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respiratory distress

Practice targeted AMC-style multiple-choice questions on respiratory distress.

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A 7-year-old boy is brought to the emergency department by his parents due to sudden onset wheezing and difficulty breathing. He has a history of asthma, for which he uses a salbutamol inhaler as needed. His parents report that he had a cold over the past few days, and today he started wheezing and became short of breath. On examination, he is in moderate respiratory distress, with a respiratory rate of 30 breaths per minute, oxygen saturation of 92% on room air, and widespread wheezing on auscultation. What is the most appropriate initial management step for this child?

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A 3-year-old child presents to the clinic with a history of recurrent wheezing episodes, especially during viral infections. What is the most common cause of wheezing in children under 5 years of age?

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A 4-year-old child presents with a history of recurrent wheezing and cough, particularly at night and with exercise. What is the most appropriate long-term management strategy?

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For preterm neonate with RDS, when is surfactant most effective?

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A 28-year-old male is brought to the emergency department after a high-speed motor vehicle accident. He is unconscious with a Glasgow Coma Scale (GCS) score of 6. His blood pressure is 90/60 mmHg, heart rate is 120 bpm, and respiratory rate is 28 breaths per minute. On examination, there is bruising over the left chest and decreased breath sounds on the left side. What is the most appropriate immediate management step?

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A 62-year-old man with a history of chronic obstructive pulmonary disease (COPD) and type 2 diabetes presents to the emergency department with increasing shortness of breath over the past two days. He reports a productive cough with greenish sputum and denies chest pain. On examination, he is using accessory muscles to breathe, has a respiratory rate of 28 breaths per minute, and oxygen saturation of 88% on room air. His blood pressure is 130/85 mmHg, and his heart rate is 105 bpm. Auscultation of the chest reveals diffuse wheezing and decreased breath sounds bilaterally. An arterial blood gas analysis shows pH 7.32, PaCO2 55 mmHg, and PaO2 60 mmHg. What is the most appropriate next step in the management of this patient?

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A 45-year-old man presents to the general practice clinic with a 6-month history of progressive shortness of breath and a persistent dry cough. He works as a construction worker and has a 20-pack-year smoking history. On examination, he has clubbing of the fingers and fine inspiratory crackles at the lung bases. Pulmonary function tests show a restrictive pattern. A high-resolution CT scan of the chest reveals reticular opacities and honeycombing predominantly in the lower lobes. Which of the following is the most likely diagnosis?

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A 3-year-old child presents to the emergency department with a sudden onset of cough, wheezing, and difficulty breathing after playing with small toys. The child is in mild respiratory distress, with a respiratory rate of 40 breaths per minute and oxygen saturation of 92% on room air. On auscultation, there are decreased breath sounds on the right side with wheezing. The child has no fever, and there is no history of recent illness. What is the most likely cause of these symptoms?

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A 2-year-old child is brought to the emergency department by their parents due to a persistent cough, wheezing, and difficulty breathing that has worsened over the past two days. The child has a known history of eczema and multiple food allergies, including peanuts and eggs. On examination, the child appears in mild respiratory distress with nasal flaring and intercostal retractions. Auscultation of the chest reveals bilateral wheezing. The child is afebrile, with a respiratory rate of 40 breaths per minute, heart rate of 120 bpm, and oxygen saturation of 94% on room air. A chest X-ray shows hyperinflation but no focal consolidation. Which of the following is the most likely diagnosis?

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A 5-year-old child with a known history of asthma presents with acute shortness of breath and wheezing after playing outside. What is the most appropriate initial treatment?

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A 6-year-old child with a history of asthma presents with increased wheezing and difficulty breathing after exposure to cold air. What is the most appropriate immediate management?

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A 10-year-old girl with a 3-day history of shortness of breath, fever, and headache has been diagnosed with pneumonia. What signs might be seen in severe pneumonia?

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A 10-year-old boy with a history of asthma presents to the emergency department with wheezing and shortness of breath. His mother reports that he has been using his salbutamol inhaler more frequently over the past two days. On examination, he has a respiratory rate of 28 breaths per minute, and his oxygen saturation is 92% on room air. What is the most appropriate initial management step?

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A 45-year-old man presents to the clinic with a 3-month history of persistent cough and shortness of breath. He is a non-smoker and works as a carpenter. On examination, there are bilateral inspiratory crackles at the lung bases. A chest X-ray shows reticular opacities predominantly in the lower lobes. Pulmonary function tests reveal a restrictive pattern. What is the most likely diagnosis?

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A 6-year-old boy is brought to the emergency department by his parents due to sudden onset wheezing and difficulty breathing. He has a history of atopic dermatitis and allergic rhinitis. His parents mention that he was playing outside when the symptoms began. On examination, he is in mild respiratory distress with a respiratory rate of 28 breaths per minute, oxygen saturation of 94% on room air, and bilateral wheezing on auscultation. There is no fever, and his heart rate is 110 bpm. Which of the following is the most likely diagnosis?

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A 4-year-old boy is brought to the pediatrician by his parents due to a persistent cough and wheezing for the past two weeks. The symptoms started after he had a cold. He has no significant past medical history and is up to date with his vaccinations. On examination, he is afebrile, with mild respiratory distress and bilateral wheezing on auscultation. What is the most appropriate initial treatment?

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A 72-year-old man with a history of hypertension and type 2 diabetes mellitus is being managed with lisinopril. He presents to the emergency department complaining of lip swelling and difficulty breathing. On examination, his tongue appears swollen. What is the most appropriate immediate management?

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A 5-year-old boy presents with wheezing, shortness of breath, and a history of recurrent respiratory infections. His symptoms worsen with exercise and during the night. What is the most likely diagnosis?

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A 3-year-old child is brought to the general practice clinic by his parents due to recurrent episodes of wheezing and cough, particularly following viral upper respiratory tract infections. The child has had multiple similar episodes over the past year, each resolving with bronchodilator therapy. There is no history of eczema or allergic rhinitis, and the family history is unremarkable for atopic conditions. On examination, the child appears well between episodes, with normal growth parameters and no signs of respiratory distress. Auscultation of the chest reveals clear lung fields without wheezes or crackles. Which of the following is the most likely underlying condition?

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A 1-year-old child is brought to the emergency department with a 3-day history of cough, wheezing, and difficulty breathing. The child has a fever of 38.5°C and a runny nose. On examination, the child appears in mild respiratory distress with nasal flaring and intercostal retractions. Auscultation reveals diffuse wheezing and crackles throughout the lung fields. The child has no significant past medical history and is up to date with vaccinations. A chest X-ray shows hyperinflation but no focal consolidation. Which of the following is the most likely diagnosis?

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