Residency: Pediatrics

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  1. What are the most common causes of acute otitis media?
    • Strep pneumonia
    • nontypable H. influenzae
    • Moraxella catarrhalis
  2. A patient presents with exudative pharyngitis, generalized lymphadenopathy, fever, and profound fatigue.  What diagnostic measures would be useful?
    • dx: infectious mono (EBV)
    • CDC w/diff: lymphocytosis with high percentage (10%) of atypical lymphocytes
    • (+) heterophile antibody test
    • PCR serology
  3. What is the classic presentation of a kid with croup?
    • dx: parainfluenza infection
    • barking cough
    • inspiratory stridor
    • epiglottitis
    • respiratory distress
  4. A patient presents with a barking cough, severe inspiratory stridor, and epiglottitis.  What should you do?
    • immediate treatment: prevent respiratory distress
    • nebulized epinephrine
    • corticosteroids
    • sedation: endotracheal intubation (direct visualization)
  5. What is the classic presentation of bronchiolitis?
    • fever
    • wheezing
    • tachypnea
    • rhinorrhea
    • respiratory distress
    • (neonates: apnea)
  6. Who should receive palivizumab treatment for suspected RSV infection?
    • <24mo in winter months
    • chronic lung disease (bronchopulmonary dysplasia) who require oxygen 
  7. What is the most common cause of bacterial pneumonia in all age groups?
    Strep pneumonia
  8. What are common pathogens of pneumonia in older children?
    • M. pneumoniae
    • C. pneumoniae
  9. Which microbe causes the majority of large pleural effusions complicating pneumonia?
    S. aureus
  10. Which antibiotics are used to empirically treat suspected bacterial meningitis?
    • neonate: ampicillin, cefotaxime
    • child: 3rd gen cephalosporin, vancomycin
  11. Which pathogens are associated with hemolytic uremic syndrome?
    • S. dysenteriae
    • E. coli OH157:H7
  12. A child presents with bloody, watery stool and seizures.  What is the likely pathogen?
  13. How many children with hepatitis A infection are asymptomatic?
  14. What are the different transmission routes of Hep A-E?
    • Hep A: oral, fecal
    • Hep B: body fluids
    • Hep C: body fluids
    • Hep D: body fluids, previous Hep B infection
    • Hep E: oral, fecal, parenteral
  15. How does a child with congenital symphils present?
    • "snuffles"
    • saddle-nose (destruction of nasal bridge)
    • hepatosplenomegaly
    • mucocutaneous lesions
    • jaundice
    • lymphadenopathy
  16. A neonate presents with snuffles, hx of persistent rhinitis, hepatosplenomegaly, lymphadenopathy, and maculopapular rash.  What test would best diagnosis his condition?
    • VDRL
    • RPR
    • FTA-ABS 
  17. What is the preferred treatment for someone with suspected (mild) PID?
    • dx: C. trachomatis and/or N. gonorrhoeae infection
    • tx: 
    • single dose parenteral cephalosporin
    • 14d oral doxycycline
  18. How long will ELISA and Western blot tests show positive HIV reactions in a neonate?
    • dx: IgG antibodies to HIV
    • positive for up to 18mo in neonate
  19. If you have a newborn baby with an HIV positive mother, what is the best way to detect if the infant has been infected?
    • HIV PCR 
    • (ELISA/Western blot = false positive reaction to maternal IgG)
  20. A patient presents with fever, headache, and a rash that starts on the extermities and moves towards her trunk.  All of this started after a trip to the woods and a tick bite.  What should you do?
    • treat for suspicion of Rocky Mountain Spotted Fever
    • tx: doxycycline
  21. What rash is associated with Lyme disease?
    • dx: Borellia infection
    • erythema migrans
    • bulls-eye appearrance
    • annular erythema, central clearing, central erythema/purpura
  22. How would you treat Lyme disease?
    • <8yo: oral amoxicillin
    • >8yo: oral doxycycline
    • Lyme meningitis: IV ceftriaxone
  23. Which vaccines are contraindicated in someone with severe immune deficiency?
    • MMr
    • varicella
    • rotavirus
    • live attenuated flu vaccine (i.e. flu mist)
  24. What is an absolute contraindication to the DTap vaccine?
    previous development of encephalopathy in <7d after DTap
  25. Which vaccines are contraindicated in pregnant women?
    • MMR
    • varicella
  26. Who should receive polysaccharide pneumococcal and polysaccharide meingococcal vaccines at 2yo?
    • asplenic patients
    • e.g. Sickle Cell Anemia
  27. At what age is the risk of occult bacteremia greatest?
  28. What is the most common cause of sepsis in the nenoate?
    • Group B strep
    • enteric gram (-) bacilli
    • Listeria monocytogenes
  29. What is the most common cause of sepsis in kids between 1mo to 5yo?
    • Strep pneumoniae
    • Neisseria meningitidis
  30. What is the most common cause of sepsis in kids >5yo?
    • Staph aureus
    • Salmonella
    • Pseudomonas aeruginosa
    • viridans Streptococci
  31. What structural physiology predisposes children to ear infections?
    • eustachian tube dysfunction
    • angle of entry
    • short length
    • decreased tone
    • concurrent URI: edema narrows E tube and creates vacuum
  32. What are common viral causes of otitis media?
    • RSV
    • parainfluenza 
    • influenza
  33. How does myringitis present?
    • viral URI
    • TM is inflammed but has normal mobility
  34. Which patients with otitis media should be prescribed antibiotics?
    • <24mo
    • ill-appearing
    • chronic illnesses/immunodeficiencies
    • recurrent/severe/perorated acute otitis media
  35. Which kids with otitis media qualify for more antibiotics?
    • treated <1mo ago and have not improved in 48hrs
    • tx: amoxicillin/clavulanic acid
    • tx: oral 2nd/3rd cephalosporin
    • tx: IM ceftriaxone
  36. What is the most common complication of acute otitis media?
    otitis media with effusion
  37. Who should receive a tympanostomy tube?
    • AOM that lasts for >3mo
    • >4 AOM in 6mo
    • >5 AOM in 12mo
  38. What are complications of chronic otitis media with effusion?
    • permanent hearing loss
    • delay of language acquisition
  39. What are complications of frequent AOM?
    • excessive scarring (tympanosclerosis)
    • cholesteatoma formation
    • chronic suppurative AOM
  40. What is the diagnosis and treatment of a child with recent AOM that presents with high fever, tenderness of the skull behind the ear, and anterior displacement of the external ear?
    • dx: mastoiditis
    • tx: IV antibiotics, +/- surgical drainage
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Residency: Pediatrics
2015-10-31 21:11:16
Blueprints Pediatrics residency

Blueprints Pediatrics
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