Croup Diagnosis and Management
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Questions and Answers

What is the primary indication for radiographic imaging in croup?

  • To diagnose subglottic stenosis
  • To rule out epiglottitis or bacterial tracheitis
  • To identify the steeple sign
  • None of the above (correct)

    • What is the significance of the steeple sign in croup?

  • It is a specific sign for croup
  • It is only seen in laryngomalacia
  • It is a sensitive sign for croup
  • It is neither specific nor sensitive for croup (correct)

    • When is laryngoscopy indicated in croup?

  • When stridor is present at rest
  • In all cases of croup
  • Only in atypical presentations or suspected alternate diagnoses (correct)
  • When the Westley Croup Score is high

    • What is the concern when performing laryngoscopy in suspected epiglottitis?

    <p>Rapid airway obstruction</p> Signup and view all the answers

    What is the primary factor in determining the management of croup?

    <p>The severity of illness</p> Signup and view all the answers

    What is a possible indication for computed tomography of the neck in croup?

    <p>To identify an abscess, tumor, or foreign body aspiration</p> Signup and view all the answers

    What is laryngomalacia?

    <p>A large airway lesion</p> Signup and view all the answers

    What is the score used to assess the severity of croup?

    <p>Westley Croup Score</p> Signup and view all the answers

    What is the primary purpose of placing a symptomatic child in a comfortable position?

    <p>To improve the evaluation and treatment process</p> Signup and view all the answers

    According to the Westley Croup Score, what is the category of croup severity corresponding to a total score of 3 to 7?

    <p>Moderate</p> Signup and view all the answers

    What is the recommended treatment for children with hypoxemia or severe respiratory distress?

    <p>Oxygen administration</p> Signup and view all the answers

    What is the importance of minimizing agitation in a symptomatic child?

    <p>To help improve symptoms</p> Signup and view all the answers

    What is the name of the algorithm provided in Figure 1 for managing children with croup in an outpatient setting?

    <p>Not specified in the content</p> Signup and view all the answers

    What is the severity of croup corresponding to a total score of ≤2 on the Westley Croup Score?

    <p>Mild</p> Signup and view all the answers

    What is the reference for the study mentioned in the content regarding nebulized racemic epinephrine by IPPB for the treatment of croup?

    <p>Am J Dis Child. 1978;132(5):485</p> Signup and view all the answers

    What is the purpose of humidified air inhalation in croup management?

    <p>Historically used for management of croup</p> Signup and view all the answers

    What are the typical clinical findings of croup?

    <p>Barking cough, stridor, and hoarseness</p> Signup and view all the answers

    Is diagnostic testing necessary for croup?

    <p>No, clinical findings are sufficient for diagnosis</p> Signup and view all the answers

    What is the effect of humidified air inhalation on croup symptoms?

    <p>It has no effect on symptoms</p> Signup and view all the answers

    Who should receive corticosteroids for croup?

    <p>Patients with croup of any severity</p> Signup and view all the answers

    When should epinephrine be administered to patients with croup?

    <p>In patients with moderate to severe croup</p> Signup and view all the answers

    What is the typical age range for patients who receive corticosteroids for croup?

    <p>Six months to 5 years</p> Signup and view all the answers

    What is the effect of corticosteroids on croup symptoms?

    <p>They significantly improve symptoms</p> Signup and view all the answers

    What is the typical respiratory rate in patients with croup?

    <p>Increased</p> Signup and view all the answers

    What is the primary mechanism of action of epinephrine in improving symptoms in patients with croup?

    <p>Arteriole vasoconstriction in the upper airway mucosa</p> Signup and view all the answers

    What is the recommended dose of dexamethasone for the treatment of croup?

    <p>0.15 to 0.60 mg per kg orally or parenterally, single dose</p> Signup and view all the answers

    What is the primary difference between mild and moderate or severe croup?

    <p>Frequency of barking cough</p> Signup and view all the answers

    What is the purpose of the Westley Croup Score?

    <p>To assess the severity of croup</p> Signup and view all the answers

    What is the effect of corticosteroids on the resolution of symptoms in children with acute respiratory conditions?

    <p>Faster resolution</p> Signup and view all the answers

    What is the recommended treatment for mild croup?

    <p>Single dose of dexamethasone</p> Signup and view all the answers

    What is the primary benefit of using dexamethasone in the treatment of croup?

    <p>Rapid onset of action</p> Signup and view all the answers

    What is the primary indication for using epinephrine in the treatment of croup?

    <p>Moderate or severe croup</p> Signup and view all the answers

    What is the typical duration of epinephrine's effects in patients with croup?

    <p>One to two hours</p> Signup and view all the answers

    Why is dexamethasone the preferred corticosteroid for croup treatment?

    <p>It is given as a single dose and can be administered orally, intramuscularly, or intravenously.</p> Signup and view all the answers

    What is the recommended dose of dexamethasone for croup treatment?

    <p>0.6 mg per kg</p> Signup and view all the answers

    What is the advantage of using dexamethasone over budesonide in croup treatment?

    <p>Dexamethasone is superior to budesonide in improving symptoms scores.</p> Signup and view all the answers

    Why should patients receiving frequent nebulized epinephrine treatments be monitored?

    <p>For adverse cardiac effects</p> Signup and view all the answers

    What is the purpose of monitoring patients for at least two hours after epinephrine administration?

    <p>To ensure the effects of epinephrine have worn off</p> Signup and view all the answers

    What is the significance of using dexamethasone in the emergency department or hospital?

    <p>It reduces the risk of return visits or readmissions</p> Signup and view all the answers

    What was the purpose of the PubMed search conducted for this article?

    <p>To update previous articles on croup</p> Signup and view all the answers

    Study Notes

    Croup Diagnosis and Management

    • Diagnosis of croup is based on clinical findings of barking cough, inspiratory stridor, and hoarseness.
    • Diagnostic testing is typically not necessary, and the absence of fever does not rule out croup.
    • Respiratory rate is often increased in patients with croup.

    Croup Treatment

    • Corticosteroids should be administered to patients with croup of any severity.
    • Epinephrine should be administered to patients with moderate to severe croup.
    • Humidified air inhalation does not improve symptoms in patients with moderate croup.
    • Oxygen should be administered to children with hypoxemia or severe respiratory distress.

    Westley Croup Score

    • The Westley Croup Score is used to assess the severity of croup.
    • The score is based on clinical signs such as level of consciousness, stridor, air entry, and retractions.
    • A score of ≤2 indicates mild croup, 3-7 indicates moderate croup, and ≥12 indicates impending respiratory failure.

    Outpatient Management

    • Minimizing agitation in a symptomatic child can help improve symptoms.
    • Placing the child in a comfortable position may help improve the evaluation and treatment process.
    • Dexamethasone is the preferred corticosteroid due to its single-dose administration and ability to be given orally, intramuscularly, or intravenously.
    • The optimal dose of dexamethasone is unclear, but 0.6 mg per kg is the most commonly used.

    Use of Epinephrine

    • Epinephrine is thought to improve symptoms in patients with croup through arteriole vasoconstriction in the upper airway mucosa.
    • The effects of epinephrine wane after one to two hours, so patients should be monitored for at least two hours after administration.
    • Adverse effects of nebulized epinephrine are rare, but patients receiving frequent treatments should be monitored for adverse cardiac effects.

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    Croup: Diagnosis and Management PDF

    Description

    This quiz covers the diagnosis and management of croup, a common childhood illness characterized by cough, inspiratory stridor, and hoarseness.

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