Pediatrics

Question 1

What is the pediatric age range?

Answer 1

birth to 18 years

Question 2

What is the neonate age range?

Answer 2

0-28 days of life

Question 3

What is the infant age range?

Answer 3

28 days to 12 months

Question 4

What is the child age range?

Answer 4

1-11 years

Question 5

What is the adolescent age range?

Answer 5

12-18 years

Question 6

What is gestational age?

Answer 6

first day of last menstrual period to birth

Question 7

Postnatal age is the same as a person’s…

Answer 7

chronological age

Question 8

What is the corrected age?

Answer 8

Postnatal age minus their weeks (or months) born early

Question 9

What is postmenstrual age?

Answer 9

gestational age + postnatal age

Question 10

What is the trend for pediatric heart rates?

Answer 10

HR decreases w/ time

Question 11

What is the trend for pediatric blood pressure?

Answer 11

blood pressures increase with time

Question 12

What is the trend for pediatric respiratory rate?

Answer 12

respiratory rate decreases with time

Question 13

When do you refer a fever?

Answer 13

• everyone younger than 3 months
• fever for more than 24 hours if younger than 2 years
• fever for more than 72 hours if 2 years and older
• fever great than 104 F (40 C)
• if no improvement despite treatment

Question 14

What is the pediatric acetaminophen dosing recommendation?

Answer 14

10-15 mg/kg/dose Q4-6H

Question 15

What is the max dose for acetaminophen?

Answer 15

75 mg/kg/day

Question 16

What is the dosing recommendation for ibuprofen in peds?

Answer 16

5-10 mg/kg/dose Q6-8H

only given to children older than 6 monthsb

Question 17

What is the max dose for ibuprofen?

Answer 17

40 mg/kg/day

Question 18

How is absorption different for peds?

Answer 18

increased gastric pH

Question 19

How is distribution different for peds?

Answer 19

• increased total body water
• increased ECF
• decreased protein binding

Question 20

How is metabolism different for peds?

Answer 20

their liver enzymes aren’t mature

Question 21

What is appropriate urine output?

Answer 21

greater than 1 mL/kg/hour

Question 22

What is oliguria?

Answer 22

less than 0.5 mL/kg/hour

Question 23

What is anuria?

Answer 23

0 ml/kg/hour

Question 24

How do you calculate creatinine clearance?

Answer 24

eGFR (ml/min/1.73m^2) = 0.413 * (height in cm/ SCr)

Bedside Schwartz

Question 25

What is the difference between GER and GERD?

Answer 25

GER is the symptom, whereas GERD is the reflux causing other symptoms and complications

Question 26

GERD symptoms for infants:

Answer 26

- regurgitation - feeding difficulties - hematemesis - irritability - failure to thrive - back arching - persistent cough - apnea/BRUE

Question 27

What are the GI symptoms of GERD in children?

Answer 27

- heartburn - feeding difficulties - hematemesis - vomiting - regurgitation - dysphagia - chest pain

Question 28

What are the extra-intestinal symptoms of GERD in children?

Answer 28

- persistent cough - wheezing - laryngitis - stridor - asthma - recurrent pneumonia - dental erosions

Question 29

What are the alarm symptoms that indicate referral is needed?

Answer 29

- bilious or projectile emesis - GI bleeding - difficulty swallowing - fever - lethargy - diarrhea/constipation

Question 30

What are the non-pharm options for GERD?

Answer 30

- feeding changes (thickening feeds) - positioning therapy (keep upright after feeds) - lifestyle changes (smaller, more frequent feeds)

Question 31

What is the pediatric H2RA of choice?

Answer 31

Famotidine (Pepcid)

Question 32

How to choose between H2RA and PPI for peds patient?

Answer 32

- H2RA is first choice unless the patient requires more intense therapy --> then PPI comes first

Question 33

What is the dose for PPIs?

Answer 33

1 mg/kg/day (one daily dosing unless GI bleed)

Question 34

What are the vomiting alarm symptoms?

Answer 34

- hematemesis - clinical dehydration - evidence of shock - focal neurological changes - abdominal distension - vomiting that awakes the child from sleep

Question 35

What is the normal stooling pattern for infants?

Answer 35

3-4 stools per day

Question 36

What is the normal stooling pattern for toddlers?

Answer 36

2-3 stools per day

Question 37

What are the constipation alarm symptoms?

Answer 37

- delayed passage of meconium - failure to thrive - bloody stools - severe abdominal distention - fistula

Question 38

What is the first line for constipation in infants?

Answer 38

glycerin suppository

Question 39

What is the preferred method for disimpaction in children?

Answer 39

PEG

Question 40

Which component of amox/clav can cause significant diarrhea?

Answer 40

Clavulanate

Question 41

What is the standard dose of amox/clav?

Answer 41

40-50 mg/kg/days

Question 42

What is the high dose for amox/clav?

Answer 42

80-90 mg/kg/day

Question 43

Which formulation should you try to use for high doses of amox/clav?

Answer 43

600 mg-42.9mg/5 mL

Question 44

What value do you want to keep clavulanate under?

Answer 44

less than 10 mg/kg/day

Question 45

How do you calculate fluid requirements for a child up to 10 kg?

Answer 45

100mL/kg

Question 46

How do you calculate fluid requirements for a child 10-20 kg?

Answer 46

1000 mL + 50mL/kg for every kg greater than 10

Question 47

How do you calculate fluid requirements for a child greater than 20 kg?

Answer 47

1500 mL + 20 mL/kg greater than 20