Respiratory Diseases — MCQs

Q: A patient develops acute respiratory distress, stridor, unilateral hyperinflation of the chest with decreased breath sounds on that side. What is the most likely cause?

Foreign body aspiration. ### Explanation The clinical presentation of **acute respiratory distress, stridor, and unilateral hyperinflation** is a classic triad for **Foreign Body Aspiration (FBA)**. **Why Foreign Body Aspiration is Correct:** When an object is aspirated, it often creates a **"check-valve" effect**. During inspiration, the airways dilate, allowing air to pass the object. During expiration, the airways narrow, trapping air distal to the foreign body. This leads to **obstructive emphysema (unilateral hyperinflation)** and decreased breath sounds on the affected side. Stridor indicates the object may be lodged in the upper airway or trachea, while localized wheezing or decreased air entry suggests a bronchial location (most commonly the right main bronchus). **Why Other Options are Incorrect:** * **Asthma:** Typically presents with bilateral diffuse wheezing and a history of atopy. It does not cause focal unilateral hyperinflation unless complicated by a secondary pneumothorax. * **Aspiration Pneumonia:** Usually presents with fever, cough, and crackles rather than acute stridor. Radiologically, it shows opacification/consolidation rather than hyperinflation. * **Pleural Effusion:** This would result in **stony dullness** on percussion and **collapsed/shifted lung** (mediastinal shift away from the lesion), but the affected side would show decreased expansion and opacification on X-ray, not hyperinflation. **High-Yield Clinical Pearls for NEET-PG:** * **Gold Standard Diagnosis & Management:** Rigid Bronchoscopy (both diagnostic and therapeutic). * **Most Common Site:** Right main bronchus (due to it being wider, shorter, and more vertical). * **Radiological Sign:** Mediastinal shift away from the affected side during expiration (due to air trapping). * **Age Group:** Most common in children aged 1–3 years (the "peanut" age).

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Upper Respiratory Tract Infections

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Lower Respiratory Tract Infections

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Asthma Management

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Cystic Fibrosis

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Bronchiolitis

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Foreign Body Aspiration

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Sleep-Disordered Breathing

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Congenital Lung Malformations

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Pleural Diseases

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Pulmonary Function Testing

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