pedi 12 - sami2004

[ArchivalUser]

You have a child in the ED who is toxic appearing with
the sudden onset of high fever, drooling, and stridor.
You suspect epiglottitis

What is the FIRST step in the treatment of this
patient?
A) Draw blood work including a CBC.
B) Place an IV for access and fluids.
C) Give a dose of IM steroids (eg, dexamethasone
0.6 mg/kg) to help shrink the epiglottis.
D) Put a face mask on the child and administer
albuterol via face mask.
E) Leave the child on the mother’s lap and do not
upset the child (you don’t want a temper tantrum
in the ED).

Which of the following is NOT needed in the
optimal diagnosis and treatment of epiglottitis?
A) “Thumb sign” on radiograph.
B) Antibiotics to cover Haemophilus influenza.
C) Antibiotics to cover Streptococcus pneumonia.
D) An operating room.
E) Personnel able to emergently manage the airway.

[ArchivalUser]

da

[ArchivalUser]

1-c 2-a

[ArchivalUser]

b
a

[ArchivalUser]

C) Give a dose of IM steroids (eg, dexamethasone
0.6 mg/kg) to help shrink the epiglottis.
A) “Thumb sign” on radiograph.

[ArchivalUser]

ANSWER

E
A

[ArchivalUser]

sami why the answer is eeeee for first

please post explaination

[ArchivalUser]

I KNEW U WERE GOING TO ASK FOR EXPLANATION, THIS IS WHY I PICKED THIS QUES

The correct answer is E. Anything that upsets the child
can lead to increased airway obstruction. Leave the child
in the parent’s lap and do not upset him. Answers A and
B are incorrect because they may upset the child, leading
to increased work of breathing and increased obstruction.
Answer C, dexamethasone, is indicated for croup
and not for epiglottitis. Answer D is incorrect. However,
it would not be wrong to give blow-by oxygen or blowby
nebulized epinephrine if it did not agitate the child