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Bronchiolitis — MCCQE Part 1 MCQ

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EasyWheezingBronchiolitisMCCQE Part 1

5-month-old infant presents with cough, coryza and wheeze. He has mild subcostal recession, oxygen saturation 94% and is feeding adequately. Which of the following is the most appropriate next step?

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Correct answer: D — Provide supportive care with nasal suction/hydration advice and no routine salbutamol or CXR

Provide supportive care with nasal suction/hydration advice and no routine salbutamol or CXR is best because typical bronchiolitis is self-limited and managed supportively. Provide only reassurance without clear follow-up or safety-netting is suboptimal because children can deteriorate quickly and follow-up must be explicit; Use adult dosing or adult pathways without paediatric adjustment is suboptimal because children require age- and weight-appropriate care; Delay assessment until the next routine visit is suboptimal because developmental, infectious and neonatal red flags require timely assessment; Give antibiotics, steroids or investigations routinely despite no indication is suboptimal because over-treatment can cause harm when supportive or targeted care is indicated. Routine bronchodilators, antibiotics and chest radiographs are not helpful in uncomplicated bronchiolitis.

Reference: Canadian Paediatric Society bronchiolitis statement