Respiratory — Prometric Style Questions, Set 2

What this deck covers

Respiratory – Prometric Style Questions, Set 2 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. Confirming what the history suggests
2. Noisy the moment she runs
3. Wheeze only with colds
4. Worse every morning
5. Treatment that never worked
6. Two collected in a year
7. Getting the drug into a four-year-old
8. Not himself since the tablet
9. Before she leaves the ward
10. Crossing down the centiles
11. The nose behind the wheeze
12. The inhaler that did nothing
13. Steroids for a fungus
14. One change worth making
15. Egg allergy and the vaccine
16. After the screening call
17. A first growth in a well child
18. Capsules that are not working
19. Losing weight and lung function
20. Treating the fault, not the damage
21. Pauses and gasping at night
22. Still snoring after surgery
23. Sleepy after the operation
24. Headache every morning
25. Pauses in a thriving baby
26. Headaches and a falling capacity
27. A cough too weak to clear
28. Before the spinal operation
29. Coughing at every meal
30. Talking before the crisis
31. Going home on oxygen
32. Getting through the winter
33. Wheeze that is not asthma
34. More oxygen than the lungs explain
35. Clubbing with a dry cough
36. Ill after every visit
37. Anaemia and a changing chest
38. Heart on the other side
39. Fed by the wrong artery
40. Weeks of cough in a vaper
41. After a mouthful of lamp oil
42. Better once they left home
43. Two weeks after the peanuts
44. The road outside the window
45. Reading the numbers in order
46. Four months of a wet cough
47. What the plain film missed
48. The test that disagrees
49. A number moving the wrong way
50. Not enough sweat to test

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: A chest radiograph taken between episodes, That the diagnosis of asthma should be reconsidered, The inhaler used directly into the mouth, Stop the inhaled corticosteroid entirely, Invasive aspergillosis of the lung, A repeat blood spot immunoreactive trypsinogen, Cystic fibrosis related diabetes, Repeat the surgery to remove regrown tissue, Obstructive sleep apnoea of infancy, The oxygen saturation measured while awake, Oxygen weaned off completely before he goes home, Pulmonary hypertension, by echocardiography, Pulmonary haemosiderosis, Atypical pneumonia not yet identified.

Clinical pearls from this deck

• A normal test in a well child proves nothing. Test him when he is symptomatic, or test him again.
• Ask whether the noise is going in or coming out. That one question saves years of increasing inhalers.
• Ask whether he wheezes without a cold. If he never does, most of these children grow out of it.
• The gap between morning and evening is the control measurement. A wide gap means trouble even when the numbers look reasonable.
• A wet cough is not asthma. Asthma coughs dry, and a productive one means somebody should be looking elsewhere.
• Count the prescriptions before you write another. The pharmacy record tells you more about control than the child does.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all respiratory case decks · pediatric reference values.