Which of following statements comparing the effects of aspirin and acetaminophen in children is false?
Correct Answer D:
Aspirin has anti-platelet, anti-pyretic, anti-inflammatory and analgesic properties. Acetaminophen only has anti-pyretic and analgesic properties. Though acetaminophen is used to treat inflammatory pain, it is not generally classified as an NSAID because it exhibits only weak anti-inflammatory activity.
Aspirin use in children can cause Reye's syndrome, which is a rare form of acute encephalopathy and fatty infiltration of the liver that tends to follow some acute viral infections.
Therefore, in children, acetaminophen is preferred over aspirin.
A 5-year-old boy is admitted with a provisional diagnosis of acute renal failure. The laboratory calls you to report that his serum potassium level is 7.5 mmol/L.
Which one of the following should be your next investigation?
Correct Answer A:
Hyperkalemia is serum K concentration > 5.5 mEq/L resulting from excess total body K stores or abnormal movement of K out of cells. The usual cause is impairment of renal excretion; it can also occur in metabolic acidosis as in uncontrolled diabetes. Clinical manifestations are generally neuromuscular, resulting in muscle weakness and cardiac toxicity that, if severe, can degenerate to ventricular fibrillation or asystole.
Moderate to severe hyperkalemia: Plasma K > 6 mEq/L, especially with EKG changes, requires aggressive therapy to shift K into cells.
Administration of 10 to 20 mL 10% Ca gluconate (or 5 to 10 mL 22% Ca gluceptate) IV over 5 to 10 min. Ca antagonizes the effect of hyperkalemia on cardiac muscle excitability.
If the ECG has deteriorated to a sine wave or asystole, Ca gluconate may be given more rapidly (5 to 10 mL IV over 2 min). CaCl can also be used but can be irritating and should be given through a central venous catheter.
A 5-year-old boy presents to your office complaining of right ear pain. Upon examination of the ear, pain is elicited with traction of the tragus, the tympanic membrane is not visualized well, and some periauricular lymph nodes are palpable.
What is the most likely diagnosis?
Correct Answer B:
External otitis is infection of the ear canal, typically by bacteria. Symptoms include itching, pain, and discharge. Pain can be elicited by traction of the tragus or pinna, although pain becomes persistent as the disease progresses.
Diagnosis is based on inspection. When discharge is copious, external otitis can be difficult to differentiate from perforated otitis media; pain with pulling on the pinna indicates external otitis.
Treatment is with topical drugs, including antibiotics, corticosteroids, and/or acetic acid.
A mother brings her 2-year-old toddler saying "he refuses to eat." Pregnancy and delivery were normal and his birth weight was 4 kg. He was breastfed up to 6 months of age. He is now drinking 1.5 L of milk a day, and loves juices. His height (91 cm) is in the 90th percentile and his weight 16.5 kg) is over the 97th percentile for his age.
Which one of the following measures is most appropriate in the initial management of this problem?
Correct Answer C: This child’s birth weight was normal and now he is in the 97th percentile for weight. This suggests that he is being overfed by a mother who will need proper counseling with regard to her toddler's diet.
A child, 1-2 years old, should have all of the following foods, except:
After a baby is 1 year old, whole milk may replace breast milk or formula. Children under the age of 2 should not be given low-fat milk (2%, 1%, or skim) as they need the additional calories from fat to ensure proper growth and development.
Children under the age of 1 should not be given whole milk as it has been shown to cause low blood counts. Cheese, cottage cheese, and yogurt, however, may be given in small amounts. The 1 year old child should be getting much of their nutrition from meats, fruits and vegetables, breads and grains, and the dairy group, especially whole milk.
Providing a variety of foods will help to ensure enough vitamins and minerals. Toddlers do not grow as rapidly as babies do, so their nutritional needs relative to their size decrease during the second year of life. Although they continue to gain weight, they no longer double their weight as infants do.
Click to expand