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Croup — MCCQE Part 1 MCQ

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EasyChild with FeverCroupMCCQE Part 1

3-year-old child presents with barking cough and stridor. Stridor occurs at rest with moderate recession but oxygen saturation is 96%. Which of the following is the most appropriate next step?

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Correct answer: C — Give dexamethasone and nebulised epinephrine with observation

Give dexamethasone and nebulised epinephrine with observation is best because stridor at rest indicates moderate/severe croup needing epinephrine plus steroid. Provide only reassurance without clear follow-up or safety-netting is suboptimal because children can deteriorate quickly and follow-up must be explicit; Use adult dosing or adult pathways without paediatric adjustment is suboptimal because children require age- and weight-appropriate care; Delay assessment until the next routine visit is suboptimal because developmental, infectious and neonatal red flags require timely assessment; Give antibiotics, steroids or investigations routinely despite no indication is suboptimal because over-treatment can cause harm when supportive or targeted care is indicated. Steroids benefit croup across severity levels.

Reference: Canadian Paediatric Society croup statement