08-08-2007, 01:25 PM
A 13-month-old boy is brought for evaluation of fever of 1040F, cough and nasal congestion. Other vital signs include respiratory rate of 28/min, a heart rate of 124/min. The child has moist mucus membranes, and his color is pink. He has brisk capillary refill. The child looks around the room, maintains contact with you and the father. He cries when his ears are examined, but is easily consoled. Which of the following statement best depicts the clinical scenario?
A. His Yale Observation Score suggests serious bacterial infection.
B. The child has a 50% change of needing hospitalization.
C. Serious bacterial infection can be predicted by the child=s response to an antipyretic.
D. Intravenous access should be established as quickly as possible.
E. His Yale Observation Score suggests no serious bacterial infection
2. Which febrile 8-month-old child is at the greatest immediate risk?
A. Temperature 1040F, witnessed seizure, now taking bottle quietly.
B. Temperature 1040F, seizure, now sleeping and difficult to arouse.
C. Temperature 1040F, with an infectious focus of otitis media.
D. Temperature 1020F, clear rhinorrhea, day-care contact with rotavirus.
3. A previously healthy 16-month-old male had a URI as a prodromal event to temperature spike of 102.10F. The child had no exposure to contagion. He had received the completed series of the conjugate vaccines against Haemophilus influenzae and Streptococcus pneumoniae. According to the AAP, ACEP guidelines you should:
A. Give the child 50mg/kg of Rocephin IM.
B. Perform a lumbar puncture.
C. Acquire a chest x-ray.
D. Provide supportive care.
E. Contact the child™s private physician.
4. A 21-day-old male presents with fever of 102.50F. The patient had been symptomatic for less than a four-hour period. There had been no recognized exposures. The child was born at term after an uncomplicated pregnancy. Labor and delivery were unremarkable. Exam revealed a vigorous child without apparent focus of infection. Heart rate 120/min, RR 38/min. No rash. Brisk capillary refilling time. According to the AAP, ACEP guidelines you should acquire:
A. No laboratory evaluations.
B. CBC, Blood culture, UA.
C. CBC, Blood culture, UA, chest x-ray.
D. CBC, Blood culture, UA, chest x-ray, lumbar puncture.
E. CBC, Blood culture, UA, urine culture, lumbar puncture.
5. A 28-month-old male presents with fever of 1040F. The patient has been ill for a twelve-hour time frame. There had been no recognized exposures. Past medical history was benign. Exam reveals good tone, eye contact, motor activity, coloration and responsiveness. Otitis media is apparent. Appropriate management includes:
A. Blood culture, Rocephin 75mg/kg
B. Amoxicillin by mouth T.I.D. for ten days.
C. UA, urine culture, chest x-ray, oral antibiotics.
D. Blood sugar, blood culture, lumbar puncture.
E CBC, blood culture, Amoxicillin T.I.D. for 10 day
A. His Yale Observation Score suggests serious bacterial infection.
B. The child has a 50% change of needing hospitalization.
C. Serious bacterial infection can be predicted by the child=s response to an antipyretic.
D. Intravenous access should be established as quickly as possible.
E. His Yale Observation Score suggests no serious bacterial infection
2. Which febrile 8-month-old child is at the greatest immediate risk?
A. Temperature 1040F, witnessed seizure, now taking bottle quietly.
B. Temperature 1040F, seizure, now sleeping and difficult to arouse.
C. Temperature 1040F, with an infectious focus of otitis media.
D. Temperature 1020F, clear rhinorrhea, day-care contact with rotavirus.
3. A previously healthy 16-month-old male had a URI as a prodromal event to temperature spike of 102.10F. The child had no exposure to contagion. He had received the completed series of the conjugate vaccines against Haemophilus influenzae and Streptococcus pneumoniae. According to the AAP, ACEP guidelines you should:
A. Give the child 50mg/kg of Rocephin IM.
B. Perform a lumbar puncture.
C. Acquire a chest x-ray.
D. Provide supportive care.
E. Contact the child™s private physician.
4. A 21-day-old male presents with fever of 102.50F. The patient had been symptomatic for less than a four-hour period. There had been no recognized exposures. The child was born at term after an uncomplicated pregnancy. Labor and delivery were unremarkable. Exam revealed a vigorous child without apparent focus of infection. Heart rate 120/min, RR 38/min. No rash. Brisk capillary refilling time. According to the AAP, ACEP guidelines you should acquire:
A. No laboratory evaluations.
B. CBC, Blood culture, UA.
C. CBC, Blood culture, UA, chest x-ray.
D. CBC, Blood culture, UA, chest x-ray, lumbar puncture.
E. CBC, Blood culture, UA, urine culture, lumbar puncture.
5. A 28-month-old male presents with fever of 1040F. The patient has been ill for a twelve-hour time frame. There had been no recognized exposures. Past medical history was benign. Exam reveals good tone, eye contact, motor activity, coloration and responsiveness. Otitis media is apparent. Appropriate management includes:
A. Blood culture, Rocephin 75mg/kg
B. Amoxicillin by mouth T.I.D. for ten days.
C. UA, urine culture, chest x-ray, oral antibiotics.
D. Blood sugar, blood culture, lumbar puncture.
E CBC, blood culture, Amoxicillin T.I.D. for 10 day