🏥 USMLE Exam Prep

A 9-month-old infant presents to the emergency department with a 2-day history of low-grade fever, rhinorrhea, and a characteristic "barking" cough. On examination, there is inspiratory stridor at rest. The infant is otherwise alert and well-hydrated. What is the most appropriate initial treatment?

A Albuterol nebulization
B Oral amoxicillin
C Nebulized racemic epinephrine and oral dexamethasone
D Intravenous antibiotics

✓ Correct Answer: Option C

The clinical presentation is consistent with moderate-to-severe croup. Nebulized racemic epinephrine provides rapid relief of stridor by vasoconstriction, and oral dexamethasone reduces airway inflammation, improving symptoms over time.

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