Viral Infections USMLE Step 1 Practice Question
A 2-year-old previously healthy boy presents with sudden-onset severe respiratory distress, inspiratory stridor, and cyanosis during sleep. Vital signs show HR 125/min, RR 38/min, BP 95/60 mmHg, SpO2 88% on room air, and temperature 38.2°C. Physical examination reveals marked subglottic edema; neck radiograph confirms subglottic narrowing. No drooling or tripoding noted. He received no prior dexamethasone. Which intervention is most critical for immediate management?
Answer choices
- AEmergent tracheostomy
- BDexamethasone and racemic epinephrineCorrect answer
- CBroad-spectrum antibiotics
- DImmediate intubation without trial of medical therapy
- ESupportive care alone with observation
- FNebulized budesonide and supplemental oxygen
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