Acute Bronchiolitis Clinical Case Quiz

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Questions and Answers

Which virus is responsible for 50% - 75% of acute bronchiolitis cases?

Respiratory syncytial virus (RSV) (correct)

Influenza virus

Adenovirus

Rhinovirus

What age group is commonly affected by acute bronchiolitis?

Adolescents

Children over 5 years of age

Adults

Children under 2 years of age (correct)

Which factor is NOT associated with an increased risk of acute bronchiolitis?

Exclusively breastfed children (correct)

Attending day care centers

Exposure to cigarette smoke

Gender (commoner in Males 2:1)

What is the main cause of reduced air flow in the bronchioles of babies living in crowded conditions?

Oedema of bronchiolar mucosa Signup and view all the answers

What is the immediate consequence of complete obstruction in the bronchioles?

Athelectasis Signup and view all the answers

What is the primary reason for infants being most affected by this condition?

Small airways Signup and view all the answers

Which symptom is commonly associated with this condition as a result of critical chest retraction?

Grunting Signup and view all the answers

What is a common finding in the CXR of babies with this condition?

Patchy atelectasis with hyper inflated areas Signup and view all the answers

What is a recommended treatment for hypoxemic children with this condition?

Nebulised hypertonic saline Signup and view all the answers

What is a possible prophylactic measure for preventing child-to-child transmission of this condition, particularly in hospitals or day care settings?

Periodic passive immunoprophylaxis with RSV monoclonal antibody Signup and view all the answers

What is the prognosis generally like for babies with this condition, and during which period is it most critical?

Critical during the neonatal period Signup and view all the answers

Acute bronchiolitis predominantly affects children over 5 years of age.

False Signup and view all the answers

Respiratory syncytial virus (RSV) is responsible for 50% - 75% of acute bronchiolitis cases.

True Signup and view all the answers

Exclusively breastfed children are less susceptible to acute bronchiolitis.

False Signup and view all the answers

Exposure to cigarette smoke is not a risk factor for acute bronchiolitis.

False Signup and view all the answers

Acute bronchiolitis is primarily caused by bacterial infection of the distal bronchi and bronchioles.

False Signup and view all the answers

Babies living in crowded conditions are at higher risk for developing acute bronchiolitis due to exposure to an older contact with a minor respiratory syndrome within the previous week.

True Signup and view all the answers

Babies with acute bronchiolitis may present with poor feeding or refusal to feed.

True Signup and view all the answers

A chest X-ray (CXR) is typically not necessary for diagnosing acute bronchiolitis.

True Signup and view all the answers

The use of corticosteroids in the treatment of acute bronchiolitis is widely accepted and uncontroversial.

False Signup and view all the answers

Acute bronchiolitis can be prevented through periodic passive immunoprophylaxis with RSV monoclonal antibody (Palivizumab).

True Signup and view all the answers

The case fatality rate for acute bronchiolitis is generally high.

False Signup and view all the answers

Babies with acute bronchiolitis may present with prolonged expiratory rhonchi.

True Signup and view all the answers

Match the following viruses with their association to acute bronchiolitis:

Respiratory syncytial virus (RSV) = 50% - 75% of cases Parainfluenza viruses = Especially type 3 Adenoviruses = Associated with acute bronchiolitis Rhinovirus = Linked to acute bronchiolitis Signup and view all the answers

Match the following epidemiologic risk factors with their association to acute bronchiolitis:

Age = Common in children under 2 years of age Gender = Commoner in Males 2:1 Breast feeding = Common in children not exclusively breastfed Seasonal Factors = Common during rainy season and cold harmattan months Signup and view all the answers

Match the following symptoms with their association to acute bronchiolitis:

Noisy breathing worse at night = Associated symptom Intercostal recession = Linked to acute bronchiolitis Pedal oedema = Not observed in acute bronchiolitis Poor feeding or refusal to feed = Possible presentation in acute bronchiolitis Signup and view all the answers

Match the following prophylactic measures with their association to preventing acute bronchiolitis transmission:

Passive immunoprophylaxis with RSV monoclonal antibody (Palivizumab) = Preventive measure Exclusively breastfed children = Less susceptible to acute bronchiolitis Chest X-ray (CXR) = Not typically necessary for diagnosis of acute bronchiolitis Corticosteroids = Not widely accepted treatment for acute bronchiolitis Signup and view all the answers

Match the following pathophysiological features with their effects in acute bronchiolitis:

Viral infection of distal bronchi and bronchioles causes mucous secretion, necrosis of respiratory epithelium, and oedema of bronchiolar mucosa = Reduction in the size of bronchioles' lumen with subsequent resistance to airflow Impairment of normal gaseous exchange at the alveolar level = Ventilation perfusion mismatch leading to hypoxemia early in the disease and hypercapnia later Complete obstruction in the bronchioles = Atelectasis results Incomplete obstruction in the bronchioles = Air trapping and hyperinflation Signup and view all the answers

Match the following clinical features with their presentation in acute bronchiolitis:

Episodic or paroxysmal cough = Infants affected most often due to their small airways Chest retraction = Fever which is usually low grade Reduced breath sounds = Prolonged expiratory rhonchi Grunting = Cyanosis Signup and view all the answers

Match the following investigations with their diagnostic or monitoring purposes in acute bronchiolitis:

FBC (not diagnostic, WBC and differential counts are usually normal) = Not routinely requested CXR (shows patchy atelectasis with hyperinflated areas) = Not necessary for diagnosing acute bronchiolitis Arterial Blood Gas = Pulse oximetry Rapid viral antigen or nucleic acid amplification testing of nasal or pulmonary secretions = Diagnostic testing Signup and view all the answers

Match the following differential diagnoses with their distinguishing features from acute bronchiolitis:

Bronchial Asthma = Recurrent attacks, positive family history, eosinophilia in blood Bacterial bronchopneumonia = High grade fever, no rhonchi except in severe illness, coarse creps Pertussis = - Foreign body aspiration = - Signup and view all the answers

Study Notes