USMLE Forum Archives - USMLE Step 2 CK - peds
peds
HIV - 12-31-07 12:42
A 2-year old boy is brought to the emergency department at 2:00 a.m. because of episodic coughing "fits". He was well until one day earlier when he developed rhinorrhea and a temperature of 38.3 C (101 F). He has no prior history of respiratory illnesses, and no one else in the family is ill. On arrival to the hospital, he is coughing in a rapid, "barking" fashion, but appears otherwise well. His temperature is 38.2 C (100.8 F), heart rate is 120/min, respiratory rate is 50/min, and oxygen saturation is 96% on room air with coughing. Physical examination shows clear lungs, a normal cardiac and abdominal examination, and no rash. He continues to have repeated, episodic coughing with inspiratory stridor at rest. A frontal radiograph of the chest at this time is most likely to reveal
A. cardiomegaly with pulmonary venous congestion
B. left lower lobe infiltrate
C. pneumothorax
D. subglottic swelling
E. thumb-shaped epiglottis
HIV - 12-31-07 12:42
A 2-year old boy is brought to the emergency department at 2:00 a.m. because of episodic coughing "fits". He was well until one day earlier when he developed rhinorrhea and a temperature of 38.3 C (101 F). He has no prior history of respiratory illnesses, and no one else in the family is ill. On arrival to the hospital, he is coughing in a rapid, "barking" fashion, but appears otherwise well. His temperature is 38.2 C (100.8 F), heart rate is 120/min, respiratory rate is 50/min, and oxygen saturation is 96% on room air with coughing. Physical examination shows clear lungs, a normal cardiac and abdominal examination, and no rash. He continues to have repeated, episodic coughing with inspiratory stridor at rest. A frontal radiograph of the chest at this time is most likely to reveal
A. cardiomegaly with pulmonary venous congestion
B. left lower lobe infiltrate
C. pneumothorax
D. subglottic swelling
E. thumb-shaped epiglottis
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#2
Re: peds InSitu - 01-01-08 17:14 That is croup and answer is D
Thumb refers to Epiglotitis which is more dramatic in which the patient isin severe resp distress and drooling is one give away clue.(E)
The temprature does not indicate pneumonia (B)
Cant be pneumothorax with 96% sat (C)
No reason to have cardiomegally or pulm venous congestion (A)
#5
Re: peds babbu5508 - 07-07-10 00:50 D. subglottic swelling ... laryngotracheobronchitis) is an acute viral infection of the upper airway, leading to swelling and the classical symptoms of a "barking" cough, stridor, and hoarseness.
#6
Re: peds bingousmle - 07-12-10 06:16 repeated, episodic coughing with inspiratory stridor at rest with coughing in a rapid, "barking" fashion suggests subglottic swelling in this kid
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