Respiratory – Set 2

What this deck covers

Respiratory – 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 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. Left basal crackles, drinking well
2. Cold air, running and a tight chest
3. Newly diagnosed at 7 years
4. Forgot his preventer, tight chest
5. Toddler with one lobe consolidated
6. White plaques and a hoarse voice
7. Crackles and wheeze on both sides
8. Night cough on a daily preventer
9. Tiring at the breast
10. No better after an hour of treatment
11. Swelling and wheeze after a past dose
12. Restless and vomiting on an infusion
13. Film before transfer to intensive care
14. Wheezy episodes, no test yet
15. Which problem tends to follow
16. Feverish boy, one side moving less
17. Parents want an X-ray
18. Two lobes shadowed, drinking well
19. Mite-proof bedding question
20. Vomiting and right iliac fossa pain
21. Vaccines declined, admitted on oxygen
22. Following a wheezy preschooler
23. A cold, then cough and fast breathing
24. A gas three hours into treatment
25. Nursery toddler with a chest infection
26. Well again after a round shadow
27. Toddler flaring, drinking less
28. Worsening on IV drugs in PICU
29. Spirometry before and after a reliever
30. Coughing and breathless at 5 weeks
31. Slow-building cough at school age
32. Settings after intubation
33. Counting breaths on a lap
34. Too breathless to talk or eat
35. Still needing a reliever most weeks
36. First wheezy illness at 12 months
37. A round shadow and three days of fever
38. Infection while on oral theophylline
39. Pleuritic pain, admitted on oxygen
40. Still coughing after discharge
41. A new diagnosis and a smoky home
42. Wheezy for a day, reliever not helping
43. Red eyes, sore throat and a chest
44. Grunting and refusing drinks
45. Parents ask about the viruses
46. A month after a PICU stay
47. Healthy girl, crackles at one base
48. Daily wheeze at the clinic
49. Never vaccinated, three days of fever
50. Winter infant with a wheezy chest

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: A sputum culture, An IV aminophylline loading dose, Bronchopneumonia, Magnesium sulfate 40 mg/kg over 20 minutes, A large left pleural effusion with mediastinal shift, Hyper-resonance with absent breath sounds, Pulse oximetry, Respiratory viruses, A single pCO2 value above 8 kPa on his gas, Streptococcus pneumoniae, Nebulised salbutamol driven by air, Oral amoxicillin, A chest X-ray is needed to look for an abscess, Mycoplasma pneumoniae.

Clinical pearls from this deck

• Home treatment, no tests.
• Pre-exercise reliever first, daily inhaled steroid next.
• Start with a low-dose inhaled steroid, not a reliever alone.
• Up to 10 single puffs, one every 60 seconds.
• Lobar pneumonia beyond the newborn period: think pneumococcus.
• Spacer plus rinse prevents inhaled-steroid thrush.

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.