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Viral-induced wheeze — MRCPCH FOP MCQ

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ModerateRespiratoryViral-induced wheezeMRCPCH FOP

A 2-year-old boy has his third episode of wheeze with coryza. Between colds he runs normally, has no night cough and has no eczema or family history of atopy. What would you advise the parents?

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Correct answer: E — Use salbutamol during episodes and seek review if symptoms occur between infections

This pattern is most consistent with episodic viral wheeze, so intermittent bronchodilator use and safety-netting are appropriate. Daily high-dose inhaled corticosteroid is not first-line in a well child without interval symptoms. Antibiotics and avoiding immunisations are not indicated. The pearl is that interval symptoms and atopy increase the likelihood of asthma rather than isolated viral wheeze.

Reference: NICE/BTS/SIGN Asthma pathway; NICE CKS Wheeze