CMN 568 UNIT 1 QUESTIONS & VERIFIED ANSWERS
Amoxicillin (first line) for AOM in children - Answers - 90mg/kg/day divided BID with max
of 1000mg/dose and 2000mg/day
<2yr= 10 days
2-6yr= 7 days
>6yr= 5 days
First line drug for Otitis externa? - Answers - Flouroquinalone drops
ex: ciprodex 4 gtt/dose BID for 7 days
Acetaminophen for fever/pain in children - Answers - Tylenol
10-15mg/kg every 4-6 hours
Max: 5 doses/24 hours
Ibuprofen for fever/pain in children - Answers - Motrin/Advil
5-10mg/kg every 6-8 hours
Max: 40mg/kg/day
Minimal Visual Acuity that is acceptable in children - Answers - Age 3-5: visual acuity of
20/40 is minimal accepted
Age >6: 20/30 minimal accepted
Any child who has a 2 line discrepancy on any vision chart, when comparing individual
eyes, should be referred. (And, yes, that Snellen 20/25 does count as a line.
Factors that increase the likelihood of serious bacterial illnesses - Answers - Less than
3 months old
History: prematurity, previous hospitalizations, chronic medical conditions
Appearance: toxic vs non-toxic
Non-toxic appearance - Answers - strong cry
consolable
alert, easy to arouse
pink skin tones
good hydration
, smiles
Toxic appearance - Answers - weak or high-pitched cry
inconsolable
difficult to arouse
pale, ashen, mottled, cyanotic
poor hydration
no smile, listless, dull
Management of Infants 4wk to 3mo old with possible serious infection - Answers - non
toxic appearance:
full septic work up
specific treatment for any diagnosed conditions
emperic antibiotics after cultures
*Rocephin 50mg/kg/day (up to 1gm max)*
must have reliable caregiver
close follow up in 24 hours
Management of >3mo to Preschool - Answers - non-toxic appearance:
Lab work guided by history and physical exam
CBC with diff
CXR if cough or dyspnea
Stool C&S if diarrhea
UA: all girls <2 years old and all males <6mo, uncircumcised males <12mo
Acute Otitis Media causative organisms - Answers - Often preceded by viral upper
respiratory infection
Strep pneumoniae
Hamophilus influenzae
Moraxella catarrhalis
AOM signs and symptoms - Answers - fever, pain decreased sleep/appetite, effusion,
inflammation: red/bulging TM, decreased mobility of TM, decreased light reflex and
visibility of landmarks
Tips for AOM - Answers - <3mo refer to physician
always assess for nuchal rigidity and for pneumonia
palpate mastoid area for tenderness and swelling
AOM is typically viral and bacteria
TM may be retracted very early in AOM
Fluid may remain in middle of ear for 3mo, if longer refer
There is conductive hearing loss during AOM
Fluid filled middle ear= flat tympanogram
Amoxicillin (first line) for AOM in children - Answers - 90mg/kg/day divided BID with max
of 1000mg/dose and 2000mg/day
<2yr= 10 days
2-6yr= 7 days
>6yr= 5 days
First line drug for Otitis externa? - Answers - Flouroquinalone drops
ex: ciprodex 4 gtt/dose BID for 7 days
Acetaminophen for fever/pain in children - Answers - Tylenol
10-15mg/kg every 4-6 hours
Max: 5 doses/24 hours
Ibuprofen for fever/pain in children - Answers - Motrin/Advil
5-10mg/kg every 6-8 hours
Max: 40mg/kg/day
Minimal Visual Acuity that is acceptable in children - Answers - Age 3-5: visual acuity of
20/40 is minimal accepted
Age >6: 20/30 minimal accepted
Any child who has a 2 line discrepancy on any vision chart, when comparing individual
eyes, should be referred. (And, yes, that Snellen 20/25 does count as a line.
Factors that increase the likelihood of serious bacterial illnesses - Answers - Less than
3 months old
History: prematurity, previous hospitalizations, chronic medical conditions
Appearance: toxic vs non-toxic
Non-toxic appearance - Answers - strong cry
consolable
alert, easy to arouse
pink skin tones
good hydration
, smiles
Toxic appearance - Answers - weak or high-pitched cry
inconsolable
difficult to arouse
pale, ashen, mottled, cyanotic
poor hydration
no smile, listless, dull
Management of Infants 4wk to 3mo old with possible serious infection - Answers - non
toxic appearance:
full septic work up
specific treatment for any diagnosed conditions
emperic antibiotics after cultures
*Rocephin 50mg/kg/day (up to 1gm max)*
must have reliable caregiver
close follow up in 24 hours
Management of >3mo to Preschool - Answers - non-toxic appearance:
Lab work guided by history and physical exam
CBC with diff
CXR if cough or dyspnea
Stool C&S if diarrhea
UA: all girls <2 years old and all males <6mo, uncircumcised males <12mo
Acute Otitis Media causative organisms - Answers - Often preceded by viral upper
respiratory infection
Strep pneumoniae
Hamophilus influenzae
Moraxella catarrhalis
AOM signs and symptoms - Answers - fever, pain decreased sleep/appetite, effusion,
inflammation: red/bulging TM, decreased mobility of TM, decreased light reflex and
visibility of landmarks
Tips for AOM - Answers - <3mo refer to physician
always assess for nuchal rigidity and for pneumonia
palpate mastoid area for tenderness and swelling
AOM is typically viral and bacteria
TM may be retracted very early in AOM
Fluid may remain in middle of ear for 3mo, if longer refer
There is conductive hearing loss during AOM
Fluid filled middle ear= flat tympanogram
