PEDS APEA CERTIFICATION EVALUATION SET
2026 PRACTICE SOLUTION EXPERT CHECKED
◉ PNA: peds
management. Answer: Bacterial:
- High-dose amoxicillin (90mg/kg/d) first line; consider amox-clav
or 3rd-gen cephalosporin if recent AB exposure
- If type 1 rxn to pcn, then macrolide (clindamycin)
Symptomatic Management:
- Fluids
- Antipyretics
- Rest
- Hospitalization/oxygen if respiratory distress
◉ Bronchiolitis: peds
+ass't findings, dx/management. Answer: - A lower respiratory tract
infection that obstructs small respiratory airways (bronchioles)
- Most common from infancy to 2 yrs; especially <12m
- Self-limited syndrome
- URI for 1-3 days then progresses to LRTI
,- Paroxysmal wheezing peaks on days 3-5, then resolves over 2-4
wks
- Increased RR (40-60/min)
- Fever (lower temps w/ RSV, higher w/ adenovirus)
- Cough may be hoarse before becoming productive
- Respiratory distress
- Thick, purulent nasal secretions
- Bronchiolitis is a clinical diagnosis
- No bronchodilators
- No steroids
- Modest short-term clinical improvement; does not affect overall
outcome
- For moderate to severe s/s, usu in-pt, nebulized bronchodilators
◉ Croup. Answer: - Laryngotracheitis: inspiratory stridor, barking
cough, hoarseness
- Viral croup most common 6m-3y
- Self-limited: fever, congestion, cough usually 3 days
- Steeple sign = tapering of upper trachea on AP X-ray
- Spasmodic croup occurs night
,◉ Viral Gastroenteritis. Answer: - One of the most common
infectious diseases in humans
Presentation:
- >3 watery/loose stools in 24h
- Vomiting, fever, abd pain may be present
- S/S last < 1-2 wks
Gastroenteritis
- Most common cause: viruses
- Rotavirus, norovirus
- Incidence of rotavirus decreased since vaccine
- Fecal-oral route is most common mode of transmission
- Best prevention = hand washing
◉ Degree of Dehydration. Answer: - Most common complication of
gastroenteritis
- Severity = degree of dehydration
Best measures of dehydration:
- Weight loss
- Prolonged capillary refill
, - Loss of skin turgor
- Increased and deep respiratory pattern
◉ Dehydration. Answer: - Mild to moderate dehydration = 3.9% los;
severe = 10% or more
- Pulse: Mild: normal, mod: rapid, severe: rapid and weak
- Systolic BP: Mild: normal, mod: normal to low, severe: low
- RR: normal, deep/increased rate, deep/increased rate
- Mucosa: sticky, dry, parched
- Anterior fontanel: normal, sunken, very sunken
- Eyes: Normal, sunken, very sunken
- Skin turgor: normal, reduced, tenting
- Skin: normal, cool, cool/mottled
- Urine output: normal or slightly reduced, reduced, none
- Systemic signs: thirsty, irritable, lethargy
◉ Viral Gastroenteritis: peds. Answer: - Goal is to correct fluid deficit
and prevent electrolyte imbalance with commercially-prepared oral
rehydration solution
- Oral rehydration for mild to moderate dehydration over 3-4h
- Age-appropriate diet as soon as rehydration is complete
2026 PRACTICE SOLUTION EXPERT CHECKED
◉ PNA: peds
management. Answer: Bacterial:
- High-dose amoxicillin (90mg/kg/d) first line; consider amox-clav
or 3rd-gen cephalosporin if recent AB exposure
- If type 1 rxn to pcn, then macrolide (clindamycin)
Symptomatic Management:
- Fluids
- Antipyretics
- Rest
- Hospitalization/oxygen if respiratory distress
◉ Bronchiolitis: peds
+ass't findings, dx/management. Answer: - A lower respiratory tract
infection that obstructs small respiratory airways (bronchioles)
- Most common from infancy to 2 yrs; especially <12m
- Self-limited syndrome
- URI for 1-3 days then progresses to LRTI
,- Paroxysmal wheezing peaks on days 3-5, then resolves over 2-4
wks
- Increased RR (40-60/min)
- Fever (lower temps w/ RSV, higher w/ adenovirus)
- Cough may be hoarse before becoming productive
- Respiratory distress
- Thick, purulent nasal secretions
- Bronchiolitis is a clinical diagnosis
- No bronchodilators
- No steroids
- Modest short-term clinical improvement; does not affect overall
outcome
- For moderate to severe s/s, usu in-pt, nebulized bronchodilators
◉ Croup. Answer: - Laryngotracheitis: inspiratory stridor, barking
cough, hoarseness
- Viral croup most common 6m-3y
- Self-limited: fever, congestion, cough usually 3 days
- Steeple sign = tapering of upper trachea on AP X-ray
- Spasmodic croup occurs night
,◉ Viral Gastroenteritis. Answer: - One of the most common
infectious diseases in humans
Presentation:
- >3 watery/loose stools in 24h
- Vomiting, fever, abd pain may be present
- S/S last < 1-2 wks
Gastroenteritis
- Most common cause: viruses
- Rotavirus, norovirus
- Incidence of rotavirus decreased since vaccine
- Fecal-oral route is most common mode of transmission
- Best prevention = hand washing
◉ Degree of Dehydration. Answer: - Most common complication of
gastroenteritis
- Severity = degree of dehydration
Best measures of dehydration:
- Weight loss
- Prolonged capillary refill
, - Loss of skin turgor
- Increased and deep respiratory pattern
◉ Dehydration. Answer: - Mild to moderate dehydration = 3.9% los;
severe = 10% or more
- Pulse: Mild: normal, mod: rapid, severe: rapid and weak
- Systolic BP: Mild: normal, mod: normal to low, severe: low
- RR: normal, deep/increased rate, deep/increased rate
- Mucosa: sticky, dry, parched
- Anterior fontanel: normal, sunken, very sunken
- Eyes: Normal, sunken, very sunken
- Skin turgor: normal, reduced, tenting
- Skin: normal, cool, cool/mottled
- Urine output: normal or slightly reduced, reduced, none
- Systemic signs: thirsty, irritable, lethargy
◉ Viral Gastroenteritis: peds. Answer: - Goal is to correct fluid deficit
and prevent electrolyte imbalance with commercially-prepared oral
rehydration solution
- Oral rehydration for mild to moderate dehydration over 3-4h
- Age-appropriate diet as soon as rehydration is complete
