Paediatric infections: Mycoplasma pneumonia: practice question

A Pediatrics 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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Pediatrics · Paediatric infections: Mycoplasma pneumonia

Sample item

A 10-year-old has had 2 weeks of dry hacking cough, low-grade fever and headache but looks fairly well. The chest radiograph shows patchy bilateral interstitial infiltrates out of proportion to examination findings, and cold agglutinins are positive. Which drug is the best choice?

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

The answer and the reasoning

A. Azithromycin

Mycoplasma pneumoniae causes atypical pneumonia in school-age children with a prolonged dry cough, radiograph worse than the clinical picture and cold agglutinins. The organism has no cell wall, so beta-lactams are ineffective, and macrolides such as azithromycin are used. Extrapulmonary features include haemolysis, rash and neurological signs.

Option by option

  • A. Azithromycin (correct)

    Correct. A macrolide acts on the bacterial ribosome and covers this atypical organism.

  • B. Ceftriaxone

    Ceftriaxone is a beta-lactam and does not cover Mycoplasma.

  • C. Amoxicillin

    Amoxicillin acts on the cell wall, which Mycoplasma lacks.

  • D. Cefazolin

    Cefazolin is a cell wall agent and is ineffective for the same reason.

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.

More Pediatrics questions

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Azithromycin. Mycoplasma pneumoniae causes atypical pneumonia in school-age children with a prolonged dry cough, radiograph worse than the clinical picture and cold agglutinins.

Why is "Ceftriaxone" not the answer?

Ceftriaxone is a beta-lactam and does not cover Mycoplasma.

Why is "Amoxicillin" not the answer?

Amoxicillin acts on the cell wall, which Mycoplasma lacks.

Why is "Cefazolin" not the answer?

Cefazolin is a cell wall agent and is ineffective for the same reason.

What concept does this question test?

It tests Paediatric infections: Mycoplasma pneumonia in Pediatrics. The organism has no cell wall, so beta-lactams are ineffective, and macrolides such as azithromycin are used. Extrapulmonary features include haemolysis, rash and neurological signs.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Paediatric infections: Mycoplasma pneumonia?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.