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Croup — RACP Paediatrics MCQ

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HardRespiratoryCroupRACP Paediatrics

A 2-year-old with moderate croup receives oral dexamethasone and nebulised adrenaline for persistent stridor at rest. Stridor resolves completely. The family lives nearby and can return promptly. What is the minimum disposition safeguard?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Observe three hours after adrenaline and discharge if stridor-free at rest

Explanation lettering: E = shown as A · C = shown as B · A = shown as C · B = shown as E

B is correct because recurrence may follow the transient adrenaline effect; RCH requires at least three hours of observation and clinical resolution before discharge. C ignores rebound deterioration. D is unnecessarily absolute when risk factors and recovery are favourable. E treats without an indication. A can distress a child with upper-airway obstruction and does not replace observation. Longer observation is appropriate overnight, after repeated stridor or when access to care is limited.

Reference: Royal Children’s Hospital Melbourne, Croup: https://www.rch.org.au/clinicalguide/guideline_index/Croup_laryngotracheobronchitis/