Question 1

The provider sees a child with a history of high fever and sore throat. When entering the exam room, the provider finds the child sitting in the tripod position and notes stridor, drooling, and anxiety. What is the initial action for this patient?

A) Administer empirical intravenous antibiotics and steroids.
B) Have the child lie down and administer high-flow, humidified oxygen.
C) Obtain an immediate consultation with an otolaryngologist.
D) Perform a thorough examination of the oropharynx.

C

Accepted Answer

The presence of stridor, drooling, and anxiety in a child with a history of high fever and sore throat suggests a potential airway obstruction. Obtaining an immediate consultation with an otolaryngologist is the best initial action to manage this potentially life-threatening situation. The child should be positioned upright to ease breathing and intubation equipment should be readily available. Administering antibiotics and steroids may have a role in the long-term management but are not the initial action. Lying down and administering high-flow, humidified oxygen can worsen the airway obstruction. Performing a thorough examination of the oropharynx may cause further agitation and exacerbation of the condition.

Question 2

An adult patient is diagnosed with epiglottitis secondary to a chemical burn. Which medication will be given initially to prevent complications?&#10;A) Chloramphenicol&#10;B) Clindamycin&#10;C) Dexamethasone&#10;D) Metronidazole

Accepted Answer

Dexamethasone is the best initial choice as it is a corticosteroid that helps reduce inflammation and swelling of the epiglottis, which can prevent airway obstruction. Chloramphenicol, clindamycin, and metronidazole are antibiotics and may be given in addition to dexamethasone, but are not the first line of treatment to prevent complications.

Question 3

An adult patient is seen in clinic with fever, sore throat, and dysphagia. Which diagnostic test will the provider order to confirm a diagnosis of epiglottitis?&#10;A) Blood cultures&#10;B) Complete blood count&#10;C) Fiberoptic nasopharyngoscopy&#10;D) Lateral neck film

Accepted Answer

Fiberoptic nasopharyngoscopy is the most direct and effective method to visualize the epiglottis and confirm a diagnosis of epiglottitis.

Deck 79: Epiglottitis