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Pediatrics Course Information

Pediatrics Review Course Information

Growth and Development

Development Milestones
Failure to Thrive
Normal Growth
Obesity

Preventive Pediatrics

Anticipatory Guidance
Childhood Immunizations
Disease Prevention
Periodic Health Examination / Screening

Poisoning and Environmental Exposure to Hazardous Substances

Acetaminophen Toxicity
Anticholinergics Toxicity
Anticonvulsant Toxicity
Antidepressants Toxicity (incl. Serotonin Syndrome)
Aspirin and NSAIDs Toxicity
Cardiovascular Drug Toxicity
Caustic Ingestion
Cocaine and Other Sympathomimetics Toxicity
Hallucinogen Toxicity
Heavy Metal Toxicity
Hydrocarbon Toxicity
Inhaled Toxins
Lithium Toxicity
Opiate Toxicity
Pesticide Toxicity (incl. Organophosphates)
Sedatives and Hypnotics Toxicity (incl. Barbiturates, Benzodiazepines)
Toxic Alcohols
Toxic Plant Ingestions (incl. Mushrooms)

Fetus and Newborn Infant

Delivery Room
Effects of Maternal Conditions, Medications, and Substance Abuse
Jaundice in Newborn Infants
Newborn Conditions and Diseases
Newborn Respiratory Distress and Cyanosis
Routine Care of the Newborn Infant

Genetics and Dysmorphology

Inheritance
Gene Syndromes and Associations
Diagnostic Testing and Counseling
Chromosome Abnormalities
Gene Abnormalities

Allergic and Immunologic Disorders

Allergic Reactions
Allergic Rhinitis
Allergy-Induced Asthma
Immunodeficiency Disorders
Allergy Testing & Immunotherapy

Infectious Diseases

Bacterial Infections
HIV/AIDS
Infections in Immunocompromised Hosts
MRSA in the Pediatric Population
Parasitic Infections
Prevention of Infectious Disease
Soft Tissue Infections
Systemic Fungal Infections
Viral Infections

Endocrinology, Metabolism, and Nutrition

Adrenal Insufficiency
Diabetes
Disorders of Calcium
Metabolism Fluids and Electrolytes
Hypoglycemia
Inborn Errors of Metabolism
Infant Feeding
Lactic Acidosis
Normal Nutritional Requirements
Thyroid Disease

Gastrointestinal Disorders

Acute and Chronic Abdominal Pain
Constipation
Diarrhea
Esophageal Disorders and Foreign Bodies
Gastrointestinal Bleeding
Gastrointestinal Disorders in Newborn Infants
Inflammatory Bowel Disease
Jaundice
Malabsorption
Vomiting

Respiratory Disorders

Parenchyma
Asthma
Extrapulmonary / Heart Failure
Infant and Ciliary Conditions
Lower Airway
Pneumonia
Signs and Symptoms
Sleep Apnea / Respiratory Diagnostic Testing
Upper Airway SIDS and Brief Resolved Unexplained Events (BRUE)

Cardiovascular Disorders

Clinical Presentations of Cardiovascular Disorders
Congestive Heart Failure
Congenital Heart Disease
Acquired Heart Disease
Myocarditis and Pericarditis
Rate and Rhythm Disorders
Systemic Diseases Affecting the Heart
Cardiomyopathies
Hypertension
Valvular Heart Disease

Blood and Neoplastic Disorders

Erythrocyte Disorders
Coagulation Disorders
Leukocyte Disorders
General Aspects of Blood and Neoplastic Disorders
Neoplastic Disorders
Platelet Disorders
Pancytopenia

Renal and Urologic Disorders

General Renal and Urologic Disorders
Infections of the Urinary Tract
Renal Failure

Neurologic Disorders

Altered Levels of Consciousness and Neurodegenerative Disorders
Cerebrovascular Disease
Headaches & Intracranial Pressure
Infectious Causes of Neurologic Disorders
Movement Disorders (incl. Ataxia)
Peripheral Nerve and Neuromuscular Junction Disorders
Seizures
Spinal Cord Disease and Dysraphism
Weakness and Muscle Disease (incl. Hypotonia and Cerebral Palsy)

Musculoskeletal Disorders, Orthopedics, and Sports Medicine

Evaluation for Sports Participation
Musculoskeletal Disorders
Orthopedic Injuries

Skin Disorders

Acne
Dermatitis
Infectious Rashes
Other Dermatologic Disorders
Pigmented Lesions
Skin Disorders in Newborn Infants

Collagen Vascular and Other Multisystem Disorders

Arthritis
Systemic Lupus Erythematosus
Vasculitis Syndromes

Eye, Ear, Nose and Throat Disorders

Dental and Oral Disorders
EENT Infections
External Disorders of the Eye
Internal Disorders of the Eye
Miscellaneous Disorders of the Eye
Nasal Disorders
Throat Disorders

Adolescent Medicine and Gynecology

Female Pubertal Development
Gynecologic Health Care
Male Pubertal Development
Pregnancy and Contraception
Self-Identity and Family Influence
Sexuality and Emotional Development
Sexually Transmitted Infections

Behavioral and Mental Health Issues

Autism Spectrum Disorders
Child Abuse
Disorders of Attention and Impulse Control
Eating Disorders
Mood and Affect Disorders
Suicidal Behavior, Psychotic Behavior, Thought Disorders
Pediatric Substance Abuse

Critical and Emergency Care

Abdominal, Chest, and Multisystem Trauma
Burns and Fractures
Common Conditions Requiring Life Support
Emergency Life Support
Emergent Fever and Seizure Care
Head and CNS Trauma
Impending Systemic Failure
Wounds

Pharmacology and Pain Management

ADHD: Non-Stimulant Medications
ADHD: Stimulant Medications
Pain Management
Pharmacology
Procedural Sedation

Ethics, Patient Safety, and Quality Improvement

Communication, Family, and Cultural Issues
End-of-Life Care
Medical Error Prevention
Medical Ethics

Sample Question 1

A 14-year-old boy complains of a severe migraine that has worsened over the past few hours. He experiences his typical aura and nausea. The pain does not improve with ibuprofen. What treatment should he try next?

aspirin
triptan
topiramate
acetaminophen
codeine

The 2 treatments commonly used for acute migraine attacks are nonsteroidal anti-inflammatory drugs and triptans. Ibuprofen or naproxen sodium should be taken at the onset of headache but no more than a few times per week. The goal of acute treatment should be relief within 1 hour.

A triptan should be added for a moderate to severe headache but should not be taken more than 4-6 times per month. Adequate hydration is essential when taking a triptan due to the vascular constriction symptoms.

Reference:
Hershey AD. Headaches. In: Kliegman RM, et al, eds. Nelson Textbook of Pediatrics. 19th ed., 2011:2039-2046.

Sample Question 2

A 2-year-old boy is rushed to you by his mother. He has been ill for a few days with fever and vomiting, but he is now having voluminous stools. He has dry mucous membranes, poor skin turgor, and minimal urine output. He has a fever of 104 °F, but his hands and feet are cool.

What type of shock is he most likely experiencing?

obstructive
septic
hypovolemic
cardiogenic

Educational Objective:

Characterize the clinical presentation of hypovolemic shock.

Explanation:

Shock is caused by the inability of the body to distribute enough oxygen to the organs and tissues. Hypovolemic shock is the most common cause of shock in the pediatric population. It is normally caused by diarrhea, vomiting, or heavy bleeding, which in turn causes a decreased preload.

Cardiogenic shock is due to poor myocardial function. Obstructive shock is due to a mechanical barrier limiting cardiac output. Distributive shock is caused by poor vasomotor tone. Septic shock often involves a combination of distributive, hypovolemic, and cardiogenic types of shock.

Reference:

Turner DA, Chiefetz IM. Shock. In: Kliegman RM, et al. Nelson Textbook of Pediatrics. 19th ed., 2015:305-313.

Sample Question 3

A boy spikes a fever and starts vomiting. His parents increase his clear fluid intake and offer acetaminophen. When he develops signs of dehydration, the parents bring him in to see you.

Which of the following males is most likely to have urinary tract infections (UTIs)?

infant boy
toddler boy undergoing toilet training
elementary school boy with constipation
uncircumcised teenage boy

Educational Objective:

Recognize the characteristics of children more likely to develop urinary tract infections.

Key Point:

Infant boys (especially if uncircumcised), infant girls, and girls who are toilet training are the children most likely to develop UTIs.

Explanation:

Boys younger than 1 years of age are more likely than girls to develop UTIs (male:female ratio of 2.8 to 5.4:1). Uncircumcised boys develop them more often. After infancy, girls are more likely to have UTI. The peak incidence for UTIs in girls occurs during infancy and toilet training.

Other risk factors include constipation, vesicoureteral reflux, voiding dysfunction, wiping hygiene (in girls), labial adhesion, neuropathic bladder, sexual activity, and pregnancy.

Reference:

Elder JS. Urinary tract infections (chapter 538). In: Kliegman RM, et al, eds. Nelson Textbook of Pediatrics. 20th ed., 2016: 2556-2562.

Sample Question 4

An 11-year-old girl with known heart arrhythmia is started on extended-release guanfacine for the treatment of attention deficit-hyperactivity disorder. How should the treatment be initiated?

starting dose 1 mg, titrated to effect at biweekly intervals in 2-mg steps, maximum dose 7 mg/day
starting dose 1 mg, titrated to effect at weekly intervals in 0.5-mg steps, maximum dose 4 mg/day
starting dose 1 mg, titrated to effect at weekly intervals in 1-mg steps, maximum dose 4 mg/day
starting dose 2 mg, titrated to effect at weekly intervals in 1-mg steps, maximum dose 4 mg/day
starting dose 2 mg, titrated to effect at weekly intervals in 1-mg steps, maximum dose 4 mg/day

Correct!

Extended-release guanfacine should be started at an initial dose of 1 mg/day. It should be titrated to effect at weekly intervals in 1-mg increments to a maximum dose of 4 mg/day.

Reference:
Wolraich M, Brown L, Brown RT, et al; Subcommittee on Attention-Deficit/Hyperactivity Disorder; Steering Committee on Quality Improvement and Management. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011;128(5):1007-1022.

Sample Question 5

A 14-year-old boy presents with 1-day history of abdominal pain and bloody diarrhea. His mother reports that several other friends are sick with similar symptoms. Enterohemorrhagic Escherichia coli 0157:H7 (EHEC) has been held responsible for a number of outbreaks of acute gastroenteritis from undercooked meats, contaminated water, and other sources. Which of the following is true concerning EHEC?

Commonly acquired through contact with reptiles.
Treatment consists of hydration and antibiotics.
Bloody diarrhea is rarely present in patients with EHEC.
Renal failure, microangiopathic hemolytic anemia, and thrombocytopenia (hemolytic uremic syndrome [HUS]) due to EHEC are most frequently seen in children.
Most patients with EHEC gastroenteritis require hospital admission.

Also known as Shiga-toxin producing E. coli, enterohemorrhagic E. coli infection starts like a bad case of traveller’s diarrhea, then progresses to vomiting, crampy abdominal pain, and diarrhea that eventually becomes bloody. The abdominal exammay resemble an acute abdomen (similar to campylobacter), but fever will be absent or minor ; Fecal WBC are scant, but feces will test positive for Shiga toxin. HUS occurs in 5% of cases. Usually, children and elderly are at greatest risk. It is estimated that 25-50% of patients with EHEC require hospitalization. Treatment is only supportive. Antibiotics and antimotility agents increase the risk of HUS.

Reference:

Menne J, Nitschke M, Stingele R, et al; EHEC-HUS consortium. Validation of treatment strategies for enterohaemorrhagic Escherichia coli O104:H4 induced haemolytic uraemic syndrome: case-control study. BMJ. 2012;345:e4565.

Target Audience

Med-Challenger PEDS is intended for practitioners of acute and primary care or clinicians otherwise involved in the diagnosis and treatment of acute, emergent, or chronic medical problems.

Educational Objectives

After completing this activity, the participant should be better able to:

Manage the broad spectrum of acute and chronic medical problems encountered in the practice of pediatric medicine.
Formulate appropriate differential diagnoses for patients presenting with acute and chronic medical problems of uncertain etiology.
initiate therapeutic and diagnostic procedures for patients presenting with acute and chronic medical disorders.
Manage the initial treatment of acute and chronic disorders effectively.
Diagnose and treat the spectrum of common pediatric disorders involving all organ systems.
Demonstrate mastery of the knowledge and cognitive skills required to achieve objectives 1-5 by scoring at least 80% on all topics studied for CME credit.

Faculty

Kathleen K. Aiello, MD, FAAP
Pediatrician
Ambler Pediatrics
Ambler, PA

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and Challenger Corporation. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Designation Statement

AMA Credit - The Postgraduate Institute for Medicine designates this enduring material for a maximum of 167.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ANCC Credit - The maximum number of hours awarded for this Continuing Nursing Education activity is 167.0 contact hours.

ABP MOC Points - Successful completion of this CME activity, which includes participation in the activity and individual assessment of and feedback to the learner, enables the learner to earn up to 167 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit learner completion information to ACCME for the purpose of granting ABP MOC credit.

AAP Credit - This continuing medical education activity has been reviewed by the American Academy of Pediatrics and is acceptable for a maximum of 167.00 AAP credits. These credits can be applied toward the AAP CME/CPD Award available to Fellows and Candidate Members of the American Academy of Pediatrics.

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Pediatrics Board Review
Product Comparison

Take a look at premiere Pediatrics knowledge products from leading vendors.

FEATURE	MED-C PEDS	Pass Machine	True Learn	Board Vitals
Questions	1700+	600	1000	1500
AMA Cat 1 CME	167	54.75	No CME	45
AAP CME	167	0	No CME	0
ABP MOC Part 2 Points	167	No Points	No Points	30
Ongoing Updates	Yes	No	No	No
Exam Simulator	Yes	No	No	No
Learning Rx	Yes	No	No	No
Low-Cost Renewal	Yes	No	No	No

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