Pharynx and tonsils: Kawasaki disease versus streptococcal pharyngitis: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Pharynx and tonsils: Kawasaki disease versus streptococcal pharyngitis

Sample item

A 3-year-old has had fever for six days despite amoxicillin. He has red cracked lips, bilateral non-purulent conjunctival injection, pharyngeal erythema and a single 2 cm unilateral cervical node. What is the most appropriate treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Intravenous immunoglobulin with aspirin

Persistent fever with mucosal changes, conjunctivitis and a large unilateral cervical node unresponsive to antibiotics is Kawasaki disease. Early intravenous immunoglobulin with aspirin lowers the risk of coronary artery aneurysm.

Option by option

  • A. Intravenous immunoglobulin with aspirin (correct)

    Correct. Kawasaki disease is treated with IVIG and aspirin to protect the coronary arteries.

  • B. Drainage of the cervical node

    A single reactive node in Kawasaki disease is not a collection and needs no drainage.

  • C. Switch to intravenous cefotaxime

    A change of antibiotic does not treat a vasculitis, which is why fever persists.

  • D. Oral prednisolone alone

    Steroid alone is not the standard first treatment and does not protect the coronaries as IVIG does.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is A, Intravenous immunoglobulin with aspirin. Persistent fever with mucosal changes, conjunctivitis and a large unilateral cervical node unresponsive to antibiotics is Kawasaki disease.

Why is "Drainage of the cervical node" not the answer?

A single reactive node in Kawasaki disease is not a collection and needs no drainage.

Why is "Switch to intravenous cefotaxime" not the answer?

A change of antibiotic does not treat a vasculitis, which is why fever persists.

Why is "Oral prednisolone alone" not the answer?

Steroid alone is not the standard first treatment and does not protect the coronaries as IVIG does.

What concept does this question test?

It tests Pharynx and tonsils: Kawasaki disease versus streptococcal pharyngitis in ENT. Early intravenous immunoglobulin with aspirin lowers the risk of coronary artery aneurysm.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Pharynx and tonsils: Kawasaki disease versus streptococcal pharyngitis?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.