دانشجویان پزشکی 87 کرمان
CASE 8 - A 7-month-old baby was brought by her mother to an outpatient clinic because of a 2-day history of fever, copious nasal secretions, and wheezing. The mother volunteered that the baby has been healthy and has not had these symptoms in the past. The infant’s temperature is noted to be 100.7°F (38.1°C), her respiratory rate is 50 breaths per minute, and her pulse oximetry is 95% on room air. Physical examination reveals no signs of dehydration, but wheezing is heard on bilateral lung fields on auscultation. The infant shows no improvement after three treatments with nebulized albuterol. Which of the following is the recommended treatment?
B. Antihistamines and decongestants
C. Antibiotics for 7 days
D. Initiate synagis
E. Supportive care with hydration and humidified oxygen
CASE 9 - A 9-year-old girl is being seen in your office with fever and difficulty breathing. You are concerned about the diagnosis of epiglottitis. Which of the following is the most accurate statement regarding epiglottitis?
A. Child usually prefers to be in prone position.
B. Radiographic finding of “steeple sign.”
C. Every effort should be made to visualize the epiglottis in the office to confirm the diagnosis.
D. Diagnosis is decreasing in incidence.
CASE 10 - A 5-year-old child is brought into the office due to the mother’s concern of difficulty breathing. On examination wheezing is noted. In which of the following conditions is antibiotic therapy most appropriate?
E. Foreign-body aspiration
CASE 11 - A 12-year-old girl was brought to the emergency department because of severe sore throat, muffled voice, drooling, and fatigue. She had been sick for the past 3 days and is unable to eat because of painful swallowing. The parents deny any history of recurrent pharyngitis. The patient still managed to open her mouth and you were able to see an abscess at the upper pole of the right tonsil with deviation of the uvula toward the midline. Examination of the neck reveals enlarged and tender lymph nodes. Which of the following is the most appropriate management?
A. Analgesics for pain
B. Oral antibiotics
C. Nebulized racemic epinephrine
D. Incision and drainage of the abscess
E. Tonsillectomy and adenoidectomy
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