Respiratory Prometric Style Questions – 50 Cases with Answers

What this deck covers

Respiratory – Prometric Style Questions, Set 1 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. A cough like a barking seal
2. Night stridor with no cold
3. Mild croup in a playing child
4. Dusky lips and a silent chest
5. Drooling and sitting forward
6. The cherry red swelling in theatre
7. Wheeze on one side only
8. One lung too full of air
9. Noisy since the first weeks
10. Winter cough in a small baby
11. What to give the admitted infant
12. Coughing fits, well in between
13. Belly pain with signs in the chest
14. First antibiotic for a lobar shadow
15. Holes in the consolidated lung
16. Still febrile on day four
17. Turbid fluid from the chest
18. Gave up football because of breathing
19. Wheezy after a cold
20. Getting sleepy despite everything
21. Pressures up, blood pressure down
22. Checking the parents’ warning list
23. Chest infections and greasy stools
24. No meconium and a tiny colon
25. Antibiotics that stopped working
26. Salt lost in a heatwave
27. A lump that comes out with straining
28. Sudden collapse in an asthmatic
29. A chest pulled to one side
30. A cold every month at nursery
31. Three months of a rattly cough
32. Big hilar nodes and sore shins
33. Pneumonia in the same spot again
34. A brassy cough that worsens lying down
35. Is this respiratory failure yet
36. Reading the gas in order
37. Which dial moves the carbon dioxide
38. A sunken chest before theatre
39. Snoring, gasping and poor school reports
40. Well child, positive test
41. A small baby who stops breathing
42. Still on oxygen at term
43. What grew from the drained pus
44. Using the blue inhaler most weeks
45. Cupfuls of sputum every day
46. A newborn with an empty abdomen
47. Fast breathing after a planned section
48. Pink when crying, blue when calm
49. Wet cough since the first week
50. Fast breathing but drinking well

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Parainfluenza virus, Oxygen with nebulised adrenaline, The larynx above the vocal cords, Streptococcus pneumoniae, Acute appendicitis with a retrocaecal appendix, Intravenous magnesium sulphate given over 20 minutes, Vomiting and abdominal discomfort, Pseudomonas aeruginosa, Gastro-oesophageal reflux causing a chronic cough, Pulmonary sequestration of the intralobar type, Increase the ventilator rate, No treatment, with clinical review in three months, Staphylococcus aureus, Insert a needle into the left chest to decompress it.

Clinical pearls from this deck

• Stridor is an inspiratory noise from above the thoracic inlet; wheeze is expiratory and from below it. That one distinction sorts most noisy children.
• Croup that arrives without a cold and leaves before morning, again and again, is not an infection.
• Even the child you are about to send home gets the steroid; that dose is what stops him coming back at three in the morning.
• A quiet chest in a noisy illness is the most frightening sign there is; the noise stopped because the air stopped.
• Drooling with no cough is epiglottitis until proved otherwise. Put the tongue depressor down and call the anaesthetist.
• A case of this today is a vaccine question. Ask what the child received, and check the rest of the household.

This deck is open to everyone with no sign-in. Work through it once for recognition, then again a week later to test yourself.

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