NUNP 6541 Pediatric Final Exam
Questions and Answers
Recommended treatment for RSV in a 7 month old (outpatient) - correct
answers✅✅Use of saline drops and suctioning of the nares. Indications of
when to use antipyretics. Signs of respiratory distress or dehydration.
Guidelines for feeding an infant with signs of mild respiratory distress which
includes smaller more frequent feedings; monitoring of the respiratory rate;
and guarding against vomiting. The parents should be educated that the
child may have the symptoms over the course of 2-3 weeks
Epiglottitis s/s - correct answers✅✅Acute and rapid onset of high fever,
chills, and toxicity. Severe sore throat and drooling saliva. Will not eat or
drink, muffled (hot potato) voice, and anxiety. Sitting posture with
hyperextended neck with open-mouth breathing. Stridor, tachycardia, and
tachypnea
Epiglottitis prevention - correct answers✅✅Haemophilus influenzae type
B (Hib) vaccine
Steeple sign - correct answers✅✅a radiologic sign found on radiograph
where the subglottic tracheal narrowing produces a shape of a church
steeple which supports a diagnosis of croup
Foreign body aspiration antibiotic? - correct answers✅✅Depends on the
nature of the material aspirated, plus the location and degree of obstruction.
Bronchial or laryngeal foreign body aspiration, a bronchoscopy must be
performed for removal of the foreign body
Antibiotics for bronchiolitis? - correct answers✅✅Use of saline drops and
suctioning of the nares. There is no evidence to support the routine use of
antibiotics
Antibiotics for croup? - correct answers✅✅Nebulized epinephrine,
corticosteroids (dexamethasone oral or IM), blow by oxygen or heliox in
,NUNP 6541 Pediatric Final Exam
Questions and Answers
severe croup. Racemic epinephrine with the use of corticosteroids to limit
rebound swelling
Antibiotics for epiglottitis? - correct answers✅✅Establish an airway
preferably by nasotracheal intubation. Administer IV antibiotics such as
rocephin to cover H.influenzae. Administer oxygen and respiratory support.
Antibiotics should be continued for 10 days. Rifampin prophylaxis 20 mg/kg
in a single dose (maximum of 600 mg) for 4 days for infants and children,
600 mg once a day for adults for 4 days. Should be provided for household
contacts who are at risk (Younger than 4 years old who is non-immunized or
incompletely immunized, children less than 12 months who have not
received primary series of Hib, and immunocompromised children.
Asthma treatment - correct answers✅✅The pharmacological
management of asthma in children is based on the severity of asthma and
the child's age. After initial control, decrease treatment to the least amount
of medication needed to maintain control. Systemic corticosteroids may be
needed at any time and stepped up if there is a major flare-up of symptoms.
Step 1 Asthma management for children 0-4 years old - correct
answers✅✅Step 1: SABA (Short acting beta2-agonist) PRN: With viral
respiratory symptoms short acting beta 2-agonist should be used every 4-6
hours up to 24 hours (longer with a physician consult). Consider short course
of oral systemic corticosteroids if severe exacerbation. Frequent use of SABA
may indicate the need to step up treatment
Step 2 Asthma management for children 0-4 years old - correct
answers✅✅Step 2: Consider consultation with asthma specialist. Low dose
of inhaled corticosteroids.
Step 3 asthma mgmt for children 0-4 yrs - correct answers✅✅Step 3:
Medium-dose of inhaled corticosteroids
,NUNP 6541 Pediatric Final Exam
Questions and Answers
Steps 4-6 asthma mgmt for children 0-4 yrs - correct answers✅✅Step 4:
Medium-dose ICS and Long acting beta2-agonist or montelukast.
Step 5: High dose ICS and Long acting beta 2-agonist or montelukast.
Step 6: High dose of ICS and LABA or montelukast and oral corticosteroids
Steps 1-3 asthma mgmt for children 5-11 yrs - correct answers✅✅Step 1:
SABA (Short acting beta 2-agonist) PRN: Increasing the use of short-acting
beta 2-agonist or use greater than 2 days a week for symptom relief
generally indicates inadequate control and the need to step up treatment.
Step 2: Consider consultation with asthma specialist. Low dose of inhaled
corticosteroids.
Step 3: Low dose of inhaled corticosteroid and LABA. Or medium dose of
inhaled corticosteroids.
Steps 4-6 asthma mgmt for children 5-11 yrs - correct answers✅✅Step 4:
Medium-dose ICS and LABA or medium dose of inhaled corticosteroid and
leukotriene receptor antagonist or theophylline. .
Step 5: High dose ICS and LABA or high dose of inhaled corticosteroid and
leukotriene receptor antagonist or theophylline. .
Step 6: High dose of ICS and LABA and oral corticosteroids or high dose of
inhaled corticosteroids and leukotriene receptor antagonist or theophylline
and oral corticosteroids.
, NUNP 6541 Pediatric Final Exam
Questions and Answers
** Theophylline levels must be monitored.
Differentials for patient with sore throat - correct answers✅✅Strep
pharyngitis
Peritonsillar abscess
Viral pharyngitis
Infectious mononucleosis
Epiglottitis
small-for-gestational-age infants: which type of chromosomal analysis should
be included? - correct answers✅✅Trisomy 18
Holt-Olram
Trisomy 13
Turner Syndrome
Trisomy 21
Prader-Willi Syndrome
heart defects associated with Down syndrome - correct
answers✅✅Atrioventricular Septal Defect
Ventricular Septal Defect
Persistant Ductus Arteriosus
Tetrology of Fallot
Contact sports with Down's Syndrome - correct answers✅✅Do not
recommend due to atlantoaxial instability
Questions and Answers
Recommended treatment for RSV in a 7 month old (outpatient) - correct
answers✅✅Use of saline drops and suctioning of the nares. Indications of
when to use antipyretics. Signs of respiratory distress or dehydration.
Guidelines for feeding an infant with signs of mild respiratory distress which
includes smaller more frequent feedings; monitoring of the respiratory rate;
and guarding against vomiting. The parents should be educated that the
child may have the symptoms over the course of 2-3 weeks
Epiglottitis s/s - correct answers✅✅Acute and rapid onset of high fever,
chills, and toxicity. Severe sore throat and drooling saliva. Will not eat or
drink, muffled (hot potato) voice, and anxiety. Sitting posture with
hyperextended neck with open-mouth breathing. Stridor, tachycardia, and
tachypnea
Epiglottitis prevention - correct answers✅✅Haemophilus influenzae type
B (Hib) vaccine
Steeple sign - correct answers✅✅a radiologic sign found on radiograph
where the subglottic tracheal narrowing produces a shape of a church
steeple which supports a diagnosis of croup
Foreign body aspiration antibiotic? - correct answers✅✅Depends on the
nature of the material aspirated, plus the location and degree of obstruction.
Bronchial or laryngeal foreign body aspiration, a bronchoscopy must be
performed for removal of the foreign body
Antibiotics for bronchiolitis? - correct answers✅✅Use of saline drops and
suctioning of the nares. There is no evidence to support the routine use of
antibiotics
Antibiotics for croup? - correct answers✅✅Nebulized epinephrine,
corticosteroids (dexamethasone oral or IM), blow by oxygen or heliox in
,NUNP 6541 Pediatric Final Exam
Questions and Answers
severe croup. Racemic epinephrine with the use of corticosteroids to limit
rebound swelling
Antibiotics for epiglottitis? - correct answers✅✅Establish an airway
preferably by nasotracheal intubation. Administer IV antibiotics such as
rocephin to cover H.influenzae. Administer oxygen and respiratory support.
Antibiotics should be continued for 10 days. Rifampin prophylaxis 20 mg/kg
in a single dose (maximum of 600 mg) for 4 days for infants and children,
600 mg once a day for adults for 4 days. Should be provided for household
contacts who are at risk (Younger than 4 years old who is non-immunized or
incompletely immunized, children less than 12 months who have not
received primary series of Hib, and immunocompromised children.
Asthma treatment - correct answers✅✅The pharmacological
management of asthma in children is based on the severity of asthma and
the child's age. After initial control, decrease treatment to the least amount
of medication needed to maintain control. Systemic corticosteroids may be
needed at any time and stepped up if there is a major flare-up of symptoms.
Step 1 Asthma management for children 0-4 years old - correct
answers✅✅Step 1: SABA (Short acting beta2-agonist) PRN: With viral
respiratory symptoms short acting beta 2-agonist should be used every 4-6
hours up to 24 hours (longer with a physician consult). Consider short course
of oral systemic corticosteroids if severe exacerbation. Frequent use of SABA
may indicate the need to step up treatment
Step 2 Asthma management for children 0-4 years old - correct
answers✅✅Step 2: Consider consultation with asthma specialist. Low dose
of inhaled corticosteroids.
Step 3 asthma mgmt for children 0-4 yrs - correct answers✅✅Step 3:
Medium-dose of inhaled corticosteroids
,NUNP 6541 Pediatric Final Exam
Questions and Answers
Steps 4-6 asthma mgmt for children 0-4 yrs - correct answers✅✅Step 4:
Medium-dose ICS and Long acting beta2-agonist or montelukast.
Step 5: High dose ICS and Long acting beta 2-agonist or montelukast.
Step 6: High dose of ICS and LABA or montelukast and oral corticosteroids
Steps 1-3 asthma mgmt for children 5-11 yrs - correct answers✅✅Step 1:
SABA (Short acting beta 2-agonist) PRN: Increasing the use of short-acting
beta 2-agonist or use greater than 2 days a week for symptom relief
generally indicates inadequate control and the need to step up treatment.
Step 2: Consider consultation with asthma specialist. Low dose of inhaled
corticosteroids.
Step 3: Low dose of inhaled corticosteroid and LABA. Or medium dose of
inhaled corticosteroids.
Steps 4-6 asthma mgmt for children 5-11 yrs - correct answers✅✅Step 4:
Medium-dose ICS and LABA or medium dose of inhaled corticosteroid and
leukotriene receptor antagonist or theophylline. .
Step 5: High dose ICS and LABA or high dose of inhaled corticosteroid and
leukotriene receptor antagonist or theophylline. .
Step 6: High dose of ICS and LABA and oral corticosteroids or high dose of
inhaled corticosteroids and leukotriene receptor antagonist or theophylline
and oral corticosteroids.
, NUNP 6541 Pediatric Final Exam
Questions and Answers
** Theophylline levels must be monitored.
Differentials for patient with sore throat - correct answers✅✅Strep
pharyngitis
Peritonsillar abscess
Viral pharyngitis
Infectious mononucleosis
Epiglottitis
small-for-gestational-age infants: which type of chromosomal analysis should
be included? - correct answers✅✅Trisomy 18
Holt-Olram
Trisomy 13
Turner Syndrome
Trisomy 21
Prader-Willi Syndrome
heart defects associated with Down syndrome - correct
answers✅✅Atrioventricular Septal Defect
Ventricular Septal Defect
Persistant Ductus Arteriosus
Tetrology of Fallot
Contact sports with Down's Syndrome - correct answers✅✅Do not
recommend due to atlantoaxial instability
