Rosh Internal Medicine Boost Practice Exam

What is the likely diagnosis in a healthy 24-year-old with productive cough following fever and sinus pressure?

1. Acute bronchitis

2. Asthma

3. Chronic bronchitis

4. Community-acquired pneumonia

The correct answer is: Acute bronchitis

The symptoms presented—a productive cough following a fever and sinus pressure—strongly indicate acute bronchitis as the most likely diagnosis. Acute bronchitis is characterized by the inflammation of the bronchial tubes, often caused by viral infections following upper respiratory tract infections such as sinusitis. The fever suggests a possible infectious etiology, while the productive cough points to mucus production resulting from airway irritation and inflammation. In a healthy 24-year-old, the acute onset of these symptoms aligns with typical patterns observed in acute bronchitis after a viral upper respiratory infection. The absence of other serious symptoms like significant breathing difficulties, chest pain, or high fever—often seen in conditions like pneumonia—further supports acute bronchitis as the more likely diagnosis. Although community-acquired pneumonia could present with similar symptoms, it typically includes more severe manifestations such as high fever, pleuritic chest pain, and a more pronounced level of respiratory distress. In this case, the context of a productive cough primarily following sinusitis points toward acute bronchitis as the most fitting diagnosis.