UC Davis Health
Department of Pediatrics

Pediagogy Podcast | Department of Pediatrics | UC Davis Health

A pediatric education podcast

Pediagogy™

Pediagogy™ is an evidence-based podcast, reviewed by expert specialists, and made by UC Davis Children’s Hospital physicians.

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Pediagogy, a pediatric education podcast

About the Pediagogy™ Podcast

Tammy Yau and Lindia Park
Pediatricians Lidia Park and Tammy Yau

Pedagogy is the art and science of teaching. In this same regard, Pediagogy was created with the goal of teaching on-the-go medical students, residents, and any other interested learners about bread-and-butter pediatrics. Pediagogy is an evidence-based podcast, reviewed by expert specialists, and made by UC Davis Children’s Hospital physicians.

Let’s learn about kids!

  • CCHD Screen

    Ever wonder what CCHD meant on a newborn discharge summary? Learn about how we screen for Critical Congenital Heart Defects in newborns (and which ones we miss!) in this episode.

    This episode was written by Lidia Park and Tammy Yau with content support from Heather Siefkes. Lidia and Tammy take full responsibility for any errors or misinformation.

    Key Points:

    • Critical Congenital Heart Defects (CCHD) screening looks for heart defects that can be life threatening in infancy such as coarctation of the aorta, single ventricle defects like hypoplastic left heart syndrome, Tetralogy of Fallot (ToF), pulmonary atresia, total anomalous pulmonary venous return (TAPVR), transposition of the great arteries (TGA), and tricuspid atresia (TA).
    • CCHD screening does not detect atrial septal defects (ASD), ventricular septal defects (VSD), or atrioventricular septal defects (AVSD)
    • CCHD screening is performed by checking the pulse oximeter of the right hand and either foot of a newborn. SpO2 less than 90% is an automatic fail. SpO2 differences of 3% or more or SpO2 91-95% should be repeated twice before counting as a fail. Failed CCHD’s should be followed up with an echocardiogram.

    Sources:
    CDC: Clinical Screening and Diagnosis for Critical Congenital Heart Defects | Congenital Heart Defects (CHDs) | CDC
    BMC Pediatric 2021, Jullien S. Newborn pulse oximetry screening for critical congenital heart defects. doi:10.1186/s12887-021-02520-7
    Pediatrics 2011, Kemper AR, Mahle WT, Martin GR, et al. Strategies for implementing screening for critical congenital heart disease. doi:10.1542/peds.2011-1317

  • Kawasaki Disease

    In this episode, we have some special guests, Daniel Dodson, and one of our medical students, Aneri Patel, talk to us about Kawasaki disease. Special thanks to Natasha Nakra for content review.

    Key points:

    • Vasculitis with the clinical features in the mnemonic CRASH and Burn
    • Incomplete Kawasaki has lab features including elevated ESR and CRP, thrombocytosis, hypoalbuminemia, anemia, elevated ALT, leukocytosis, and sterile pyuria.
    • Treatment is to prevent coronary artery aneurysms with IVIG and aspirin.

    References:

  • Maintenance Fluids

    In this episode, listeners will learn about the intricacies of how the AAP guidelines came to be on maintenance intravenous fluids for pediatric patients. Get ready to learn about the 4-2-1 rule and breakdown some misconceptions about fluids based on adult data!

    This episode was written by Tammy Yau and Lidia Park with content support from Alexis Toney, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • Remember the 4-2-1 rule for calculating maintenance fluids in children
    • Use of hypotonic fluids is based on historical data in healthy children
    • Data now supports use of isotonic fluids like NS or LR to reduce risk of hyponatremia and SIADH
    • Newer data may support LR over NS

    Supplemental Information:

  • Obesity Management

    Let’s briefly discuss the new 2023 AAP obesity guidelines in this episode.

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

    This episode was written by Tammy Yau and Lidia Park, with content support from Sean Munoz. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Obesity is now the most common chronic disease of childhood
    • Children 10 years of age and older with obesity should have lipid, A1c, and ALT checked.
    • Children ages 2-9 with obesity should have lipid checked and potentially ALT
    • Treatment is multimodal and includes lifestyle modification, medications, and surgery.

    AAP 2023 obesity guidelines:

  • DKA

    Join us as we go through this “sweet” episode on diabetic ketoacidosis (DKA) causes, presentation, and management, while learning a fun UC Davis hospital historical fact!

    This episode was written by Tammy Yau and Lidia Park with content support from Nicole Glaser, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • DKA presents with hyperglycemia, ketosis, and anion gap metabolic acidosis, which if severe can cause cerebral edema and CNS dysfunction
    • Initial management includes fluid resuscitation and IV insulin -Learn about the 2-bag IV fluid system for DKA
    • Correct for hyponatremia in hyperglycemia
    • Learn about how to manage potassium, bicarbonate, and phosphorus in DKA

    Supplemental Information:

  • Type 1 Diabetes

    Learn how to be a mini-endocrinologist as we talk about how to differentiate Type 1 from Type 2 diabetes and how to create a starter insulin regimen, among other things in today's podcast!

    This episode was written by Tammy Yau and Lidia Park with content support from Nicole Glaser, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • There are specific clinical criteria for diabetes
    • There are some differences to help distinguish between type 1 versus type 2 diabetes
    • Learn about how to manage diabetes on the inpatient floor, including how to calculate total daily insulin dose, correction factors, and carbohydrate ratios.

    Supplemental Information:

  • Type 2 Diabetes

    Got diabetes? Well, which one? With rising childhood obesity rates, we’re getting more of a mix of both! Today we talk about type 2 diabetes and how management can include both medications and lifestyle management.

    This episode was written by Tammy Yau and Lidia Park with content support from Nicole Glaser, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • First line management is insulin when in DKA
    • First line management is lifestyle modification and metformin when not in DKA
    • Consider adding insulin and GLP-1 agonists if still in poor control

    Supplemental Information:

  • Gastroenteritis

    In this hot topic summer episode, listeners will learn about the management of infectious gastroenteritis.

    Follow us on Twitter @Pediagogypod

    This episode was written by Tammy Yau and Lidia Park, with content support from Christopher Kim, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Gastroenteritis is a major cause of pediatric morbidity annually due to dehydration
    • Learn about oral rehydration with balanced electrolyte solutions vs water or sports drinks
    • Understand why we avoid testing and antibiotics
    • Other supportive measures that are available

    Supplemental information:

  • Iron Deficiency Anemia

    Join us today where we discuss one of the most common causes of microcytic anemia in pediatric patients.

    This episode was written by Tammy Yau and Lidia Park, with content support from Anjali Pawar, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Excessive milk consumption inhibits iron absorption. Limit to 16-24 oz/day
    • Iron supplementation dosing depends on gestational age and major food source. Prevention vs treatment dosing also differ.
    • Mentzer index greater than 13 indicates iron deficiency anemia

    Supplemental information:

  • Newborn Jaundice Part 1

    In the first installment of this 2-part episode, we break down the causes of unconjugated (indirect) and conjugated (direct) hyperbilirubinemia.

    This episode was written by Tammy Yau and Lidia Park, with content support from Daphne Say, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Unconjugated hyperbilirubinemia causes are due to increased bilirubin production, decreased liver conjugation, or decreased clearance
    • Conjugated hyperbilirubinemia can be due to outflow or transport problem, infection, metabolic disorders, liver dysfunction, and parenteral nutrition
    • Always consider biliary atresia in a newborn with pale white stools. The earlier the surgical treatment, the better outcomes

    Supplemental Information:

  • Newborn Jaundice Part 2

    Learn about management of newborn jaundice in our 2-part series.

    This episode was written by Tammy Yau and Lidia Park, with content support from Daphne Say, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Unconjugated bilirubin is fat soluble so can cross the blood brain barrier and cause kernicterus
    • Check bilirubin levels at least every 24 hours while a newborn is first hospitalized
    • New AAP guidelines on hyperbilirubinemia management raised phototherapy and exchange transfusion thresholds
    • Transcutaneous bilirubin monitoring has a +/- 3 margin of error

    Supplemental Information:

  • Community Acquired Pneumonia

    Learn how to classify and manage pneumonia in today’s episode!

    This episode was written by Tammy Yau and Lidia Park with content support from Natasha Nakra. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • Pneumonia can be due to bacteria or viruses and there is no reliable way to distinguish the two
    • Pneumonia can be diagnosed clinically based on exam or with a CXR. Lab work is not always necessary
    • Treatment of bacterial pneumonia depends on if you think it is community acquired (first line amoxicillin), atypical (first line azithromycin), or nosocomial/hospital acquired (consider antibiotics for pseudomonal or MRSA coverage)

    Sources:
    AAP 2023, Pinto: https://doi.org/10.1542/aap.ppcqr.396216
    Pediatrics in Review 2017, Messinger: https://doi.org/10.1542/pir.2016-0183
    Pediatric Care Online 2016, Light: https://publications.aap.org/pediatriccare/book/348/chapter/5785224/Pneumonia-Chapter-315
    IDSA 2013: https://doi.org/10.1093/cid/cir531

  • Congenital CMV

    Part 2 of our TORCH series discusses CMV, the most common infectious cause of hearing loss in the US.

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com

    This episode was written by Tammy Yau and Lidia Park, with content support from Dean Blumberg. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Findings include blueberry muffin rash, microcephaly, periventricular calcifications, sensorineural hearing loss, and jaundice.
    • Infection persists lifelong and treatment with valganciclovir is meant to prevent long term sequelae
    • Monitor for myelosuppression with treatment.
    • Frequent hearing screening is needed.

    Sources:

    • AAP Red Book CMV chapter
    • Fowler KB, Boppana SB. Congenital cytomegalovirus infection. Semin Perinatol. 2018 Apr;42(3):149-154. doi: 10.1053/j.semperi.2018.02.002. Epub 2018 Mar 2. PMID: 29503048.

  • Congenital HSV

    Learn about how the virus that causes cold sores can also cause serious complications in infants.

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com

    This episode was written by Tammy Yau and Lidia Park, with content support from Ritu Cheema. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • First time HSV infection in pregnancy is higher risk to infants than reactivation of previous infection
    • Symptoms of neonatal HSV infection include seizures, vesicles, and irritability
    • Diagnose HSV with viral culture or PCR of bodily fluids
    • Use acyclovir to treat infants and pregnant people with HSV infection

    Sources:
    AAFP 2022 https://www.aafp.org/pubs/afp/issues/2002/0315/p1138.html
    Redbook 2021 https://publications.aap.org/redbook/book/347/chapter-abstract/5752755/Herpes-Simplex?redirectedFrom=fulltext
    Neoreview 2018 https://publications.aap.org/neoreviews/article/19/2/e89/87448/Neonatal-Herpes-Simplex-Virus-Infection

  • Congenital Rubella

    We are starting our mini-series on TORCH infections with congenital rubella, a rare disease nowadays in the US but prevalent still worldwide.

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com

    This episode was written by Tammy Yau and Lidia Park, with content support from Dean Blumberg. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Think of this disease in infants of immigrant or under-immunized mothers.
    • Findings include cataracts, retinopathy, PDA, hearing loss, blueberry muffin rash
    • Treatment is supportive, with patients needing to isolate for at least several months.
    • There is little evidence for immunoglobulin to prevent disease

    Sources:

  • Congenital Syphilis

    This week on our series on TORCH infections, we are discussing syphilis, an increasingly prevalent disease in the pediatric population.

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com

    This episode was written by Tammy Yau and Lidia Park, with content support from Elizabeth Partridge. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Most congenital syphilis is asymptomatic. Less commonly will present with rash, snuffles, hepatosplenomegaly, anemia, and jaundice.
    • Untreated disease can cause neurosyphilis and bone defects
    • Compare mother's RPR titers to baby's and look for findings consistent with syphilis.
    • Workup is based on whether mother was adequately treated and includes CBC, LP, skeletal survey, and LFTs.
    • Treatment is with IV penicillin G for 10 days.

    Sources:

    • AAP Red Book Syphilis chapter
    • Sankaran D, Partridge E, Lakshminrusimha S. Congenital Syphilis-An Illustrative Review. Children (Basel). 2023 Jul 29;10(8):1310. doi: 10.3390/children10081310. PMID: 37628309; PMCID: PMC10453258.
    • Fang J, Partridge E, Bautista GM, Sankaran D. Congenital Syphilis Epidemiology, Prevention, and Management in the United States: A 2022 Update. Cureus. 2022 Dec 27;14(12):e33009. doi: 10.7759/cureus.33009. PMID: 36712768; PMCID: PMC9879571.
    • https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf

  • Congenital Toxoplasmosis

    Toxoplasmosis is a parasitic TORCH infection that is often associated with cats but did you know owning a cat is not associated with increased prevalence? Learn more on how the disease is actually acquired and how to prevent infection in this episode!

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

    This episode was written by Tammy Yau and Lidia Park, with content support from Ritu Cheema. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

  • Congenital Varicella

    Despite widespread vaccination, there are still breakthroughs of varicella (commonly known as chicken pox). Let's dive into this episode of our TORCH series.

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com

    This episode was written by Tammy Yau and Lidia Park, with content support from Ritu Cheema. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Transplacental varicella transmission can lead to congenital varicella syndrome which includes dermatomal rash, cicatrix, limb hypoplasia, microcephaly, and cataracts
    • Use Acyclovir to treat neonates and pregnant people with active varicella infection. Congenital varicella syndrome does not require treatment.
    • Varicella immunoglobulin can be used to prevent infection in certain cases including exposed neonates 5 days before delivery and 2 days after delivery.

    Sources:
    VZV in Newborns: Neoreviews (2016) 17 (9): e507–e514. https://doi.org/10.1542/neo.17-9-e507
    TORCH infections: Pediatr Rev (2011) 32 (12): 537–542. https://doi.org/10.1542/pir.32-12-537

  • Hepatitis C Screening

    Learn how research continues to change our ability to detect and treat pediatric patients with hepatitis C in today’s episode.

    This episode was written by Lidia Park and Tammy Yau with content support from Daniel Dodson. Lidia and Tammy take full responsibility for any errors or misinformation.

    Key Points:

    • Perinatal hepatitis C exposure is the most common cause of pediatric hepatitis C infection
    • NAT testing for hepatitis C RNA can be done as early as 2 months of life to detect hepatitis C infection in pediatric patients rather than waiting until 18 months of life when hepatitis C antibody testing can be done
    • Hepatitis C positive moms can still breastfeed but should halt breastfeeding temporarily if breasts are cracked or bleeding

    Sources:

  • Journal Club: Febrile UTI

    Stay up to date with new research on shortening antibiotic treatment duration for urinary tract infections (UTIs) with our episode today where we review a recently published randomized control trial (RCT). Learn how to critically analyze study data and what key points we take away.

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

    This episode was written by Tammy Yau and Lidia Park, with content support from Michelle Hamline. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • A single RCT found similar risk of UTI recurrence in children who received a 5 day course vs 10 day course of antibiotics within the first 30 days

    Sources
    Pediatrics 2024, Montini et al: https://doi.org/10.1542/peds.2023-062598
    BMJ 2007, Montini et al: https://doi.org/10.1136/bmj.39244.692442.55
    Cochrane Rev 2012, Altamimi et al: https://doi.org/10.1002/14651858.CD004872.pub3
    JAMA Ped 2021, Pernica et al: https://doi.org/10.1001/jamapediatrics.2020.6735
    JAMA Ped, 2022, Williams et al: https://doi.org/10.1001/jamapediatrics.2021.5547

  • Phoenix Sepsis Score

    Did you know that if you exercise while you have a fever, you probably meet SIRS criteria? The new Phoenix sepsis scoring systems aims to better categorize sepsis through specific categories based on the patient’s vitals, labs, and medications. Learn with us as we walk through this new scoring system in today’s episode.

    This episode was written by Lidia Park and Tammy Yau with content support from Alexis Toney. Lidia and Tammy take full responsibility for any errors or misinformation.

    Key Points:

    • The Phoenix sepsis score is based out of 13 points. 2 or more points meets sepsis criteria. The score is based on 4 categories: respiratory, cardiovascular, coagulation, and neurologic.
    • The Phoenix sepsis score is better at predicting mortality than SIRS criteria but does not predict morbidity

  • Sepsis

    In this *shocking​* episode, we discuss identifying and managing sepsis and septic shock in the pediatric population. This episode features two of our 2nd year pediatric residents, Victoria and Kat. We are so excited to have them join us and teach us about this very common chief complaint, especially for patients getting admitted to the hospital.

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

    This episode was written by Victoria Tran, Katrina Marks, Tammy Yau, and Lidia Park, with content support from Moonjoo Han. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points

    • Defining and differentiating SIRS, sepsis, and septic shock. Identifying the symptoms of sepsis is important for appropriate patient triage.
    • SIRS comprises of constellation of symptoms. For SIRS criteria, 2 or more criteria must be met, which include hyper/hypothermia, leukocytosis/leukopenia, tachycardia/bradycardia, tachypnea.
    • SIRS + infectious source = sepsis
    • Initial management of sepsis includes broad-spectrum antibiotics and fluid resuscitation with isotonic fluids (typically 10-20 cc/kg)

    Sources:

    • Weiss, Scott L. MD, MSCE, FCCM (Co-Vice Chair) et al. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. Pediatric Critical Care Medicine 21(2):p e52-e106, February 2020. | DOI: 10.1097/PCC.0000000000002198
    • Link: https://journals.lww.com/pccmjournal/Fulltext/2020/02000/Surviving_Sepsis_Campaign_International_Guidelines.20.aspx
    • Menon, Kusum et al. “A Prospective Multicenter Study of Adrenal Function in Critically Ill Children.” American journal of respiratory and critical care medicine: an official journal of the American Thoracic Society, medical section of the American Lung Association. 182.2 (2010): 246–251. Web.

  • Sinusitis

    Prolonged viral upper respiratory symptoms or is it actually sinusitis in disguise? Join us as we discuss all things sinusitis in this episode!

    This episode was written by Tammy Yau and Lidia Park with content support from Natasha Nakra. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • Acute bacterial sinusitis can be clinically diagnosed based on persistent respiratory symptoms lasting more than 10 days without improvement, worsening or new respiratory symptoms after initial improvement, or severe symptoms at onset lasting more than 3 days.
    • First line antibiotic treatment for acute bacterial sinusitis is with amoxicillin or amoxicillin-clavulanate
    • Complications include orbital or intracranial spread of infection

    Sources:
    Pediatrics in Review 2013, Demuri and Wald: https://doi.org/10.1542/pir.34-10-429
    AAP Pediatrics 2013, Wald et al: https://doi.org/10.1542/peds.2013-1071
    Pediatrics 2024, Conway et al: https://doi.org/10.1542/peds.2023-064244

  • UTI and Pyelonephritis

    Help my kid has a UTI! Does cranberry juice have any benefit for UTIs? Find out with us in today’s episode about urinary tract infections (UTIs)!

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

    This episode was written by Tammy Yau and Lidia Park, with content support from Natasha Nakra. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • A fever may be your only symptom in a young child with a UTI
    • If you think it’s a UTI, get a clean specimen for culture. A positive culture has more than 50k CFUs/ml on a catheter sample and more than 100k CFUs/ml on a clean catch/void sample.
    • Most common bacteria causing UTIs are E. coli, Klebsiella, Proteus, Enterococcus, and Enterobacter
    • Simple cystitis may only need 3-10 days of treatment depending on age, whereas pyelonephritis needs 10-14 days.

    Sources

  • Febrile Infants

    Listen up! Today we talk about the management of well-appearing febrile infants aged 8-60 days old including work-up algorithms and treatment. It's a lot of information so pay close attention and you might even want to pull up the AAP guideline diagrams to follow along!

    Follow us on Twitter @Pediagogypod.

    This episode was written by Tammy Yau and Lidia Park with content support from Nathan Kuppermann, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • New strategies for management of febrile infants depending on age (1-3 weeks, 3-4 weeks, or 4-8 weeks)
    • Inflammatory markers like CRP and procalcitonin help to determine if LP is needed in older patients
    • Learn about common bugs that cause infection in infants and the antibiotics we use to treat them
    • Observation of febrile infants is now reduced from 48 hours to 24-36 hours

    Supplemental information:

  • Nursemaid's Elbow

    In today’s episode, you’ll learn how to recognize and reduce this common pediatric orthopedic injury on your own and even teach parents if needed!

    This episode was written by Tammy Yau and Lidia Park with content support from Emily Andrada. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • Nursemaid’s elbow, subluxation of the radial head, or annular ligament displacement all refer to the same injury of the elbow that occurs most often when a child’s arm is pronated and pulled.
    • Treatment of a nursemaid’s is through reduction - either by supinating and flexing the elbow (or) pronating, hyperextending, and then flexing the elbow
    • Imaging is not routinely indicated for highly suspicious nursemaid’s but should be considered if you have concern for fracture

    Sources:

    • Pediatrics in Review 2013, https://doi.org/10.1542/pir.34-8-366
    • Pediatrics 2002, https://doi.org/10.1542/peds.110.1.171
    • Eur J Emerg Med 2009, https://doi.org/10.1097/MEJ.0b013e32831d796a

    • Febrile Seizures

      Seizures can be scary and fevers aren't fun but we'll teach you why simple febrile seizures aren't so bad in this episode!

      This episode was written by Tammy Yau and Lidia Park, with content support from Shannon Liang, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

      Key points:

      • Simple febrile seizures are generalized, less than 15 minutes, and occur no more than once in a 24-hour period.
      • No work-up or treatment is recommended for simple febrile seizures

      Supplemental information:

    • Sacral Dimples

      Ever seen a tuft of hair over the lower back or a sacral dimple? Learn how to recognize and manage normal vs abnormal back and spinal findings in our episode today.

      Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

      This episode was written by Tammy Yau and Lidia Park, with content support from Laura Kair. Tammy and Lidia take full responsibility for any errors or misinformation.

      Key points:

      • Spinal dysraphism is the incomplete fusion of the spine during development.
      • Not all spinal dysphraphisms will have abnormal cutaneous manifestations that you can see on exam
      • Diagnose spinal dysphraphisms with spinal ultrasound in young children and MRI in older children
      • Sacral dimples can be normal but should be worked up if they are larger than 5 mm at the base, above 2.5cm from the anus, not midline, or if there are multiple dimples

      Sources
      Pediatrics in Review 2019, Holmes and Li: https://doi.org/10.1542/pir.2018-0155
      Peds in Review 2011, Zywicke and Rozzelle: https://doi.org/10.1542/pir.32-3-109
      Hospital Pediatrics 2020, Aby et al: https://doi.org/10.1542/hpeds.2019-0264

    • BRUE

      Today we talk about BRUE – brief, resolved, unexplained, events – and try to breakdown what it is and what we do for low-risk versus high-risk cases.

      This episode was written by Tammy Yau and Lidia Park with content support from Eunice Kim, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

      Key Points:

      • Brief, resolved, unexplained events in patients <1 year of age with color change, tone change, abnormal breathing, or altered level of consciousness.
      • BRUE can be classified as low versus high risk based on age of patient, frequency of events, and exam or history findings
      • Only brief observation is needed in low risk BRUE.
      • High risk BRUE requires more extensive workup.

      Supplemental Information:

    • HIV and Breastfeeding

      Can someone with HIV breastfeed their child? You might be surprised at the answer!

      Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

      This episode was written by Tammy Yau and Lidia Park, with content support from Laura Kair. Tammy and Lidia take full responsibility for any errors or misinformation.

      Key Points:

      • New guidelines from the CDC recommend allowing mothers with HIV on antiretroviral therapy (ART) with an undetectable viral load to breastfeed their child if they desire, whether or not they live in a developed or underdeveloped country. The risk for HIV transmission through breastmilk in these cases is 0.6%
      • In the US, you can call the national perinatal HIV/AIDS hotline at 1-888-448-8765 for advice

      Sources:
      CDC 2023 Infant Feeding for Individuals with HIV in the US: https://www.cdc.gov/breastfeeding-special-circumstances/hcp/illnesses-conditions/hiv.html

    • Newborn Vitamin K

      This episode was written by Tammy Yau and Lidia Park, with content support from Lisa Rasmussen. Tammy and Lidia take full responsibility for any errors or misinformation.

      Key points:

      • Vitamin K is important in preventing early and late onset bleeding in newborns (up to 6 months of age), most importantly, intracranial bleeding.
      • Intramuscular vitamin K is most effective but oral vitamin K regimens are used outside of the US and are better than not giving any vitamin K

      Sources/Supplemental Information:
      AAP Pediatrics 2022, Handout: https://doi.org/10.1542/peds.2021-056036
      CDC Vitamin K Handout: https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients/vitamin-k.html

    • Asthma

      Learn about asthma management in the outpatient and acute setting including 2020 NIH guideline changes.

      This episode was written by Tammy Yau and Lidia Park with content support from Rory Kamerman-Kretzmer, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

      Key Points:

      • Ask about common triggers for asthma like smoke or allergens as well as medication adherence
      • Asthma is a clinical diagnosis but ancillary tests like PFTs may help
      • Symptom frequency and severity can help you classify asthma as intermittent versus persistent
      • Learn about controller/maintenance therapy, including the new SMART therapy
      • Learn about steroid use for acute exacerbations as well as next line medications like magnesium, ipratropium, and epinephrine

      Supplemental Information:

    • Bronchiolitis

      Listen to this episode’s topic on bronchiolitis and how we manage it in the hospital!

      This episode was written by Tammy Yau and Lidia Park with content support from Rory Kamerman-Kretzmer, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

      Key Points:

      • Bronchiolitis is seen in kids under the age of 2 and most commonly caused by RSV
      • Treatment is supportive including fluids, oxygen, and suction
      • Learn about palivizumab and other new preventive therapies against bronchiolitis

      Supplemental Information: