nbme 12

[firstaid2012]

8 month old boy is bought to ER after 20 minutes sudden onset dificulty breathing while playing outside. Ausculation of chest shows decrease air movement on right and wheezes are heard. Which of the following.
a-anaphylactic reaction
b-bronchiolits
c-foreign body aspiration
d-pneumonia
e-spontaneous pneumonia

why is it C n not a?

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[MrBeauregard]

Anaphylaxis, being a systemic reaction, would lead to diffuse wheezes since it affects both lungs. Foreign body aspiration, if it lodges in a mainstem bronchus, will only affect one lung.

 

[ashik33]

Anaphylaxis, being a systemic reaction, would lead to diffuse wheezes since it affects both lungs. Foreign body aspiration, if it lodges in a mainstem bronchus, will only affect one lung.

And the scenario also favors it. There's nothing suspicious that would have lead to anaphylaxis in this child (no bee sting or something like that). The child is more likely to have aspirated a foreign body while playing with it.

 

[OveractiveBrain]

8 month old boy is bought to ER after 20 minutes sudden onset dificulty breathing while playing outside. Ausculation of chest shows decrease air movement on right and wheezes are heard. Which of the following.
a-anaphylactic reaction
b-bronchiolits
c-foreign body aspiration
d-pneumonia
e-spontaneous pneumonia

why is it C n not a?

For the boards "unattended child" in the vignette immediately leap to FBAO. Almost a sure thing. Look for reasons why it SHOULDNT be, otherwise, go with gut.