Do not go where the pay may lead, go instead where there is no path and leave a trail.-Ralph Waldo Emerson
Now onto this week’s podcast
A 4-week-old boy presents with a 2-week history of increasing dyspnea, cough, and poor feeding. On examination you note conjunctivitis, and a chest examination reveals tachypnea and rales. A chest X-ray shows hyperinflation and diffuse interstitial infiltrates. Which of the following is the most likely etiologic agent?
A. Chlamydia trachomatis
B. Parainfluenza virus
C. Respiratory syncytial virus
D. Staphylococcus species
A 6-year-old immigrant boy from Bangladesh presents with fever and rash. The fever started three days ago followed by a rash which started on the head and spread to the rest of the body. Examination reveals a well-appearing child with a maculopapular rash and posterior cervical lymphadenopathy. Which of the following is the most likely causative organism for this disease?
A. Measles virus
B. Mumps virus
C. Parvovirus B19
D. Rubella virus
A 4-year-old boy presents with respiratory failure. Which of the following represents the correct endotracheal tube for this patient?
A. 4.0 cuffed endotracheal tube
B. 5.0 uncuffed endotracheal tube
C. 5.5 cuffed endotracheal tube
D. 6.0 cuffed endotracheal tube
Which of the following is the most common manifestation of abusive head trauma in infants?
A. Epidural hematoma
B. Retinal hemorrhage
C. Subarachnoid hemorrhage
D. Subdural hematoma
Which of the following should be administered to a symptomatic 3-day-old infant with glucose of 25 mg/dL?
A. 1 mL/kg of 50% dextrose (D50)
B. 2 mL/kg of 25% dextrose (D25)
C. 5 mL/kg of 10% dextrose (D10)
D. Glucagon subcutaneously
A healthy 6-year-old boy presents to the ED with bloody diarrhea. He was in his usual state of health until one week ago when loose, watery stools (up to 10 per day) were noted. He was seen by his pediatrician four days ago but has since developed increasing amounts of blood and pus in his stools along with a low-grade fever. Mom states there is no recent travel, antibiotic use, or known sick contacts. His vitals are heart rate 118 beats per minute, oxygen saturation 100% on room air, and rectal temperature of 38.3°C. Your physical exam reveals a mildly tender abdomen without localization, rebound, guarding, or peritoneal signs. You note grossly bloody stool on rectal exam. A brief discussion with his pediatrician confirms your suspicion of an invasive bacterial diarrhea; a stool culture was positive for Shigella. Which of the following statements is true regarding this condition?
A. Antibiotics should be avoided because this is a severe case and the patient is at highest risk of developing hemolytic uremic syndrome
B. Antidiarrheal agents (such as diphenoxylate and atropine) are indicated, given the frequency of loose stools
C. Extraintestinal manifestations such as hallucinations, confusion, and seizures may occur
D. Oral rehydration should be avoided; IV fluids should be initiated
That wraps up Episode 36. Don’t forget to follow us on Twitter @Roshcast and @RoshReview. We can also be reached by email at firstname.lastname@example.org and are open to any feedback, corrections, or suggestions. You can help us pick questions by identifying ones you would like us to review. To do so, write “Roshcast” in the submit feedback box as you go through the question bank. And finally, if you have a minute, make sure to rate us and leave comments on iTunes to help spread the word about Roshcast.
Until next time,
Jeff and Nachi
The post Podcast Ep 36: Pediatrics, Chlamydial Pneumonia, & More appeared first on RoshReview.com.