Mock oral exams › Adenotonsillectomy in a child with sleep apnea and a recent cold, then a post-tonsillectomy bleed
Full access · Session 2: short stem · 13 questions · 35 min
Adenotonsillectomy in a child with sleep apnea and a recent cold, then a post-tonsillectomy bleed
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The stem
A 4-year-old boy, 17 kg, is scheduled for adenotonsillectomy for obstructive sleep apnea. He snores nightly with witnessed pauses and is restless in sleep. Polysomnography showed an apnea-hypopnea index of 14 with an oxygen saturation nadir of 78%. Twelve days ago he developed a cold with fever and cough; the fever and cough have resolved, and he still has clear rhinorrhea. He was born at term, takes no medications, and has no allergies. His mother smokes outdoors.
- Temperature 37.2 °C, HR 112, RR 24, BP 98/56, SpO2 96% on room air
- Tonsils 4+, mouth breathing, no syndromic features
- Chest clear, no wheeze; no stridor
- Hemoglobin 12.4 g/dL