Baby Fever
Name the 3 most common causes of late onset sepsis in a newborn?
E. Coli
GBS
Strep pneumo
A 3 year old comes to the ED crying with his arm held limp at his side after parents grabbed him from running into a busy street. You suspect a _______.
Radial head subluxation (Nursemaid's elbow)
2cc/kg
A child was found next to an empty bottle of acetaminophen. You wait _____ hours before checking a level. If the level is high, he should receive _____.
4 hours
NAC
Name that bug:
A 4 year old presents with 4 days of high fevers, decreased PO intake, drooling, and vesicles of the tonsils and the soft palate.
Coxsackie virus (herpangina)
7d old infant presents with b/l conjunctival injection and drainage. He received Vit K, HepB, and erythro at birth and is now taking Vit D. What is the most likely cause of symptoms? How would you treat this?
Chlamydia trachomatis
Oral erythromycin. Bonus Q: What is a known complication of this med?
A 5 year old has positive X-ray findings for a distal radius fracture. The fracture is along the line of the epiphyseal plate and extends proximally. What classification system will you use to describe this fracture when you call ortho? Bonus point: which is this fracture?
SALTER-HARRIS (this is a Salter-Harris II)
S (straight across)
A (above)
L (lower or beLow)
T (two or through)
ER (ERasure of growth plate)
You want to provide stacked nebulizers to a patient presenting with status asthmaticus. Your attending asks you albuterol vs duonebs. You answer ____ because of _____.
Duonebs
You have just given a dose of ativan to a patient presenting in status epilepticus. If still seizing in ____ minutes, you should give this medication. Bonus: what's the dose?
5 minutes
Ativan (0.1mg/kg)
Name these bugs:
- painful genital ulcer
- painless genital ulcer
- thick malodorous discharge with friable cervix
H. Ducryei
Syphilis
Trichomoniasis
Infant presents with lethargy and poor feeding. HR 232, T 99.8F, RR 40, you can't obtain a BP because they are kicking. You are struggling to gain venous access. What interventions should you perform in the meantime?
Vagal maneuvers
- rectal temp
- ice on the face
- pressing knees to chest
Parents bring in their 2 month old for evaluation after he rolled off the bed. He is crying and refuses to use his left arm. X-ray of the arm shows a fracture. What additional imaging is warranted, if any?
Skeletal Survey (2 mos don't roll!)
A 4 yo pt with a history of asthma presents with tachypnea and wheezing. You obtain a chest X-ray and note hyperinflation of the right lung without opacifications. You suspect ______.
Foreign body ingestion
A child likely took this medicine who presents with...
- AG Metabolic acidosis
- Hyperventilation
- Tinnitus
- Confusion
Aspirin
Name that bug:
A patient has failed courses of amox and augmentin for a swollen right cerivical node. You note an overlying violaceous hue.
What lab values can help you decide if a 25d/o febrile infant needs an LP?
Procal >0.5
ANC >4K or <500
A 12 y/o presents with severe pain in the upper right tibia. It worsens overnight. It does improve with NSAIDs. X-ray shows round lesion with a rim of radiodensity.
Osteoid osteoma
12mg
The toxidrome below is likely caused by which class of medication:
AMS, seizure, drowsiness, wide QRS, prolonged QT
TCAs
These 2 criteria must be met for a diagnosis of acute chest syndrome.
New pulmonary density on CXR
At least 1 of:
- fever, hypoxemia, tachypnea, accessory muscle use