- The most concerning physical finding in an infant with an acute respiratory infection or RAD exacerbation is:
Your answer:
grunting
abdominal breathing
wheezing
tachypnea
retractions
- All of the following are consistent with the diagnosis of bacterial tracheitis EXCEPT:
Your answer:
high fever
drooling
preceding viral URI
minimal sputum production
stridor
- What proportion of bronchiolitis cases are caused by RSV?
Your answer:
35%
50%
70%
90%
15%
- Which of the following is the most likely diagnosis in a 6-week-old infant with a ten-day history of mild cough, who on examination is quietly tachypneic and afebrile:
Your answer:
pertussis
RSV/ bronchiolitis
FB ingestion
chlamydia pneumonia
congenital airway anomaly
- The BEST induction agent for intubation of infants greater than 3-months-old with respiratory failure due to bronchiolitis is:
Your answer:
etomidate
thiopental
ketamine
fentanyl
versed
- In the absence of other concerning associated signs, APNEA is defined as a respiratory pause of greater than:
Your answer:
1 minute
15 seconds
10 seconds
20 seconds
30 seconds
- Of the following causes of upper airway obstruction, which is LEAST likely to result in an acute, precipitous deterioration in the ED?
Your answer:
smoke inhalation/ thermal injury
epiglottitis
foreign body ingestion
retropharyngeal abscess
croup
- Which of the following is the LEAST LIKELY cause of stridor in an infant or child < 6 years old?
Your answer:
foreign body aspiration
croup
bacterial tracheitis
peritonsillar abscess
retropharyngeal abscess
- Which of the following is NOT associated with the need for admission in the context of an asthma exacerbation?
Your answer:
Pneumothorax on CXR
Altered mental status or fatigue
Poor social situation
Pneumomediastinum on CXR
Failure to respond to bronchodilators and steroids
- The administration of beta-agonists via MDI with a spacer has been shown to be as effective as the use of a nebulizer for the reversal of acute bronchospasm in all age groups (infants, children and adults).
Your answer:
TrueFalse
- All of the following are currently considered standard treatments for bronchiolitis EXCEPT:
Your answer:
steroids (oral, IV or IM)
supplemental oxygen as needed
hydration (oral or IV)
trial of albuterol (via MDI or nebulized)
trial of racemic epinephrine (nebulized)
- Compared with the adult airway, which of the following is NOT characteristic of the pediatric airway:
Your answer:
narrowest portion located at the cricoid cartilage
more posterior location
smaller diameter and shorter length
more easily obstructed by edema, secretions or posterior displacement of the tongue
more easily visualized with a straight (eg. Miller) blade
- Oral dexamethasone is as effective as IM dexamethasone in the treatment of croup.
Your answer:
TrueFalse
- RSV testing would be LEAST helpful in the management of which of the following patients:
Your answer:
3-week-old neonate with nasal congestion and mild cough
5-month-old intubated for respiratory failure with a peri-bronchial infiltrate on CXR
4-month-old previously healthy infant with significant URI Sx’s and wheezing but no fever
6-month-old ex-preemie with BPD and cough/congestion
- All of the following support a clinical diagnosis of pertussis EXCEPT:
Your answer:
elevated WBC with marked lymphocytosis
prolonged course
history of incomplete vaccination
temperature > 101
age < 4-years-old
- The most common CXR finding in infants with bronchiolitis is:
Your answer:
atelectasis
normal
focal infiltrate
hyperinflation
pneumothorax
- Antibiotics given for “Whooping Cough” (pertussis) shorten the course of symptoms.
Your answer:
TrueFalse
- All of the following statements are true of croup (viral laryngotracheobronchitis) EXCEPT:
Your answer:
it can easily be confused with bacterial tracheitis
it primarily affects children aged 6-36 month
symptoms are often worst at night
it is most commonly caused by parainfluenza virus
it is characterized by a barky cough, hoarse voice and inspiratory stridor
- Regarding pneumonia in the neonate, all of the following are TRUE EXCEPT:
Your answer:
mortality is low when promptly diagnosed and appropriately treated
maternally-acquired Group B Strep (GBS) remains the most common bacterial pathogen
full sepsis work-up, including LP, is mandatory
admission and IV ampicillin & cefotaxime (or gentamicin) is required in all cases
viral etiologies are common
- Which of the following is the most likely cause of pneumonia in a generally well-appearing 8-year-old with a gradually progressive cough over two weeks and bilateral crackles on lung exam?
Your answer:
Klebsiella
Pertussis
Influenza
S. pneumoniae
Mycoplasma
- All of the following are true of croup EXCEPT:
Your answer:
first-line treatment includes steroids
oral steroids are as effective as parenteral steroids
racemic epinephrine need only be given to children with stridor at rest (while not agitated) or
well-appearing children with croup, who have improved after receiving nebulized racemic
- A 3-week-old infant with several days of mild diarrhea and decreased oral intake presents with severe tachypnea, cyanosis and lethargy. The initial oxygen saturation is 87%, breath sounds are clear throughout and the cardiac exam is normal. Peripheral perfusion is poor (CR > 4 sec.) and the administration of 100% oxygen by face mask results in a saturation of only 94%. A portable CXR is normal. Of the following tests, which is MOST likely to reveal a diagnosis?
Your answer:
ECG
ABG
echocardiogram
RSV
methemoglobin level