Croup

Question 1

What is croup?

Answer 1

Croup, or laryngotracheobronchitis, is an upper respiratory tract infection in children aged 6 months to 3 years, characterised by a barking cough, inspiratory stridor, and respiratory distress.

Question 2

What is the peak age for croup?

Answer 2

Croup most commonly affects children aged 6 to 36 months.

Question 3

During which season is croup most prevalent?

Answer 3

Croup is most common during the winter months.

Question 4

What is the most common causative organism of croup?

Answer 4

Parainfluenza viruses are the most common causative organisms.

Question 5

Name two other viruses that can cause croup.

Answer 5

Respiratory syncytial virus (RSV) and influenza virus.

Question 6

What are the typical symptoms of croup?

Answer 6

Upper respiratory tract symptoms, fever, hoarse voice, barking cough, and inspiratory stridor.

Question 7

What is the characteristic cough associated with croup?

Answer 7

A barking cough, often described as ‘seal-like’.

Question 8

What is inspiratory stridor?

Answer 8

A high-pitched, wheezing sound heard during inhalation, indicating airway narrowing.

Question 9

How is the severity of croup assessed?

Answer 9

Severity is assessed based on the presence and degree of stridor, work of breathing, and level of consciousness.

Question 10

What are the signs of mild croup?

Answer 10

No stridor at rest, barking cough, and mild work of breathing.

Question 11

What are the signs of moderate croup?

Answer 11

Stridor at rest, mild work of breathing, and no agitation.

Question 12

What are the signs of severe croup?

Answer 12

Significant stridor at rest, severe respiratory distress, and signs of agitation, pallor, or fatigue.

Question 13

What are the signs of impending respiratory failure in croup?

Answer 13

Reduced consciousness, fatigue, marked retractions, absent respiratory sounds, tachycardia, and cyanosis or pallor.

Question 14

What is the first-line treatment for croup?

Answer 14

Oral or intramuscular dexamethasone to reduce airway inflammation.

Question 15

When is nebulised adrenaline indicated in croup?

Answer 15

Nebulised adrenaline is indicated in moderate to severe cases to reduce airway swelling.

Question 16

What supportive care measures are recommended for croup?

Answer 16

Humidified oxygen, maintaining hydration, and monitoring respiratory status.

Question 17

Are antibiotics indicated in the treatment of croup?

Answer 17

No, antibiotics are not indicated as croup is typically caused by viruses.

Question 18

What are the potential complications of croup?

Answer 18

Respiratory distress, hypoxia, and in severe cases, respiratory failure.

Question 19

What is the typical duration of croup symptoms?

Answer 19

Symptoms usually last 3 to 7 days, with the most severe symptoms occurring on the second or third night.

Question 20

How can croup be prevented?

Answer 20

Preventive measures include good hand hygiene, avoiding exposure to respiratory infections, and ensuring up-to-date vaccinations.

Question 21

What is the role of the ‘steeple sign’ in diagnosing croup?

Answer 21

The ‘steeple sign’ is a radiographic finding on a lateral neck X-ray, indicating subglottic narrowing characteristic of croup.

Question 22

When should a child with croup be referred to hospital?

Answer 22

Referral is necessary if the child has severe respiratory distress, persistent hypoxia, or if symptoms worsen despite initial treatment.

Question 23

What is the role of humidified air in the management of croup?

Answer 23

Humidified air can help soothe the airway and reduce symptoms, but it is not a substitute for medical treatment.

Question 24

How does agitation affect a child with croup?

Answer 24

Agitation can worsen airway obstruction and increase respiratory distress.

Question 25

What is the role of epinephrine in the management of croup?

Answer 25

Nebulised epinephrine can provide temporary relief by reducing airway swelling in moderate to severe cases.

Question 26

What is the importance of monitoring oxygen saturation in children with croup?

Answer 26

Monitoring oxygen saturation helps assess the severity of respiratory distress and guides the need for supplemental oxygen.

Question 27

What is the role of the parent or caregiver in managing a child with croup?

Answer 27

Parents should monitor the child’s symptoms, maintain hydration, and seek medical attention if symptoms worsen or if the child shows signs of severe distress.

Question 28

How does the age of the child influence the severity of croup?

Answer 28

Younger children, especially those under 6 months, are at higher risk for severe croup due to smaller airway size.

Question 29

What is the role of the healthcare provider in managing croup?

Answer 29

Healthcare providers should assess the severity of symptoms, provide appropriate medications, and offer supportive care while educating parents on symptom management.

Question 30

What is the prognosis for children with croup?

Answer 30

With appropriate treatment, the prognosis is generally good, and most children recover without complications.

Question 31

How does croup differ from epiglottitis?

Answer 31

Croup typically presents with a barking cough and gradual onset, whereas epiglottitis presents with sudden onset of high fever, drooling, and difficulty swallowing, and is a medical emergency.

Question 32

What is the role of the ‘steeple sign’ in diagnosing croup?

Answer 32

The ‘steeple sign’ is a radiographic finding on a lateral neck X-ray, indicating subglottic narrowing characteristic of croup.

Question 33

When should a child with croup be referred to hospital?

Answer 33

Referral is necessary if the child has severe respiratory distress, persistent hypoxia, or if symptoms worsen despite initial treatment.

Question 34

What is the role of humidified air in the management of croup?

Answer 34

Humidified air can help soothe the airway and reduce symptoms, but it is not a substitute for medical treatment.

Question 35

How does agitation affect a child with croup?

Answer 35

Agitation can worsen airway obstruction and increase respiratory distress.

Question 36

What is the role of epinephrine in the management of croup?

Answer 36

Nebulised epinephrine can provide temporary relief by reducing airway swelling in moderate to severe cases.

Question 37

What is the importance of monitoring oxygen saturation in children with croup?

Answer 37

Monitoring oxygen saturation helps assess the severity of respiratory distress and guides the need for supplemental oxygen.

Question 38

What is the role of the parent or caregiver in managing a child with croup?

Answer 38

Parents should monitor the child’s symptoms, maintain hydration, and seek medical attention if symptoms worsen or if the child shows signs of severe distress.

Question 39

How does the age of the child influence the severity of croup?

Answer 39

Younger children, especially those under 6 months, are at higher risk for severe croup due to smaller airway size.

Question 40

What is the role of the healthcare provider in managing croup?

Answer 40

Healthcare providers should assess the severity of symptoms, provide appropriate medications, and offer supportive care while educating parents on symptom management.

Question 41

What is the prognosis for children with croup?

Answer 41

With appropriate treatment, the prognosis is generally good, and most children recover without complications.