Neck Extension in Pediatrics — 4yo Child | Pediatric Emergency | SMLE Q#11053

SMLE Question #11053

Pediatrics Pediatric Emergency

Objective: OBJ-OPH-REFERRAL-001

Last updated: February 2026
A 4-year-old girl has 3 days of fever, sore throat, decreased oral intake, and worsening dysphagia to solids. She prefers to keep her neck slightly flexed and has pain with neck extension. Oropharyngeal exam shows mild erythema without tonsillar exudate, uvular deviation, or visible bulge. She has a single, firm, tender 2-cm right cervical lymph node and no respiratory distress. What is the most important next step in evaluation?

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