Bronchiolitis

Question 1

Bronchiolitis

• Aetiology
• Epidemiology
• Risk factors
• Presentation
• Differential diagnosis
• Investigations
• Management

Answer 1

• Aetiology
  
  • RSV
• Epidemiology
  
  • <1 year old
• Risk factors
  
  • Prematurity
    
    • Bronchopulmonary dysplasia
  • CF
  • Congenital heart disease
• Presentation
  
  • History
    
    • Prodromal coryzal symptoms
    • Dry cough
    • Dyspnoea
      
      • Feeding difficulties
    • Episodes of apnoea
  • Examination
    
    • Tachypnoea
    • Sub/intercostal recessions
    • Hyperinflation
      
      • Prominent sternum
      • Displaced liver (↓)
    • Wheeze & crackles
    • Tachycardia
    • Cyanosis/pallor
• Differential diagnosis
  
  • Pneumonia
  • CF
  • Croup
• Investigations
  
  • Pulse oximetry
  • PCR analysis of nasopharyngeal secretions (virology)
  • CXR
    
    • Hyperinflation
    • Focal atelectasis
  • ABG
• Management
  
  • Supportive
    
    • Oxygen
    • (Bronchodilators)
    • Fluids (NG/IV)
  • Infection control (highly infectious)
    
    • Side-room
    • Good hand hygeine
  • Prophylaxis (high risk)
    
    • Palivizumab