American Board of Family Medicine (ABFM) Practice Exam

Which condition is characterized by stridor, difficulty breathing, and fever in children?

1. Croup

2. Bronchiolitis

3. Pneumonia

4. Asthma

The correct answer is: Croup

Croup, also known as laryngotracheobronchitis, is characterized by a combination of stridor (a high-pitched wheezing sound due to turbulent airflow), difficulty breathing, and typically a fever. This condition is most commonly seen in children, particularly those under the age of five, and is often caused by viral infections, most notably the parainfluenza virus. In croup, the inflammation of the upper airways leads to swelling around the vocal cords, which results in stridor and a characteristic "barking" cough. Fever may accompany the illness as a result of the viral infection. The clinical presentation and age of the patient are key factors in diagnosing croup, making it the most likely condition among the options provided. Bronchiolitis, on the other hand, primarily affects the lower respiratory tract and is typically associated with wheezing rather than stridor. Pneumonia can present with respiratory distress and fever, but stridor is not a characteristic symptom of pneumonia. Asthma may cause wheezing and difficulty breathing, but it does not commonly present with fever unless there is a concurrent infection. Therefore, the combination of symptoms described aligns with the definition of croup.