NRNP 6541 PEDIATRICS FINAL
EXAM WITH ALL CORRECT
ANSWERS.
What would you do if you only saw a red reflex in one eye?
Retinoblastoma
Common treatment for dog and cat bites
Administer a tetanus booster and rabies prophylaxis if indicated. 3-5 day
course of prophylactic antibiotics (Broad spectrum first (Amoxicillin
Clavulanate) if penicillin allergy (Cephalosporin or trimethoprim-
sulfamethoxazole plus clindamycin)
What would be a common diagnosis for a patient with a diffuse petechial
rash?
Rocky Mountain Spotted Fever
S/S excema
Dry skin
In infants (develops between ages 2 weeks and 6 months with ½ cases
resolving
by 3 years of age)- erythematous, itchy, easily irritated scaly patches on
face, head, trunk, and extensor surfaces
In older children, more focal pruritic patches in the antecubital and popilteal
Creases
,Chronic changes include hyperpigmentation and lichenification in flexor
surfaces of the neck, antecubital areas, wrists, popliteal area, ankle, fingers,
and toes.
Pruritus for both, worsens with sweating and temperature extremes
Circle under eyes (allergic shiners)
Facial pallor
Nasal crease on top of nose from frequent rubbing
Dry scalp (pustules present if secondary bacterial infection)
Pityriasis alba
condition of hypopigmentation, finely scaled macular lesions of varying sizes
and shapes with indistinct borders. Mostly on cheeks. Associated with overy
drying of skin. Common ages 3-12 years of age and dark skin. Sunlight
makes lesions more pronounced.
Pityriasis rosea
acquired common mild inflammatory condition characterized by scaly,
hypopigmented and hyperpigmented lesions predominately on the trunk,
upper arms, and upper thighs. Possibly associated with a virus. Occurs most
often in fall and spring months especially in older children of all ethnic
groups. Scaly, pink marks on skin of light-skinned & hyperpigmented on dark
skin; Possible prodrome of malaise and low-grade fever before onset of rash.
s/s of seborrheic dermatitis
In newborns and infants: erythema under yellow crusts and greasy scales on
scalp, face, neck folds, postauricular, and axillary creases. Can be present on
trunk and in diaper area.
,In adolescents: white flakes and greasy scaling on scalp, forehead, eyebrows,
and face (often pruritic).
Cause of seborrheic dermatitis
Increase in excessive oil production of the scalp is contributed to hormonal
stimulation at
times when hormonal influence is highest. Occurs most often in spring and
summer
months.
Recommended treatment for RSV in a 7 month old (outpatient)
Use of saline drops and suctioning of the nares. Indications of when to use
antipyretics. Signs of respiratory distress or dehydration. Guidelines for
feeding an infant with signs of mild respiratory distress which includes
smaller more frequent feedings; monitoring of the respiratory rate; and
guarding against vomiting. The parents should be educated that the child
may have the symptoms over the course of 2-3 weeks
Epiglottitis s/s
Acute and rapid onset of high fever, chills, and toxicity. Severe sore throat
and drooling saliva. Will not eat or drink, muffled (hot potato) voice, and
anxiety. Sitting posture with hyperextended neck with open-mouth breathing.
Stridor, tachycardia, and tachypnea
Epiglottitis prevention
Haemophilus influenzae type B (Hib) vaccine
, Steeple sign
a radiologic sign found on radiograph where the subglottic tracheal
narrowing produces a shape of a church steeple which supports a diagnosis
of croup
Foreign body aspiration antibiotic?
Depends on the nature of the material aspirated, plus the location and
degree of obstruction. Bronchial or laryngeal foreign body aspiration, a
bronchoscopy must be performed for removal of the foreign body
Antibiotics for bronchiolitis?
Use of saline drops and suctioning of the nares. There is no evidence to
support the routine use of antibiotics
Antibiotics for croup?
Nebulized epinephrine, corticosteroids (dexamethasone oral or IM), blow by
oxygen or heliox in severe croup. Racemic epinephrine with the use of
corticosteroids to limit rebound swelling
Antibiotics for epiglottitis?
Establish an airway preferably by nasotracheal intubation. Administer IV
antibiotics such as rocephin to cover H.influenzae. Administer oxygen and
respiratory support. Antibiotics should be continued for 10 days. Rifampin
prophylaxis 20 mg/kg in a single dose (maximum of 600 mg) for 4 days for
infants and children, 600 mg once a day for adults for 4 days. Should be
provided for household contacts who are at risk (Younger than 4 years old
EXAM WITH ALL CORRECT
ANSWERS.
What would you do if you only saw a red reflex in one eye?
Retinoblastoma
Common treatment for dog and cat bites
Administer a tetanus booster and rabies prophylaxis if indicated. 3-5 day
course of prophylactic antibiotics (Broad spectrum first (Amoxicillin
Clavulanate) if penicillin allergy (Cephalosporin or trimethoprim-
sulfamethoxazole plus clindamycin)
What would be a common diagnosis for a patient with a diffuse petechial
rash?
Rocky Mountain Spotted Fever
S/S excema
Dry skin
In infants (develops between ages 2 weeks and 6 months with ½ cases
resolving
by 3 years of age)- erythematous, itchy, easily irritated scaly patches on
face, head, trunk, and extensor surfaces
In older children, more focal pruritic patches in the antecubital and popilteal
Creases
,Chronic changes include hyperpigmentation and lichenification in flexor
surfaces of the neck, antecubital areas, wrists, popliteal area, ankle, fingers,
and toes.
Pruritus for both, worsens with sweating and temperature extremes
Circle under eyes (allergic shiners)
Facial pallor
Nasal crease on top of nose from frequent rubbing
Dry scalp (pustules present if secondary bacterial infection)
Pityriasis alba
condition of hypopigmentation, finely scaled macular lesions of varying sizes
and shapes with indistinct borders. Mostly on cheeks. Associated with overy
drying of skin. Common ages 3-12 years of age and dark skin. Sunlight
makes lesions more pronounced.
Pityriasis rosea
acquired common mild inflammatory condition characterized by scaly,
hypopigmented and hyperpigmented lesions predominately on the trunk,
upper arms, and upper thighs. Possibly associated with a virus. Occurs most
often in fall and spring months especially in older children of all ethnic
groups. Scaly, pink marks on skin of light-skinned & hyperpigmented on dark
skin; Possible prodrome of malaise and low-grade fever before onset of rash.
s/s of seborrheic dermatitis
In newborns and infants: erythema under yellow crusts and greasy scales on
scalp, face, neck folds, postauricular, and axillary creases. Can be present on
trunk and in diaper area.
,In adolescents: white flakes and greasy scaling on scalp, forehead, eyebrows,
and face (often pruritic).
Cause of seborrheic dermatitis
Increase in excessive oil production of the scalp is contributed to hormonal
stimulation at
times when hormonal influence is highest. Occurs most often in spring and
summer
months.
Recommended treatment for RSV in a 7 month old (outpatient)
Use of saline drops and suctioning of the nares. Indications of when to use
antipyretics. Signs of respiratory distress or dehydration. Guidelines for
feeding an infant with signs of mild respiratory distress which includes
smaller more frequent feedings; monitoring of the respiratory rate; and
guarding against vomiting. The parents should be educated that the child
may have the symptoms over the course of 2-3 weeks
Epiglottitis s/s
Acute and rapid onset of high fever, chills, and toxicity. Severe sore throat
and drooling saliva. Will not eat or drink, muffled (hot potato) voice, and
anxiety. Sitting posture with hyperextended neck with open-mouth breathing.
Stridor, tachycardia, and tachypnea
Epiglottitis prevention
Haemophilus influenzae type B (Hib) vaccine
, Steeple sign
a radiologic sign found on radiograph where the subglottic tracheal
narrowing produces a shape of a church steeple which supports a diagnosis
of croup
Foreign body aspiration antibiotic?
Depends on the nature of the material aspirated, plus the location and
degree of obstruction. Bronchial or laryngeal foreign body aspiration, a
bronchoscopy must be performed for removal of the foreign body
Antibiotics for bronchiolitis?
Use of saline drops and suctioning of the nares. There is no evidence to
support the routine use of antibiotics
Antibiotics for croup?
Nebulized epinephrine, corticosteroids (dexamethasone oral or IM), blow by
oxygen or heliox in severe croup. Racemic epinephrine with the use of
corticosteroids to limit rebound swelling
Antibiotics for epiglottitis?
Establish an airway preferably by nasotracheal intubation. Administer IV
antibiotics such as rocephin to cover H.influenzae. Administer oxygen and
respiratory support. Antibiotics should be continued for 10 days. Rifampin
prophylaxis 20 mg/kg in a single dose (maximum of 600 mg) for 4 days for
infants and children, 600 mg once a day for adults for 4 days. Should be
provided for household contacts who are at risk (Younger than 4 years old
