A 15-year-old boy presents with a history of recurrent, severe, unilateral nosebleeds. He denies any trauma or history of a bleeding disorder. Nasal examination reveals a firm, reddish mass in the posterior nasal cavity. What is the most likely diagnosis?
A child is diagnosed with primary ciliary dyskinesia after evaluation for chronic sinopulmonary disease. Transmission electron microscopy of his nasal cilia reveals a specific defect in the outer dynein arms. This ultrastructural abnormality would most directly impair which of the following ciliary functions?
A 6-year-old child develops chronic cough, wheezing, and exercise intolerance following a severe, culture-proven adenovirus pneumonia hospitalization one year ago. Pulmonary function tests show a fixed obstructive defect. A high-resolution computed tomography (HRCT) of the chest is performed to evaluate for post-infectious lung disease. Which constellation of findings on HRCT is characteristic of bronchiolitis obliterans and can often make a lung biopsy unnecessary?
A 4-year-old unimmunized child presents with a high fever, sore throat, and drooling, and is assuming a tripod position. What is the most critical immediate step in this patient’s management?
A 3-year-old child presents to the emergency department with fever, torticollis, drooling, and respiratory distress. A contrast-enhanced CT of the neck confirms a retropharyngeal abscess. Which pathogen has demonstrated an increasing incidence as the cause of this condition, particularly in children under the age of 2?
A 5-year-old child with progressive hypoxemic respiratory failure is diagnosed with secondary pulmonary alveolar proteinosis. The history is significant for failure to thrive, vomiting, and hyperammonemia. The family history reveals a rare autosomal recessive disorder. In addition to supportive respiratory care such as whole lung lavage, which specific management strategy targets the underlying condition?
A 14-year-old girl presents with a 2-month history of fever, fatigue, painful sinusitis, and recurrent epistaxis. She now has hemoptysis and her urinalysis shows hematuria and proteinuria, with an elevated serum creatinine. A chest CT reveals multiple cavitating nodular infiltrates. Which of the following serologic markers is most specific for her underlying condition?
A 4-year-old, fully immunized, and previously healthy boy is brought to the clinic with a 3-day history of fever to 39°C (102.2°F), cough, and tachypnea. On examination, he has localized crackles in the right lower lung field but is not in significant respiratory distress and is well-hydrated. A diagnosis of community-acquired pneumonia is made, and he is deemed stable for outpatient management. What is the most appropriate first-line antibiotic therapy?
A mother of a healthy 2-month-old infant asks for advice on reducing the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related deaths. Which of the following recommendations is most consistent with current American Academy of Pediatrics (AAP) guidelines?
A 7-month-old infant in the pediatric intensive care unit for respiratory failure due to respiratory syncytial virus requires endotracheal intubation and mechanical ventilation. A routine chest radiograph shows the development of lobar collapse. Which pulmonary lobe is most likely to be involved in this infant?
