Stridor – Differential Diagnosis MCQ Quiz | Respiratory

Welcome to this specialized quiz on the differential diagnosis of stridor, a critical topic in the respiratory module for MBBS students. This quiz is designed to test your understanding of the various causes of stridor, from common pediatric conditions like croup and laryngomalacia to life-threatening emergencies such as epiglottitis and foreign body aspiration. You will be challenged to differentiate between these conditions based on clinical presentation, radiological findings, and typical patient demographics. This assessment consists of 25 multiple-choice questions to sharpen your diagnostic skills. After submitting your answers, you can review your score and download all the questions with their correct answers in a PDF format for future study and revision.

1. A 2-month-old infant presents with a high-pitched inspiratory stridor that is worse when supine and during feeding, but improves when prone. The infant is otherwise thriving. What is the most likely diagnosis?

2. A 2-year-old child presents to the emergency department with a ‘barking’ cough, low-grade fever, and inspiratory stridor at rest. A neck X-ray is ordered. What classic radiological finding would support a diagnosis of laryngotracheobronchitis (Croup)?

3. A 4-year-old, unvaccinated child presents with a rapid onset of high fever, sore throat, drooling, and is sitting in a ‘tripod’ position. Physical examination should be avoided to prevent airway compromise. What is the most probable diagnosis?

4. Biphasic stridor is typically associated with an obstruction at which level of the airway?

5. A previously healthy 18-month-old child suddenly starts coughing, gagging, and develops stridor while playing with small toys. The episode was followed by a period of quiescence, but now the child has a persistent wheeze. This history is most suggestive of:

6. A 55-year-old patient develops inspiratory stridor two days after a total thyroidectomy. What is the most likely iatrogenic cause?

7. Chronic stridor in an infant that is present since birth and associated with feeding difficulties (dysphagia) and occasional cyanosis should raise suspicion for:

8. Which of the following is the gold standard investigation for definitively diagnosing laryngomalacia?

9. A patient presents with acute stridor, urticaria, and hypotension after a bee sting. What is the immediate and most crucial pharmacological intervention?

10. Acquired subglottic stenosis in children is most commonly associated with:

11. A muffled “hot potato” voice, unilateral sore throat, and trismus in an adolescent are characteristic features of:

12. Purely expiratory stridor (more accurately described as wheeze) is characteristic of an obstruction in the:

13. A child with severe croup (stridor at rest, marked retractions) is not responding to humidified oxygen. What is the next best step in management?

14. What key feature helps differentiate acute epiglottitis from croup in a child?

15. A patient with a history of rheumatoid arthritis develops progressive hoarseness and inspiratory stridor. This could be due to:

16. The “thumb sign” on a lateral neck X-ray is pathognomonic for which condition?

17. A 3-year-old child presents with fever, neck pain, stiffness, and stridor. On examination, there is a visible bulge in the posterior pharyngeal wall. This clinical picture is most consistent with:

18. The immediate priority in managing a patient with suspected acute epiglottitis is:

19. A condition characterized by paradoxical adduction of the vocal cords during inspiration, leading to stridor, often in young athletic females, is known as:

20. Ludwig’s angina is a rapidly spreading cellulitis of the floor of the mouth. Stridor occurs due to:

21. Stridor caused by an extrathoracic (e.g., laryngeal) fixed obstruction would be primarily:

22. A child with a history of a difficult birth presents with a weak cry and mild inspiratory stridor. This could be indicative of:

23. In an adult, unilateral vocal cord paralysis is most often caused by:

24. A patient with stridor due to a large goiter compressing the trachea is an example of what type of cause?

25. Which of the following is NOT a typical cause of acute stridor?