Paediatric infections: parapneumonic effusion: 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: parapneumonic effusion

Sample item

A 3-year-old with lobar pneumonia remains febrile after 72 hours of intravenous antibiotics. Percussion is stony dull at the right base with reduced breath sounds. What is the next best investigation?

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

The answer and the reasoning

D. Chest ultrasound

Persistent fever with dullness and reduced air entry suggests a parapneumonic effusion or empyema. Ultrasound confirms fluid, shows septations and guides drainage. A child unable to expectorate would not yield a sputum sample.

Option by option

  • A. Echocardiography

    Echocardiography is not the first test for suspected pleural collection.

  • B. Repeat sputum Gram stain

    Young children rarely expectorate and sputum does not address the suspected complication.

  • C. Mantoux test only

    A Mantoux test does not explain the findings or guide acute management.

  • D. Chest ultrasound (correct)

    Correct. Ultrasound detects and characterises pleural fluid at the bedside.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Chest ultrasound. Persistent fever with dullness and reduced air entry suggests a parapneumonic effusion or empyema.

Why is "Echocardiography" not the answer?

Echocardiography is not the first test for suspected pleural collection.

Why is "Repeat sputum Gram stain" not the answer?

Young children rarely expectorate and sputum does not address the suspected complication.

Why is "Mantoux test only" not the answer?

A Mantoux test does not explain the findings or guide acute management.

What concept does this question test?

It tests Paediatric infections: parapneumonic effusion in Pediatrics. Ultrasound confirms fluid, shows septations and guides drainage. A child unable to expectorate would not yield a sputum sample.

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: parapneumonic effusion?

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.