peds

Question 1

risk factors for otitis media

Answer 1

smoke exposure
formula feeding
immunization status
atopy
daycare attendance
males
family history
onset before 12 months
non white
congenital anomalies
immune deficiency

Question 2

difference in anatomy with kids in ears

Answer 2

shorter eustachian tube

Question 3

bacteria is isolated from what percent of acute otitis media

Answer 3

65-75%

Question 4

commom pathogens for acute otitis media

Answer 4

strep pneumo
h. flu
moraxella cat

• strep pyogenes (rare)
• viral 30%

Question 5

when is pneumococcal vax given

Answer 5

2,4,6,12-15 months

Question 6

how does tympanic membrane look in AOM

Answer 6

bulging
cloudy or purulent
immobile

Question 7

diagnosis of acute otitis media requires what

Answer 7

1. acute onset
2. middle ear effusion
3. symptoms

Question 8

severe otitis media classification

Answer 8

> 39

Question 9

patient populations that have the option to observe and not treat

Answer 9

nonsevere unilateral 6 month-2 years
nonsevere unilateral and bilateral 2 years +

Question 10

if we choose to observe how long do we observe

Answer 10

48-72 hours
follow-up if failure
SNAP - safety net prescription

Question 11

how is strep pneumo overcome in treatment of AOM

Answer 11

high dose amoxicillin

Question 12

how is h flu and moraxella over come in treatment of AOM

Answer 12

amox/clav
adding a beta lactamase inhib

Question 13

first line treatment AOM

Answer 13

amoxicillin 80-90mg/kg/day q12 h

Question 14

when do we not use amoxicillin first line in AOM

Answer 14

allergy
known resistance
treatment failure (after 72h)
amoxicillin in last 30 days
conjuncitvitis

Question 15

2nd line therapy used if amoxicillin failure or if high dose amoxicillin in last 30 days or conjuctivitis

Answer 15

amoxicillin/clav 90 mg/kg q12h

Question 16

clav consideration

Answer 16

keep at <10 mg/kg/day

Question 17

amox/clav strength

Answer 17

600/42.9

Question 18

2nd line if pt has amox allergy

Answer 18

cefpodoxime
cefuroxime
cefdinir

Question 19

when would we use ceftriaxone

Answer 19

oral not available
treatment failure

Question 20

ceftraixone dosage form and dosing

Answer 20

IM
1 injection if initial dose
3 injections if treatment failure

Question 21

disadvantages of ceftriaxone

Answer 21

calcium coadmin
c. diff risk
avoid in <1 month

Question 22

how long should we have AOM treatment in < 2 years old pts

Answer 22

10 days

Question 23

for pts over 2 years how long to treat

Answer 23

5-7 days
10 days if:
- severe or recurrent
- TM perforation

Question 24

adjunctive therapy for AOM

Answer 24

APAP 10-15 mg/kg/day
ibuprofen 5-10 mg/kg/day
- ibuprofen not for <6 months

Question 25

lidocaine OTC drop usage

Answer 25

do not use in ruptured membrane or tubes may consider in 2+

Question 26

follow-up timeline AOM

Answer 26

young infants -days young children w freq - 2 weeks children w sporadic episode - 1 month older children - not needed

Question 27

who may benefit from antibiotic prophylaxis AOM

Answer 27

> 6 episodes per year

Question 28

treatment of AOM in tubes pts

Answer 28

ofloxacin or levofloxacin drops 4-5 drops BID 5-7 days

Question 29

chronic supperative ottiis media risk pathogen

Answer 29

MRSA (lasting >6 weeks)

Question 30

chronic supperative otitis media treatmetn

Answer 30

ofloxacin or cipro drops x 2 weeks

Question 31

otitis externa (swimmers ear) orgnaisms

Answer 31

pseudomonas staph aureus fungal

Question 32

otitis externa swimmers ear treatmet

Answer 32

ear drops

Question 33

UTI ped risk factors girls

Answer 33

white <12 months temp >39 fever > 2 days

Question 34

UTI ped risk factors boys

Answer 34

non black temp >39 fever >24 h uncircumcised

Question 35

pathogens causing UTI in kids

Answer 35

e. coli 80-85% also Klebsiella

Question 36

signs and symptoms of UTI in peds

Answer 36

check all fever children < 2 years newborns - jaundice, looking sick infants/young kids - flank pain, foul urine school kids - dysuria, frequnecy, urgency

Question 37

preferred method of urine collection peds

Answer 37

catheterization fo < 2 years old

Question 38

positive urinalysis results indicating UTI in ped

Answer 38

leukocyte esterase nitrite

Question 39

urine culture that would not be contaminanted CFU cound

Answer 39

> 100,000 > 10,000 in catheter

Question 40

treatment of UTI in children

Answer 40

cephalexin q 6 hours could do Bactrim last line is FQs

Question 41

what can we not give in a feeding tube

Answer 41

fluroquinolones

Question 42

duration of treatment of UTI in uncomplicated < 2 years

Answer 42

7 days

Question 43

duration of treatment of UTI in pyelonephritis peds

Answer 43

10-14 days

Question 44

duration of treatment in UTI of older female peds

Answer 44

3-7 days

Question 45

IV vs oral for UTI

Answer 45

IV if cant keep oral down (ceftriaxone) or if looking toxic

Question 46

what is bronchiolitis

Answer 46

lower resp infection viral edema, inflammation

Question 47

what causes bronchiolitis

Answer 47

RSV rhinovirus

Question 48

RSV season is when

Answer 48

November-April

Question 49

risk factors for RSV

Answer 49

age < 6 months pre-term chronic lung disease weakened immune system

Question 50

treatment of bronchiolitis

Answer 50

supportive therapy! - oxygen - hydration - mechanical vent - ECMO

Question 51

how can we prevent RSV

Answer 51

nirsevimab pregnant people vaccine

Question 52

vaccine for pregnant people RSV

Answer 52

Abrysvo

Question 53

how much time before pregnancy must RSV vaccine be given to pregnant women

Answer 53

14 days before delivery

Question 54

when can babies get Nirsevimab

Answer 54

right at birth if RSV season right before RSV season in office if its not in season

Question 55

who should get second nirsevimab dose

Answer 55

chronic lung disease chronic corticosteroid therapy immunocompromised heart disease Indian