stridor

Question 1

what is stridor

Answer 1

harsh, monomorphic inspiratory wheeze caused by partial obstruction of the airway

Question 2

name 6 causes of stridor

Answer 2

• foreign body
• malignancy
• airway oedema (e.g. trauma - intubation)
• infection
• laryngospasm/vocal cord paralysis
• laryngomalacia

Question 3

what is epiglottitis

Answer 3

infection of the epiglottis

Question 4

epiglottitis is most common in

Answer 4

kids aged 3-7

Question 5

what is the most common cause of epiglottitis

Answer 5

H. influenzae

Question 6

epiglottitis presentation

Answer 6

short with rapid progression with:
- head forward, tongue out and drooling
- sore throat with no cough
- change in voice (muffled)
- refusal to eat
- hoarseness
- dysphagia
- fever
- shortness of breath

Question 7

epiglottitis diagnosis

Answer 7

do not examine throat, take bloods or stress the child

Question 8

epiglottitis management

Answer 8

• call anaesthetist
• 1st line: ceftriaxone 2g IV
• step down: co-amoxiclav or doxycycline and metronidazole

Question 9

what is laryngomalacia

Answer 9

congenital abnormality of the larynx where cartilages of the larynx are soft and immature -> collapse on inspiration

Question 10

laryngomalacia presentation

Answer 10

• stridor while sleeping, excited or in specific positions
• absence of any associated respiratory distress
• difficulty feeding

Question 11

laryngomalacia management

Answer 11

• most cases improve by 2 years old
• some severe cases require corrective surgery

Question 12

stridor presentation

Answer 12

inspiratory wheeze and
- pale/cyanosed
- use of accessory muscles
- dysphagia and drooling

Question 13

stridor diagnosis

Answer 13

• ABCDE
• call ENT -> arrange tracheostomy kit
• ABG
• chest x-ray/neck x-ray
• laryngoscopy

Question 14

stridor management

Answer 14

• oxygen or heliox
• nebulised adrenaline
• nebulised budesonide
• IV steroids (dexamethasone)