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WorksheetsGroup 2's quiz
Total questions: 20
Worksheet time: 14mins
Which of the following is the most common cause of recurrent wheezing in children?
Foreign Body Airway
Obstruction
Asthma
Pneumonia
Congenital heart disease
A 10-month-old infant presents with acute-onset wheezing. The clinical history reveals a prodrome of upper respiratory tract infection symptoms for the past two days. This presentation occurs during the winter season. Which of the following diagnoses is most likely?
Gastroesophageal reflux
Bronchiolitis
Foreign Body Airway
Obstruction
Asthma
While both tracheomalacia and vascular rings can present with persistent wheezing that is affected by position, which feature is more specific to a vascular ring?
Presence of a monophonic wheeze
Onset early in infancy
Improvement of symptoms in the prone position
Poor response to bronchodilators
A 3-year-old boy has recurrent episodes of wheezing and cough that improve with bronchodilators. The most likely diagnosis is:
Acute bronchiolitis
Asthma
Pneumothorax
Laryngitis
A 7-year-old child presents with persistent wheezing unresponsive to bronchodilators and inhaled corticosteroids. Viral serology is negative. Sputum culture is pending. What additional laboratory investigations would you consider?
Sweat chloride test, immunoglobulin quantification
Only repeat CBC
Chest CT and MRI brain
Methacholine challenge test
What does the presence of eosinophilia on a complete blood count (CBC) suggest in children with wheezing?
Viral infection
Allergic disease or parasitic infection
Bacterial pneumonia
Gastroesophageal reflux disease (GERD)
A 2-year-old child has recurrent wheezing requiring bronchodilator therapy. The mother had obesity before pregnancy. Which of the following statements best reflects current evidence?
Obesity in pregnancy only increases the risk of maternal hypertension, not respiratory problems in the child
Children of obese mothers are protected against wheezing due to higher birth weight
Maternal weight before pregnancy has no effect on childhood wheezing
Maternal pre-pregnancy obesity increases the risk of bronchodilator use in offspring by approximately 22%
A 4-year-old child presents with severe wheezing and respiratory distress. The physician is considering hospital admission. According to current evidence, which of the following is the most appropriate role of antibiotics in this case?
Azithromycin may be considered in preschool children with severe wheezing at risk of hospitalization
Antibiotics are not indicated because most wheezing episodes are viral in origin
Prolonged antibiotics should be used in all cases of wheezing to prevent asthma
Antibiotics are routinely recommended since wheezing is usually bacterial in origin
Which of the following history questions is most relevant in evaluating a wheezing child?
“Does your child have itchy eyes or nose?”
“Does the wheezing get worse at night or with exercise?”
“Has your child recently traveled abroad?”
“How many hours does your child sleep per night?”
A 2-year-old child presents with acute onset of wheezing after eating peanuts. The most likely diagnosis is:
Bronchial asthma
Viral bronchiolitis
Foreign Body Airway
Obstruction
Allergic rhinitis
A 6-month-old infant presents with wheezing, cough, and feeding difficulty. On auscultation, diffuse expiratory wheezes are heard. Oxygen saturation is 88%. Which of the following is the MOST likely cause?
Asthma
Viral bronchiolitis
Foreign Body Airway
Obstruction
Gastroesophageal reflux disease
A 4-year-old boy with a prior diagnosis of "difficult-to-control asthma" is seen for persistent daily wheezing despite being compliant with high-dose inhaled corticosteroids and regular albuterol use. His symptoms are particularly worse after large meals and when lying down at night. He occasionally complains of a stomach ache. What is the most appropriate next step in his management?
Perform a methacholine challenge test to confirm asthma
Investigate for GERD with a 24-hour esophageal pH probe
Refer for rigid bronchoscopy to rule out a foreign body
Increase the dose of his inhaled corticosteroid
Which statement correctly differentiates between rigid bronchoscopy and flexible bronchoscopy?
Rigid bronchoscopy is best for airway structure evaluation; flexible bronchoscopy is preferred for foreign body removal
Flexible bronchoscopy is first-line in sudden-onset wheezing; rigid bronchoscopy is for chronic symptoms
Rigid bronchoscopy is preferred in suspected foreign body aspiration; flexible bronchoscopy is useful to assess airway structural abnormalities
Both methods are interchangeable with no specific indications
A 7-month-old infant presents to the emergency department with acute respiratory distress, wheezing, high fever (40°C or 104°F), and a toxic appearance. On examination, there is a loud, harsh stridor in addition to wheezing. This clinical picture is more severe than typical bronchiolitis and should raise suspicion for a secondary bacterial infection. While not explicitly in the table, which diagnosis is a critical consideration?
Bacterial tracheitis
Vascular ring compression
Swallowing dysfunction
A typical asthma flare
Which imaging study is recommended as the first step in evaluating acute wheezing of unclear cause or persistent wheezing unresponsive to treatment?
Chest CT
Chest X-ray
Magnetic Resonance Angiography (MRA)
Barium swallow X-ray
A 7-month-old infant is brought to the clinic with acute wheezing and mild respiratory distress. On auscultation, bilateral wheezes are noted. The child is otherwise stable, with oxygen saturation at 96% on room air. According to current recommendations, which of the following is the most appropriate initial management?
Observe only, as bronchodilators are ineffective in all infants < 2 years
Start systemic corticosteroids and antibiotics empirically
Refer immediately to the hospital for detailed evaluation
Administer bronchodilator via metered-dose inhaler (MDI) with spacer
A 3-year-old child presents with recurrent episodes of wheezing following viral respiratory infections. The physician is considering the use of montelukast. Based on current evidence, which of the following statements is most accurate?
Montelukast completely prevents recurrent wheezing after viral infections
Montelukast may provide modest benefit in post-viral wheezing, but evidence shows it is a weak treatment option
Montelukast is highly effective and should be the first-line treatment for all wheezing episodes in young children
Montelukast is only indicated for acute severe wheezing requiring hospitalization
A "Videofluoroscopic Swallow Study" (VFSS) is a particularly useful diagnostic tool for identifying which of the following causes of wheezing?
Tracheomalacia
Asthma
Gastroesophageal reflux
Swallowing dysfunction
A 2-year-old child is frequently brought to the emergency department for recurrent wheezing. Despite receiving prescriptions, the parents often fail to administer the medications correctly due to a lack of understanding of the condition. Which of the following best addresses this issue?
Avoiding pharmacologic treatment until parents gain more experience
Referring the child to a tertiary hospital for advanced investigations
Providing parental education sessions to improve disease understanding and treatment adherence
Prescribing stronger medications to ensure better symptom control
In which clinical situations is esophageal pH and impedance monitoring indicated for children with wheezing?
Children with suspected tuberculosis
Infants and children <2 years with recurrent wheezing unresponsive to therapy
Children with well-controlled asthma
Children with acute foreign body aspiration
