Bronchiolitis

Question 1

Bronchiolitis: what is the underlying pathology?

Answer 1

Acute inflammation of the bronchioles, most commonly due to RSV.

Question 2

What percentage of bronchiolitis cases are caused by RSV?

Answer 2

75–80%.

Question 3

Bronchiolitis: which age group is most affected?

Answer 3

Infants under 1 year, especially between 1–9 months, with peak incidence at 3–6 months.

Question 4

Why are newborns partially protected from RSV?

Answer 4

Maternal IgG provides early passive immunity.

Question 5

When is bronchiolitis incidence highest during the year?

Answer 5

Winter months.

Question 6

What other organisms can cause bronchiolitis besides RSV?

Answer 6

Mycoplasma and adenoviruses.

Question 7

Which infants are at higher risk of severe bronchiolitis?

Answer 7

Those with bronchopulmonary dysplasia, congenital heart disease, or cystic fibrosis.

Question 8

What symptoms typically precede bronchiolitis?

Answer 8

Coryzal symptoms and mild fever.

Question 9

What are the key respiratory features of bronchiolitis?

Answer 9

Dry cough, increasing breathlessness, wheeze, and fine inspiratory crackles.

Question 10

Why do many infants with bronchiolitis require hospital admission?

Answer 10

Feeding difficulties associated with increasing dyspnoea.

Question 11

According to NICE, what features warrant immediate emergency referral in bronchiolitis?

Answer 11

Apnoea, seriously unwell appearance, severe respiratory distress (grunting or marked recession or RR >70), central cyanosis, or oxygen saturations <92% in air.

Question 12

According to NICE, when should clinicians consider hospital referral in bronchiolitis?

Answer 12

RR >60, difficulty feeding or intake 50–75% of normal, or signs of clinical dehydration.

Question 13

What investigation can confirm RSV in bronchiolitis?

Answer 13

Immunofluorescence of nasopharyngeal secretions.

Question 14

What is the main approach to bronchiolitis management?

Answer 14

Supportive care.

Question 15

When is humidified oxygen recommended in bronchiolitis?

Answer 15

When oxygen saturations are persistently <92% in air.

Question 16

What feeding support may be required in bronchiolitis?

Answer 16

Nasogastric feeding if oral intake is inadequate.

Question 17

What supportive technique may be used for excessive upper-airway secretions in bronchiolitis?

Answer 17

Suctioning.