TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED
FIRST PUBLISHED: SEPTEMBER 2024
PAEA PEDIATRICS EOR EXAM 2024-2025 ACTUAL
EXAM 300 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES
what is the MC conjunctivitis seen in children? what is the cause? source? - Answer✔️✔️-
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? -
Answer✔️✔️-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? - Answer✔️✔️-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? - Answer✔️✔️-dx: bacterial conjunctivitis (MC S. aureus, Strep pneumo, H.
influenzae)
,TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED
FIRST PUBLISHED: SEPTEMBER 2024
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? -
Answer✔️✔️-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? - Answer✔️✔️-
ophthalmia neonatorum; corneal ulceration, opacification/scarring, visual
impairment/blindness
standard prophylaxis given immediately after birth to prevent ophthalmia neonatorum
(neonatal conjunctivitis) includes: - Answer✔️✔️-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? - Answer✔️✔️-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? - Answer✔️✔️-sinus; 7-12y; other causes include dental/facial infxns or
bacteremia
,TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED
FIRST PUBLISHED: SEPTEMBER 2024
what is the most common sinus infection (90%) that causes secondary orbital cellulitis?
what organisms are the cause? - Answer✔️✔️-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? - Answer✔️✔️-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? - Answer✔️✔️-
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?
- Answer✔️✔️-strabismus; 2-3 mos
convergent strabismus is aka? divergent strabismus is aka? - Answer✔️✔️-convergent:
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? - Answer✔️✔️-strabismus; cover-uncover test to determine the angle of
strabismus, cover test, convergence testing
how can strabismus be treated? - Answer✔️✔️--patch therapy: normal eye is covered to
stimulate and strengthen the affected eye
, TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS RESERVED
FIRST PUBLISHED: SEPTEMBER 2024
-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? - Answer✔️✔️-
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? - Answer✔️✔️-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 - Answer✔️✔️-a viral URI that causes edema of eustachian tube,