PAEA Blueprint PEDIATRIC EOR STUDY GUIDE Cylee Burns, PA-C 1 Table of Contents Dermatology – 15% ................................................................................................................................................... 3 Acne Vulgaris ................................................................................................................................................................................... 3 Atopic Dermatitis ............................................................................................................................................................................ 5 Burns ............................................................................................................................................................................................... 7 Drug Eruptions: ............................................................................................................................................................................... 8 Lichen planus ................................................................................................................................................................................. 12 Tinea Infections ............................................................................................................................................................................. 14 Urticaria ......................................................................................................................................................................................... 16 EENT – 15% ............................................................................................................................................................. 18 Acute Otitis Media ........................................................................................................................................................................ 18 Streptococcal Pharyngitis ............................................................................................................................................................. 19 Conjunctivitis ................................................................................................................................................................................ 20 Mastoiditis .................................................................................................................................................................................... 22 Orbital Cellulitis ............................................................................................................................................................................ 24 Strabismus ..................................................................................................................................................................................... 25 INFECTIOUS DISEASE – 12% ..................................................................................................................................... 27 Atypical mycobacterial disease .................................................................................................................................................... 27 Epstein-Barr disease ..................................................................................................................................................................... 28 Pertussis - ..................................................................................................................................................................................... 29 Herpes Simplex ............................................................................................................................................................................. 30 Influenza ........................................................................................................................................................................................ 32 Exanthem: Measles ....................................................................................................................................................................... 33 PULOMONLOGY – 12% ............................................................................................................................................ 37 Acute Bronchiolitis ........................................................................................................................................................................ 37 Asthma .......................................................................................................................................................................................... 37 Cystic Fibrosis ................................................................................................................................................................................ 39 Pneumonia .................................................................................................................................................................................... 41 Respiratory Syncytial Virus ........................................................................................................................................................... 44 CARDIOVASCULAR – 10% ........................................................................................................................................ 46 Acute Rheumatic Fever ................................................................................................................................................................. 46 Hypertrophic Cardiomyopathy ..................................................................................................................................................... 49 Patent Ductus Arteriosus .............................................................................................................................................................. 50 Tetralogy of Fallot ......................................................................................................................................................................... 52 GASTROINTESTINAL & NUTRITIONAL SYSTEM – 10% ............................................................................................... 55 Appendicitis .................................................................................................................................................................................. 55 Constipation .................................................................................................................................................................................. 57 Duodenal atresia ........................................................................................................................................................................... 59 Gastroesophageal Reflux Disease ................................................................................................................................................ 61 Hepatitis ........................................................................................................................................................................................ 62 Inguinal Hernia .............................................................................................................................................................................. 65 Lactose Intolerance ....................................................................................................................................................................... 67 Pyloric Stenosis ............................................................................................................................................................................. 68 Vitamin A deficiency ..................................................................................................................................................................... 69 NEUROLOGY & DEVELOPMENT – 6% ....................................................................................................................... 71 Down syndrome ............................................................................................................................................................................ 71 Meningitis ..................................................................................................................................................................................... 72 Seizure disorders ........................................................................................................................................................................... 73 Teething ........................................................................................................................................................................................ 78 2 PSYCHIATORY & BEHAVIORAL MED – 6% ................................................................................................................ 80 GAD ............................................................................................................................................................................................... 80 Child abuse .................................................................................................................................................................................... 82 Conduct Disorder .......................................................................................................................................................................... 85 Disruptive disorder ....................................................................................................................................................................... 86 Anorexia Nervosa .......................................................................................................................................................................... 86 ORTHOPEDICS AND RHEUMATOLOGY – 5% ............................................................................................................ 90 Avascular necrosis of the proximal femur .................................................................................................................................... 90 Juvenile rheumatoid arthritis ....................................................................................................................................................... 91 Malignant neoplasia of the musculoskeletal system ................................................................................................................... 91 Benign Neoplasia of the MSK system ........................................................................................................................................... 93 Scoliosis ......................................................................................................................................................................................... 94 ENDOCRINOLOGY – 3% ........................................................................................................................................... 97 Diabetes Mellitus .......................................................................................................................................................................... 97 Hyperthyroidism ........................................................................................................................................................................... 99 Obesity ........................................................................................................................................................................................ 102 HEMATOLOGY – 3% .............................................................................................................................................. 103 Anemia of Chronic Disease ......................................................................................................................................................... 104 Thrombotic thrombocytopenic Purpura .................................................................................................................................... 111 Von Willebrand Factor Deficiency .............................................................................................................................................. 114 Multiple Myeloma ...................................................................................................................................................................... 116 Leukemias ................................................................................................................................................................................... 117 Lymphomas ................................................................................................................................................................................. 119 UROLOGY & RENAL – 3% ....................................................................................................................................... 122 Cryptorchidism ............................................................................................................................................................................ 122 Hydrocele .................................................................................................................................................................................... 130 Phimosis ...................................................................................................................................................................................... 131 Vesicourethral Reflux .................................................................................................................................................................. 132 3 Dermatology – 15% Acne Vulgaris Etiology: • Inflammatory skin condition associated with papules and pustules involving pilosebaceous units • Stress • Lithium, steroids, progestins, phenytoin • Hormones o Can activate pilosebaceous glands which may cause cystic flares that coincide with menstruation Risk Factors/Demographics: • Males • Adolescents • Puberty (comdeonal acne) Pathophysiology: • Inflammation of pilosebaceous units • Increased sebum production • Hyper keratinization of the follicle • Colonization by Propionibacterium acnes • Follicular obstruction due to hyper keratinization causing plugging of sebaceous ducts • Comedone: dilated epithelium lined follicular sac filled with lamellated keratinaceous material o White heads are more likely to turn to inflammatory • Plugged follicles, retained sebum, bacterial overgrowth, release of fatty acids Clinical Manifestations: • Most commonly presents in areas with increase sebaceous glands – face, back, chest, upper arms • Open and closed Comedones, papules, pustules, nodulocystic lesions • Mild o Non-inflammatory: Comedones – mostly § Open: blackheads § Closed: white heads o Inflammatory: only a small amount § Occurs from a comedone that has ruptured and extruded its contents into the sub adjacent dermis § Papules, pustules, nodules, 10 • Stage II: Moderate o Moderate numbers of papules and pustules and comedones. • Stage III: Moderate-severe o Numerous papules and pustules present o Many comedones o Occasional larger, deeper, nodular inflammatory lesions • Stage IV: Severe o Nodulocystic acne and conglobate acne Diagnosis: • Clinical Management: • Mild comedones – monotherapy