Multiprofessional Critical Care Review: Pediatric 2024 (MCCRCP24ON)-MCCRCPeds_BoardReviewAnswers_Part4

MCCRCPeds_BoardReviewAnswers_Part4_2024

Pdf Summary

The text comprises a series of medical case studies and questions related to pediatric emergency and intensive care. Each case study presents a clinical scenario followed by a set of multiple-choice questions and detailed rationales explaining the correct answers.<br /><br />Here are summaries of the key cases:<br /><br />1. **4-month-old Boy with Severe Traumatic Brain Injury (TBI)**: The boy presents with a Glasgow Coma Scale score of 6 and a large subdural hematoma. The treatment involves maintaining cerebral perfusion pressure greater than 40 mm Hg and aggressively managing elevated temperatures.<br /><br />2. **4-year-old Boy with Bilateral Lower Extremity Weakness**: Symptoms suggest Guillain-Barré syndrome (GBS) following a respiratory infection. Management should include supportive care, possible intubation, and monitoring for respiratory failure.<br /><br />3. **18-month-old Boy with Metoprolol Toxicity**: The child presents with bradycardia and hypotension after ingesting metoprolol. Treatment sequence includes fluid bolus, glucagon, epinephrine, and possibly dextrose and high-dose insulin therapy.<br /><br />4. **16-year-old Girl with Suspected Methanol Poisoning**: The girl has severe metabolic acidosis and requires hemodialysis due to suspected methanol ingestion, alongside treatment with fomepizole.<br /><br />5. **15-year-old Boy with Spinal Cord Injury**: Following a high fall, the boy presents with T10 vertebra burst fracture and lower extremity issues. Immediate care includes pressure ulcer prevention, venous thromboembolism prophylaxis, and managing urinary retention.<br /><br />6. **17-year-old Girl with Drug Overdose**: She showed signs of ingested diphenhydramine toxicity resulting in wide complex tachycardia, best treated with sodium bicarbonate to address acidosis and support cardiac function.<br /><br />7. **4-year-old Girl with Suspected Pesticide Poisoning**: Presenting with cholinergic symptoms such as drooling, miosis, and muscle fasciculations, management involves atropine administration.<br /><br />8. **11-year-old Boy with Guillain-Barré Syndrome**: Predictors of increased respiratory support need include bulbar weakness.<br /><br />9. **8-year-old Girl with Altered Mental Status and Hydrocephalus**: A CT scan shows interstitial edema due to increased intraventricular pressure from a posterior fossa tumor.<br /><br />Each case entails specific treatment protocols rooted in detailed understanding and guidelines for managing various critical conditions in pediatric patients. These summaries would aid healthcare providers in identifying and administering appropriate treatments.

Keywords

pediatric emergency

intensive care

traumatic brain injury

Guillain-Barré syndrome

metoprolol toxicity

methanol poisoning

spinal cord injury

drug overdose

pesticide poisoning

hydrocephalus

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