A 5-year-old boy with moderate persistent asthma appears with wheezing and shortness of breath despite using inhaled steroids for the past 3 months. The next step in management is:

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Question 1 of 5

A 5-year-old boy with moderate persistent asthma appears with wheezing and shortness of breath despite using inhaled steroids for the past 3 months. The next step in management is:

Correct Answer: B

Rationale: Adding a leukotriene antagonist is the next step for uncontrolled moderate persistent asthma on inhaled steroids, per GINA. A-D may escalate unnecessarily.

Question 2 of 5

A child with a history of cystic fibrosis appears with increased coughing and wheezing. Pulmonary function test reveals FEV1 of 60% predicted. Most likely diagnosis is:

Correct Answer: D

Rationale: Cystic fibrosis exacerbation fits increased symptoms and reduced FEV1, per CFF. A-C, E are less likely.

Question 3 of 5

A child with a history of cystic fibrosis appears with fever and hemoptysis. Chest x-ray reveals cavitation in the right upper lobe. Most likely diagnosis is:

Correct Answer: D

Rationale: Bronchiectasis fits hemoptysis and cavitation in cystic fibrosis, per CFF. A-C, E are less likely.

Question 4 of 5

A 3-year-old girl presents with a limp and knee pain. X-ray shows a lytic lesion in the femur. Most likely diagnosis is:

Correct Answer: B

Rationale: Ewing sarcoma presents with lytic bone lesions in young children, per NCI. A, C-E have different x-ray or clinical features.

Question 5 of 5

A 2-year-old boy presents with a barky cough and stridor. X-ray shows a steeple sign. Most likely diagnosis is:

Correct Answer: A

Rationale: Croup features a barky cough, stridor, and steeple sign, per AAP. B-E differ in presentation.

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