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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

On physical examination of a sexually abused child, which of the following is seen in the majority of cases?

Fimbriated hymen
Labial fusion
No abnormality
Discharge
Torn hymen

The majority of children who have been sexually abused will have a normal examination, either because the physical contact produced no injury or because the injury has healed completely.

Sample Question 2

A 2-year-old girl presents to you with runny nose and coughing. She has not had a fever and is drinking well. She smiles and reaches for the stethoscope. She has mild, clear rhinorrhea, clear lungs, and appears to be well hydrated. She started daycare last week. The girl’s mother is receiving antibiotics for bronchitis.

Which of the following illnesses would most likely require an antibiotic?

3-year-old boy with sore throat, fever, and bumps on his palms and soles
8-year-old boy with vomiting, diarrhea, and fever
2-year-old girl with cough and rhinorrhea whose mother is being treated for bronchitis
9-year-old girl with sore throat, fever, and sandpaper rash

Educational Objective:

Identify situations for which antibiotic use is appropriate.

Key Point:

Antibiotics are useful for bacterial illnesses but not viral illnesses. Antibiotics should be used to treat scarlet fever.

Explanation:

Antibiotics should be used when the benefits outweigh the risks of medication's side effects or antibiotic resistance. Resistance develops when bacteria develop the ability to defeat the antibiotic. Overuse of antibiotics contributes to resistance, and antibiotics should not be prescribed for the treatment of viral processes.

The only illness likely caused by a bacterial illness is the girl with sore throat, fever, and sandpaper rash. She probably has scarlet fever with streptococcal pharyngitis and should be treated with antibiotics.

The 2-year-old girl most likely has a viral respiratory illness. The 8-year-old boy has viral gastroenteritis. The 3-year-old boy most likely has hand, foot, and mouth syndrome, which is caused by coxsackievirus.

Reference:

Centers for Disease Control and Prevention. Antibiotic prescribing and use. Updated April 6, 2018. Accessed September 10, 2018.

Sample Question 3

A newborn boy presents with poor feeding and lethargy on his third day of life.   He was a full-term baby who was precipitously delivered in the emergency department. Prior to this presentation, he had been breastfeeding well with good urine and stool output. 

What is the most likely cause of his lethargy?

intracranial hemorrhage
hypokalemia
infection
hyperglycemia
congenital heart disease

The differential diagnosis of lethargy in a newborn includes infection, asphyxia, hypoglycemia, hypercapnia, an intracranial defect, inborn error of metabolism, or effects from maternal analgesia or anesthesia

Infection is the first diagnosis that should be ruled out when lethargy appears after the second day of life. The other choices are not part of the differential.

Reference:

Kliegman RM, et al, eds. Nelson Textbook of Pediatrics. 20th ed., 2016.

Sample Question 4

A 6-year-old boy presents with signs of right-sided heart failure. On examination, you note a loud systolic ejection click heard in the second left intercostal space.

What is the most likely diagnosis in this patient?

ventricular septal defect (VSD)
coarctation of the aorta
pulmonary stenosis
first-degree heart block

Educational Objective:

Describe the presentation of pulmonic stenosis.

Key Point:

Cases of severe pulmonary valve stenosis can present with signs of right-sided heart failure such as hepatomegaly and edema. A pulmonic ejection click may be heard after the first heart sound near the left upper sternal border.

Explanation:

The most likely diagnosis is pulmonary stenosis. Patients with severe pulmonary stenosis may present with signs of right-sided heart failure and heart murmur. A loud pulmonary ejection click can be heard on auscultation. Those with mild or moderate pulmonary stenosis may be asymptomatic.

A long P-R interval seen on electrocardiography is diagnostic of first-degree heart block. Coarctation of the aorta is associated with hypertension and differential blood pressures in the upper and lower extremities. VSD is usually associated with a holosystolic murmur.

Reference:

Bernstein D. Acyanotic congenital heart disease: regurgitant lesions. In: Kliegman RM, et al, eds. Nelson Textbook of Pediatrics. 20th ed., 2016:2209-2210.

Sample Question 5

A 17-year-old girl has been hospitalized for several days because of stimulant-induced rhabdomyolysis. Her initial creatine kinase level was 17,000 IU/L but is now 50,000 IU/L. She is no longer tachycardic, hypertensive, agitated, or confused. Her serum creatinine has bumped to 2.4 mg/dL. You are called to respond when she has the following results on electrocardiography (ECG; see Figure 1).

Figure 1.

Just prior to this rhythm, findings on ECG looked like this (see Figure 2).

Figure 2.

Which of the following electrolyte disturbances is most likely to be the cause of these findings?

hypernatremia
hypokalemia
hyperkalemia
hypocalcemia
hypomagnesemia

Correct!

Findings on the initial ECG is representative of ventricular fibrillation, while results from the second ECG demonstrate a widening of the QRS and peaked T waves. These are findings of hyperkalemia. Hypokalemia, hypomagnesemia, and hypocalcemia are all associated with QT prolongation and torsades de points. Hyperkalemia is commonly associated with rhabdomyolysis due to tissue destruction and release of potassium from intracellular stores.

Reference:
Rao RB, Hoffman RS. Cocaine and other sympathomimetics. In: Marx JA, et al. Rosen's Emergency Medicine. 7th ed., 2010.

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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