Step II nbme 4 pediatric

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250256

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11) A 10-month-old infant is broughtto the emergency department because of labored breathing for 1 hour She has had cough, coryza, and feverfor 18 hours Hertemperature
is 39°C (1022°F), pulse is 120/mni, respirations are 54/mni. and blood pressure is 82/60 mm Hg Pulse oximetry shows an oxygen saturation of 92% Bilateral wheezes and
basilar crackles are heard

o A) Allergen-induced bronchospasm
o B) Barotrauma-related alveolar disease
O C) Cardiac-induced pulmonary edema
o D) Chemical irritant pneumonitis
o E) Community-acquired viral disease
O F) Contiguously spread bacterial infection
0 G) Osmotically generated fluid shift
O H) Toxin-mediated capillary leak



I think it is bilateral wheezes , probably virus is the correct one. But can virus be so severe? I know that has bacteral infection after the virus infection. But that is should happen when URI is getting better. Thank you!
 
Lower respiratory symptoms (wheezing and crackles) following viral URI symptoms (coryza, cough and fever) is typical for viral bronchiolitis. This is also supported by the fact that viral bronchiolitis is very common in <2 years of age.