A 6-month-old boy appears with fever, wheezing, and respiratory distress following an upper respiratory infection (URI). Physical examination reveals bilateral wheezing, subcostal retractions, and nasal flaring. Most likely diagnosis is:

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Question 1 of 5

A 6-month-old boy appears with fever, wheezing, and respiratory distress following an upper respiratory infection (URI). Physical examination reveals bilateral wheezing, subcostal retractions, and nasal flaring. Most likely diagnosis is:

Correct Answer: D

Rationale: Bronchiolitis is typical at 6 months post-URI with bilateral wheezing and distress, per AAP. Asthma is rare this young, and A, B, E are less likely.

Question 2 of 5

A child appears with jaundice and dark urine. Physical examination reveals hepatomegaly. Sweat chloride test is positive. Most likely diagnosis is:

Correct Answer: C

Rationale: Cystic fibrosis fits jaundice, hepatomegaly, and positive sweat test, likely biliary cirrhosis, per CFF. A, B, D, E don’t match.

Question 3 of 5

A child with a history of cystic fibrosis appears with fever and increased coughing. Sputum culture reveals Pseudomonas aeruginosa and Staphylococcus aureus. The next step in management is:

Correct Answer: C

Rationale: IV antibiotics treat dual infection with P. aeruginosa and S. aureus in cystic fibrosis, per CFF. A, B, D, E are inadequate.

Question 4 of 5

A 6-month-old boy has poor weight gain and frequent respiratory infections. Physical exam reveals a pansystolic murmur. Echocardiogram shows a ventricular septal defect. The next step is:

Correct Answer: B

Rationale: Diuretics and observation manage small VSDs with heart failure symptoms, per AHA. A is for large defects, C-E are not primary steps.

Question 5 of 5

A 2-year-old boy presents with fever and a seizure. Exam shows a bulging fontanelle. Most likely diagnosis is:

Correct Answer: B

Rationale: Meningitis fits fever, seizure, and bulging fontanelle, per AAP. A, C-E lack this triad.

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