Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the first-line treatment for croup in pediatric patients?

1. Inhaled steroids

2. Oral dexamethasone

3. Intravenous fluids

4. Antibiotics

The correct answer is: Oral dexamethasone

The first-line treatment for croup in pediatric patients is oral dexamethasone. Croup, often caused by viral infections, leads to inflammation of the upper airway, resulting in symptoms such as a characteristic barking cough, hoarseness, and stridor. The administration of oral dexamethasone, a corticosteroid, reduces inflammation and helps to alleviate these symptoms effectively. Oral dexamethasone is preferred because it is easy to administer, has a favorable side effect profile, and is well-tolerated by children. It provides significant relief from inflammation, helping to prevent the progression of croup and reducing the likelihood of hospital admission. Inhaled steroids, while they have anti-inflammatory properties, are not the preferred initial treatment for croup. Intravenous fluids and antibiotics do not address the underlying inflammation caused by the viral infection, making them inappropriate for routine management of croup in otherwise healthy children.