A 2-year-old has a barking cough, hoarse voice and stridor only when upset, and is alert. What is the most appropriate treatment?
Answer and explanation
Correct answer: C. A single dose of oral dexamethasone
- Step 1: This is mild to moderate croup, a viral laryngotracheobronchitis.
- Step 2: A single dose of oral corticosteroid reduces airway oedema; nebulised adrenaline is for severe croup.
Answer
A single dose of oral dexamethasone.
Why not the others: Regular nebulised salbutamol every four hours at home: Salbutamol does not relieve upper airway oedema. Immediate throat examination with a tongue depressor: Examining the throat risks triggering complete obstruction if epiglottitis is possible. Oral amoxicillin for seven days at home: Antibiotics do not treat viral croup.
Practise more Emergencies and acute illness.
Free questions with an explanation for every one, and full timed PLAB 1 (GMC, international medical graduates) mock tests.
More Emergencies and acute illness questions
- A 3-year-old child is found unresponsive and not breathing. A lone lay rescuer has started basic life support. According to Resuscitation Co…
- A 6-week-old baby has a temperature of 38.4 degrees Celsius but looks well and is feeding. What does NICE advise?
- A 4-month-old has had 3 days of coryza, then a wheezy cough and feeding difficulty. Oxygen saturation is 88 percent in air. What is the appr…
- A 3-year-old has a generalised tonic-clonic seizure lasting 2 minutes during a febrile illness at 39.5 degrees Celsius. He recovers fully wi…
- A 5-year-old is admitted with 2 days of diarrhoea and vomiting. He is irritable with sunken eyes, reduced skin turgor and a fast heart rate.…
- A 7-year-old with type 1 diabetes presents in diabetic ketoacidosis with pH 7.1. Why are rapid large fluid boluses avoided unless he is shoc…