PEPP Module 2 fn fn
1. Youfnarefndispatchedfntofnthefnlocalfnelementaryfnschoolfnforfnafn7-year-
oldfnfemalefnwithfndifficultyfnbreathing.fnThefnoutsidefntemperaturefnisfn35°Ffn(1°C).fn
Uponfnarrival,fnyoufnarefngreetedfnbyfnthefnschoolfnnurse,fnwhofntellsfnyoufnthatfnthefngi
rlfnenteredfnherfnofficefnwithfnmildfnrespiratoryfndistress.fnThefnnursefnfurtherfntellsfnyo
ufnthatfnthefnchild'sfntemperaturefnwasfn97.8°Ffn(36.5°C).fnThefnlittlefngirlfnisfnconsciou
sfnandfnalert.fnShefnsaysfnthatfnshefnisfnhavingfntroublefnbreathingfnandfnforgotfnherfnas
thmafnmedicinefnatfnhome.fnHerfnairwayfnisfnpatent,fnrespirationsfnincreased,fnandfnsh
efnhasfnintercostalfnretractionsfnandfnwheezesfnbilaterally.fnRadialfnpulsefnisfnstrongfn
andfnregular,fnthoughfnslightlyfnincreased.fnHerfnskinfnisfnpink,fnwarm,fnandfndry.fnWha
tfninitialfnmanagementfnisfnrequired?fn-
fn correctfnanswer✔ ✔ Administerfninhaledfnbronchodilator
2. Forfnthefn7-year-
oldfngirlfninfnthefnpreviousfnquestion,fnwhatfnisfnthefnmostfnlikelyfndiagnosis?fn-
fn correctfnanswer✔ ✔ Asthma
3. Youfnrespondfntofnafn2-year-
oldfnwithfnafnhistoryfnoffnlaboredfnbreathingfnforfnthefnpastfn2fndaysfnthatfnhasfnprogres
sivelyfnworsened.fnInitially,fnthefnchildfnhadfnsymptomsfnoffnanfnupperfnrespiratoryfninf
ection.fnYesterdayfnhefnbeganfntofnhavefnafnbarkyfncough,fnandfntodayfnhefnisfnmaking
a high-
fn fn
pitchedfnsoundfnonfninspiration.fnAsfnyoufnenterfnthefnroom,fnyoufnseefnanfnanxiousfnto
ddlerfnsittingfnonfnhisfnmom'sfnlapfnandfnworkingfnhardfntofnbreathe.fnHefnhasfnobviousf
nnasalfnflaringfnandfnintercostalfnandfnsuprasternalfnretractions.fnHisfnbreathingfnisfnn
otfnrapid.fnYoufnhearfnafnhigh-
pitchedfninspiratoryfnsoundfnwithfneachfnbreath.fnHefnhasfnanfnoccasionalfnharsh,fnbar
kyfncough.Hisfnmucousfnmembranesfnandfnskinfnappearfnpale.fnWhatfnisfnyourfninitialf
ndetermination?fn-fncorrectfnanswer✔ ✔ Viralfninfectionfnleadingfntofncroup
1. Youfnarefndispatchedfntofnthefnlocalfnelementaryfnschoolfnforfnafn7-year-
oldfnfemalefnwithfndifficultyfnbreathing.fnThefnoutsidefntemperaturefnisfn35°Ffn(1°C).fn
Uponfnarrival,fnyoufnarefngreetedfnbyfnthefnschoolfnnurse,fnwhofntellsfnyoufnthatfnthefngi
rlfnenteredfnherfnofficefnwithfnmildfnrespiratoryfndistress.fnThefnnursefnfurtherfntellsfnyo
ufnthatfnthefnchild'sfntemperaturefnwasfn97.8°Ffn(36.5°C).fnThefnlittlefngirlfnisfnconsciou
sfnandfnalert.fnShefnsaysfnthatfnshefnisfnhavingfntroublefnbreathingfnandfnforgotfnherfnas
thmafnmedicinefnatfnhome.fnHerfnairwayfnisfnpatent,fnrespirationsfnincreased,fnandfnsh
efnhasfnintercostalfnretractionsfnandfnwheezesfnbilaterally.fnRadialfnpulsefnisfnstrongfn
andfnregular,fnthoughfnslightlyfnincreased.fnHerfnskinfnisfnpink,fnwarm,fnandfndry.fnWha
tfninitialfnmanagementfnisfnrequired?fn-
fn correctfnanswer✔ ✔ Administerfninhaledfnbronchodilator
2. Forfnthefn7-year-
oldfngirlfninfnthefnpreviousfnquestion,fnwhatfnisfnthefnmostfnlikelyfndiagnosis?fn-
fn correctfnanswer✔ ✔ Asthma
3. Youfnrespondfntofnafn2-year-
oldfnwithfnafnhistoryfnoffnlaboredfnbreathingfnforfnthefnpastfn2fndaysfnthatfnhasfnprogres
sivelyfnworsened.fnInitially,fnthefnchildfnhadfnsymptomsfnoffnanfnupperfnrespiratoryfninf
ection.fnYesterdayfnhefnbeganfntofnhavefnafnbarkyfncough,fnandfntodayfnhefnisfnmaking
a high-
fn fn
pitchedfnsoundfnonfninspiration.fnAsfnyoufnenterfnthefnroom,fnyoufnseefnanfnanxiousfnto
ddlerfnsittingfnonfnhisfnmom'sfnlapfnandfnworkingfnhardfntofnbreathe.fnHefnhasfnobviousf
nnasalfnflaringfnandfnintercostalfnandfnsuprasternalfnretractions.fnHisfnbreathingfnisfnn
otfnrapid.fnYoufnhearfnafnhigh-
pitchedfninspiratoryfnsoundfnwithfneachfnbreath.fnHefnhasfnanfnoccasionalfnharsh,fnbar
kyfncough.Hisfnmucousfnmembranesfnandfnskinfnappearfnpale.fnWhatfnisfnyourfninitialf
ndetermination?fn-fncorrectfnanswer✔ ✔ Viralfninfectionfnleadingfntofncroup
