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Bronchiolitis — MCCQE Part 1 MCQ

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HardWheezingBronchiolitisMCCQE Part 1

A 5-month-old with bronchiolitis has persistent oxygen saturation 88–89% while awake, moderate retractions and intake under half normal. There is no focal bacterial finding. Which management is most appropriate?

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Correct answer: C — Admit for supportive hydration and supplemental oxygen titrated to target

Give scheduled salbutamol and discharge when wheeze transiently changes: Routine bronchodilator trials do not improve meaningful outcomes in typical infant bronchiolitis. Admit for supportive hydration and supplemental oxygen titrated to target: Nasal care, appropriately delivered oxygen and oral or nasogastric hydration address the physiologic problems while the infant is monitored. Give dexamethasone and antibiotics because low oxygen proves pneumonia: Corticosteroids and antibiotics are not routine without an alternative steroid-responsive process or bacterial infection. Perform routine chest physiotherapy and withhold enteral hydration: Chest physiotherapy is ineffective, and hydration must be maintained safely. Discharge with codeine because cough is causing feeding difficulty: Codeine is unsafe in infants and does not treat small-airway obstruction.

Reference: https://cps.ca/en/documents/position/bronchiolitis