CPEN STUDY MANUAL 2025/2026 QUESTIONS WITH
SOLUTION GRADED A+
✔✔Labs/tests to work up fever if no focal source and fever lasts > 5+ days - ✔✔-
Consider Kawasaki Dz
-CBC, Bldcx, U/A, Ucx, Resp viral PCR panel, ESR, CRP
-Peds ID consult
✔✔Mgmt of fever - ✔✔-ABCs
-Anti-pyretics: Acetaminophen: 15mg/kg q4hrs or Ibuprofen: 10mg/kg q6hrs
-Fluids: PO or IV depending on patient condition
-Abx if indicated: Empiric if neonate or by source (OM, pneumonia, UTI, strep)
✔✔Abx for neonates ≤8wk - ✔✔-Ampicillin 50mg/kg IV q6hrs AND
-Cefotaxime 50mg/kg IV q8hrs (≤6wks) OR
-Ceftriaxone 50mg/kg IV Q12hrs
-Admit
✔✔Abx for fever without a focal source in infant-3yrs old - ✔✔-Option 1: empiric abx
after cx obtained and f/u in 24hrs
-Option 2: abx only if WBC ≥15k and f/u 24hrs
✔✔Mgmt of fever if no focal source and fever lasts > 5+ days - ✔✔*Admit
✔✔What is meningitis? - ✔✔Infection of the meninges, either viral or bacterial
✔✔Epidemiology of meningitis - ✔✔MC in children than adults
✔✔Complications of meningitis - ✔✔-Can be fatal if unrecognized or untreated
-Severe developmental issues
✔✔Presentation of meningitis - ✔✔-Fever, HA, stiff neck
-Ill and/or irritable appearing child
-Bulging fontanels in infant/neonate
-Extreme discomfort with movement
✔✔Labs/tests to work up meningitis - ✔✔-Labs and LP if stable
✔✔Mgmt of menintitis - ✔✔-ABCs
-High flow O2
-20ml/kg boluses IV/IO push
-Empiric abx
-Intubate if needed
-Admit to PICU
, ✔✔% of body weight loss in infants vs children in moderate dehydration - ✔✔-Infants
lose up to 10% of their body weight
-Child loses up to 6-8% of their body weight
✔✔% of body weight loss in infants vs children in severe dehydration - ✔✔-Infants lose
up to 15% of their body weight
-Child loses up to 10-13% of their body weight
✔✔PE work up of dehydration - ✔✔-Observe skin color, pt alertness, respiratory status
-Vitals
✔✔History work up of dehydration - ✔✔-Associated symptoms: vomiting, diarrhea,
when began and how many episodes of each, along with fevers, sore throat
-Intake and urine output (how many wet diapers)
-Medications or treatments
✔✔% of body weight loss in infants vs children in mild dehydration - ✔✔-Infants lose up
to 5% of their body weight
-Child loses up to 3-4% of their body weight
✔✔Signs of mild dehydration - ✔✔barely visible
✔✔Signs of moderate dehydration - ✔✔-Poor skin color & turgor, dry mucous
membranes, decreased urine output & increased thirst, no tears
✔✔Signs of severe dehydration - ✔✔-Danger of life-threatening hypovolemic shock
-Poor skin color and turgor, cool extremities, dry mucous membranes, altered mental
status, no tears, decreased to no urine output
✔✔Tx of mild or moderate dehydration - ✔✔-ABCs
-PO fluids if no abdominal pain, continuing vomiting, diarrhea, and pt is alert
✔✔Tx of severe dehydration - ✔✔-ABCs
-High flow O2, IV/IO with NS in 20ml/kg fluid boluses, accucheck
-Check and correct electrolyte disturbances
✔✔Most common etiology for hoarseness, cough, and onset of acute stridor in febrile
children - ✔✔Croup
✔✔What is croup? - ✔✔Inflammation of the larynx and trachea
✔✔Etiologic agent of croup - ✔✔-Parainfluenza 1/2 viruses
-Influenza A/B
SOLUTION GRADED A+
✔✔Labs/tests to work up fever if no focal source and fever lasts > 5+ days - ✔✔-
Consider Kawasaki Dz
-CBC, Bldcx, U/A, Ucx, Resp viral PCR panel, ESR, CRP
-Peds ID consult
✔✔Mgmt of fever - ✔✔-ABCs
-Anti-pyretics: Acetaminophen: 15mg/kg q4hrs or Ibuprofen: 10mg/kg q6hrs
-Fluids: PO or IV depending on patient condition
-Abx if indicated: Empiric if neonate or by source (OM, pneumonia, UTI, strep)
✔✔Abx for neonates ≤8wk - ✔✔-Ampicillin 50mg/kg IV q6hrs AND
-Cefotaxime 50mg/kg IV q8hrs (≤6wks) OR
-Ceftriaxone 50mg/kg IV Q12hrs
-Admit
✔✔Abx for fever without a focal source in infant-3yrs old - ✔✔-Option 1: empiric abx
after cx obtained and f/u in 24hrs
-Option 2: abx only if WBC ≥15k and f/u 24hrs
✔✔Mgmt of fever if no focal source and fever lasts > 5+ days - ✔✔*Admit
✔✔What is meningitis? - ✔✔Infection of the meninges, either viral or bacterial
✔✔Epidemiology of meningitis - ✔✔MC in children than adults
✔✔Complications of meningitis - ✔✔-Can be fatal if unrecognized or untreated
-Severe developmental issues
✔✔Presentation of meningitis - ✔✔-Fever, HA, stiff neck
-Ill and/or irritable appearing child
-Bulging fontanels in infant/neonate
-Extreme discomfort with movement
✔✔Labs/tests to work up meningitis - ✔✔-Labs and LP if stable
✔✔Mgmt of menintitis - ✔✔-ABCs
-High flow O2
-20ml/kg boluses IV/IO push
-Empiric abx
-Intubate if needed
-Admit to PICU
, ✔✔% of body weight loss in infants vs children in moderate dehydration - ✔✔-Infants
lose up to 10% of their body weight
-Child loses up to 6-8% of their body weight
✔✔% of body weight loss in infants vs children in severe dehydration - ✔✔-Infants lose
up to 15% of their body weight
-Child loses up to 10-13% of their body weight
✔✔PE work up of dehydration - ✔✔-Observe skin color, pt alertness, respiratory status
-Vitals
✔✔History work up of dehydration - ✔✔-Associated symptoms: vomiting, diarrhea,
when began and how many episodes of each, along with fevers, sore throat
-Intake and urine output (how many wet diapers)
-Medications or treatments
✔✔% of body weight loss in infants vs children in mild dehydration - ✔✔-Infants lose up
to 5% of their body weight
-Child loses up to 3-4% of their body weight
✔✔Signs of mild dehydration - ✔✔barely visible
✔✔Signs of moderate dehydration - ✔✔-Poor skin color & turgor, dry mucous
membranes, decreased urine output & increased thirst, no tears
✔✔Signs of severe dehydration - ✔✔-Danger of life-threatening hypovolemic shock
-Poor skin color and turgor, cool extremities, dry mucous membranes, altered mental
status, no tears, decreased to no urine output
✔✔Tx of mild or moderate dehydration - ✔✔-ABCs
-PO fluids if no abdominal pain, continuing vomiting, diarrhea, and pt is alert
✔✔Tx of severe dehydration - ✔✔-ABCs
-High flow O2, IV/IO with NS in 20ml/kg fluid boluses, accucheck
-Check and correct electrolyte disturbances
✔✔Most common etiology for hoarseness, cough, and onset of acute stridor in febrile
children - ✔✔Croup
✔✔What is croup? - ✔✔Inflammation of the larynx and trachea
✔✔Etiologic agent of croup - ✔✔-Parainfluenza 1/2 viruses
-Influenza A/B
