Rosh Pediatrics Practice Exam

Which condition is most likely diagnosed in a 3-year-old girl exhibiting neck stiffness, stridor, and a history of a sore throat?

1. Croup

2. Epiglottitis

3. Retropharyngeal abscess

4. Streptococcal pharyngitis

The correct answer is: Epiglottitis

The diagnosis of epiglottitis is particularly relevant in this scenario due to the characteristic presentation of neck stiffness, stridor, and a history of sore throat in a young child. Epiglottitis is an inflammation of the epiglottis that can lead to airway obstruction, making the stridor a significant clinical sign indicating a potentially severe condition. In this age group, the presence of neck stiffness can suggest the child is trying to adopt a position that may relieve discomfort associated with airway issues. Additionally, a sore throat may precede the acute onset of symptoms associated with epiglottitis, as it often starts with a mild infection that progresses quickly. This combination of symptoms aligns with epiglottitis, which could lead to remarkable distress and severe respiratory compromise. Timely recognition is critical, as epiglottitis can rapidly become life-threatening if the airway becomes completely obstructed. Other conditions like croup, retropharyngeal abscess, and streptococcal pharyngitis present with differing symptom profiles. Croup typically involves a barking cough and is more common in children aged 6 months to 3 years, generally not presenting with neck stiffness. A retropharyngeal abscess can cause similar symptoms