ABP Pediatric Hospital Medicine flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Bronchiolitis first-line treatment

Supportive care: oxygen if SpO2 <90%, hydration, nasal suctioning. Bronchodilators, steroids, and antibiotics are not routinely recommended.

CAP empiric therapy >3 months

Ampicillin or penicillin for typical bacteria; add macrolide if atypical pathogens suspected (e.g., Mycoplasma).

Dehydration ORS volumes

Mild (3-5%): 50 mL/kg; moderate (6-9%): 100 mL/kg; severe (≥10%): 20 mL/kg IV boluses.

Asthma exacerbation first-line

Inhaled short-acting beta-agonist (albuterol) via MDI with spacer or nebulizer; add ipratropium and systemic corticosteroids for moderate-severe.

Febrile infant 0-28 days

Full sepsis workup and empiric antibiotics (ampicillin + gentamicin or cefotaxime) are standard.

UTI empiric therapy

Parenteral ceftriaxone or cefotaxime for febrile infants; adjust based on culture. Renal ultrasound for <2 years or recurrent UTI.

Status epilepticus first-line

Benzodiazepines: lorazepam 0.1 mg/kg IV or midazolam 0.2 mg/kg IM.

Holliday-Segar maintenance fluids

100 mL/kg/day for first 10 kg, 50 mL/kg/day for next 10 kg, 20 mL/kg/day for remaining kg.

Neonatal hyperbilirubinemia treatment

Phototherapy threshold based on age in hours, gestational age, and risk factors; exchange transfusion for higher levels.

I-PASS handoff

Illness severity, Patient summary, Action list, Situation awareness, Synthesis by receiver.

Discharge follow-up timing

High-risk patients: follow-up within 48-72 hours; provide written instructions and medication reconciliation.

Pediatric medication error prevention

Use computerized order entry and double-check weight-based dosing calculations.

GRADE framework

System for rating quality of evidence and strength of recommendations, considering patient values and preferences.

PDSA cycle

Plan-Do-Study-Act: iterative quality improvement method; measure outcomes, process, and balancing measures.

Family-centered rounds

Include parents in decision-making; improves satisfaction and reduces errors.

Transition to adult care

Start planning in early adolescence for children with chronic conditions; assess self-management skills.

Bronchiolitis oxygen target

Maintain SpO2 >90% with supplemental oxygen as needed.

CAP atypical pathogens

Mycoplasma pneumoniae common in school-aged children; add macrolide if suspected.

Severe dehydration IV bolus

20 mL/kg isotonic crystalloid (e.g., 0.9% NaCl) bolus, reassess and repeat as needed.

Asthma corticosteroid timing

Systemic corticosteroids within 1 hour for moderate-severe exacerbations.

Febrile infant 29-90 days

Risk stratification (e.g., Rochester criteria) guides workup; may avoid lumbar puncture if low risk.

UTI urine culture

Obtain before starting antibiotics; preferably via catheter or suprapubic aspirate in infants.

Status epilepticus second-line

Fosphenytoin, levetiracetam, or valproate after benzodiazepines.

Isotonic maintenance fluid

0.9% NaCl with 5% dextrose; avoids hyponatremia compared to hypotonic fluids.

Kernicterus risk factors

Hemolysis, prematurity, sepsis, and rapid bilirubin rise increase risk.

Multidisciplinary team

Includes nurses, pharmacists, social work, case management to address social determinants of health.

Medication reconciliation

Review all medications at admission and discharge to prevent discrepancies and errors.

Balancing measures

Assess unintended consequences of quality improvement interventions.

Self-management skills

Assess adolescent's ability to manage chronic condition before transition to adult care.

Written discharge instructions

Provide clear, written instructions including follow-up, medications, and warning signs.

Computerized order entry

Reduces medication errors by standardizing dosing and checking for allergies/interactions.

Patient values in GRADE

Consider patient preferences and values when making recommendations.