Upper Airway Obstruction

Question 1

CHARGE SYNDROME

Answer 1

Coloboma
Heart defect
Atresia choanae
Retarded growth and devt or CNS anomalies
Genital anomalies or hypogonadism
Ear anomalies

Question 2

Upper Airway Obstruction

Answer 2

CROUP
Foreign Body Aspiration
Anaphylaxis

Question 3

Viral CROUP

rhinorrhea, pharyngitis, low grade fever
STRIDOR (inspiratory)
hoarse voice
BARKING COUGH

Answer 3

CROUP (LARYNGOTRACHEOBRONCHITIS)

CLARS

cyanosis
level of consciousness
air entry
retractions
stridor

Question 4

Neck x-ray finding in CROUP

Answer 4

STEEPLE SIGN - subglottic narrowing

Question 5

Management of CROUP (MILD)

Answer 5

Dexamethasone

Question 6

Management of CROUP (MODERATE TO SEVERE)

Answer 6

O2
NPO
nebulized epinephrine
dexamethasone
re-assess after 2 hrs

Question 7

Management of CROUP (IMPENDING RESPIRATORY FAILURE)

Answer 7

high O2 (NRM)
assisted ventilation for <90%
dexamethasone IV/IM
endotracheal intubation if indicated

Question 8

3-7 yrs
Hib
rapid onset
high grade fever
THUMBPRINT/LEAF SIGN

Answer 8

Epiglottitis

Question 9

3 mos-3 yrs
parainfluenza virus
low grade fever
STEEPLE SIGN

Answer 9

Viral CROUP

Question 10

Signs of Upper Airway Obstruction

Answer 10

increased rate and effort

changes in voice, cry or presence of barking cough

stridor (inspiration)

poor chest rise

poor air entry on auscultation

drooling, snoring or gurgling sounds

Question 11

(+) signs of upper airway obstruction

patchy infiltrates and ragged tracheal column

Answer 11

Bacterial tracheitis

antibiotics

Question 12

(+) signs of upper airway obstruction

“THUMB’S SIGN)

Answer 12

Epiglottitis

Question 13

(+) signs of upper airway obstruction

SUBGLOTTIC NARROWING (STEEPLE SIGN)

Answer 13

CROUP

Question 14

(+) signs of upper airway obstruction

air trapping on the right lungs w/ mediastinal shift towards the right lung

Answer 14

Foreign Body Airway Obstruction

Question 15

(+) sore, scratchy throat, nasal obstruction, rhinorrhea

prominent itching and sneezing
nasal eosinophilia

Answer 15

Allergic Rhinitis

Question 16

(+) sore, scratchy throat, nasal obstruction, rhinorrhea

unilateral foul-smelling discharge
bloody nasal secretion

Answer 16

Foreign body in the nose

Question 17

(+) sore, scratchy throat, nasal obstruction, rhinorrhea

headache, facial pain, periorbital edema, rhinorrhea > 2 weeks

Answer 17

Sinusitis

Question 18

(+) sore, scratchy throat, nasal obstruction, rhinorrhea

persistent rhinorrhea w/ onset in the first 3 mos of life (snuffles)

Answer 18

Congenital Syphilis

Question 19

(+) sore, scratchy throat, nasal obstruction, rhinorrhea

Hx of prolonged use of topical or oral decongestant

Answer 19

Rhinitis medicamentosa

Question 20

(+) sore, scratchy throat, nasal obstruction, rhinorrhea

paroxysms of cough leaving the baby breathless and subconjunctival hemorrhages

Answer 20

Pertussis or whooping cough

Question 21

Sinuses present at BIRTH

Answer 21

ME

maxillary
ethmoid

Question 22

Sinuses pneumatized at 4 years old

Answer 22

sphenoid

Question 23

Sinuses begin to develop at 7-8 years old

Answer 23

frontal

Question 24

Ragged air column - CXR

Answer 24

Bacterial Tracheitis

Question 25

MC organisms associated with sinusitis

Answer 25

S. pneumonia
Hib
M. catarrhalis