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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{AZ}}
|QuestionAuthor={{AZ}}
|Prompt=A 18-year-old African american male comes to the office for the evaluation of pain in his right hip that started 7 weeks ago. The pain has gradually progressed, and now it limits his daily activities. He has sickle cell disease and was hospitalized 4 months ago due to a painful crisis that was successfully treated with hydration, oxygen,  and  analgesics. His temperature is 37.4C (99F), blood pressure is 120/90 mmHg, pulse is 90/min, and respirations are 14/min. Physical examination reveals no local tenderness, but there is restriction of abduction and internal rotation of the hip. What is the most likely diagnosis?
|Prompt=A 3 year-old boy is brought to the emergency due to a cough and a "whistling" sound with breathing. Three days ago, he developed fever, a hoarse cry, rhinorrhea and  a  progressively  worsening,  harsh,  "barky"  cough. His  immunizations  are  up-to-date.  His  6-year-old  brother  also  has  cold symptoms. His temperature is 37.5C (99.5F),pulse is 140/min, and respirations are 36/min. On examination, he is conscious, in mild respiratory distress, has a dry barking cough. His pharynx is slightly injected, but without enlargement or asymmetry. The lungs are clear on auscultation. Lateral neck x-rays reveal a mildly narrowed subglottic region. What is the most likely diagnosis?
|Explanation=.
|Explanation='''Educational Objective:'''
 
'''Educational Objective:'''
Avascualr necrosis should be considered in patients with multiple attacks of sickle cell crisis.
Avascualr necrosis should be considered in patients with multiple attacks of sickle cell crisis.
|AnswerA=Femoral fracture
|AnswerA=Foreign body aspiration
|AnswerAExp='''Incorrect'''-[[]]
|AnswerAExp='''Incorrect'''-[[]]
|AnswerB=Joint effusion from septic arthritis
|AnswerB=Epiglottitis
|AnswerBExp='''Incorrect'''-[[]].
|AnswerBExp='''Incorrect'''-[[]].
|AnswerC=Avascular necrosis
|AnswerC=Laryngeal diphtheria
|AnswerCExp='''Correct'''-[[]]
|AnswerCExp='''Incorrect'''-[[]]
|AnswerDExp='''Incorrect'''-[[]].
|AnswerD=Croup
|AnswerE=Osteomyelitis caused by Staphylococcus
|AnswerDExp='''Correct'''-[[]].
|AnswerE=Laryngo-tracheo-broncho pneumonitis
|AnswerEExp='''Incorrect'''-[[]]
|AnswerEExp='''Incorrect'''-[[]]
|RightAnswer=C
|RightAnswer=C

Revision as of 01:05, 27 January 2014

 
Author [[PageAuthor::Ahmed Zaghw, M.D. [1]]]
Exam Type ExamType::
Main Category
Sub Category
Prompt [[Prompt::A 3 year-old boy is brought to the emergency due to a cough and a "whistling" sound with breathing. Three days ago, he developed fever, a hoarse cry, rhinorrhea and a progressively worsening, harsh, "barky" cough. His immunizations are up-to-date. His 6-year-old brother also has cold symptoms. His temperature is 37.5C (99.5F),pulse is 140/min, and respirations are 36/min. On examination, he is conscious, in mild respiratory distress, has a dry barking cough. His pharynx is slightly injected, but without enlargement or asymmetry. The lungs are clear on auscultation. Lateral neck x-rays reveal a mildly narrowed subglottic region. What is the most likely diagnosis?]]
Answer A AnswerA::Foreign body aspiration
Answer A Explanation [[AnswerAExp::Incorrect-[[]]]]
Answer B AnswerB::Epiglottitis
Answer B Explanation [[AnswerBExp::Incorrect-[[]].]]
Answer C AnswerC::Laryngeal diphtheria
Answer C Explanation [[AnswerCExp::Incorrect-[[]]]]
Answer D AnswerD::Croup
Answer D Explanation [[AnswerDExp::Correct-[[]].]]
Answer E AnswerE::Laryngo-tracheo-broncho pneumonitis
Answer E Explanation [[AnswerEExp::Incorrect-[[]]]]
Right Answer RightAnswer::C
Explanation [[Explanation::Educational Objective:

Avascualr necrosis should be considered in patients with multiple attacks of sickle cell crisis.
Educational Objective:
References: ]]

Approved Approved::No
Keyword WBRKeyword::Drug induced myopathy, WBRKeyword::Steroid induced myopathy
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