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MMLU / A 2-year-old boy is brought to the emergency department by his babysitter…

Problem

Answer published by the source. Consult the official source to check your work against its answer.

question

A 2-year-old boy is brought to the emergency department by his babysitter because of a 30-minute history of respiratory distress. The babysitter reports that she is 15 years old and has cared for the patient on numerous occasions during the past year. The child's mother, who is a single parent, is currently out of town for business but will return later tonight. The babysitter says, "He has had a runny nose since I started babysitting yesterday, but this afternoon he awoke from a nap with a barking sound and he was breathing real heavy." She does not know the child's prior health history, nor does she know if the boy takes any medications on a regular basis. The child looks tired and sits upright on the babysitter's lap. He is obviously comfortable with his caregiver. Vital signs are temperature 38.7°C (101.7°F), pulse 110/min, respirations 28/min and labored, and blood pressure 85/50 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 89%. Physical examination discloses inspiratory stridor. Neck is supple, tympanic membranes are normal, and there is a profuse nasal discharge. Examination of the pharynx discloses no abnormalities. Auscultation of the chest discloses equal air entry on both sides and no crackles. The remainder of the examination shows no abnormalities. Treatment with 40% oxygen via venturi mask and intravenous fluids is initiated. Despite continued supplemental oxygen and hydration, the child remains tachypneic and stridorous at rest. Oxygen saturation is now 93%. In addition to administering racemic epinephrine by nebulizer, which of the following is the most appropriate next step?

choices

  1. Intravenous aminophylline therapy
  2. Intravenous antibiotic therapy
  3. Intubation
  4. Oral dexamethasone therapy

subject

professional_medicine

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Source and history

task_id
458b5d3f-669a-54ec-a082-38ad7f076bd4
task_key
all--test--458b5d3f-669a-54ec-a082-38ad7f076bd4
task_revision_id
1
config / split
all / test

Official source

initial import