PAEA Pediatrics EOR Topics EXAM 2023-2024 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+

PAEA Pediatrics EOR Topics EXAM 2023-2024
ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED A+
what is the MC conjunctivitis seen in children? what is the cause? source? - CORRECT
ANSWERS-viral conjunctivitis; Adenovirus; swimming pools
Dx? preauricular lymphadenopathy, copious watery eye discharge, scanty mucoid
discharge, usually unilateral with punctate staining on slit lamp examination; Tx? -
CORRECT ANSWERS-dx: viral conjunctivitis
tx: supportive (cool compresses, artificial tears) +/- antihistamines for itching
(Olopatadine)
Dx? bilateral eye itching, tearing, redness, string discharge, chemosis (conjunctival
swelling) with cobblestone appearance to inner/upper eyelids; Tx? - CORRECT
ANSWERS-dx: allergic conjunctivitis
tx: topical antihistamines (H1 blockers) (Olopatadine, Pheniramine/Naphazoline,
Emedastine), topical NSAID (ketorolac), topical corticosteroids (but s/e of long term use
= glaucoma, cataracts, HSV keratitis)
Dx? purulent eye discharge, lid crusting, no visual changes, absence of ciliary injection;
Tx? - CORRECT ANSWERS-dx: bacterial conjunctivitis (MC S. aureus, Strep pneumo,
H. influenzae)
tx: topical abx (erythromycin, fluoroquinolones, sulfonamides, aminoglycosides); if
contact lens wearer cover for pseudomonas w/ fluoroquinolone or aminoglycoside
if bacterial conjunctivitis is found to be chlamydia or gonorrhea what is the tx? -
CORRECT ANSWERS-admit for IV and topical abx (ophtho emergency)
-gonoccoccal: IV ceftriaxone + topical
-chlamydia: IV azithromycin
neonatal conjunctivitis is aka? if left untreated can develop what? - CORRECT
ANSWERS-ophthalmia neonatorum; corneal ulceration, opacification/scarring, visual
impairment/blindness
standard prophylaxis given immediately after birth to prevent ophthalmia neonatorum
(neonatal conjunctivitis) includes: - CORRECT ANSWERS-erythromycin ointment,
tetracycline ointment, silver nitrate, or povidone-iodine
if ophthalmia neonatorum (neonatal conjunctivitis) develops on day 1 after birth what is
the most likely cause? day 2-5? day 5-7? day 7-11? - CORRECT ANSWERS-day 1:
silver nitrate (chemical cause- prophylaxis is what can cause the condition)
day 2-5: gonococcal
day 5-7: chlamydia
day 7-11: HSV
orbital (septal) cellulitis is usually secondary to _________ infection in most commonly
what age group? - CORRECT ANSWERS-sinus; 7-12y; other causes include
dental/facial infxns or bacteremia
what is the most common sinus infection (90%) that causes secondary orbital cellulitis?
what organisms are the cause? - CORRECT ANSWERS-ethmoid; S. aureus, Strep.
pneumo, GABHS (Strep. pyogenes), H. influenzae
work up/Dx? decreased vision, pain w/ ocular movement, proptosis (bulging eye), eyelid
erythema and edema; tx? - CORRECT ANSWERS-dx: orbital cellulitis
work up: CT scan (showing infxn of fat & ocular muscles) or MRI
tx: IV antibiotics (Vanc, Clinda, Cefotaxime, Ampicillin/Sulbactam)
what is the difference b/t orbital (septal) cellulitis and preseptal cellulitis? - CORRECT
ANSWERS-preseptal may still have ocular pain, redness and swelling but NO visual
changes or pain w/ ocular mvmt (hasn't affected the muscles)
misalignment of the eyes is aka? when does stable ocular alignment present in infants?
- CORRECT ANSWERS-strabismus; 2-3 mos
convergent strabismus is aka? divergent strabismus is aka? - CORRECT ANSWERSconvergent: esotropia (deviated inward "cross eyed")
divergent: exotropia (deviated ouward)
a + Hirschberg corneal light reflex test, diplopia, scotomas (blind spots), or amblyopia
(lazy eye) are clinical manifestations of what condition? what other tests can be
performed? - CORRECT ANSWERS-strabismus; cover-uncover test to determine the
angle of strabismus, cover test, convergence testing
how can strabismus be treated? - CORRECT ANSWERS--patch therapy: normal eye is
covered to stimulate and strengthen the affected eye
-eyeglasses
-corrective therapy: if severe or unresponsive to conservative therapy
if not treated before 2 y/o, amblyopia may occur and cause decreased visual acuity that
is not correctable
Dx? 1-2 days of ear pain, pruritis in the ear canal, auricular discharge, pressure/fullness,
hearing usually preserved, pain with tug test and tragus pressure, auditory canal
erythema/edema/debris, recent swimming pool use; MC organisms? Tx? - CORRECT
ANSWERS-Dx: otitis externa
MC organisms: *pseudomonas*, proteus, s. aureus, s. epidermis, GABHS, anaerobes
(peptostreptococcus), aspergillus
Tx: 1. protect ear against moisture (isopropyl alcohol and acetic acid) 2.
ciprofloxacin/dexamethasone (ofloxacin safe if there is an associated TM perf) 3.
Aminoglycoside combo (neomycin/polytrim-B/hydrocortisone -BUT not used if perf
suspected bc ototoxic 4. amphotericin B if fungal
malignant otitis externa is osteomyelitis at the skull base secondary to ___________
infxn; MC seen in what pt populations; Tx? - CORRECT ANSWERS-pseudomonas; MC
in DM and immunocompromised pts; Tx w/ IV Ceftazidime or Piperacillin + FQ or
Aminoglycoside
acute otitis media is an infection of the middle ear, temporal bone and mastoid air cells
that is MC preceded by - CORRECT ANSWERS-a viral URI that causes edema of
eustachian tube, negative pressure, transudation of fluid and mucus in middle ear that
allows for bacterial growth
what are the 4 MC organisms seen in acute otitis media? - CORRECT ANSWERS-
*Strep pneumo*, H. influenza, Moraxella catarrhalis, Strep pyogenes (same as seen in
acute sinusitis)
Dx: fever, otalgia, ear tugging in infants, conductive hearing loss, stuffiness, possible
drainage from ear, bulging/erythematous TM w/ effusion, dec TM mobility on pneumatic
otoscopy; Tx? - CORRECT ANSWERS-dx: acute otitis media
tx: 1st line- amoxicillin, 2nd line- augmentin (amoxicillin-clavulate); if PCN allergyazithromycin, clarithromycin, erythromycin-sulfisoxazole,
trimethoprim/sulfamethoxazole, if PCN adverse effect but not allergy- ceftriaxone,
cefdinir, cefixine