What this deck covers
Obstructive Sleep Apnea & Adenotonsillar Hypertrophy in ten clinical teaching 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.
Diagnoses and management options tested
Across the ten cases you are asked to choose between options such as: Habitual snoring without pauses, Paradoxical rib cage movement, Sleep talking and night terrors, Diaphoresis in the first half of night, Grade 1+, Adenoid Facies, Crouzon Syndrome, Pierre Robin Sequence, Treacher Collins Appearance, Nocturnal Pulse Oximetry, In-lab Polysomnography (PSG), Lateral Neck X-ray for Adenoid Size, Home Sleep Apnea Testing (HSAT), Primary Snoring (Normal), Mild OSA, Moderate OSA, Severe OSA, Continuous Positive Airway Pressure (CPAP), Intranasal Corticosteroids for 6 months, Adenotonsillectomy (T&A), Weight loss and positional therapy, Isolated adenoid hypertrophy, Generalized hypotonia and macroglossia, Recurrent viral upper respiratory infections, Excessive lymphoid tissue in the larynx, Coarctation of the Aorta.
Clinical pearls from this deck
- Paradoxical rib-cage movement (the chest moving IN on inspiration) reflects high upper-airway resistance and a hard struggle against a collapsing pharynx — the most specific physical sign of true obstruction in a sleeping child. Snoring is common and nonspecific; witnessed gasping/apneas are suggestive. Daytime irritability and ADHD-like behavior come from fragmented sleep.
- Tonsils meeting in the midline (“kissing tonsils”) = Brodsky Grade 4+ (>75% of the oropharyngeal airway). The scale: 1+ 75%. Caveat: resting tonsil size does not reliably predict obstruction during sleep, so the sleep study and clinical picture still drive management.
The ten worked cases in this deck, with the images and the full explanation of every option, are part of Pediatric Case Review membership. See what is included.
More from this system: all ent decks and question sets · pediatric reference values.
