PEDS EXAM 3.4

1.

1 point

in a patient with cervical adenitis its important to mark and measure the nodes to track the progression. Helps with diagnosing what disease?

Kawasakis

Rheumatic Fever

mononucleosis

Allergic Rhinitis

2.

1 point

normal BUN/Cr ratio???

3.

1 point

Infectious Mononucleosis you would find what in the blood work?

atypical leukocytes

atypical lymphocytes

atypical monocytes

atypical neutrophils

4.

1 point

You treat sinusitis with Augmentin, cefdinir, cefuroxime or levoflaxacin. Why do you treat for at least 10 days, some say even 14-21 days?

hard to kill

Preventing sequili

ABx take awhile to permeate into sinuses

ABx aren't very effective so it takes awhile

5.

1 point

Patients that have Strep pharyngitis can have the scarlettiniform rash and the strawberry tongue and such. What is it that separates strep from scarlet fever?

onset

Big Fever

Low Grade Fever

timing

6.

1 point

For mono, if treating with amoxicillin it is a)the amoxicillin rash, b)drug allergy, c) mono rash. This is why you treat with macrolide or PEN V K

True

False

7.

1 point

Mono has an associated maculopapular rash. The rash may begin after being treated with ampicillin or amoxicillin in 80% of cases?

True

False

8.

1 point

Treatment for Cervical Adenitis?

depends on the cause

ABx

Warm compress

drainage

all of the above

9.

1 point

Diagnosing Rheumatic fever relies on what criteria?

Jones

Boley

Ladd

Swensen

10.

1 point

Mono presents as malaise, fatigue, fever, headache, sore throat and myalgia that can last 1-2 weeks. It has an incubation period of?

5-7 days

30-50 days

1-2 weeks

2 weeks

12.

1 point

Biggest complication of kawasakis disease?

GI

Renal

Cardiac

Pulmonary

13.

1 point

Treatment for Retropharyngeal Abscess? After I&D can move to PO ABx

PCN

IV ABx: ampicillin/sulbactum

PEN V K

amoxicillin

14.

1 point

If giving long term aspirin to patients with kawasakis what two vaccines do you need to give?

varicella vaccine

flu vaccine

HiB

pneumococcal

15.

1 point

a 12 year old female comes to your office with a complaing of severe pain in their throat, especially with penning mouth and swallowing. You note that they have a altered voice, almost as if a hot potato was in their mouth, malodorous breath and a deviated uvula. What is your most likely diagnosis?

Laryngitis

Peritonsillar Abscess

Pharnygitis

Retropharangeal Abscess

16.

1 point

Rheumatic Fever can present with all of the following except?

Sydenham's Chorea: characterized by emotional instability and involuntary movements that become progressively severe. slurred speech and ataxia. may be unilateral and is self limiting.

Polyarthritis: two or more joints involved

Erythema Marginatum: macular erythematous rash with a circinate border on trunk and extremities.

Carditis: a new murmur OR pericarditis OR evidence of CHF OR arrhythmia

Subcutaneous Nodules: usually seen in severe cases over joints, scalp and spinal column. They are non tender and mobile

Lypomas: usually seen in severe cases over joints, scalp and spinal column. They are non tender and mobile

17.

1 point

etiology of kawasakis?

Herpes

Unknown

E.Coli

coxsackie A/B

18.

1 point

Treatment for Pharyngitis/Tonsilitis?

PCN

PEN V K

Amoxicillin

Augmentin

19.

1 point

When do you start treatment for patients with kawasakis?

3 or more abnormal labs alone

abnormal Echo

Elevated CRP and/or ESR alone

Elevated CRP and/or ESR with 3 or more abnormal labs

20.

1 point

EBV was the first human virus found to be associated with cancer

True

False

21.

1 point

Complication of strep pharyngitis that is most commonly caused by Group AP Streptococcus resulting in an abnormal immune response that can cause systemic problems such as carditis and polyarthritis?

Laryngitis

Rheumatic Fever

Scarlet Fever

Retropharyngeal Abscess

22.

1 point

To diagnose kawasakis you need 5 days of fever, and 4 out of the 5 criteria of?

bilateral conjunctival injection

mucosal changes of oropharynx

changes in peripheral extremities

rash

cervical adenopathy > or = to 1.5cm

all of the above

23.

1 point

Treatment for Kawasakis?

IVIG and High Dose Aspirin

Glucosteroids

PEN V K

Benzathing PEN G

24.

1 point

Biggest diagnostic tool for kawasakis disease?

CBC

Echo

Chem 7

LFTs

25.

1 point

Best way to prevent otitis media besides second hand smoke?

Pneumococcal vaccine!!

all of above

26.

1 point

Treatment for Peritonsillar Abscess?

ampicillin/sulbactam

Ampicillin

amoxicillin

sulbactam

27.

1 point

Pharyngitis/Tonsilitis is most commonly caused by?

H. Influenza

Group AB Hemolytic Streptococcus

Coxsackie A

Pneumococcal

28.

1 point

Absolute indications for tonsillectomy or adenectomy?

Obstruction of nasal pharyngeal or laryngeal airway

interference with swallowing

confirmed malignancy or suspicion of malignancy

uncontrollable hemorrhage.

all of the above

30.

1 point

unasyn is?

erythromycin/bactrim

ampicillin/sulbactam

amoxicillin/clavulanate

31.

1 point

Treatment for Scarlet Fever?

PCN or Macrolide

Amoxicillin

Ceftriaxone

Augmentin

32.

1 point

______% of patients with kawasakis either don't fit or are incomplete of the criteria needed, but present with coronary abnormalities. THESE KIDS CAN DIE

90%

10%

1%

20-60%

33.

1 point

Treatment for rheumatic fever?

Salicylates: 30-60mg/kg/day for 2-6 weeks then taper

ABx: Benzathing PEN G

Supportive Care: rest with limited activity

Corticosteroids: 2mg/kg/day for 2-6 weeks then taper

34.

1 point

You're patient presents with a fever and a sore throat. You note an abscess in the potential space between posterior and pharyngeal wall and pre vertebral fascia. What is your most likely diagnosis

Retropharyngeal Abscess

Peritonsillar abscess

Laryngitis

Strep Pharyngitis

35.

1 point

atypical or incomplete cases of kawasakis have been reported where coronary artery disease still occurs

True

False

36.

1 point

Your patient presents with a sudden onset of fever, dysphagia, headache and lymphadenopathy. You note on PE: tonsilar enlargement, erythema, hyperemic and exudate. You think its pharyngitis/Tonsilitis. What do you do to diagnose?

Rapid Antigen Test

Biopsy

Both Rapid Antigen Test and Throat Culture

Throat Culture

Nothing, self limiting

37.

1 point

What grade will you get??

A

B

F

C

38.

1 point

Jones Criteria for Rheumatic Fever requires what:

1 Major OR 2 Minor PLUS evidence of strep infection

2 Major OR 1 Major and 2 Minor PLUS evidence of strep infection

1 Major OR 1 Major and 2 Minor PLUS evidence of strep infection

2 Major OR 2 Minor PLUS evidence of strep infection

39.

1 point

Acute febrile vasculitis of childhood is know as?

Henoch Schonlein Purpura

Nephrotic Syndrome

Kawasakis

Mononucleosis

40.

1 point

Kids with mono have supportive care and the main treatment, sometimes ABx are needed. Splenic rupture can occur usually in what week of the disease? Which is why no contact sports is indicated.

2nd week

3rd week

1st week

4th week

41.

1 point

A 13 year old male comes to your office complaining of trouble swallowing, you note on PE an abscess in the potential space between the superior constrictor muscle and tonsil. What is your most likely diagnosis?

Peritonsillar Abscess

Pharyngitis

Retropharangeal Abscess

Tonsilitis

42.

1 point

Conditional indications for tonsillectomy or adenectomy

recurrent throat infections

chronic tonsillitis

tonsilar obstruction that alters voice quality

syndrome of periodic fever, etc

all of above

43.

1 point

Mononucleosis is most commonly caused by

HIV

Epstein Barr Virus

CMV

adenovirus

44.

1 point

Sinusitis often presents as a Headache, fever and facial tenderness. A key finding/diagnosis is to do what/youd see what?

Worsened symptoms when leaning forward

Worsened symptoms when standing

Worsened symptoms when sitting

45.

1 point

Your 2yo patient presents with a fever, hyperextended neck and noisy, difficult breathing. What is your most likely diagnosis?

Peritonsillar Abscess

Laryngitis

Strep Pharyngitis

Retropharyngeal Abscess

46.

1 point

you have a 4 year old patient who comes in with bilateral conjunctival injections, strawberry tongue and has dry cracked lips. You also not erythema and swelling of hands and feet. What is your most likely diagnosis?

Scarlet Fever

Rheumatic Fever

Kawasakis

Strep Pharyngitis

47.

1 point

Your patient presents with a sudden onset of fever, sore throat, headache, chills and vomiting. You note on PE a strawberry tongue and erythematous punctiform lesions on palate, circumoral pallor, pastia lines and desquamation. Their parents state that they just had strep about a week ago and ask if is that again? you say no, its most likely

Scarlet Fever

Peritonsillar Abscess

Pharyngitis

Rheumatic Fever

48.

1 point

Epstein Barr Virus is what herpes type

Herpes type 3

Herpes type 1

Herpes type 2

Herpes type 4

49.

1 point

Acute Bacterial Sinusitis presents as persistent symptoms lasting longer than 10-14 days, fever >39C, purulent Discharge for 3-4 days and the kids look sick!, x-rays are not needed in kids < what age?

<6yo

<2mos

<3yo

<15yo

50.

1 point

If IVIG is given to patients with kawasakis what do you need to do?

never give vaccines

Delay MMR and VARIVAX vaccine

Give vaccines at same time