A 12-month-old boy presents to the clinic with a cough, nasal congestion, and fever for 8 days. Vital signs reveal respirations of 50 breaths per minute, pulse 118 beats per minute, temperature 102.1°F, and oxygen saturation of 88% on room air. On physical exam, crackles are auscultated in bilateral lungs, and decreased skin turgor is noted. Which of the following is an indication for hospitalization?

A 6-month-old boy presents to the clinic due to weight loss, steatorrhea, and increased frequency of bulky, pale, and foul-smelling stools. Past medical history is significant for meconium ileus at birth and a positive sweat chloride test performed at 3 weeks of age. What is the best initial clinical intervention based on the suspected diagnosis and his current symptoms?

A 10-year-old boy with mild persistent asthma presents to the emergency department with increased chest tightness and wheezing after he played soccer this morning. It has been very windy lately, and he has experienced similar episodes during this season in years past. On physical exam, he is afebrile with a respiratory rate of 24 breaths/min and a heart rate of 122 bpm. There is loud expiratory wheezing noted on auscultation and no accessory muscle use. Which of the following is the first-line treatment for this patient?

A 2-month-old girl presents with a runny nose, persistent wet-sounding cough, and wheezing for the past 5 days that has not improved. She is having a difficult time feeding from a bottle, seems to be gasping for air between latches, and cries out of frustration. Upon physical exam, she has a fever of 100.7°F, mild retractions, and diffuse fine rales in all lung fields revealed on auscultation. Her chest radiograph is unremarkable, and a nasal secretion sample is taken to be tested. Which of the following is a risk factor for the suspected condition?

An 8-year-old boy presents to the emergency department with his father, reporting progressing right-sided throat pain and a fever that began 7 days ago. When speaking to him, you notice his voice is muffled and he is uncomfortable but in no acute respiratory distress. On physical exam, he is drooling, his uvula is deviated toward the left, and he has significant swelling to the right side of his neck. Anterior cervical lymphadenopathy is also noted. Which of the following is the most likely diagnosis?

A 2-month-old boy presents to the clinic for a well-child check with no concerns voiced by his parents. He was born vaginally at 39 weeks gestation and has had no medical complications since birth. Which of the following is an appropriate heart rate for this patient while awake?

A 6-year-old boy presents to the office with audible wheezing and a nonproductive cough off and on for several months, which lately has become more frequent. He reports some chest tightness while running and playing outdoors, especially when he is in the grass. His symptoms improve with rest but never go away. On physical examination, he is pleasant, cooperative, afebrile, and nontoxic in appearance. There is mild end-expiratory wheezing noted in all lung fields. Which of the following is the best test to diagnose his condition?

Which of the following is a risk factor for sudden infant death syndrome?

A 2-year-old boy presents to the emergency department with a 3-day history of low-grade fever, sore throat, runny nose, and a barking cough. On physical exam, he does not appear toxic but has audible inspiratory stridor. What classic radiographic finding will most likely be present on an anteroposterior neck X-ray?

A 5-year-old boy who is unvaccinated presents with an acute onset of fever and distress. Vital signs are temperature of 38.4°C, respiratory rate of 34 breaths per minute, heart rate of 125 bpm, blood pressure of 90/55 mm Hg, and oxygen saturation of 96%. On exam, you note an anxious and toxic-appearing child who is sitting with the trunk leaning forward and the neck hyperextended. A soft tissue lateral neck radiograph demonstrates a thumbprint sign. Which of the following additional physical exam findings would support the most likely diagnosis?

An 11-month-old boy presents to the ED with his mother after she found him choking in their living room 1 hour ago. She states there was a bowl of peanuts spilled on the ground around him. The mother notes the patient stopped choking after about 30 seconds but has been coughing for the past hour. On physical examination, the patient appears to be in no acute distress and is not tachypneic or cyanotic. The patient has an intermittent cough, and lung auscultation reveals monophonic wheezing and decreased breath sounds over the right lung fields. Findings on a chest radiograph are normal. Which of the following is the best next step in the management?

A 6-year-old boy presents to the clinic with a severe sore throat and fever for 2 days. The patient's father states he became worried when he noticed the patient was drooling and having difficulty swallowing foods and liquids. Exam reveals an anxious patient with a fever of 101.2°F oral. The patient is leaning forward with his neck hyperextended and chin thrust forward. What is the most appropriate next step in management?

An 8-year-old girl presents with a chronic cough and wheezing for the past 2 months that have begun to interfere with her daily activities. Her daytime symptoms occur daily, and she states her cough is worse at night and awakens her from sleep once or twice a week. She has been prescribed a short-acting beta-agonist, which she currently uses daily. Which of the following correctly classifies her disease severity?

A 5-year-old boy presents to the ED after his parents noticed he was having difficulty breathing and his cough was worsening. The symptoms began about 4 days ago with what looked like a minor cold with a low-grade fever, runny nose, and mild cough. Now, he is having increased difficulty breathing, notable stridor, and a loud barking cough. Upon examination, the patient appears toxic with a temperature of 102°F. He is using marked retraction while breathing, and inspiratory stridor is heard on auscultation. Oral examination shows erythema without exudates or pseudomembranes. The patient was initially treated with nebulized epinephrine with no response. Which of the following is the most likely diagnosis?