Bronchiolitis

Question 1

What is the pathophysiology of bronchiolitis?

Answer 1

Infection of bronchioles leading to inflammation and dyspnea

Question 2

What patient population does bronchiolitis typically affect?

Answer 2

2yo and under

Peaks at 3-6 months

Question 3

What is the most common responsible organism for bronchiolitis?

Answer 3

Respiratory Syncytial Virus***

Possible others: rhino, adeno, influenza

Question 4

What are the common presenting symptoms of bronchiolitis?

Answer 4

URTI-stuffy, sneezy, and runny nose, coughy, sore throat
Feeding difficulty
Fussy/irritable

Question 5

What are common physical examination features of bronchiolitis?

Answer 5

• Increase WOB (forward posture, nasal flaring, suprasternal/intercostal muscle retractions, paradoxical breathing)
• Wheezing
• Tachypnea (shallow breathing)
• Tachycardia

Question 6

What investigations would you do in bronchiolitis?

Answer 6

• CXR (in severe cases have air trapping, atelectasis, peribronchial thickening)
• WBC usually normal

Question 7

How would you treat bronchiolitis?

Answer 7

MILD-supportive fluid therapy, humidified O2, bronchodilator neb with 0.03cc in 3ml NS q20min then q1h
MOD-SEVERE-as above, consider intubation/ventilation

Question 8

How do you know when you should hospitalize a patient with bronchiolitis?

Answer 8

-Hypoxia- SpO2