UW ped 2

Question 1

MMR side effects

Answer 1

1-3 weeks after immunization –> maybe fever and mild rash that resolve without treatment –> avoid immunocompromised individuals

Question 2

diagnostic symptoms of acute rhinosinusitis

Answer 2

1/3:

1. Persistent symptoms for 10 or more days without improvement
2. severe symptoms, fever, purulent nasal discharfe r face pain for 3 or more days
3. worsening symptoms after 5 days after iniatially improving viral upper resp infection

Question 3

treatment and MCC of acute rhinosinusisitis

Answer 3

MCC: S. pneum + H. infl

augmentin

Question 4

Treatment of early Lyme in children younger than 8

Answer 4

amoxicillin

Question 5

Lyme - when ceftriaxone

Answer 5

mennigitis or AV block

Question 6

MC predisposing factor for acute bacterial sinusitis

Answer 6

viral upper resp infection

Question 7

causes acute unilateral cervical lymphadenitis in children

Answer 7

MC: S. aureus (non-toxic appearance) (S. pneu is the 2nd MCC)
anaerobic: dental
Bartonella: cat
Myc vium: gradual onset, no tenter

Question 8

causes of acute bilateral cervical adenitis in children

Answer 8

1. adenovirus: pharyngocunctivitis

2. EBV/CMV: mononucleosis

Question 9

congenital infeciton with increased head

Answer 9

toxoplasmosis

Question 10

congenital toxo - treatment

Answer 10

TMP-SXM PLUS FOLATE for 1 year

Question 11

Congenital toxoplasmosis vs CMV regarding calcifications

Answer 11

toxo –> diffuse intracranial calcification

CMV –> periventricular calcfication

Question 12

findings to all congenital infections

Answer 12

1. intrauterine growth restrction
2. hepatosplenomegaly
3. jaundice
4. blueberry muffin spots

Question 13

congenital infection - unique for CMV

Answer 13

periventricular calcifications

Question 14

congenital infection - unique for toxoplasmosis

Answer 14

diffuse intracerebral calcification
severe chorioretinitis
macrocephaly + hydrocephalus

Question 15

congenital infection - unique for syphilis

Answer 15

Rhinorrhea
abd long bone radiographs
desquamating or bullous rash

Question 16

features of normal lymph nodes / next step

Answer 16

soft, mobile, smaller than 2 cm, no systemic symptoms

–> observation –> if persists –> CBC

Question 17

pertusis - diagnosis

Answer 17

Culture
PCR of nasopharynx
LYMPHOCYTOSIS

Question 18

Pertussis - clinical phases

Answer 18

catarrhal (1-2 wks): mild cough, rhinitis
paroxysmal (2-6 wks): cough with isn whoop, posttusive emesis
Convasescent (wks to months: symptoms resolve gradually

Question 19

pediatric meningitis: MCC of meningitis in 0-3 months, 3 months - 10 years, older than 10

Answer 19

• 0-3: 1. S. agalacte 2. E.coli 3. listeria 4. HSV
• 3-10: S. pneum, N. meningitis
• older than 10: N. mening

Question 20

meningitis in infants - LP

Answer 20

immediately

CT in not necessary because herniation is very rare in infants

Question 21

meningitis in infnats - CT

Answer 21

no because herniation is very rare in infants 
only if: 
1. comatose
2. focal neurological findings
3. history of neurosurgical procedure

Question 22

MCC of neonatal sepsis

Answer 22

sterp agalacte

Question 23

Key resp tract infection in children - diagnosis, pathogen, presentation

Answer 23

1. croup –> parainfl –> age 6 month - 3, Barky, stridor, hoarse voice
2. epiglottitis –> H. inf –> unvaccin, sore throat, dysphagia, droolng, tripod
3. Bronchiolitis –> RSV, younger than 2, wheezing, coughing

Question 24

Neonatal sepsis - clinical feature

Answer 24

1. Q instability (fever or hypothermia
2. poor feeding
3. jaundice
4. CNS signs (lethargy, irritability, apnea
5. Abnormal WBCs (high or low)
   5 left shift

Question 25

neonatal sepsis - diagnosis / treatment

Answer 25

blood, urine, CSF culture | parenteral antibiotic therapy (eg. ampicillin + gentamycin)

Question 26

MCC of sepsis in SC anemia

Answer 26

S. pneum (despite immunization) prophylactic penicillin until age 5 (H. inf + N. mening can cause sepsis, but vaccination is enough to protect)

Question 27

rubella - when in pregnancy is worse

Answer 27

1st trimester (transplacental)

Question 28

osteomyelitis in children - orgnamisms

Answer 28

healthy children: S. aureus | with SCD: salmonella, staph

Question 29

osteomyelitis in healthy children - organism and treatment

Answer 29

S. aureus: low likelihood of MRSA: Nafcillin or cefazolin high likelihood: Clindamycin or vancomy

Question 30

osteomyelitis in chikdre with SCD - orgnaism and treatment

Answer 30

Salmonella + S. aureus | like healhty + 3rd generation cephalosporin