6 - ENT - Upper airway - Obstruction - Croup + Laryngomalacia

Question 1

croup - leading cause of? usually what age? % that is viral? nature of onset/progression? what happens

Answer 1

leading cause of stridor
usually 2-6y
95% viral
gradual onset + progression
oedema and infl of larynx, esp subglottis

Question 2

Croup- often preceded by? what happens to voice? CXR sign?

Answer 2

often preceded by URTI
harsh voice
steeple sign on CXR - tapering trachea

Question 3

severity grading of croup

Answer 3

grade 1 - inspiratory stridor and barking cough
grade 2 - expiratory stridor
grade 3 - pulsus paradoxus
grade 4 - cyanosis, decreased cognition

Question 4

signs of increasing croup severity

Answer 4

suprasternal retraction, decreased air entry

Question 5

croup mgmt - 4 principles of hospital care

Answer 5

croup tent - moist cool air
heliox - less dense easier to breath
nebulised adrenaline
steroids (PO/nebulised)

Question 6

Laryngomalacia - cause? what happens?

Answer 6

main congenital abnormality of larynx

immature and floppy aryepiglottic folds and glottis leading to laryngeal collapse in inspiration

Question 7

laryngomalacia - cause what? prognosis/treatment?

Answer 7

causes stridor

improves spontaneously by 2y in 85% - otherwise surgery if severe