1. Suspected pneumonia in a child: 
-Only get a CXR if they are hypoxic or not responding to treatment
-Everyone who is admitted for bacterial pneumonia should get a PA and lateral CXR
2. Pneumonia in a child <1 month old: 
-Etiology: E.coli, GBS, listeria
-What to do: Admit
-How to treat: Amp and gent, amp and gent!!
3. Pneumonia in a child 1 month to 3 months old: 
-Etiology: S.pneumo, C.trachomatis, viruses (flu, paraflu, RSV, adeno)
-What to do: Admit if you suspect bacterial
-How to treat: Amp or Pen G or Ceftriaxone if you suspect resistance or kid is unimmunized.
4. Pneumonia in a child 3 months to 5 years old:
-Etiology: Atypicals first, then s.pneumo and viruses
-What to do: Admit if they are hypoxic (sat <90, RR>70), its a bad bug (MRSA) or you think the family won't follow up or won't take care of the problem.
-How to treat: Amoxicillin outpatient, Amp inpatient
5. Suspected bacterial pneumonia in a child >5 years old:
-Etiology: Atypicals, S.pneumo
-What to do: Manage as outpatient unless hypoxic or no family support
-How to treat: Azithromycin
6. Screening for metabolic in children (DM, hyperlipidemia, fatty liver) 
-Screen those with BMI > 85th percentile + risk factors
-Screen those with BMI >95th percentile
-Only start lipid lowering medications if diet and exercise have failed, LDL>190 or >160 + risk factors, and only start if they are older than 10 and are more than tanner stage 2 (male) or have completed menarche.
7. Worsening winter cough is suggestive of COPD-- the cold air causes constriction of airways, which worsens underlying lung disease.
8. Paroxysmal Nocturnal Dyspnea is much more closely associated with CHF than dyspnea on exertion (17% specificity).
9. COPD physical exam findings:
-Increased AP chest diameter
-Decreased diaphragmatic excursion
-End-expiratory wheezing
-Prolonged expiratory phase
10. CHF physical exam findings:
-JVD
-Lower extremity edema
-hepatojugular reflex
-S3
-laterally displaced and diffuse PMI
-pulmonary edema (crackles, dullness to percussion)