Question 1

Childhood vaccination is done to prevent which of the following possible causes of epiglottitis?&#10;A) Haemophilus influenza type B&#10;B) Streptococcus pneumoniae&#10;C) Diphtheria&#10;D) Parainfluenza viruses

Accepted Answer

Haemophilus influenzae type B (Hib) vaccination is specifically targeted to prevent infections caused by Hib, including epiglottitis, which is a potentially life-threatening condition characterized by inflammation and swelling of the epiglottis.

Question 2

Which of the following is/are commonly seen on the lateral neck x-ray of a patient with LTB?
1) "Pencil point" narrowing of the upper airway
2) Haziness in the subglottic area
3) Classic "thumb sign"
4) "Steeple point" narrowing of the upper airway

A)1, 3
B)2, 4
C)1, 2, 4
D)2, 3, 4

1, 2, 4

Accepted Answer

The "steeple sign" (choice 4) and subglottic haziness (choice 2) are indicative of LTB (laryngotracheobronchitis or croup) on a lateral neck x-ray. "Pencil point" narrowing (choice 1) is also a description sometimes used for the narrowing seen in croup. The "thumb sign" (choice 3) is associated with epiglottitis, not LTB.

Question 3

The barking sound heard in a patient with LTB is caused by which of the following?&#10;A) Partial lower airway obstruction&#10;B) Partial upper airway obstruction&#10;C) Expiration against a partially closed glottis&#10;D) Pharyngeal edema

Accepted Answer

The barking sound heard in a patient with Laryngotracheobronchitis (LTB) is caused by partial upper airway obstruction. LTB, commonly known as croup, primarily affects the larynx and trachea, leading to the characteristic barking cough due to swelling and obstruction in the upper airway.

Question 4

A patient has been diagnosed with bacterial tracheitis. Which of the following antibiotics should the respiratory therapist most likely recommend?&#10;A) Cloxacillin&#10;B) Nebcin&#10;C) Keflex&#10;D) Unasyn

Accepted Answer

Unasyn, a combination of ampicillin and sulbactam, is often recommended for bacterial tracheitis due to its broad-spectrum activity against the types of bacteria commonly responsible for this condition.

Question 5

The respiratory therapist is assigned to the pediatric unit of the hospital. The physician who is caring for a 3-year-old boy with LTB asks what respiratory therapy treatments should be given. The respiratory therapist should suggest which of the following?
1) Racemic epinephrine
2) Cool mist
3) Antibiotics
4) Endotracheal or tracheostomy tube

A)1, 2
B)2, 4
C)1, 2, 3
D)2, 3, 4

Accepted Answer

Racemic epinephrine and cool mist are common treatments for Laryngotracheobronchitis (LTB) to reduce airway inflammation and improve breathing. Antibiotics are not typically used unless there is a bacterial infection, and airway intubation is usually a last resort.

Question 6

The diagnosis of LTB typically does not include the child:&#10;A) having inspiratory stridor and barking cough.&#10;B) having a normal temperature or low fever.&#10;C) having a significant fever.&#10;D) Being able to drink without difficulty.

Accepted Answer

LTB (Laryngotracheobronchitis) typically presents with symptoms like inspiratory stridor and a barking cough, and affected children often have a normal temperature or low-grade fever. A significant fever is less common in LTB, distinguishing it from other conditions like bacterial tracheitis.

Question 7

The medication racemic epinephrine is given to a patient with LTB because it:&#10;A) is an effective bronchodilator.&#10;B) causes mucosal vasoconstriction.&#10;C) causes bradycardia.&#10;D) has an appealing taste and smell.

Accepted Answer

Racemic epinephrine is used in LTB (laryngotracheobronchitis) primarily because it causes mucosal vasoconstriction, which reduces airway edema and improves breathing.

Question 8

The diagnosis of epiglottitis is aided by:
1) laying the patient down and observing the throat with a tongue blade.
2) visualization of the throat during tracheal intubation.
3) observing if the patient can swallow.
4) observing how the patient holds his/her tongue.

A)1, 2
B)3, 4
C)2, 3, 4
D)1, 3, 4

Accepted Answer

Epiglottitis diagnosis is supported by visualization of the throat during tracheal intubation (2), observing if the patient can swallow (3), and noting the patient's tongue position, as difficulty swallowing or altered tongue position can indicate epiglottis swelling. Direct observation with a tongue blade (1) is generally avoided due to the risk of inducing airway obstruction.

Question 9

When a patient has laryngotracheobronchitis (LTB), which of the following is the primary anatomic alteration that is found?&#10;A) Edema of the mucous membranes&#10;B) Airway smooth muscle contraction&#10;C) Excessive alveolar fluid&#10;D) Epiglottitis

Accepted Answer

Laryngotracheobronchitis (LTB), commonly known as croup, primarily involves inflammation and edema of the mucous membranes lining the larynx, trachea, and bronchi. This leads to the characteristic symptoms of a barking cough, stridor, and hoarseness.

Question 10

The following would not be expected during the assessment of a young child with LTB?&#10;A) Decreased respiratory rate.&#10;B) Diminished breath sounds.&#10;C) Use of accessory muscles.&#10;D) Hypoxemia.

Accepted Answer

During the assessment of a young child with Laryngotracheobronchitis (LTB), an increased respiratory rate is expected due to difficulty breathing, not a decreased respiratory rate. Diminished breath sounds, use of accessory muscles, and hypoxemia are all expected findings in a child with LTB due to airway obstruction and increased work of breathing.

Question 11

In evaluating a 16-month-old boy, the respiratory therapist finds him to be in mild respiratory distress, without a fever, but with a barking-type cough. A lateral neck x-ray taken in the emergency department shows a "steeple point" narrowing of the trachea. Based on this information, which of the following would the respiratory therapist conclude is the most probable diagnosis?

A) Acute bronchitis
B) Epiglottitis
C) Bronchiolitis
D) LTB

Accepted Answer

The answer of In evaluating a 16-month-old boy, the respiratory...

Question 12

Which of the following anatomic alterations may be found in a patient with LTB?
1) Increased secretions
2) Ineffective cilia
3) Narrowed airway lumen
4) Excessive surfactant production

A)1, 3
B)1, 2, 4
C)2, 3, 4
D)1, 2, 3

Accepted Answer

The answer of Which of the following anatomic alterations may...

Question 13

Most cases of LTB occur during which seasons of the year?&#10;1) Spring&#10;2) Summer&#10;3) Fall&#10;4) Winter&#10;A)1, 2&#10;B)2, 4&#10;C)3, 4&#10;D)1, 2, 3

Accepted Answer

The answer of Most cases of LTB occur during which...

Question 14

What is the main clinical risk facing a patient with epiglottitis?&#10;A) Secretions will block the trachea.&#10;B) The epiglottis will bleed.&#10;C) The laryngeal inlet may become covered by the epiglottis.&#10;D) The vocal cords will spasm and close the laryngeal inlet.

Accepted Answer

The answer of What is the main clinical risk facing...

Question 15

A patient has epiglottitis. This condition will affect which of the following?
1) Pharynx
2) Aryepiglottic folds
3) False vocal cords
4) Trachea

A)1, 2
B)2, 3
C)1, 2, 3
D)2, 3, 4

Accepted Answer

The answer of A patient has epiglottitis. This condition will...

Deck 43: Croup and Croup-Like Syndromes: Laryngotracheobronchitis, Bacterial Tracheitis, and Acute Epiglottitis