Certified Respiratory Therapist Practice Exam

In a child with wheezing and stridor, an AP x-ray shows subglottic edema. What is the likely diagnosis?

1. Bronchiolitis

2. Pneumonia

3. Croup

4. Laryngomalacia

The correct answer is: Croup

In the scenario presented, the presence of wheezing and stridor in conjunction with subglottic edema indicated by the AP x-ray strongly points to croup as the likely diagnosis. Croup, or laryngotracheobronchitis, is an inflammation of the upper airway that leads to swelling, particularly in the subglottic area, which is common in young children. The typical presentation of croup includes a "barking" cough, stridor, and respiratory distress, all of which align with the symptoms described. Subglottic edema is characteristic of croup, often resulting from viral infections like parainfluenza, and is a crucial clinical marker for this condition. In the context of other conditions: bronchiolitis typically presents with wheezing but not stridor and generally affects the smaller airways deeper in the lungs; pneumonia can also cause wheezing but is not associated with the stridor or specific subglottic edema seen in croup; and laryngomalacia is a structural abnormality that can lead to stridor but is generally not associated with acute edema and wheezing events as seen in upper airway infections like croup. Thus, the combination of wheezing, stridor, and sub