SAQ 107 – Paediatrics – infant respiratory distress

Review Completed

Marked out of 12.00

A 3-month-old infant is brought to the emergency department with shortness of breath and increased work of breathing.

Observations are BP 85/50 mmHg, HR 125/min, RR 80/min, oxygen saturation 98% on room air, and rectal temperature 36.5 C.

Complete the table with four likely differential diagnoses from different pathological categories, and one method of confirming each.

(Marked out of 8.0)

/ 8

List four historical features that would increase concern for serious illness in this infant.

(Marked out of 4.0)

/ 4

Total Score: 0 / 12

Percentage: 0%

Category	Example diagnosis	Confirmation
Infection	Viral illness such as croup or bronchiolitis, or bacterial pneumonia.	Septic work-up, chest x-ray, blood cultures, or nasopharyngeal aspirate for respiratory viruses.
Congenital cardiac disease	Congenital heart disease.	Cyanotic episodes during feeds, hyperoxia test, ECG, or echocardiography.
Trauma	Lung contusion, rib fracture, pneumothorax, or non-accidental injury.	Primary and secondary survey, eFAST, fundoscopy, skeletal survey, or chest x-ray.
Metabolic	Inborn error of metabolism or DKA.	BGL, venous blood gas, LFTs, or urine reducing substances.
Congenital anatomical abnormality	Tracheomalacia, subglottic stenosis, or diaphragmatic hernia.	Endoscopy or history of noisy breathing/increased work of breathing with feeds since birth.
Foreign body	Inhaled foreign body.	Chest x-ray, soft tissue neck x-ray, or direct/indirect laryngoscopy.