A 1-year-old baby girl was brought to your office in January because of fever, rhinorrhea, and a harsh, "barking" cough. The cough did not produce any sputum. The child's mother said that the baby's appetite was "o.k." and that she had not been vomiting. The mother also said that this was the first time the baby had ever been sick.
Question 1 - Single Best Answer
What is rhinorrhea? Bugs Database
A) watery eyes
B) runny nose
C) excessive salivation
D) sneezing
E) watery diarrhea
Question 2 - Single Best Answer
All of the following could, under certain circumstances, be a cause of the baby's symptoms. Which would be most likely in this baby? Bugs Database
A) Bordetella pertussis
B) measles virus
C) respiratory syncytial virus
D) Chlamydia trachomatis
E) papilloma virus
Further physical examination shows that the child's temperature was 38.4. She was not in acute distress although there was persistent stridor during inspiration. Her throat was slightly red. On lung examination, upper airway sounds were prominent but there were no crackles or subcostal retractions.
Question 3 - Single Best Answer
What is stridor? Bugs Database
A) high-pitched musical sound heard during inspiration
B) gasping for breath
C) bubbling sound in the lungs
D) visible sinking-in of the soft tissue between the ribs
Question 4 - Single Best Answer
The absence of crackles is an indication that? Bugs Database
A) the baby has measles
B) the baby has croup
C) the baby is not allergic
D) the baby does not have pneumonia
Question 5 - Single Best Answer
What other sign would you look for if you thought the baby had measles? Bugs Database
A) vesicular rash
B) maculopapular rash
C) conjunctivitis
D) otitis media
E) Koplik spots
Question 6 - Single Best Answer
You note no other symptoms, and decide that the child has croup (laryngotracheobronchitis). What are the defining symptoms of croup? Bugs Database
A) fever and cough
B) barking cough and stridor
C) stridor and crackles
D) rash and fever
E) runny nose and cough
Question 7 - Single Best Answer
Which of the following cause croup? Bugs Database
A) adenoviruses and AAV
B) rubella and rubeola viruses
C) RSV and parainfluenza virus
D) rhinoviruses and coronaviruses
E) parvoviruses
Question 8 - Single Best Answer
Which of the following diseases caused by Haemophilus influenza (H. flu) might be confused with croup? Bugs Database
A) influenza
B) meningitis
C) pneumonia
D) epiglottitis
E) otitis media
Question 9 - Single Best Answer
What three bacteria (besides Haemophilus influenza) might have been considered in your differential? Bugs Database
A) Corynebacteria diphtheria, Mycoplasma pneumonia, Bordetella pertussis
B) Treponema pallidum, Streptococcus pneumonia, Streptococcus pyogenes
C) Corynebacterium diphtheria, E. coli, Streptococcus agalactiae
D) Listeria monocytogenes, Streptococcus agalactiae, Chlamydia trachomatis
Question 10 - Single Best Answer
Should you worry about the baby's red throat? Bugs Database
A) definitely yes
B) definitely no
C) probably yes
D) probably no
Question 11 - Single Best Answer
If you were worried by the throat what would you be worried about? Bugs Database
A) S. pneumonia
B) S. pyogenes
C) herpes virus
D) child abuse
Question 12 - Single Best Answer
What family do parainfluenza and RSV belong to? Bugs Database
A) orthomyxoviridae
B) paramyxoviridae
C) parvoviridae
D) togaviridae
E) enteroviridae
Question 13 - Single Best Answer
How would you tell if the baby was infected with RSV or paraflu -- they both cause similar symptoms in this age group? Bugs Database
A) serology
B) virus isolation
C) viral antigen detection using fluorescent antibodies
D) Gram stain
The baby was found to be infected with Respiratory Syncytial Virus.
Question 14 - Single Best Answer
How would you treat the baby? Bugs Database
A) hyperimmune serum globulin
B) RSV vaccine
C) intravenous ribivarin
D) aerosolized ribivarin
E) humid air and supportive care
Question 15 - Single Best Answer
Flu virus has a segmented genome, while parainfluenza does not. Epidemiologically, what is the significance of this? Bugs Database
A) paraflu can only infect children
B) flu can only infect adults
C) only paraflu is spread by aerosolization
D) paraflu has stable antigenic types, flu does not
E) flu has stable antigenic types, paraflu does not