NREMT Paramedic Cognitive ExamAirway, Respiration & VentilationMedium
A 2-year-old child presents with mild respiratory distress, wheezing, and a history of recent upper respiratory infection. The child's parents report episodes of coughing and difficulty breathing, especially at night. On auscultation, diffuse expiratory wheezes are noted. Supplemental oxygen via nasal cannula at 2 L/min maintains SpO2 at 94%. What is the most likely diagnosis?
- ABronchiolitis.
- BBacterial pneumonia.
- CEpiglottitis.
- DCroup.
Show answer & explanationAnswer & explanation
Correct answer: A. Bronchiolitis.
Bronchiolitis typically affects infants and young children (under 2 years old, but can extend slightly older) and is often preceded by an URI. It's characterized by wheezing (due to inflammation of small airways) and respiratory distress. Bacterial pneumonia usually presents with fever and crackles, croup with a barking cough and stridor, and epiglottitis with high fever, drooling, and severe stridor.
Why the other options are wrong
- B. Bacterial pneumonia typically presents with crackles, higher fever, and sometimes purulent sputum, not primarily wheezing as the main finding.
- C. Epiglottitis is a severe airway emergency with high fever, drooling, and inspiratory stridor, not wheezing.
- D. Croup presents with a 'barking' cough and inspiratory stridor, not primarily expiratory wheezing.
Bronchiolitis Presentation
Bronchiolitis is a common viral lower respiratory tract infection in infants and young children, characterized by a preceding URI, wheezing, tachypnea, and respiratory distress.
- Affects infants/young children.
- Often follows URI.
- Key symptom: expiratory wheezing.
Memory trick: Bronchiolitis' 'B' is for 'Baby Wheezing' after a 'Bad Cold'.