PEDIATRICS Section 4: Airway

Question 1

This is the most common cause of acute upper airway obstruction in young children.

Answer 1

Croup

Question 2

Diagnosis? Sign?

Answer 2

Croup

“Steeple Sign”

Question 3

Culprit of Croup?

Answer 3

Parainfluenza virus 6 mos to 3 years - This one can kill you!

Question 4

Diagnosis? Sign?

What is the culprit?

Answer 4

Epiglottitis

H. Influenza in 3.5 years

Question 5

linear soft tissuefilling defect within the airway.

Common in what age?

Answer 5

Exudative Tracheitis

6-10 years

Question 6

Culprit of Exudative Tracheitis?

Answer 6

Staph Aureus

Question 7

massive retropharyngeal soft tissue thickening.

Answer 7

Retropharyngeal Cellulitis and Abscess

Question 8

Diagnosis?

Common in what age?

Answer 8

Retropharyngeal Cellulitis and Abscess

6 - 12 months

Question 9

Most common Soft tissue mass in the trachea

Answer 9

Subglottic hemangioma

Question 10

Difference between Subglottic hemangioma and Croup?

Answer 10

Croup - Symmetric narrowing with loss of shoulders in both sides (Steeple sign)

Subglottic hemangiomas - Loss of just on eof teh sides

Question 11

Subglottic hemangioma

Favors what side?
50% are associated with what condition?
7% have what syndrome?

Answer 11

Favor the left side

50% are associated with cutaneous hemangioma

7% have teh PHACES syndrome
Posterior fossa (DANDY WALKER)
Hemangiomas
Arterial anomalies
Coarcation of the aorta
Eye abdnormalities
Subglottic hemangiomas/Sternal cleft/Supraumbilical raphae

Question 12

contrast appearing in the tracheal without laryngeal penetration (aspiration)

Answer 12

Laryngeal cleft

Question 13

Diagnosis?

Describe

Answer 13

Laryngeal cleft

“thin tract of contrast extending to the larynx or trachea.”

Question 14

communicating defect in the posterior wall of the larynx and the esophagus or anterior hypo pharynx.

Answer 14

Laryngeal cleft

Question 15

If you see a lobulated grape looking thing in the airway - think of?

Answer 15

Papilloma

especially if the lungs are full of nodules (solid and cavitated).

Question 16

When I say papilloma, you say?

Answer 16

HPV! from perinatal (birgh canal ) transmission

Question 17

Diagnosis?
1.
2.

why?

Answer 17

(1) Croup and (2) Subglottic Hemangioma

You can tell them apart by the shouldering.

If you can’t tell…. try and let the history bias you. Cough? Fever? Think Croup.

Question 18

What is this?

Answer 18

Epiglottitis
Looks like a thumb

If the ordering suspects the diagnosis, do NOT bring this kid to x- ray. Have them do a portable.

Question 19

What is this?

measurement?

Answer 19

Retropharyngeal abscess

C2 > 6mm
C6 > 22 mm

Question 20

what is this?

Answer 20

onsils (adenoids)
Not seen till about 3-6 months, and not big till around 1-2 years.
Too big when they encroach the airway

Question 21

What is this?

Answer 21

Linear Filling Defect I

t’s usually staph