Pediatric Exam Scenarios: Upper Respiratory Infections

Pediatric Exam Scenarios

• Scenario 1: Upper Respiratory Infections

  • Question 1: A 3-year-old presents with a sore throat, difficulty swallowing, and fever. Which condition is most likely?

    • Correct Answer: Tonsilitis
    • Rationale: Tonsilitis is a common cause of sore throat in young children.

  • Question 2: A 2-year-old is wheezing and has a productive cough. Which condition is most likely?

    • Correct Answer: Bronchiolitis
    • Rationale: Bronchiolitis, caused by RSV, causes wheezing, cough, and difficulty breathing.

  • Question 3: A 6-month-old presents with stridor that worsens at night. Which condition is most likely?

    • Correct Answer: Croup
    • Rationale: Croup is characterized by barking cough and stridor, especially worse at night.

  • Question 4: A 4-year-old displays high fever, drooling, and difficulty swallowing. Which condition is most likely?

    • Correct Answer: Epiglottitis
    • Rationale: Epiglottitis is a serious infection requiring immediate medical attention. The symptoms are extremely concerning.

  • Question 5: A 2-year-old complains of ear pain, fever, and a purulent discharge from the ear.

    • Correct Answer: Otitis media
    • Rationale: Otitis media is an infection of the middle ear, typically involving ear pain, fever, and discharge.

• Scenario 2: Lower Respiratory Infections

  • Question 1: A 6-month-old presents with labored breathing, runny nose, and wheezing. Which condition is most likely?
    • Correct Answer: RSV
    • Rationale: RSV bronchiolitis often presents with symptoms like labored breathing in younger children.

• Scenario 3: Congenital Heart Defects (CHDs)

  • Question 1: A neonate presents with bluish discoloration of the skin (cyanosis). Which category of CHD is most likely?

    • Correct Answer: Cyanotic CHD
    • Rationale: Cyanotic CHDs cause reduced oxygen-rich blood flow to the body, resulting in cyanosis.

  • Question 2: A child with a murmur presents with shortness of breath on exertion and fatigue. Which condition is likely?

    • Correct Answer: Acyanotic CHD.
    • Rationale: Acyanotic defects impact blood flow, but not oxygen saturation immediately. Symptoms often appear gradually with exertion.

• Scenario 4: Gastrointestinal Conditions

  • Question 1: A 6-week-old infant presents with projectile vomiting, a palpable olive-shaped mass in the upper abdomen, and dehydration.

    • Correct Answer: Pyloric Stenosis
    • Rationale: The classic presentation includes projectile vomiting, a palpable olive-shaped mass, and dehydration.

  • Question 2: A child presents with episodes of severe abdominal pain, followed by passing small amounts of black, tarry stools.

    • Correct Answer: Intussusception
    • Rationale: The characteristic symptoms include pain, and a "currant jelly" stool.

• Question 3: A newborn displays refusal of feeds, bilious vomiting, and abdominal distension. - Correct Answer: Intestinal Atresia - Rationale: These are symptoms of intestinal blockage by atresia.

  • Question 4: A child with a history of constipation shows signs of bowel obstruction.
    • Correct Answer: Hirschsprung Disease
    • Rationale: Hirschsprung's disease involves a lack of ganglion cells in the colon, causing constipation.

• Note: These are simplified examples. A full pediatric exam requires a thorough history, physical exam, and potentially diagnostic testing. The provided scenarios are for illustrative purposes only. Always consult pediatric care guidelines for accurate diagnosis and treatment.