CMN 568 FINAL EXAM SET – QUESTIONS
AND ANSWERS
Fever @\causes @\by @\age @\in @\infants? @\(MODULE @\1) @\- @\correct @\Answers @\✔✔ @\-Causes:
Less @\than @\1month: @\Group @\B @\Strep, @\E. @\Coli
1 @\mo-3 @\mo: @\strep @\pneumoniae, @\H. @\Influenzae, @\N. @\Meningitidis
Fever @\without @\source @\of @\infection: @\most @\common @\cause @\- @\H.Influenza @\Type @\B @\& @\
Strep @\Pneumoniae
Fever @\appearance @\in @\infants @\for @\non @\toxic @\vs @\toxic? @\(MODULE @\1) @\- @\correct @\
Answers @\✔✔ @\-Non-toxic @\appearance: @\consolable
Toxic @\appearance: @\weak, @\high @\pitched @\cry, @\inconsolable
Seen @\Immediately: @\neck @\stiff, @\fever @\>40.6 @\C, @\<3mo @\+ @\fever @\>38C, @\petechiae, @\
drooling @\saliva @\and @\unable @\to @\swallow @\anything, @\child @\has @\sickle @\cell @\disease/ @\
splenectomy/ @\HIV/ @\chemotherapy/ @\organ @\transplant/ @\chronic @\steroids
Tympanic @\route @\is @\not @\accurate @\in @\infants @\<3mo.
RED @\FLAGS @\FOR @\SERIOUS @\ILLNESS:
<1mo: @\>40C @\temp, @\petechial @\rash, @\meningeal @\irritation, @\resp @\signs @\(tachypnea, @\stridor,
@\increased @\WOB, @\crackles, @\decreased @\breath @\sounds, @\cyanosis), @\hypotension. @\In @\
neonates, @\meningeal @\irritation @\can @\present @\as @\labile @\temperature.
Any @\infant @\less @\than @\1 @\month @\old @\with @\fever @\should @\be @\hospitalized @\and @\have @\
full @\sepsis @\work @\up
,Define @\fever @\temperature @\in @\infants? @\(MODULE @\1) @\- @\correct @\Answers @\✔✔ @\-Rectal @\
temp: @\38 @\degrees @\Celsius @\
or @\100.4 @\degrees @\Fahrenheit.
Determine @\treatment @\based @\on @\presentation, @\whether @\they @\are @\non-toxic @\or @\toxic @\
appearing
Acetaminophen @\dosing @\in @\children? @\(MODULE @\1) @\- @\correct @\Answers @\✔✔ @\-
Acetaminophen @\(Tylenol) @\10-15mg/kg @\q4 @\to @\6 @\hours
MAX @\daily @\dose: @\5 @\doses @\in @\24 @\hours
Ibuprofen @\dosing @\in @\children? @\(MODULE @\1) @\- @\correct @\Answers @\✔✔ @\-Ibuprofen @\
(Motrin/Advil) @\
5-10mg/kg @\q6 @\to @\8 @\hrs. @\
MAX: @\40mg/kg @\per @\day @\TOTAL
6 @\months @\or @\older
Fever @\treatment @\for....
Infants @\less @\than @\4 @\weeks?
Infants @\4 @\weeks @\to @\3 @\months?
Infants @\3 @\months @\to @\preschool?
@\(MODULE @\1) @\- @\correct @\Answers @\✔✔ @\-Infants @\less @\than @\4 @\weeks: @\
risk @\of @\sepsis!!
Full @\septic @\work-up @\- @\blood @\culture, @\CXR @\if @\indicated, @\stool @\culture. @\AVOID @\
CEFTRIAXONE @\(Rocephin). @\Refer @\to @\ED. @\Ampicillin, @\cefotaxime, @\acyclovir.
Infants @\4 @\weeks @\- @\3 @\months:
Toxic @\appearance @\(risks @\for @\SBI @\[systemic @\bacterial @\infection]): @\full @\septic @\work @\up. @\
CXR @\if @\indicated, @\stool @\cultures. @\Refer @\to @\ED. @\Empiric @\IV @\abx @\pending @\culture.
Non-toxic @\appearance @\(no @\risk @\for @\SBI): @\full @\septic @\work-up. @\CXR. @\Outpatient @\if @\pt @\
has @\reliable @\caregiver. @\Rocephin @\50mg/kg/day @\(empiric @\abx).
,Infants @\3 @\months @\- @\preschool:
Toxic @\appearance: @\septic @\workup. @\Lumbar @\puncture, @\CXR, @\stool @\culture, @\rapid @\viral @\
testing. @\Empiric @\abx @\(pending @\culture @\results)
Non-toxic @\appearance: @\lab @\work-up @\guided @\by @\H&P. @\Empiric @\abx @\(pending @\culture @\
results)
Acute @\Otitis @\Media @\(AOM) @\(MODULE @\1) @\- @\correct @\Answers @\✔✔ @\-Moderate @\- @\severe
@\bulging @\of @\TM. @\MUST @\have @\bulging @\TM @\and @\MEE @\(middle @\ear @\effusion)
Severe @\DX: @\toxic @\appearance, @\pain @\>48hrs, @\temp @\>102.2 @\🡪 @\IMMEDIATE @\tx
Often @\proceeded @\by @\viral @\URI @\with @\secondary @\bacterial @\infection/
Causes: @\Strep @\pneumoniae, @\H. @\Flu, @\M. @\Cat
Does @\an @\ear @\effusion @\(fluid) @\mean @\there @\is @\an @\infection? @\(MODULE @\1) @\- @\correct @\
Answers @\✔✔ @\-No.
Acute @\Otitis @\Media @\(AOM) @\treatment? @\(MODULE @\1) @\- @\correct @\Answers @\✔✔ @\-1st @\
line: @\
Amoxicillin @\90mg/kg/day @\divided @\BID @\(MAX @\1000mg/dose)
Child @\weighs @\>40kg @\= @\500-875mg @\PO @\q12hrs
2nd @\line: @\
Augmentin. @\If @\patient @\has @\taken @\abx @\within @\last @\30 @\days. @\Fails @\to @\improve @\on @\
amoxicillin @\48-72hrs. @\Otitis-conjunctivitis @\syndrome
Do @\NOT @\use @\macrolides @\(azithromycin) @\after @\amoxicillin @\failure
PCN @\allergic @\children: @\erythromycin, @\clarithromycin, @\azithromycin
External @\Otitis...Onset? @\(MODULE @\1) @\- @\correct @\Answers @\✔✔ @\-Acute @\onset @\of @\severe
@\ear @\pain. @\Clear @\🡪 @\purulent @\discharge @\from @\EC.
External @\Otitis... @\What @\must @\you @\rule @\out? @\(MODULE @\1) @\- @\correct @\Answers @\✔✔ @\-
Must @\rule @\out @\AOM @\with @\TM @\rupture @\or @\PE @\tubes: @\due @\to @\different @\tx
, External @\Otitis...What @\bacterias @\can @\cause @\this? @\(MODULE @\1) @\- @\correct @\Answers @\✔✔
@\-pseudomonas, @\or @\staph
External @\Otitis @\treatment @\if @\you @\CAN @\visualize @\the @\tympanic @\membrane? @\(MODULE @\
1) @\- @\correct @\Answers @\✔✔ @\-gentle @\removal @\of @\debris
Neomycin @\polymyxin @\B/ @\hydrocortisone
External @\Otitis @\treatment @\if @\you @\CAN'T @\visualize @\the @\tympanic @\membrane? @\(MODULE
@\1) @\- @\correct @\Answers @\✔✔ @\-MUST @\ASSUME @\PERFORATION
Do @\NOT @\give @\neomycin/polymyxin @\B
Use @\ear @\wick. @\If @\swelling @\too @\severe @\for @\ear @\wick, @\administer @\abx
🡪 @\REFER @\to @\otolaryngolist
Give @\Ciprofloxacin/dexamethasone
Cerumen @\Impaction @\(MODULE @\1) @\- @\correct @\Answers @\✔✔ @\-Relieved @\with @\detergent @\
eat @\drops @\(3% @\hydrogen @\peroxide, @\6.5% @\carbamide @\peroxide), @\mechanical @\removal, @\
suction, @\or @\irrigation @\(performed @\ONLY @\when @\TM @\is @\known @\intact). @\
Do @\NOT @\use @\WaterPik
Pharyngitis @\/ @\Tonsillitis @\(MODULE @\1) @\- @\correct @\Answers @\✔✔ @\-First, @\decide @\if @\you @\
are @\dealing @\with @\a @\viral @\or @\a @\bacterial @\infection
Over @\90% @\of @\sore @\throat @\and @\fever @\= @\viral @\infections
CLUE: @\Pharyngitis @\(viral @\infection) @\is @\associated @\with @\cough @\and @\rhinorrhea @\= @\
ANTIOBITICS @\NOT @\INDICATED @\IN @\MOST @\CASES @\OF @\SORE @\THROAT
Pharyngitis @\/ @\Tonsillitis: @\Differentiating @\viral @\causes? @\(MODULE @\1) @\- @\correct @\Answers @\
✔✔ @\-Hand, @\Foot, @\& @\Mouth @\Disease: @\ulcers @\on @\the @\tongue @\and @\oral @\mucosa; @\
vesicles, @\pustules, @\& @\papules @\on @\the @\palms, @\soles, @\interdigital @\areas, @\and @\buttocks; @\
caused @\by @\enteroviruses
Herpangina: @\2-3 @\mm @\ulcers @\on @\the @\anterior @\pillars @\and @\soft @\palate @\and @\uvula; @\
caused @\by @\Coxsackie @\virus
