8/7/2013

8/7/2013

 

Answers:

A foreign body aspiration that is present for a significant amount of time can cause a chronic cough and be misdiagnosed as what?

A) Pneumonia 

B) Asthma 

C) Croup 

D) All of the above 

E) None of the above, foreign bodies present acutely.

If a foreign body is aspirated it may not always present with acute airway symptoms and can cause a chronic cough and/or wheezing which is commonly misdiagnosed as asthma, pneumonia or croup. One must have a high index of suspicion if a patient, with a risk factor for aspiration, with one of these disease does not respond to appropriate therapy.

If a foreign body is aspirated it may cause a ball-valve effect in the bronchi which leads to --- or it can completely obstruct the bronchi leading to ---.

1) hyper expansion 2) lung collapse

MC Question:

How quickly can button batteries can cause mucosal erosion once ingested?

A) immediately on ingestion 

B) within 30 minutes 

C) within 1 hour 

D) within 3 hours 

E) within 6 hours

Free Response Question:
Under what circumstances is it appropriate to observe a patient who has ingested a coin for possible spontaneous passage?

Quick Facts:
With regards to rigid endoscopy removal of foreign body:

-retrieve object while patient is spontaneously breathing if possible
-makes passage of bronchoscope easier
-prevents distal migration of foreign body during + pressure ventilation
-takes advantage of increased cross sectional area during inspiration
-careful to avoid dropping foreign body back in airway once retrieved.