Rosh Pediatrics Practice Exam

What is the most likely diagnosis for a 12-year-old boy presenting with shortness of breath and wheezing after exposure to a sibling with a viral upper respiratory infection?

1. Allergic rhinitis

2. Asthma exacerbation

3. Pneumonia

4. Pneumothorax

The correct answer is: Asthma exacerbation

The presentation of shortness of breath and wheezing in a 12-year-old boy after being exposed to a sibling with a viral upper respiratory infection strongly suggests an asthma exacerbation. In children, respiratory infections, particularly viral ones, are common triggers for asthma symptoms. Asthma is characterized by airway hyperreactivity, inflammation, and obstruction, which can be exacerbated by respiratory infections. The viral upper respiratory infections often lead to increased airway inflammation, making it more likely for someone with pre-existing asthma to experience exacerbated symptoms, such as wheezing and difficulty breathing. While allergic rhinitis can cause respiratory symptoms, it typically does not lead to shortness of breath or wheezing to the same extent as an asthma exacerbation does. Pneumonia could also cause similar symptoms; however, it would generally present with additional signs such as fever, chest pain, or abnormal lung sounds upon examination. A pneumothorax might cause sudden sharp chest pain and difficulty breathing but is less likely in this context without other symptoms indicating a significant thoracic issue or trauma. Therefore, an asthma exacerbation is the most fitting diagnosis given the context and symptoms presented.