FB
ENT
MISC
Holy Itch!
What?!?
100
True/False
A sperical object is more difficult to remove then irregular-shaped ones.
True
100
What is the most common cause of epistaxis?
nose picking
100
Name 3 serious or life-threatening causes of excessive crying in an infant.
Abuse, CHF, congenital heart disease, SVT, Drugs/drug withdrawal, incarcerated hernia, infection, sepsis, meningitis, respiratory distress, UTI, injury, intussusception, metabolic derangement, testicular/ovarian torsion
100
12 yo female presents for itchy and rash to her hand. States intense itching, that tends to worsen at night. Patients siblings exhibiting similar symptoms and are also in clinic for evaluation. Exam reveals...
What are your differentials? treatment? Education?
Bug bites, eczema, impetigo, wash clothes in hot water, permethrin 5% apply from neck down leaving on over night and washing off in the morning.
Apply to head and neck for infants and toddlers.
Repeat in 1 week, itching may continue 4weeks, treat family
100
This tool is better for irregular-shaped foreign bodies and are most useful when the foreign body can be directly visualized in the external canal.
Alligator forceps
200
Objects that pass safely into the ________ are likely to pass through the remainder of the GI tract without complications.
stomach. This includes pointed objects such as screws or staples.
200
10 year old presents to clinic for evaluation of left ear pain. Exam reveals...
Mastoiditis, Emergency Department
200
per your readings, Intussusception is most common in what age group?
infants aged 3-24 months of age
200
8yo male patient presents for evaluation of a rash. Mom states she noticed the rash this morning. Was complaining of a sore throat last week and had fever but that has since resolved. Mom states "I am not sure what is going on" 
You suspect what diagnosis? What testing if any do you perform?
Scarletina rash secondary to group a strep, throat swab, treatment with amox.
200
State the intervention for epistaxis.
If suspected posterior bleed- ER
300
What is the ideal time for removal of a ingested button battery?
within 2 hours of ingestion
300
8yo male presents to clinic for left ear pain. Exam reveals
What additional symptoms would you expect to find, what is your diagnosis, and how would you treat?
The most common symptoms of external otitis are ear pain, pruritus, discharge, and hearing loss. topical abx such as neomycin-polymixin B-hydrocortisone, flouroquinolones
300
Colic begins by age 6 weeks and lasts up to how many months of age?
3-4months of age
Classified as crying in excess of 3 consecutive hours per day for more than 3 days out of the week in an otherwise healthy infant,300
Name 3 significant causes for petecchiae/purpura rash in children.
Meningococcemia, idiopathic thrombocytopenic purpura, rocky mountain spotted fever, leukemia/lymphoma, child abuse
300
You note while picking up a 3 month old infant under the axillae, patient appears to have increased pain, you suspect what type of injury?
Clavicle fracture
400
Chronic symptoms can indicate FB ingestion, name 2 of these.
purulent rhinorrhea, epistaxis, chronic cough
400
A 3 year old otherwise healthy female presents to clinic accompanied by mom with cc of "tugging on her right ear." Hx of fever with 102.4 highest temperature. Does attend daycare. UTD with routine vaccinations. You evaluate the right ear and confirm a erythematous bulging TM with loss of landmarks and purlent discharge behind the TM. What additional physical exam finding would lead you to believe this infection is likely caused by Haemophilus influenzae H.Flu? Discuss how you will treat this patient.
Otitis media (middle ear infection). May develop after a child has a common cold caused by a virus. Conjunctivitis. An inflammation of the conjunctiva of the eye. Sinusitis. Infection in the sinuses. Epiglottitis. Meningitis.
Most infections caused by H. influenzae are treated empirically. In general, empiric regimens are designed to include an antibiotic that treats H. influenzae. Antibiotics that have activity against H. influenzae include beta-lactams (eg, amoxicillin-clavulanate, or second- and third-generation cephalosporins), fluoroquinolones, macrolides, and tetracyclines.
400
Name 4 criteria to call per WellNow policy as it pertains to our pediatric population.
Those conditions include, but are not limited to, the following clinical presentations:
• All patients < 3 months of age
• Fever without a source < 2 y.o.
• Head injuries < 2 y.o.
o MUST include PECARN score
• RSV < 1 y.o.
• UTI with fever < 2 y.o.
Suspected abuse (child, domestic, elderly or drug)
• Abdominal pain
Patients being transferred to an Emergency Department
400
2 year old presents to clinic with reports of 102-104 fever that started 4 days ago. Parents state rash started on the chest and has spread to the arms/legs and is now on the face. Child attends daycare and is UTD with routine vaccinations. Exam reveals... You suspect what?
Roseola, supportive treatment
400
When documenting for suspected nasal bone fx, one should document the presence or absence of this?
Septal hematoma- ER
500
A mom presents to clinic with her 8month old for evaluation of pain to the toe. Exam reveals...
You quickly recognize this to be what? And what is your intervention?
If you find the leading end you can sometimes unwrap it, if you insert a blunt probe fully under the hair, you can simply cut the tourniquet, if the hair is embedded and you are unable to remove refer to ER
500
A 15 year old presents to the clinic for evaluation of left ear pain that started after cleaning ear. Exam reveals...
Denies any additional URI symptoms. What is your diagnosis? Discharge instructions? Additionally Dad is asking how long this will take to heal?
Traumatic Tympanic membrane perforation
Keep ear clean and dry, no swimming, do not submerge head underwater, use ear plugs, limit tub time.
Antibiotic ear drops (eg, ofloxacin otic drops, five drops in the affected ear two times per day for three to five days) for contaminated wounds (eg, external puncture, perforation with water contamination) and canals occluded with blood or drainage in patients with findings of middle ear trauma
Traumatic perforation of the tympanic membrane that is less than 25 percent of the total drum surface area will often heal spontaneously within four weeks in the majority of patients. Persistent perforations typically require operative repair.
500
A new mom presents with her 10 day old infant for evaluation of poor feeding. Mom states "She almost feels sweaty during feedings" This should raise red flags for what underlying cause?
Congenital heart disease. Poor feeding, tachypnea, sweating during feedings may indicate congenital or acquired heart disease.
500
6yo presents to clinic for evaluation of a rash. mom first states noticing an oval shaped patch on her back a few days ago. Believed it was related to dry skin. She applied aveno lotion and states she now has an itchy rash. Exam reveals..
you diagnose what? And treatment with?
500
Conjunctivitis, lympadenopathy, generalized desquamation rash, edematous extremities, and a red oral pharynx/strawberry tongue are all symptoms of what?
Kawasaki disease
