PAEA PEDIATRICS EOR TOPICS 2026
COMPLETE STUDY GUIDE FULL SOLUTIONS
UPDATED 2023-2024 A+
◉ most sensitive tool used to dx AOM. Answer: pneumatic otoscopy -
decreased TM mobility
◉ tx for AOM. Answer: Amoxicillin (children >2)
second line: augmentin, cefdinir
PCN allergy: azithromycin, clarithromycin, bactrim
◉ tx of AOM in recurrent cases. Answer: myringotomy (surgical
drainage) with tympanovstomy tube insertion
◉ MCC of otitis externa. Answer: Pseudomonas; due to water
immersion or local mechanical trauma (q-tips)
◉ dx of otitis externa. Answer: otoscopic exam (clinical) - edema of the
external auditory canal with erythema, debris or discharge
◉ tx of otitis externa. Answer: ciprodex or ofloxacin
amino glycoside combo (neomycin/polymixin/hydrocortisone) NOT
used if tympanic perforation suspected or if TM cannot be visualized
,◉ dx of mastoiditis. Answer: CT with contrast (1st line)
◉ Tx of mastoiditis. Answer: IV abx + middle ear or mastoid drainage
(myringotomy) with or without tympanostomy
◉ IV abx used in mastoiditis. Answer: IV Vanco +
Ceftazidime/Cefepime or Piperacillin-tazobactam
refractory or complicated: mastoidectomy
◉ Causes of TM perforation. Answer: Trauma (noise, barotrauma, direct
impact), otitis media
◉ presentation of TM perforation. Answer: Acute ear pain, hearing loss,
bloody otorrhea
may have conductive hearing loss (rinne: BC>AC, Weber: lateralization
to the affected ear)
◉ what should NOT be performed in pt with TM perforation?. Answer:
pneumatic otoscopy
◉ tx of TM perforation. Answer: Most heal spontaneously
,topical abx (ofloxacin) in some
*AVOID WATER/MOISTURE/TOPICAL AMINOGLYCOSIDES*
◉ MCC of epiglottitis if NOT vax (or also in foreign immigrants).
Answer: h.flu
◉ MCC of epiglottitis if vaccinated. Answer: Group A strep, strep
pneumo (strep species)
◉ Presentation of epiglottitis. Answer: Dysphagia, drooling, respiratory
distress
Tripod position, refuses to lie flat
Stridor
fever, hot potato voice
◉ dx of epiglottitis. Answer: soft tissue lateral cervical X-ray - thumb or
thumbprint sign (swollen, enlarged epiglottis) - not needed for dx
definitive = laryngoscopy to see the cherry red epiglottis with swelling;
performed when securing the area
◉ tx of epiglottitis. Answer: maintaining the airway = most important
(comfortable position, keep child calm); OR best setting for intubation
, dexamethasone for airway edema
abx - ceftriaxone/cefotaxime, penicillin or ampicillin; Vanco may be
added
◉ what should be given for prevention of epiglottitis. Answer: rifampin
given to all close contacts
routine use of Hib vaccine
◉ MCC of acute bronchiolitis. Answer: Respiratory syncytial virus
(RSV)
other = rhinovirus, adenovirus, influenza
◉ presentation of RSV. Answer: viral prodrome (fever, URI) for 1-2
days followed by respiratory distress (wheezing, rales, retractions,
cyanosis, nasal flaring)
◉ signs of severity in RSV. Answer: hypoxemia, apnea, respiratory
failure
◉ dx of RSV. Answer: clinical
CXR - nonspecific
COMPLETE STUDY GUIDE FULL SOLUTIONS
UPDATED 2023-2024 A+
◉ most sensitive tool used to dx AOM. Answer: pneumatic otoscopy -
decreased TM mobility
◉ tx for AOM. Answer: Amoxicillin (children >2)
second line: augmentin, cefdinir
PCN allergy: azithromycin, clarithromycin, bactrim
◉ tx of AOM in recurrent cases. Answer: myringotomy (surgical
drainage) with tympanovstomy tube insertion
◉ MCC of otitis externa. Answer: Pseudomonas; due to water
immersion or local mechanical trauma (q-tips)
◉ dx of otitis externa. Answer: otoscopic exam (clinical) - edema of the
external auditory canal with erythema, debris or discharge
◉ tx of otitis externa. Answer: ciprodex or ofloxacin
amino glycoside combo (neomycin/polymixin/hydrocortisone) NOT
used if tympanic perforation suspected or if TM cannot be visualized
,◉ dx of mastoiditis. Answer: CT with contrast (1st line)
◉ Tx of mastoiditis. Answer: IV abx + middle ear or mastoid drainage
(myringotomy) with or without tympanostomy
◉ IV abx used in mastoiditis. Answer: IV Vanco +
Ceftazidime/Cefepime or Piperacillin-tazobactam
refractory or complicated: mastoidectomy
◉ Causes of TM perforation. Answer: Trauma (noise, barotrauma, direct
impact), otitis media
◉ presentation of TM perforation. Answer: Acute ear pain, hearing loss,
bloody otorrhea
may have conductive hearing loss (rinne: BC>AC, Weber: lateralization
to the affected ear)
◉ what should NOT be performed in pt with TM perforation?. Answer:
pneumatic otoscopy
◉ tx of TM perforation. Answer: Most heal spontaneously
,topical abx (ofloxacin) in some
*AVOID WATER/MOISTURE/TOPICAL AMINOGLYCOSIDES*
◉ MCC of epiglottitis if NOT vax (or also in foreign immigrants).
Answer: h.flu
◉ MCC of epiglottitis if vaccinated. Answer: Group A strep, strep
pneumo (strep species)
◉ Presentation of epiglottitis. Answer: Dysphagia, drooling, respiratory
distress
Tripod position, refuses to lie flat
Stridor
fever, hot potato voice
◉ dx of epiglottitis. Answer: soft tissue lateral cervical X-ray - thumb or
thumbprint sign (swollen, enlarged epiglottis) - not needed for dx
definitive = laryngoscopy to see the cherry red epiglottis with swelling;
performed when securing the area
◉ tx of epiglottitis. Answer: maintaining the airway = most important
(comfortable position, keep child calm); OR best setting for intubation
, dexamethasone for airway edema
abx - ceftriaxone/cefotaxime, penicillin or ampicillin; Vanco may be
added
◉ what should be given for prevention of epiglottitis. Answer: rifampin
given to all close contacts
routine use of Hib vaccine
◉ MCC of acute bronchiolitis. Answer: Respiratory syncytial virus
(RSV)
other = rhinovirus, adenovirus, influenza
◉ presentation of RSV. Answer: viral prodrome (fever, URI) for 1-2
days followed by respiratory distress (wheezing, rales, retractions,
cyanosis, nasal flaring)
◉ signs of severity in RSV. Answer: hypoxemia, apnea, respiratory
failure
◉ dx of RSV. Answer: clinical
CXR - nonspecific
