Episodic wheeze and multiple trigger wheeze are two types of pre-school wheezing

In paediatrics, pneumonia is an indication to start inhaled corticosteroid to reduce lungs inflammation.

Patients with acute bronchiolitis may not require steroid or bronchodilators

Patients with bronchopulmonary dysplasia usually have atopic triad (eczema, allergic rhinitis and conjuctivitis)

Oral/IV dexamethasone

IV hydrocortisone

Neb budesonide

Neb adrenaline

Oral prednisolone

100mg/kg, correct dose

100mg/kg, incorrect dose

50mg/kg, correct dose

50mg/kg, incorrect dose

10kg child should be given ORS 100ml per purge

Zinc oxide cream can be given to patients with AGE even though the child does not have nappy rash.

Normal saline should not be used for fluid resuscitation due to risk of hypernatremia.

Each sachet of oral rehydration salt should be reconstituted with approximately 8 ounce of water.

To apply zinc oxide first, followed by miconazole cream on affected area, twice a day. This is to prevent miconazole being diluted by zinc oxide.

To apply zinc oxide and miconazole at separate time. E.g. To apply zinc oxide at 6am, 6pm while miconazole to be applied at 9am, 9pm.

To mix both creams and apply at the same time, twice a day. To allow homogenous distribution of both creams.

To apply zinc oxide generously on buttocks after each pampers change while miconazole to be applied twice daily on affected areas. Apply miconazole first, followed by zinc oxide.

30mg BD

40mg OD

40mg EOD

35mg BD

Draw 135ml of albumin 20%, dilute with 45ml of normal saline

Draw 40ml of albumin 20%, dilute with 140ml of normal saline

Draw 140ml of albumin 20%, dilute with 40ml of normal saline

Draw 45ml of albumin 20%, dilute with 135ml of normal saline

Nephrotic syndrome has proteinuria while nephritis has haematuria.

Regular frusemide should used in nephrotic syndrome in paediatrics

Nephrotic syndrome can be treated with steroids while nephritis may not.

One of the characteristic of nephrotic syndrome is azotemia

Mumps, Measle, Rubella (MMR)

Japanese Encephalitis (JE) vaccine (Immojev®)

Pneumococcal conjugate vaccine (Prevenar 13®)

BCG

Amoxicillin for pneumonia to cover streptococcus in pre-school children

Azithromycin for pneumonia to cover atypical pathogens in school age children.

Cloxacillin can be used for skin infection

Vancomycin can be used to cover pseudomonas in hospital acquired pneumonia

High risk of anaphylaxis reaction due to under-developed immunity in neonate

Risk of hyperbilirubinemia due to displacement of bilirubin from albumin by ceftriaxone

Risk of gasping syndrome due to the content of benzyl alcohol as preservative in ceftriaxone.

Risk of thrombopheblitis as ceftriaxone is a vesicant which may damage IV line in neonate.

In a standard PTB treatment in children, intensive phase is usually 2 months, followed by 4 months of maintenance

Separate Anti-TB medications (e.g. 3-FDC and ethambutol) can be mixed and administered together

2-FDC contains isoniazid and pyrazinamide

A standard latent TB treatment in children consists of 3 months of 3-FDC

Doxycycline should be avoided in children less than 8 years old due to teeth discolourisation but it is not an absolute contraindication.

Doxycycline is one of the treatment options for leptospirosis.

Doxycycline is one of the alternative treatment in melioidosis as eradication phase.

Doxycycline should be prepared by using X-temp because it is not stable in syrup BP.

Ceftriaxone

Cefotaxime

Tazocin

Meropenem

Ceftazidime for intensive phase of melioidosis

Ceftriaxone for severe leptospirosis

Bactrim for eradication phase of melioidosis

Amoxicillin for mild leptospirosis

1g/kg (6h),

2g/kg (24h)

1g/kg (6h),

2g/kg (10h)

Within 4 hours regardless of dose

Within 6 hours regardless of dose

IVIG from pusat darah negara is preferred to be used in hand foot mouth disease

IVIG should be diluted prior to administration to avoid cardiac arrhythmia

IVIG provides active immunity to patients

Non-live vaccines should be delayed after IVIG administration

Oral N-acetyl cysteine

Salbutamol nebulization

Sodium chloride 3% nebulization

Bromhexine

pMDI should be shaken before each puff

pMDI with aerochamber should not be used when child is sleeping

GINA 2024 recommends all children with asthma >6years old to be prescribed with inhaled corticosteroid (either given regular dose or when salbutamol is required)

Balance in pMDI can be estimated by shaking the cannister