PEDS ID

Question 1

What are common pathogens for pediatric acute otitis media (AOM)?

Answer 1

Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis.

Question 2

What are the risk factors for AOM in children?

Answer 2

Smoke exposure, daycare attendance, formula feeding, early onset <6-12 months, family history, low socioeconomic status.

Question 3

What are first-line treatments for AOM?

Answer 3

Amoxicillin 80-90 mg/kg/day divided BID; amoxicillin-clavulanate if prior amox use or conjunctivitis.

Question 4

What are alternatives for AOM in penicillin-allergic patients?

Answer 4

Cefdinir, cefuroxime, cefpodoxime, or ceftriaxone; avoid 1st gen cephalosporins in severe allergy.

Question 5

When is antibiotic therapy indicated in AOM?

Answer 5

Age <6 months, severe symptoms, bilateral AOM <2 years, or presence of otorrhea.

Question 6

When is observation appropriate in AOM?

Answer 6

Age ≥2 years, non-severe symptoms, and reliable follow-up.

Question 7

What are counseling points for AOM management?

Answer 7

Provide analgesia (APAP or ibuprofen), watchful waiting if eligible, ensure adherence to therapy.

Question 8

What are the common pathogens in pediatric UTI?

Answer 8

E. coli (80–85%), Klebsiella, Proteus, Enterococcus, S. saprophyticus.

Question 9

What are preferred empiric oral agents for UTI?

Answer 9

Amoxicillin-clavulanate, cephalexin, TMP-SMX (if susceptible).

Question 10

What are risk factors for UTI in febrile infants?

Answer 10

White race (girls), uncircumcised boys, age <12 months, fever >39°C, no other infection source.

Question 11

When is IV therapy indicated for pediatric UTI?

Answer 11

Toxic appearance, vomiting, poor oral intake, or sepsis concern.

Question 12

How should urinalysis be obtained in infants <24 months?

Answer 12

Catheterization or suprapubic aspiration (SPA). Avoid bag specimens.

Question 13

What is the typical duration of therapy for pediatric UTI?

Answer 13

7–14 days for infants/young children; 3–7 days for older girls with cystitis.

Question 14

What is the main treatment for RSV bronchiolitis?

Answer 14

Supportive care: oxygen, fluids, suctioning. Avoid antibiotics unless bacterial infection suspected.

Question 15

What are RSV risk factors?

Answer 15

Age <6 months, prematurity, congenital heart or lung disease, immunocompromised state.

Question 16

What are two prevention strategies for RSV in infants?

Answer 16

Maternal RSV vaccination (Abrysvo) and monoclonal antibody (Nirsevimab).

Question 17

Who qualifies for Nirsevimab (Beyfortus)?

Answer 17

Infants <8 months during RSV season, if mother not vaccinated during pregnancy; certain high-risk children may receive 2nd season dose.

Question 18

What is the dose of Nirsevimab based on weight?

Answer 18

50 mg if <5 kg, 100 mg if ≥5 kg.

Question 19

Is Nirsevimab used for treatment of RSV?

Answer 19

No; it is only used for prevention, not treatment.

Question 20

What is the first-line antibiotic for pediatric acute otitis media (AOM)?

Answer 20

Amoxicillin 80–90 mg/kg/day divided BID.

Question 21

When is amoxicillin-clavulanate preferred over amoxicillin in AOM?

Answer 21

If amoxicillin was used in the past 30 days, or with conjunctivitis (likely H. influenzae).

Question 22

What antibiotics are options for AOM in penicillin-allergic children?

Answer 22

Cefdinir, cefuroxime, cefpodoxime, or ceftriaxone. Avoid if anaphylactic allergy.

Question 23

What is the treatment duration for AOM in children <2 years or with severe symptoms?

Answer 23

10 days.

Question 24

What is the treatment duration for AOM in children ≥2 years with mild/moderate symptoms?

Answer 24

5–7 days.

Question 25

What is the empiric first-line oral antibiotic for pediatric UTI?

Answer 25

Amoxicillin-clavulanate or cephalexin.

Question 26

What is an alternative for UTI if local resistance to amox-clav is high?

Answer 26

TMP-SMX or a 2nd/3rd gen cephalosporin like cefixime or cefdinir.

Question 27

When is IV ceftriaxone or cefotaxime preferred for pediatric UTI?

Answer 27

If patient is toxic-appearing, vomiting, unable to tolerate PO, or febrile infant.

Question 28

What antibiotics are avoided in infants <2 months with UTI?

Answer 28

Nitrofurantoin and TMP-SMX due to immature renal function and bilirubin displacement risk.

Question 29

What is the typical duration of antibiotics for febrile pediatric UTI?

Answer 29

7–14 days.

Question 30

Are antibiotics used to treat RSV bronchiolitis?

Answer 30

No; treatment is supportive only unless there is a secondary bacterial infection.

Question 31

What is the treatment for Streptococcus pneumoniae in AOM?

Answer 31

High-dose amoxicillin (80–90 mg/kg/day).

Question 32

What is the treatment for beta-lactamase-producing H. influenzae or M. catarrhalis in AOM?

Answer 32

Amoxicillin-clavulanate.

Question 33

What is the treatment option for AOM with penicillin allergy (non-anaphylactic)?

Answer 33

Oral cephalosporins like cefdinir, cefuroxime, or cefpodoxime.

Question 34

What is the treatment for E. coli UTI in children?

Answer 34

Cephalexin or amoxicillin-clavulanate if susceptible; TMP-SMX or cefixime as alternatives.

Question 35

What is the treatment for Enterococcus in pediatric UTI?

Answer 35

Amoxicillin or ampicillin if susceptible; vancomycin if resistant.

Question 36

What antibiotics are active against Proteus and Klebsiella in pediatric UTI?

Answer 36

Cephalexin, cefixime, or cefdinir if susceptible.

Question 37

What is the role of antibiotics in RSV bronchiolitis?

Answer 37

None; RSV is viral. Antibiotics only if there is a documented secondary bacterial infection.