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4 Cards in this Set
- Front
- Back
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Regarding croup, which is correct?
1. Peak incidence between 3-4 years 2 viral exanthems such as varicella may present with concomitant croup in small children 3 the narrowest region of the airway in children <8 years is the glottis opening 4 croup will not coexist in younger children with wheeze, and older children with signs of asthma |
1 incorrect, 1-2 years
2 CORRECT 3 incorrect - the cricoid cartilage 4 may coexist if there is lower airway involvement |
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True or false
1 natural history of airway obstruction is to peak in 24-48 hours 2 croup without viral prodrome (recurrent or spasmodic croup) is likely genetic in origin 3 persistence of stridor between croup episodes may suggest pre-existing airway narrowing, and a higher likelihood of severe obstruction when croup occurs 4 immunisation history is important as full immunisation makes croup extremely unlikely 5 hyper extension and abnormal neck positioning suggest severe croup 6 saliva intolerance and sore neck are unusual in croup 7 a lateral XR is important to exclude epiglottitis and retro pharyngeal abscess in the presence of critical airway obstruction |
1 t
2 f - allergic 3 t e.g. Due to laryngomalacia, infantile floppy larynx) 4 f - may reduce likelihood of DDx e.g. Epiglottitis, diphtheria 5 f - retro pharyngeal abscess, epiglottitis 6 t - consider dx in 5 7 f - may be helpful in the stable pt |
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Which is INCORRECT
1 cord paresis and vascular rings are a part of the differential diagnosis of croup 2 allergic angioedema may mimic croup after exposure to allergen e.g. Peanut 3 all children presenting to ED with croup should receive steroids 4 steroids have been shown to reduce mortality |
4 INCORRECT - reduce relapse rate of discharged pt, decrease need for ICU and intubation, decrease hospital LOS
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Regarding treatment of croup which is correct
1. Adrenaline requirement is an indication for admission 2 oral dexamethasone showed significant improvement in croup score within 30/60 compared to placebo 3 adrenaline may be associated with rebound phenomenon 4 intubation should be considered once cyanosis and confusion are evident |
2 correct
3 1-2 hours after adrenaline obstruction may recur 4 prior to this - worsening obstruction, fatigue despite adrenaline, hypoxia |
