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Pediatrics From A to Z
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270
Q/12
7-year-old child has history of recurrent cough and wheeze, he was diagnosed as bronchial asthma, He had history of daily cough at day and nearly more than two times attack at night per week. Select medication that is least recommended as long term control treatment:
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Empyema – Golden Keys
🔑 Definition
Pus in the pleural space
Complication of bacterial pneumonia
🔑 Age Group
• خاصة بعد pneumonia غير مستجيبة للعلاج
🔑 Key History
Fever persists or worsens despite antibiotics
Cough + purulent sputum
Pleuritic chest pain
Dyspnea
⸻
🔑 Key Examination
• ↓ Breath sounds
• Dullness on percussion
• ↓ Chest expansion on affected side
• Signs of pleural effusion
⸻
🔑 Key Investigations
• CXR: Pleural effusion
• US chest: Septations / loculations
• Thoracentesis: PUS ⭐⭐⭐ (diagnostic)
⸻
🔑 Common Organisms
• Streptococcus pneumoniae ⭐
• Staphylococcus aureus
• Streptococcus pyogenes
⸻
🔑 Management Keys
• IV antibiotics
• Chest tube drainage
• Fibrinolytics / VATS if loculated
⸻
Golden One-liner
Pneumonia + persistent fever + pleural pus = Empyema
270
Q/11
A 10-year-old girl presents with fever, cough, and yellowish sputum. She was initially treated with antibiotics for 3 days but showe
no improvement. Six days later, she returns with pleuritic chest pain and shortness of breath. On examination, classical signs of pleural effusion are noted. A chest X-ray reveals right-sided pleural effusion, and Thoracentesis reveals pus. What is the most
likely diagnosis?
270
Q/10
A 5-year-old girl presents with respiratory distress. She has a recent upper respiratory tract infection. A provisional diagnosis of
bacterial tracheitis was made. Which of the following clinical features is least typically associated with bacterial tracheitis?
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Q/9
A 3-year-old boy with sudden onset of barking cough started in the early morning. He ordered neck and chest X-ray. The following
radiographic changes is most likely expected to notice:
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Q/8
A 2-month-old neonate presents with symptoms suggestive of pneumonia. Which pathogen is least commonly associated with
pneumonia at this age?
270
Q7/
A 4-year-old boy is admitted to hospital with suspicion of epiglottitis. Which of the following statements about the management of epiglottitis is TRUE?
270
Q6/
A 4-year-old male patient was suffering from recurrent attack of cough and difficult breathing aggravated by upper respiratory
tract infection; He has bilateral expiratory rhonchi all over the chest. Which of the following drugs is least effective for treatment
of his current respiratory distress?
270
Q5/
A 5-month-ill patient admitted to the emergency room diagnosed as a case of bronchiolitis. Which one of these features is least
consistent with the diagnosis of bronchiolitis?
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Q/4
6-month-old girl is referred after her first episode of wheezing. She had rhinorrhea and cough for three days, followed by
breathing difficulty. Her RR is 60 breaths/min., temperature is 38.2°C, Subcostal retraction and diffuse wheezing are observed.
Which of the following is the most likely diagnosis?
