Topic Breakdown of MOH Paediatric Exam

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MOH Paediatric Sample Test

1 of 5

A 5-year old child presents with fever, exudative pharyngitis, a fine, raised, pink rash, and anterior cervical lymphadeopathy. What is MOST likely the diagnosis?

Correct Answer:

scarlet fever.

the most likely diagnosis for a child presenting with fever, exudative pharyngitis, a pink, fine, raised rash, and anterior cervical lymphadenopathy is scarlet fever, also known as scarlatina. this condition is characterized by its distinctive rash, which can feel rough like sandpaper, and is caused by an infection with the bacterium streptococcus pyogenes, or group a beta-hemolytic streptococci (gabhs).

in addition to the symptoms noted, scarlet fever often involves a red, sore throat with white patches, a strawberry-like appearance of the tongue, and a high fever. the rash typically starts on the chest and spreads to other areas of the body. it is important to note that the presence of the rash, while a hallmark of scarlet fever, does not suggest a more severe illness or a higher risk of being contagious.

scarlet fever is treated effectively with antibiotics, which help in reducing the duration of symptoms, preventing the spread of the infection, and reducing the risk of complications. complications can include rheumatic fever, which can affect the heart, and post-streptococcal glomerulonephritis, which affects the kidneys.

other conditions like roseola, rubella, and eczema may present with some similar symptoms such as rash and fever, but they have distinct features that differentiate them from scarlet fever. for instance, roseola typically resolves with a sudden rash following a high fever and mostly affects infants and toddlers under two years. rubella, or german measles, presents with a fine rash and swollen glands but is generally milder and includes joint pains in older children and adults. eczema primarily involves itchy, inflamed skin and does not typically include systemic symptoms like fever or sore throat.

therefore, given the combination of exudative pharyngitis, fever, and a fine, raised, pink rash along with anterior cervical lymphadenopathy, scarlet fever remains the most fitting diagnosis for the described scenario. prompt medical evaluation and treatment are advised to manage the symptoms and prevent any potential complications.