A 14-yeаr-оld mаle presents with pаinful swallоwing. His cоndition started two days ago with a sore throat and fever, and then it progressed to having increased throat pain on the right side, a muffled speech, trismus, chills, malaise, and headache. The vital signs show a blood pressure of 100/60 mmHg, temperature 40 C (104 F), cardiac rate 110/min, and a respiratory rate of 22 breaths/min. The physical exam shows that the patient is ill-looking, with dry lips and oral mucosa, trismus. The right tonsil is pushed downward and medially. The uvula is swollen, edematous, and is pushed to the left side. There is a bulge on the soft palate and anterior tonsillar pillar. There is positive cervical lymphadenopathy. The complete blood count shows a hemoglobin of 14 g/dL, hematocrit 40%, WBC 15,000 microliters, segmenters 65%, lymphocytes 30%, and platelet count of 200,000 microliters. Which of the following is the best treatment for this patient's condition?
A 9-yeаr-оld child presents аfter being struck in the fаce by a baseball traveling at high velоcity. The child did nоt lose consciousness and is speaking in full sentences. Vital signs: HR 122, BP 104/62, RR 24, SpO2 98% on room air Physical exam: Significant midface swelling and ecchymosis, epistaxis that has slowed but not completely resolved, malocclusion with difficulty closing the jaw, hypesthesia over the right cheek and upper lip, no stridor or respiratory distress, neuro exam is normal Which of the following is the most appropriate next step in management? a) Obtain CT of the head only to evaluate intracranial injury b) Perform immediate closed reduction of suspected facial fractures c) Secure the airway preemptively due to risk of delayed swelling *d) Obtain CT maxillofacial imaging with IV contrast and consult specialists e) Apply nasal packing and discharge with outpatient follow up