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Pulmonary haemosiderosis — RACP Paediatrics MCQ

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HardRespiratoryPulmonary haemosiderosisRACP Paediatrics

A 6-year-old Aboriginal child has a chronic wet cough, recurrent bacterial exacerbations and persistent crackles despite an adequate protracted-bacterial-bronchitis course. Chest radiography is non-diagnostic. What is the best next diagnostic step?

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Correct answer: D — Arrange respiratory review and chest CT interpreted with paediatric bronchiectasis criteria

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

E is correct because persistent wet cough with recurrent exacerbations warrants specialist evaluation; multidetector CT with high-resolution reconstruction and paediatric criteria confirms bronchiectasis and guides aetiological work-up. A ignores a suppurative phenotype. B overstates the sensitivity of plain radiography. C accumulates radiation without definitive anatomy. D commits to long-term therapy before culture, airway-clearance planning and investigation of causes.

Reference: Thoracic Society of Australia and New Zealand, bronchiectasis position statement 2023: https://thoracic.org.au/wp-content/uploads/2023/05/Respirology-2023-Chang-Thoracic-Society-of-Australia-and-New-Zealand-TSANZ-position-statement-on-chronic.pdf