Bronchiolitis vs Pneumonia and pediatric asthma
How to tell Bronchiolitis and Pneumonia and pediatric asthma apart when a board question makes them look alike.
Bronchiolitis is first infant viral wheeze; pneumonia is febrile focal infection; asthma is recurrent reversible wheeze.
Side by side
Bronchiolitis causes viral lower airway disease in infants with wheezing, crackles, increased work of breathing, and RSV association.
Pneumonia causes fever and focal infiltrate/crackles; asthma causes recurrent episodic wheeze triggered by allergens/exercise with bronchodilator response.
Bronchiolitis causes viral lower airway disease in infants with wheezing, crackles, increased work of breathing, and RSV association.
Pneumonia causes fever and focal infiltrate/crackles; asthma causes recurrent episodic wheeze triggered by allergens/exercise with bronchodilator response.
The repair move
Before naming the answer, force the stem through the separator: Bronchiolitis is first infant viral wheeze; pneumonia is febrile focal infection; asthma is recurrent reversible wheeze.
Try a free question
CoreA 6-month-old infant in winter has 3 days of progressive cough, rhinorrhea, low-grade fever, and now wheezing with increased work of breathing. Exam shows tachypnea, intercostal retractions, diffuse crackles, and wheezing. RSV antigen testing is positive. Which condition is most likely?
Show answer and explanation
Answer: A. Bronchiolitis. Bronchiolitis is viral lower airway disease in infants <2 years, most commonly RSV (winter epidemics). Features: cough, wheezing, crackles, tachypnea, increased work of breathing. Diagnosis is clinical; RSV testing confirms etiology. Treatment is SUPPORTIVE (oxygen, hydration, nasal suction). Bronchodilators and corticosteroids generally NOT effective. Palivizumab (anti-RSV monoclonal) for high-risk infants.
Why the other choices are tempting
- B. Bacterial pneumonia has focal infiltrate and higher fever; not typical for first wheeze in infant.
- C. Pediatric asthma typically presents older (after 2-3 years) with recurrent wheeze and bronchodilator response.
- D. Foreign body has sudden onset.
- E. CF exacerbation has chronic clue (recurrent infections, growth failure, family history).
Flashcards
Tap a card to flip it.
What clue supports Bronchiolitis?
Choose Bronchiolitis when the stem gives this pattern: Bronchiolitis causes viral lower airway disease in infants with wheezing, crackles, increased work of breathing, and RSV association.
What clue supports Pneumonia and pediatric asthma?
Choose Pneumonia and pediatric asthma when the stem gives this contrasting pattern: Pneumonia causes fever and focal infiltrate/crackles; asthma causes recurrent episodic wheeze triggered by allergens/exercise with bronchodilator response.
Quick answers
What is the fastest way to tell Bronchiolitis from Pneumonia and pediatric asthma?
Bronchiolitis is first infant viral wheeze; pneumonia is febrile focal infection; asthma is recurrent reversible wheeze.
What is the key clue for Bronchiolitis?
Bronchiolitis causes viral lower airway disease in infants with wheezing, crackles, increased work of breathing, and RSV association.
What is the key clue for Pneumonia and pediatric asthma?
Pneumonia causes fever and focal infiltrate/crackles; asthma causes recurrent episodic wheeze triggered by allergens/exercise with bronchodilator response.