Respiratory – Set 3

What this deck covers

Respiratory – Set 3 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 paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. Still febrile on day 3 in hospital
2. Usual germ behind pleural pus
3. Sudden worsening in a severe attack
4. Where vomit lands when lying flat
5. Acidic turbid tap at the left base
6. What sets this segment apart
7. Wet cough, clubbing and poor growth
8. Film after a sudden pleuritic pain
9. Choking on bottles, then a fever
10. Node biopsy in a boy with uveitis
11. Listless infant in a heatwave
12. Wet cough since birth and a right apex
13. Where an exudate begins
14. Third infection in the same lobe
15. When a collapsed lung turns deadly
16. Foul sputum and a cavity on two views
17. Faltering infant, pale stools, cough
18. Questions about the faulty gene
19. Feverish wheelchair user, feeble chest
20. Coughing at mealtimes in a wheelchair
21. Weight loss and nodules on the shins
22. Blocked nose and no sense of smell
23. Tall teenager, sudden pain, stable
24. Daily sputum after an old adenovirus
25. Vomiting after a hot week
26. Thick creamy fluid from a septated tap
27. Round shadow beside the lower trachea
28. Building the annual review list
29. Possetting baby, right-lung infections
30. Holiday plans after a collapsed lung
31. Worse despite oral treatment at 12
32. Proof at a specialist centre
33. Worsening breathlessness after biopsy
34. Septic despite drain and urokinase
35. Chance in the next pregnancy
36. Blood-streaked coughs and pallor at 3
37. Wedge that never clears, left base
38. Treating the protein, not the mucus
39. Drugs to avoid in a chest infection
40. Fever the day after a long seizure
41. Swab results in the toddler years
42. Flare of a wet cough with fever
43. Toddler with a mass at the anus
44. Mild ache, walked in, smokes
45. Six weeks on, still feverish
46. Before fixing a sunken breastbone
47. Third infection at the left base
48. First positive swab in a well boy
49. Blood-streaked sputum at 18 months
50. Wet cough antibiotics will not end

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Chest ultrasound to look for a pleural collection, Anterior segment of the right upper lobe, Cystic fibrosis, Caseating granulomas with acid-fast bacilli, A lung abscess, Enlarged adenoids blocking the back of the nose, High urine chloride, Ventilation-perfusion lung scan, Staphylococcus aureus, Remove the drain and finish oral antibiotics at home, Bronchography with contrast put into the airway, Azithromycin, Anorectal manometry, CT Haller index, lung function and echocardiogram.

Clinical pearls from this deck

• Pneumonia not settling at 48 hours: look for pleural fluid with ultrasound.
• Childhood empyema: pneumococcus first, and always cover Staphylococcus aureus.
• Asthma plus sudden one-sided hyper-resonance: think pneumothorax, then check for tension.
• Supine aspiration: posterior right upper lobe.
• Beside pneumonia, pleural pH under 7.2 with low glucose means drain it.
• Aortic artery in, no bronchus out.

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.