A 6-Year-Old Boy Is Brought to the Office Due to Persistent

question 63

Multiple Choice

A 6-year-old boy is brought to the office due to persistent cough.  His symptoms began with a mild, upper respiratory illness 2 weeks ago, but the cough has progressively worsened, and now spells of dry cough are often followed by vomiting.  The patient has no chronic medical conditions but has not received childhood vaccinations due to parental beliefs.  He recently returned from a summer camp.  On physical examination, the patient is afebrile, and lungs are clear to auscultation.  Testing of respiratory secretions shows gram-negative coccobacilli.  Which of the following is most likely involved in the pathogenesis of this patient's symptoms?

• A)Alveolar influx of polymorphonuclear leukocytes
• B)Circulating endotoxin-mediated vasodilation
• C)Inflammation and edema of supraglottic tissue
• D)Interferon-gamma-induced macrophage activation
• E)Loss of ciliated respiratory epithelial cells

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