Croup (1A) Flashcards
What is croup?
it is a common URTI in children aged 6 months to 6 years old
What is the most common causative organism for croup?
parainfluenza virus
What symptoms may be present with croup?
- barking seal like cough
- inspiratory stridor/harsh noise on inspiration/noisy breathing
- coryzal symptoms
- intercostal/sternal recession
- fever
A 2 year old boy comes to the GP with his mother - you suspect a diagnosis of Croup.
- presence of barking cough
- no/little stridor
- no respiratory distress (sternal/intercostal recession)
- normal vital signs (no hypoxia)
- no agitation or lethargy
According to the above findings is the patients croup classified as mild, moderate or severe?
Mild
Why?
Only barking cough present
A 2 year old boy comes to the GP with his mother - you suspect a diagnosis of Croup.
- barking cough
- stridor
- sternal recession at rest - no agitation or lethargy
According to the above findings is the patients croup classified as mild, moderate or severe?
Moderate
Why?
no agitation or lethargy
A 2 year old boy comes to the GP with his mother - you suspect a diagnosis of Croup.
- barking cough
- stridor
- sternal recession at rest - agitation and lethargy
According to the above findings is the patients croup classified as mild, moderate or severe?
Severe
A 2 year old boy comes to the GP with his mother - you suspect a diagnosis of Croup.
- barking cough
- stridor
- sternal recession at rest - agitation and lethargy
Taking into account the above findings, what is your treatment plan for the patient?
Oral Dexamethasone (0.15mg/kg)
AND
Admit for nebulised adrenaline + high flow oxygen (because classified as severe croup)
NOTE - all with moderate/severe croup should be admitted
A 2 year old boy comes to the GP with his mother - you suspect a diagnosis of Croup.
- barking cough
- no stridor
- no sternal recession at rest
- no agitation or lethargy
Taking into account the above findings, what is your treatment plan for the patient?
Oral Dexamethasone only
A 16-month-old girl is reviewed by her GP. She has a 3 day history of fever and coryzal symptoms. Overnight she has developed a harsh cough. On examination she has a temperature of 38ºC and inspiratory stridor is noticed although there are no signs of intercostal recession. What is the most likely diagnosis?
(A) Bronchiolitis
(B) Croup
(C) Pertussis
(D) Epiglottitis
(B) Croup
BUZZWORDS
- coryzal symptoms
- harsh cough
- inspiratory stridor
A man brings his 18-month-old daughter to your GP clinic. She has had coryzal symptoms for the last 2 days. Last night, she started with a barking cough and a mild temperature of 37.8º.
On examination, there is mild stridor when mobilising, with no recessions visible. Chest sounds clear with good air entry bilaterally. The temperature today remains at 37.8º, but all other observations are normal.
What is the most appropriate management?
A) Admit to hospital
B) Give nebulised adrenaline
C) Give a stat dose of dexamethasone 150 micrograms/kg PO
D) Give a salbutamol inhaler
E) Start antibiotics
C) Give a stat dose of dexamethasone 150 micrograms/kg PO
A 5-year-old child presents to the emergency department accompanied by the mother with a week history of cough and low-grade fever. The mother describes the cough as barking. She has completed all the vaccinations to date.
On examination, you can observe suprasternal wall retraction at rest, but the child looks alert and reactive. The child produces strident breath sounds at rest.
What is the most appropriate management plan?
A) Admit to the paediatric ward
B) Discharge with dexamethasone
C) Discharge with oral antibiotics
D) Discharge with safety-netting
E) Non-urgent referral to ENT
A) Admit to the paediatric ward
Why?
Audible stridor
Therefore, mod/severe croup and admission indicated
