PAEA Pediatrics EOR Topics with Solutions 2024 Updated

PAEA Pediatrics EOR Topics with Solutions what is the MC conjunctivitis seen in children? what is the cause? source? - Answer -viral conjunctivitis; Adenovirus; swimming pools Dx? preauricular lymphadenopathy, copious watery eye discharge, scanty mucoid discharge, usually unilateral with punctate staining on slit lamp examination; Tx? - Answer -dx: viral conjunctivitis tx: supportive (cool compresses, artificial tears) +/- antihistamines for itching (Olopatadine) Dx? bilateral eye itching, tearing, redness, string discharge, chemosis (conjunctival swelling) with cobblestone appearance to inner/upper eyelids; Tx? - Answer -dx: allergic conjunctivitis tx: topical antihistamines (H1 blockers) (Olopatadine, Pheniramine/Naphazoline, Emedastine), topical NSAID (ketorolac), topical corticosteroids (but s/e of long term use = glaucoma, cataracts, HSV keratitis) Dx? purulent eye discharge, lid crusting, no visual changes, absence of ciliary injection; Tx? - Answer -dx: bacterial conjunctivitis (MC S. aureus, Strep pneumo, H. influenzae) tx: topical abx (erythromycin, fluoroquinolones, sulfonamides, aminoglycosides); if contact lens wearer cover for pseudomonas w/ fluoroquinolone or aminoglycoside if bacterial conjunctivitis is found to be chlamydia or gonorrhea what is the tx? - Answer -admit for IV and topical abx (ophtho emergency) -gonoccoccal: IV ceftriaxone + topical -chlamydia: IV azithromycin neonatal conjunctivitis is aka? if left untreated can develop what? - Answer -ophthalmia neonatorum; corneal ulceration, opacification/scarring, visual impairment/blindness standard prophylaxis given immediately after birth to prevent ophthalmia neonatorum (neonatal conjunctivitis) includes: - Answer -erythromycin ointment, tetracycline ointment, silver nitrate, or povidone-iodine if ophthalmia neonatorum (neonatal conjunctivitis) develops on day 1 after birth what is the most likely cause? day 2-5? day 5-7? day 7-11? - Answer -day 1: silver nitrate (chemical cause- prophylaxis is what can cause the condition) day 2-5: gonococcal day 5-7: chlamydia day 7-11: HSVorbital (septal) cellulitis is usually secondary to _________ infection in most commonly what age group? - Answer -sinus; 7-12y; other causes include dental/facial infxns or bacteremia what is the most common sinus infection (90%) that causes secondary orbital cellulitis? what organisms are the cause? - Answer -ethmoid; S. aureus, Strep. pneumo, GABHS (Strep. pyogenes), H. influenzae work up/Dx? decreased vision, pain w/ ocular movement, proptosis (bulging eye), eyelid erythema and edema; tx? - Answer -dx: orbital cellulitis work up: CT scan (showing infxn of fat & ocular muscles) or MRI tx: IV antibiotics (Vanc, Clinda, Cefotaxime, Ampicillin/Sulbactam) what is the difference b/t orbital (septal) cellulitis and preseptal cellulitis? - Answer -preseptal may still have ocular pain, redness and swelling but NO visual changes or pain w/ ocular mvmt (hasn't affected the muscles)