ in one IV line for drug compatibility

Question 22

What is the formula method for fluids?

Answer 22

100 ml for first 10 kg +
50 ml for each additional kg between 11-20 +
20 ml for each additional kg over 20 kg

Question 23

What is the 4/2/1 method for fluids?

Answer 23

4 ml/kg for first 10 kg +
2 ml/kg for kg 11-20 +
1 ml/kg for each additional kg above 20

Question 24

Which fluid formula is for daily and hourly?

Answer 24

formula= daily
4/2/1= hourly

Question 25

What is the fluid used?

Answer 25

D5W/NS

Question 26

When can you not use D5W/NS?

Answer 26

if renal or cardiac disease, severe burns, electrolyte dz, diabetic ketoacidosis

Question 27

What do you need to interpret BP of a kid?

Answer 27

age, sex, height, BP

Question 28

When is it considered HTN for a kid?

Answer 28

if around 95 percentile of BP for their age and height

Question 29

IN general what is kids BP compared to adult?

Answer 29

lower

Question 30

IN general what is kids HR/RR compared to adult?

Answer 30

much higher

Question 31

Gold standard for temp?

Answer 31

rectal

Question 32

How much lower is oral temp to rectal?

Answer 32

0.6 degrees celsius

Question 33

What is normal temperature for kid?

Answer 33

37.2 +/- 0.5

Question 34

Issues with tetracyclines?

Answer 34

bad with bones and teeth

Question 35

At what age is tetracyclines CI?

Answer 35

<8

Question 36

What is a safe course of tetracyclines?

Answer 36

<21

Question 37

Issues with FQ?

Answer 37

arthropathy=cartilage and tendon rupture

Question 38

CI age of SMP/TMX?

Answer 38

<2 months due to hyperbilirubinemia and kernicterus

Question 39

What is kernicterus?

Answer 39

permanent brain damage due to high bilirubin= Cerebral palsy, hearing loss, vision issues, bad intellectual

Question 40

What clavulanic dose causes diarrhea?

Answer 40

about 8 mg/kg/day

Question 41

When is ASA used in kids?

Answer 41

Kawasaki disease, rheumatic fever, congenital heart repair prophylaxis

Question 42

Is ciprofloxacin okay to put through tube?

Answer 42

NO- suspension will clog, dissolve and dose

Question 43

Calculate fluid maintenance of a 40.2 kg patient who is now 39.7kg due to water loss at 1.5x? How long will it take to get them back to their weight?

Answer 43

4 2 1 rule= 120ml/hr 120-80ml=40ml/hr x hr/500ml= 12.5 hours

Question 44

To find normal blood pressure for a kid hat do we need?

Answer 44

for accurate= age, sex, and height

Question 45

When is it considered HTN for a kid?

Answer 45

if in 95 percentile

Question 46

Normal temperature in kid?

Answer 46

37.2

Question 47

Why are tetracyclines bad for kids?

Answer 47

<8= CI due to chelating with calcium and refining bones and teeth

Question 48

What duration of tetracyclines are probably okay?

Answer 48

<21 days

Question 49

Why should we avoid FQ?

Answer 49

tendon rupture and arthropathy

Question 50

When is Septra CI?

Answer 50

<2 months= causes hyperbilirubinemia and kernicterus

Question 51

What is kernictereus?

Answer 51

lots of bilirubin in brain= brain damage such as cerebral palsy

Question 52

At what dose of clavulanic acid is risk of diarrhea?

Answer 52

>8mg/kg/day

Question 53

What is high dose amoxicillin?

Answer 53

>90mg/kg/day

Question 54

Why do doctors use two forms of amoxicillin?

Answer 54

keep clavulanic acid low to get a 14:1 ratio

Question 55

Why not use ASA in kids?

Answer 55

Reyes syndrome = <18

Question 56

What patients (kids) need ASA therapy?

Answer 56

Kawasaki, heart repair, rheumatic fever