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Grade A | 100% Correct (Verified Answers)
Question 1 A 2-year-old child presents with fever, cough, and stridor. The child is drooling and
leaning forward. The most likely diagnosis is: A. Croup B. Epiglottitis C. Foreign body
aspiration D. Bacterial tracheitis Answer: B. Epiglottitis Rationale: Drooling, fever, and tripod
position (leaning forward) are classic for epiglottitis, a medical emergency. Croup typically
presents with barking cough and no drooling.
Question 2 A 6-month-old infant is brought in with poor feeding, lethargy, and a bulging
fontanelle. The most likely diagnosis is: A. Dehydration B. Meningitis C. Hydrocephalus D.
Hypoglycemia Answer: B. Meningitis Rationale: Bulging fontanelle, lethargy, and poor
feeding in an infant are red flags for bacterial meningitis (e.g., Streptococcus pneumoniae,
Neisseria meningitidis).
Question 3 A 4-year-old child has a sudden onset of high fever, sore throat, and drooling. The
child is sitting forward and appears anxious. The most appropriate initial management is: A.
Immediate throat exam B. Administer amoxicillin C. Do not examine the throat; transport to OR
for intubation D. Give racemic epinephrine Answer: C. Do not examine the throat; transport
to OR for intubation Rationale: This is classic epiglottitis; throat examination can cause
complete airway obstruction. Secure airway in OR with ENT/anesthesia.
Question 4 A 3-year-old child presents with barking cough, stridor, and hoarseness. The child is
mildly ill-appearing. The most likely diagnosis is: A. Epiglottitis B. Croup C. Foreign body
aspiration D. Bacterial tracheitis Answer: B. Croup Rationale: Viral laryngotracheobronchitis
(croup) presents with barking cough, stridor, and hoarseness, usually mild to moderate.
Question 5 The first-line treatment for moderate croup is: A. Dexamethasone 0.6 mg/kg IM or
PO B. Racemic epinephrine nebulized C. Nebulized saline D. Antibiotics Answer: A.
Dexamethasone 0.6 mg/kg IM or PO Rationale: Corticosteroids reduce airway inflammation
and are the cornerstone of croup treatment. Racemic epinephrine is used for severe cases.
, Question 6 A 2-month-old infant presents with paroxysmal coughing fits followed by whoop
and vomiting. The most likely diagnosis is: A. RSV bronchiolitis B. Pertussis C. Croup D.
Foreign body aspiration Answer: B. Pertussis Rationale: Classic “whooping cough” with
paroxysms and post-tussive emesis in unvaccinated or partially vaccinated infants.
Question 7 A 6-year-old child has fever, sore throat, and tonsillar exudate. The rapid strep test is
positive. The most appropriate treatment is: A. Amoxicillin for 10 days B. Azithromycin for 5
days C. Observation only D. Ceftriaxone IM Answer: A. Amoxicillin for 10 days Rationale:
Group A streptococcal pharyngitis requires 10 days of penicillin/amoxicillin to prevent
rheumatic fever.
Question 8 A 10-year-old child has a sudden onset of high fever, drooling, and tripod position.
The most appropriate initial management is: A. Immediate throat exam B. Administer
amoxicillin C. Transport to OR for intubation without throat exam D. Give racemic epinephrine
Answer: C. Transport to OR for intubation without throat exam Rationale: This is
epiglottitis; throat examination can cause complete airway obstruction.
Question 9 A 2-year-old child presents with barking cough and stridor at rest. The child is
moderately ill-appearing. The most appropriate initial treatment is: A. Dexamethasone alone B.
Racemic epinephrine nebulized C. Amoxicillin D. Observation only Answer: B. Racemic
epinephrine nebulized Rationale: Stridor at rest indicates moderate to severe croup; racemic
epinephrine is indicated for airway edema.
Question 10 A 4-month-old infant has a high-pitched cry, poor feeding, and a bulging
fontanelle. The most likely diagnosis is: A. Dehydration B. Meningitis C. Hydrocephalus D.
Colic Answer: B. Meningitis Rationale: Bulging fontanelle, high-pitched cry, and poor feeding
are classic signs of bacterial meningitis in infants.
Question 11 A 3-year-old child has fever, cough, and stridor. The child is drooling and leaning
forward. The most likely diagnosis is: A. Croup B. Epiglottitis C. Foreign body aspiration D.
Bacterial tracheitis Answer: B. Epiglottitis Rationale: Drooling and tripod position are classic
for epiglottitis, a medical emergency.