Rosh Pediatrics Practice Exam

What is the most likely physical examination finding in a child experiencing foreign body aspiration?

1. Coughing

2. Cyanosis of the lips

3. Global wheezing

4. Vomiting

The correct answer is: Coughing

Coughing is the most likely physical examination finding in a child experiencing foreign body aspiration because it is a natural reflex response to irritation or obstruction in the airway. When a foreign body is inhaled, it can cause immediate distress and activate the cough reflex in an attempt to expel the obstruction. This reflex is often vigorous, and children typically exhibit bouts of coughing that can be both forceful and persistent. While cyanosis of the lips may occur in more severe cases where there is significant airway obstruction and reduced oxygenation, it is not as common as coughing in the initial stages. Global wheezing might be present, but it is less specific and may not occur if the airway is completely occluded. Vomiting can be seen in some cases, possibly due to airway irritation or gagging, but it is not a typical finding directly associated with foreign body aspiration. The primary presentation during the physical examination will usually highlight recurrent or persistent coughing as the child attempts to clear the obstruction.