Pediatrics flash lessons learned

"Does This Child Have Acute Otitis Media?" R Rothman et all

Otitis media costs about $5billion a year. 

Happens most in kids 6-18months old.

Breast feeding is protective.

S. pneumoniae, H. influenza (often co-existing conjunctivitis), C. moraxella.

Look at position, color, landmarks, degree of translucency, and mobility.

Ear pain is the only useful symptom, but only has a likelihood ratio of only 3.0. 

Signs are more useful:

Distinctly impaired mobility has LR of 31.

Cloudy opaque eardrums also have LR of 34.

Bulging has LR of 51.

In conclusion, "a tympanic membrane that is cloudy, bulging, or distinctly immobile is highly suggestive of acute otitis media".

I also learned about magic mouth wash for the mouth lesions that cocksackie virus causes (BMX = lidocaine+malox,+diphenhydramine)

The difference between lactose intolerance and milk protein allergy.

Difference between allergy shiner and Dennie-Morgan Folds.

Amelogenesis Imperfecta vs. Enamel Hypoplasia

HEEADSSS survey for adolescents.

How ring worm can cause kerions.

The 5S's of comforting babies (Suck, Swing, Swaddle, Shhh, Side/stomach position).

Treat ring worm with clotrimazole unless under hair where you need griseofulvin.

I loved this brief 2-week window into pediatrics. I seem to get along with kids pretty well and can put their parents at ease by clearly explaining everything I'm doing and the reason I'm doing it (or asking for it).

The most frustrating thing about pediatrics for me was the lack of interest and pride in gynecologic care of their female patients and overall sexual health of both males and females. The reality is that many kids are having sex in their teens and it has a profound effect on their physical and mental health. I want to practice in a specialty that allows me to directly address sexual health in a proactive rather than reactive way.