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Croup — USMLE Step 2 CK MCQ

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HardPediatricsCroupUSMLE Step 2 CK

A 14-month-old White boy comes to the pediatric clinic because of new symptoms noticed by a caregiver. History and focused examination are notable for barking cough, inspiratory stridor, hoarseness, and low-grade fever. Temperature is 102.2°F (39.0°C), blood pressure is 108/66 mmHg, pulse is 112/min, respirations are 22/min, and oxygen saturation is 94% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Growth parameters, hydration status, and focused testing are consistent with the described pediatric presentation. Which of the following is the most appropriate next step in management?

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Correct answer: C — Dexamethasone with nebulized epinephrine for stridor at rest

The vignette describes Croup, supported by barking cough, inspiratory stridor, hoarseness, and low-grade fever. Dexamethasone with nebulized epinephrine for stridor at rest is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: AAP Pediatric Airway Guidance