peds

Question 1

Why is intussusception rare before 3m?

Answer 1

passive immunity is still high in first 3m of life, and most intussusception in kids is 2/2 hypertrophic lymphoid tissue following an infection

Question 2

initial fluid bolus in pediatric DKA

Answer 2

10 cc/kg over 1h

Question 3

Fentanyl dosing (IV and IN)

Answer 3

IV: 0.5-1 mcg/kg (max 50 mcg)
IN: 1-2 mcg/kg

…so basically, 1 mcg/kg but can upgrade it for IN

Question 4

morphine dosing and routes

Answer 4

0.05-0.1 mg/kg (max 5 mg IV)

IV, IM, or SC

Question 5

Narcan dosing (IV and IN)

Answer 5

IV: 0.01 mg/kg
IN: 0.1 mg/kg

adolescents: 2 mg/dose

repeat q2-3m

Question 6

APAP dosing and max

Answer 6

15 mg/kg (max 1 g)

Question 7

oxycodone dosing

Answer 7

0.05-0.15 mg/kg

Question 8

how long does LMX take to work

Answer 8

20m

Question 9

ketamine sub-dissociative dosing

Answer 9

<0.3 mg/kg

Question 10

important thing to monitor during neonatal sedation

Answer 10

glucose

Question 11

Versed dosing (IV, IN, and PO)

Answer 11

IV: 0.05-0.1 mg/kg (max 2 mg)
IN: 0.2-0.3 mg/kg (max 5 mg)
PO: 0.5-0.7 mg/kg, max 15 mg

Question 12

flumazenil dosing

Answer 12

0.01 mg/kg (max 0.2 mg) over 15s
repeat: same dose after 45s
may keep repeating every min to max 0.05 mg/kg or 1 mg (whichever is lower)

Question 13

ketamine sedative dosing

Answer 13

1 mg/kg IV, repeated q20-30m, to max 3 mg/kg

Question 14

propofol dosing (push and gtt)

Answer 14

0.5 mg/kg IV (max 2 mg/kg)

gtt 25-75 mcg/kg/min

Question 15

Precedex dosing and contraindications

Answer 15

1-2 mcg/kg IV over 10m > gtt at 0.2-1 mcg/kg/hr

careful: bradycardia, AV block, dig

Question 16

NPO guidelines

Answer 16

clears: 2h
breastmilk: 4h
formula and solids: 6h

Question 17

neonatal ETT sizing: < 28 wks, 28-34 wks, 34-38 wks, > 38 wks

Answer 17

< 28 wks: 2.5
28-34 wks: 3
34-38 wks: 3.5
> 38 wks: 3.5-4

Question 18

neonatal ETT depth

Answer 18

6 + weight (kg)

Question 19

peds ETT sizing

Answer 19

uncuffed = 4 + age/4
cuffed = 3.5 + age/4

Question 20

definition of a UTI on cath

Answer 20

> 50,000 CFU of a single organism

Question 21

infant UTI organism

Answer 21

GBS

Question 22

> 1y old UTI organism

Answer 22

E. coli

Question 23

malrotation age group

Answer 23

within 1y of life

Question 24

intussusception age group

Answer 24

3m-5y

Question 25

HUS

Answer 25

E. coli bloody diarrhea w/ART: anemia, renal failure, thrombocytopenia
- NO ABX

Question 26

croup: who gets dex, who gets racemic epi

Answer 26

dex 0.6 mg/kg for all (PO is fine)

racemic epi for stridor at rest or significant respiratory distress (observe x 3h post since sx may recur - then, admit)

Question 27

differentiating bacterial tracheitis from croup

Answer 27

tracheitis pts look toxic, are older (3-5y), and don’t respond to croup tx

Question 28

Salter-Harris classification

Answer 28

S-A-L-T-ER

1 = slipped (separated through growth plate, think SCFE)
2 = above growth plate
3 = lower than growth plate
4 = through growth plate
5 = erasure of growth plate (crush)

Question 29

most common Salter-Harris fracture

Answer 29

type II

Question 30

Which Salter-Harris fractures require surgery?

Answer 30

4 and 5

Question 31

Shigella tx

Answer 31

azithromycin or cipro

Question 32

Shigella complications

Answer 32

HUS, reactive arthritis, seizures, confusion, hallucinations

Question 33

pediatric rectal prolapse

Answer 33

consider CF

Question 34

infantile spasm

Answer 34

< 1y w/neurodevelopmental delay and clusters of spasms a few mins at a time
tx: ACTH, steroids, benzos, vigabatrin

Question 35

Hirschsprung disease is associated with

Answer 35

trisomy 21, male sex

Question 36

adenosine dosing

Answer 36

dose 1 = 0.1 mg/kg

dose 2: 0.2 mg/kg

Question 37

newborn RR

Answer 37

50

Question 38

1yo RR

Answer 38

30

Question 39

Tetralogy of Fallot

Answer 39

P - pulmonic stenosis
R - RV hypertrophy
O - overriding aorta
V - VSD

Question 40

breastfeeding jaundice

Answer 40

jaundice in the first week of life 2/2 poor intake or poor maternal production

Question 41

SVT: adenosine and cardioversion dosing

Answer 41

0. 1 mg/kg (max 6 mg) > 0.2 mg/kg (max 12 mg)

cardioversion: 1 J/kg > 2 J/kg

Question 42

epi dosing

Answer 42

0.01 mg/kg

Question 43

needle cricothyrotomy

Answer 43

14/16-gauge needle with angiocath > attach syringe with saline and aspirate (hopefully bubbles) > advance angiocath > attach 3.5mm ETT cap and BVM through it