PASAY CITY GENERAL HOSPITAL
DEPARTMENT OF PEDIATRICS
NAME:
YEAR:
TOPIC: Nelson’s Series: Acute Cough in Distress
For numbers 1-4:
1) A 5 y/o male patient comes in with a 2-day history
of runny nose and mild dry cough with a fever of
39C. He was brought in for consult today because
the mother noted worsening of brassy cough, with
hoarseness, and with production of copious purulent
sputum. PE revealed HR 102, RR 58, T 39C. The child
is seen on semi-recumbent position with his mother
on the examination bed, looks anxious, with
erythematous posterior pharynx, (+) rhonchi on
auscultation. What is the most likely diagnosis?
A. Atypical pneumonia
B. Bacterial tracheitis
C. Epiglottitis
D. Laryngotracheobronchitis
2) If a chest x-ray was done for the patient, what is
the most likely finding seen?
A. Thumb sign
B. Ragged air column sign
C. Steeple sign
D. Diffuse interstitial infiltrates
3) What is the most common isolated pathogen in
the disease entity identified above?
A. Klebsiella pneumoniae
B. Staphylococcus aureus
C. Moraxella catarrhalis
D. Streptococcus pyogenes
4) What is the recommended empiric therapy for the
disease entity identified?
A. Vancomycin and Clindamycin or a 2nd-generation
cephalosporin
B. Clindamycin and macrolides
C. Vancomycin or Clindamycin and a 3rd-generation
cephalosporin
D. Vancomycin only
For numbers 5-8:
5) A 4-year-old male child is brought to the
emergency room due to difficulty breathing. He has
high fever of 39C. 12 hours ago, he started having
sore throat and a mild fever which progressed and
prompted consult. Patient is seen drooling and the
neck is slightly held hyperextended. What is the
most likely diagnosis in this case?
A. Acute Laryngotracheobronchitis
B. Acute Bronchiolitis
C. Acute Epiglottitis
D. Foreign Body Aspiration
DATE:
6) Which among the following is the best next step in
the management of this patient?
A. Start IV and antibiotics
B. Chest x-ray
C. Secure airway with intubation
D. Nebulize with racemic epinephrine
7) In relation to the above case, if an x-ray was done
in this patient, what is the expected finding?
A. Consolidation
B. Thumb sign
C. Steeple sign
D. Ragged air column sign
8) In the recent times, what had been the cause of
reduction of the occurrence of the disease entity
above?
A. Haemophilus influenzae B vaccine
B. Pneumococcal vaccine
C. Proper social distancing and wearing of masks
D. Influenza vaccine
For numbers 9-10:
9) A 3 y/o male comes in with a 2-day history of
runny nose and mild dry cough with a fever of 38C.
His elder brother was noted to have cough and colds
5 days prior. He was brought in for consult today
because the mother noted worsening of cough with
a barking character. The child’s voice was also
hoarse. PE showed HR 102, RR 43, T 38C, seen sitting
upright, looks anxious whenever examined,
erythematous posterior pharynx, and stridor. What
is the most likely diagnosis?
A. Atypical pneumonia
B. Bronchiolitis
C. Bacterial tracheitis
D. Epiglottitis
E. Laryngotracheobronchitis
10) In relation to the above case, if an x-ray was
done in this patient, what is the expected finding?
A. Consolidation
B. Thumb sign
C. Steeple sign
D. Ragged air column sign