NURP 502 PRIMARY Exam 1 Questions
and answers 2025
What .is .the .most .important .piece .of .data .in .a .child .with .a .fever? .- .ANS✓✓-
Thorough .history
What .is .a .brief .diagnostic .work-up .for .a .fever .in .a .child? .- .ANS✓✓-- .CBC .with
.differential
- .Urinalysis .with .Culture
- .Rapid .viral .swabs .(RSV .and .Flu)
What .are .the .signs .and .symptoms .of .a .toxic .appearing .2 .year .old? .- .ANS✓✓--
.Lethargic
- .Tachycardia
- .Purpura
- .Petechiae
- .Cyanosis
What .antibiotics .are .given .to .a .child .younger .than .1 .month .with .a .fever? .- .ANS
✓✓--Ampicillin* .(100-200 .mg/kg/day) .IV .or .IM .divided .Q .6 .hours .
- .Gentamycin .(2.5mg/kg .IV .or .IM .Q .8 .hours, .with .adjustments .based .on .serum
.levels
Alternative: .
- .Ampicillin* .(100-200 .mg/kg/day .IV .or .IM .divided .Q .6 .hours)
- .Cefotaxime .(Claforan; .50mg/kg .IV .Q .8 .hours)
What .antibiotics .are .given .to .a .child .older .than .1 .month .with .a .fever .and
.urinary .findings? .- .ANS✓✓-- .Cefotaxime .(Claforan; .50mg/kg .IV .Q .8 .hours)
- .Alternative: .Cefixime .(Suprax; .8 .mg/kg .twice .on .1st .day, .then .8 .mg/kg/day)
What .antibiotics .are .given .to .a .child .1-3 .months .in .which .you .do .NOT .suspect
.meningitis? .- .ANS✓✓-Ceftriaxone .(Rocephin; .50mg/kg/day .IV .or .IM .divided .Q
.12-24 .hours
What .antibiotics .are .given .to .a .child .1-3 .months .in .which .you .suspect
.meningitis? .- .ANS✓✓-Ceftriaxone .(100mg/kg/day .IV .or .IM .divided .every .12-24
.hours)
What .antibiotics .are .given .to .a .child .1-3 .months .with .a .fever .and .findings .of
.Listeria/Enterococcus? .- .ANS✓✓-Add .Ampicillin* .(100-200mg/kg/day .IV .or .IM
.divided .every .6 .hours) .to .other .abx
,What .antibiotics .are .given .to .a .child .3 .months .or .older .with .a .fever .and
.findings .of .pneumonia? .- .ANS✓✓-- .Amoxicillin .(80mg/kg/day .divided .Q .12
.hours)
- .Alternative: .azithromycin .(Zithromax; .10mg/kg .orally .on .day .1, .then .5 .mg/kg
.daily .for .the .next .4 .days.
What .are .clinical .red .flags .in .a .child .with .a .fever? .- .ANS✓✓-- .Parental
.concerns
- .Physician .instinct
- .Change .in .crying .pattern
- .Inconsolability
- .Moaning
- .Cyanosis
- .Crackles
- .Decreased .breath .sounds
- .Poor .peripheral .circulation
- .Rapid .breathing
- .Shortness .of .breath
- .Decreased .skin .elasticity/turgor
- .Dehydration
- .Meningeal .irritation
- .Petechial .rash
- .Seizures
- .Unconsciousness
When .do .you .order .a .chest .x-ray .for .a .child .with .a .fever? .- .ANS✓✓-- .Older
.than .1 .month .with .respiratory .symptoms .(tachypnea, .retractions, .auscultatory
.findings, .O2 .level .<95%)
- .Fever .> .102.2F .(39C)
- .WBC .> .20,000 .per .mm3
When .do .you .perform .a .lumbar .puncture .in .a .febrile .child? .- .ANS✓✓-- .All
.febrile .neonates .(0-15w6d)
- .Infants .and .young .children .with .clinical .signs .of .meningitis .(nuchal .rigidity,
.petechia, .or .abnormal .neurologic .findings)
When .is .a .lumbar .puncture .not .recommended? .- .ANS✓✓-- .Children .older .than
.3 .months .unless .neurologic .signs .present
- .Well .appearing, .previously .healthy .infant .with .no .focal .signs .of .infection
.(WBC .5000-15000, .no .pyuria, .no .bacteruria)
When .do .you .perform .a .urine .culture .on .a .child? .- .ANS✓✓-- .All .males .younger
.than .6 .months
- .All .uncircumcised .males .under .12 .months
- .All .females .under .24 .months
- .Older .females .with .s/s .of .UTI
, A .17 .day .old .child .comes .into .the .office .for .a .persistent .fever .over .101.7F .for
.the .last .3 .weeks .with .diarrhea, .what .diagnostics .studies .should .be .ordered?
.Should .this .child .be .admitted? .What .is .empiric .antibiotics .can .be .given .after
.cultures .are .obtained? .- .ANS✓✓-- .CBC .with .diff
- .Blood .cultures
- .UA .and .culture
- .Lumbar .puncture
- .Stool .culture/WBC
- .Chest .x-ray
- .Admit .child
- .Ampicillin, .Gentamycin, .Ampicillin .with .Cefotaxime
A .3 .month .old .child .presents .to .the .office .with .a .fever .of .103.5F, .cyanosis,
.poor .perfusion, .and .neurologic .changes, .what .diagnostic .studies .should .be
.ordered? .Should .this .child .be .admitted? .What .empiric .antibiotics .can .be .given
.after .cultures .are .obtained? .- .ANS✓✓-- .CBC .with .diff
- .Blood .cultures
- .UA .and .culture
- .Lumbar .puncture .(since .ill-appearing)
- .Chest .x-ray .(cyanosis)
- .Admit .child
- .Ceftriaxone .or .Cefotaxime
A .2 .year .old .child .presents .to .clinic .with .a .persistent .fever .of .101.9F .for .the
.past .3 .weeks, .but .is .playful .in .office .with .no .signs .of .distress. .Mother .notes
.darker .urine .and .frequent .loose .BMs. .What .diagnostic .studies .should .be
.ordered? .Should .this .child .be .admitted? .What .antibiotics .can .be .given .for .this
.child? .- .ANS✓✓-- .UA .and .Culture
- .Possibly .stool .culture/WBC
- .No .need .to .admit, .close .follow .up
- .Ceftriaxone .or .Cefixime .(urinary)
What .are .the .clinical .features .of .Kawasaki .Disease? .- .ANS✓✓-Reflect
.widespread .inflammation .of .primarily .medium-sized .muscular .arteries
What .are .the .signs .and .symptoms .of .Kawasaki .Disease? .- .ANS✓✓-- .High .fever
.(greater .than .102.2) .for .5 .days .plus .four .of .the .following:
- .Bilateral .conjunctival .injection .without .exudate
- .Polymorphous .rash .that .may .be .urticarial .or .pruritic
- .Inflammatory .changes .in .the .lips .and .oral .cavity
- .Changes .in .extremities .(peripheral .edema, .erythema .or .palms/soles,
.desquamation .of .the .hands .and .feet .only .in .convalescent .period)
- .Cervical .lymphadenopathy .often .unilateral .and .anterior .cervical
What .is .the .treatment .for .Kawasaki .Disease? .- .ANS✓✓-IVIG .and .ASA
What .are .associated .or .negative .symptoms .of .a .fever? .- .ANS✓✓-- .Increased
.fluid .loss .(dehydration)
and answers 2025
What .is .the .most .important .piece .of .data .in .a .child .with .a .fever? .- .ANS✓✓-
Thorough .history
What .is .a .brief .diagnostic .work-up .for .a .fever .in .a .child? .- .ANS✓✓-- .CBC .with
.differential
- .Urinalysis .with .Culture
- .Rapid .viral .swabs .(RSV .and .Flu)
What .are .the .signs .and .symptoms .of .a .toxic .appearing .2 .year .old? .- .ANS✓✓--
.Lethargic
- .Tachycardia
- .Purpura
- .Petechiae
- .Cyanosis
What .antibiotics .are .given .to .a .child .younger .than .1 .month .with .a .fever? .- .ANS
✓✓--Ampicillin* .(100-200 .mg/kg/day) .IV .or .IM .divided .Q .6 .hours .
- .Gentamycin .(2.5mg/kg .IV .or .IM .Q .8 .hours, .with .adjustments .based .on .serum
.levels
Alternative: .
- .Ampicillin* .(100-200 .mg/kg/day .IV .or .IM .divided .Q .6 .hours)
- .Cefotaxime .(Claforan; .50mg/kg .IV .Q .8 .hours)
What .antibiotics .are .given .to .a .child .older .than .1 .month .with .a .fever .and
.urinary .findings? .- .ANS✓✓-- .Cefotaxime .(Claforan; .50mg/kg .IV .Q .8 .hours)
- .Alternative: .Cefixime .(Suprax; .8 .mg/kg .twice .on .1st .day, .then .8 .mg/kg/day)
What .antibiotics .are .given .to .a .child .1-3 .months .in .which .you .do .NOT .suspect
.meningitis? .- .ANS✓✓-Ceftriaxone .(Rocephin; .50mg/kg/day .IV .or .IM .divided .Q
.12-24 .hours
What .antibiotics .are .given .to .a .child .1-3 .months .in .which .you .suspect
.meningitis? .- .ANS✓✓-Ceftriaxone .(100mg/kg/day .IV .or .IM .divided .every .12-24
.hours)
What .antibiotics .are .given .to .a .child .1-3 .months .with .a .fever .and .findings .of
.Listeria/Enterococcus? .- .ANS✓✓-Add .Ampicillin* .(100-200mg/kg/day .IV .or .IM
.divided .every .6 .hours) .to .other .abx
,What .antibiotics .are .given .to .a .child .3 .months .or .older .with .a .fever .and
.findings .of .pneumonia? .- .ANS✓✓-- .Amoxicillin .(80mg/kg/day .divided .Q .12
.hours)
- .Alternative: .azithromycin .(Zithromax; .10mg/kg .orally .on .day .1, .then .5 .mg/kg
.daily .for .the .next .4 .days.
What .are .clinical .red .flags .in .a .child .with .a .fever? .- .ANS✓✓-- .Parental
.concerns
- .Physician .instinct
- .Change .in .crying .pattern
- .Inconsolability
- .Moaning
- .Cyanosis
- .Crackles
- .Decreased .breath .sounds
- .Poor .peripheral .circulation
- .Rapid .breathing
- .Shortness .of .breath
- .Decreased .skin .elasticity/turgor
- .Dehydration
- .Meningeal .irritation
- .Petechial .rash
- .Seizures
- .Unconsciousness
When .do .you .order .a .chest .x-ray .for .a .child .with .a .fever? .- .ANS✓✓-- .Older
.than .1 .month .with .respiratory .symptoms .(tachypnea, .retractions, .auscultatory
.findings, .O2 .level .<95%)
- .Fever .> .102.2F .(39C)
- .WBC .> .20,000 .per .mm3
When .do .you .perform .a .lumbar .puncture .in .a .febrile .child? .- .ANS✓✓-- .All
.febrile .neonates .(0-15w6d)
- .Infants .and .young .children .with .clinical .signs .of .meningitis .(nuchal .rigidity,
.petechia, .or .abnormal .neurologic .findings)
When .is .a .lumbar .puncture .not .recommended? .- .ANS✓✓-- .Children .older .than
.3 .months .unless .neurologic .signs .present
- .Well .appearing, .previously .healthy .infant .with .no .focal .signs .of .infection
.(WBC .5000-15000, .no .pyuria, .no .bacteruria)
When .do .you .perform .a .urine .culture .on .a .child? .- .ANS✓✓-- .All .males .younger
.than .6 .months
- .All .uncircumcised .males .under .12 .months
- .All .females .under .24 .months
- .Older .females .with .s/s .of .UTI
, A .17 .day .old .child .comes .into .the .office .for .a .persistent .fever .over .101.7F .for
.the .last .3 .weeks .with .diarrhea, .what .diagnostics .studies .should .be .ordered?
.Should .this .child .be .admitted? .What .is .empiric .antibiotics .can .be .given .after
.cultures .are .obtained? .- .ANS✓✓-- .CBC .with .diff
- .Blood .cultures
- .UA .and .culture
- .Lumbar .puncture
- .Stool .culture/WBC
- .Chest .x-ray
- .Admit .child
- .Ampicillin, .Gentamycin, .Ampicillin .with .Cefotaxime
A .3 .month .old .child .presents .to .the .office .with .a .fever .of .103.5F, .cyanosis,
.poor .perfusion, .and .neurologic .changes, .what .diagnostic .studies .should .be
.ordered? .Should .this .child .be .admitted? .What .empiric .antibiotics .can .be .given
.after .cultures .are .obtained? .- .ANS✓✓-- .CBC .with .diff
- .Blood .cultures
- .UA .and .culture
- .Lumbar .puncture .(since .ill-appearing)
- .Chest .x-ray .(cyanosis)
- .Admit .child
- .Ceftriaxone .or .Cefotaxime
A .2 .year .old .child .presents .to .clinic .with .a .persistent .fever .of .101.9F .for .the
.past .3 .weeks, .but .is .playful .in .office .with .no .signs .of .distress. .Mother .notes
.darker .urine .and .frequent .loose .BMs. .What .diagnostic .studies .should .be
.ordered? .Should .this .child .be .admitted? .What .antibiotics .can .be .given .for .this
.child? .- .ANS✓✓-- .UA .and .Culture
- .Possibly .stool .culture/WBC
- .No .need .to .admit, .close .follow .up
- .Ceftriaxone .or .Cefixime .(urinary)
What .are .the .clinical .features .of .Kawasaki .Disease? .- .ANS✓✓-Reflect
.widespread .inflammation .of .primarily .medium-sized .muscular .arteries
What .are .the .signs .and .symptoms .of .Kawasaki .Disease? .- .ANS✓✓-- .High .fever
.(greater .than .102.2) .for .5 .days .plus .four .of .the .following:
- .Bilateral .conjunctival .injection .without .exudate
- .Polymorphous .rash .that .may .be .urticarial .or .pruritic
- .Inflammatory .changes .in .the .lips .and .oral .cavity
- .Changes .in .extremities .(peripheral .edema, .erythema .or .palms/soles,
.desquamation .of .the .hands .and .feet .only .in .convalescent .period)
- .Cervical .lymphadenopathy .often .unilateral .and .anterior .cervical
What .is .the .treatment .for .Kawasaki .Disease? .- .ANS✓✓-IVIG .and .ASA
What .are .associated .or .negative .symptoms .of .a .fever? .- .ANS✓✓-- .Increased
.fluid .loss .(dehydration)
