Respiratory – Exam Review Set 3

What this deck covers

Respiratory – Exam Review 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. 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 without any effort
22. Still snoring after surgery
23. Hard to rouse after the operation
24. Headache every morning
25. Pauses in a thriving baby
26. Headaches and a falling capacity
27. The steeple on the film
28. Blue, and still noisy
29. Choking, but still coughing
30. What nobody should do
31. Score of five, slow and shallow
32. Slowing pulse, rising reading
33. When two doses are not enough
34. When the noise stops
35. One half sounds hollow
36. The drug that needs a number
37. Which one earns a bed
38. Whether to order the film
39. Clusters, and one word in the report
40. The step after the first one
41. What to look for on the film
42. Telling one film from another
43. What a wide gap means
44. Saturation is not enough
45. Where the blood comes from
46. Infections plus a failing walk
47. Why the same organism keeps winning
48. The child who can go home
49. Whether one drug is enough
50. The whole family at once

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: A chest radiograph taken between episodes, Poorly controlled asthma with marked variability, The inhaler used directly into the mouth each time, 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, Oral antibiotics, Intubate and ventilate, A silent chest on auscultation, The presence of a wheeze on auscultation, A repeat needle in the same place if he deteriorates.

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.