Certified Registered Nurse Anesthetist (CRNA) Practice Exam

What is the primary treatment for acute laryngotracheobronchitis (croup)?

1. Aspirin therapy

2. Aerosolized epinephrine

3. Bronchodilators

4. Oral steroids

The correct answer is: Aerosolized epinephrine

The primary treatment for acute laryngotracheobronchitis, commonly known as croup, is aerosolized epinephrine. This treatment is effective because it acts as a potent vasoconstrictor and can help reduce edema in the airways, providing rapid relief of stridor and respiratory distress associated with croup. The administration of aerosolized epinephrine causes bronchodilation and helps to decrease airway swelling through its alpha-adrenergic and beta-adrenergic effects, making it crucial in managing acute symptoms. While other treatments, such as oral steroids, may be used in conjunction with aerosolized epinephrine for more severe cases to reduce inflammation, they do not provide the immediate symptom relief required in acute settings. Bronchodilators, though beneficial in other respiratory conditions, are not the first line of treatment for croup and are generally not effective for the inflammation seen in this condition. Aspirin therapy is also not appropriate for croup, as it is not indicated in this scenario and can pose risks, especially in children due to the association with Reye's syndrome.