CURRENT DIAGNOSIS AND TREATMENT
PEDIATRICS FINAL PAPER TESTED
QUESTIONS WITH GRADED A+ ANSWERS
●● Risk Factors
-Childhood (6 months - 3 years of age)
Answer: Patient history that should make you think of croup
●● Clinical manifestations of croup
Answer: -Acute onset of SEAL-LIKE BARK cough
-Stridor
-Sternal/intercostal retractions
-Coryza
-Fever
●● -Clinical Diagnosis
-X-ray anteroposterior and lateral neck
---STEEPLE SIGN (narrowed trachea)
Answer: Laboratory and diagnostic studies for croup
●● Steeple sign
,Answer: What is this?
●● -PATIENT EDUCATION
---Avoid frightening the child to avoid agitation
---Parental reassurance and education to the self-limited nature of the
illness
-OUTPATIENT
---SUPPORTIVE CARE
---ORAL CORTICOSTEROIDS
-----Dexamethasone
-------One time dose
-INPATIENT
---STRIDOR AND RESPIRATORY DISTRESS PRESENT
-----IM or IV Dexamethasone
-----Nebulized epinephrine
-----Supplemental oxygen
-------Blow-by oxygen via tubing held a few centimeters from the child's
nose and mouth
----- +/- intubation
Answer: Treatment for croup
●● Pneumonia
Answer: Complications of croup
,●● Acute bronchiolitis
Answer: -Viral infection of the lower respiratory tract (bronchioles)
-*Leading cause* of hospital admission in infants under 1 year of age
-*Respiratory syncytial virus (RSV)* is the *most common* etiologic
agent
-Most cases are mild and self-limited
-Although it can affect individuals of any age, the term is most often
used to refer to infection in infancy
-Almost exclusively an infantile disease
-By 3 years of age essentially all children have serologic evidence of
having been infected with RSV
●● -Risk Factors:
---Infant < 1 year of age
---Under 6 months of age
---Prematurity
---Congenital heart disease
---Bronchopulmonary dysplasia
---Impaired airway clearance and function
-----Cystic Fibrosis
---Passive tobacco smoke exposure
-Seasonal pattern
, ---November to May
Answer: Patient history that should make you think of acute
bronchiolitis
●● Clinical manifestations of acute bronchiolitis
Answer: -Cough
-Wheezing
-Labored breathing
-Rhinitis
-Grunting
-Nasal flaring
-Retractions
-Tachypnea
-Fever
●● -Pulse oximetry
-ELISA rapid antigen detection
---*Positive* detection of viral antigen (RSV)
-Chest x-ray
---Hyperinflation, interstitial inflammation, atelectasis
-----Not required for diagnosis
Answer: Laboratory and diagnostic studies for acute bronchiolitis
PEDIATRICS FINAL PAPER TESTED
QUESTIONS WITH GRADED A+ ANSWERS
●● Risk Factors
-Childhood (6 months - 3 years of age)
Answer: Patient history that should make you think of croup
●● Clinical manifestations of croup
Answer: -Acute onset of SEAL-LIKE BARK cough
-Stridor
-Sternal/intercostal retractions
-Coryza
-Fever
●● -Clinical Diagnosis
-X-ray anteroposterior and lateral neck
---STEEPLE SIGN (narrowed trachea)
Answer: Laboratory and diagnostic studies for croup
●● Steeple sign
,Answer: What is this?
●● -PATIENT EDUCATION
---Avoid frightening the child to avoid agitation
---Parental reassurance and education to the self-limited nature of the
illness
-OUTPATIENT
---SUPPORTIVE CARE
---ORAL CORTICOSTEROIDS
-----Dexamethasone
-------One time dose
-INPATIENT
---STRIDOR AND RESPIRATORY DISTRESS PRESENT
-----IM or IV Dexamethasone
-----Nebulized epinephrine
-----Supplemental oxygen
-------Blow-by oxygen via tubing held a few centimeters from the child's
nose and mouth
----- +/- intubation
Answer: Treatment for croup
●● Pneumonia
Answer: Complications of croup
,●● Acute bronchiolitis
Answer: -Viral infection of the lower respiratory tract (bronchioles)
-*Leading cause* of hospital admission in infants under 1 year of age
-*Respiratory syncytial virus (RSV)* is the *most common* etiologic
agent
-Most cases are mild and self-limited
-Although it can affect individuals of any age, the term is most often
used to refer to infection in infancy
-Almost exclusively an infantile disease
-By 3 years of age essentially all children have serologic evidence of
having been infected with RSV
●● -Risk Factors:
---Infant < 1 year of age
---Under 6 months of age
---Prematurity
---Congenital heart disease
---Bronchopulmonary dysplasia
---Impaired airway clearance and function
-----Cystic Fibrosis
---Passive tobacco smoke exposure
-Seasonal pattern
, ---November to May
Answer: Patient history that should make you think of acute
bronchiolitis
●● Clinical manifestations of acute bronchiolitis
Answer: -Cough
-Wheezing
-Labored breathing
-Rhinitis
-Grunting
-Nasal flaring
-Retractions
-Tachypnea
-Fever
●● -Pulse oximetry
-ELISA rapid antigen detection
---*Positive* detection of viral antigen (RSV)
-Chest x-ray
---Hyperinflation, interstitial inflammation, atelectasis
-----Not required for diagnosis
Answer: Laboratory and diagnostic studies for acute bronchiolitis
