Which of the following statements regarding asthma in children is CORRECT?
a. The compliant chest wall of younger children makes it more difficult to recognize respiratory distress.
b. In children aged <2 years, wheezing should always be treated with oral corticosteroids and bronchodilators.
c. Asthma should be considered in any child aged ≥2 years who has had at least 3 episodes of wheezing in their life or at least 2 wheezing episodes in the past year.
d. “Silent chest” is seen only in adults with asthma.
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Answer: C. Current guidelines indicate that asthma should be considered in children aged ≥2 years who have had at least 3 episodes of wheezing in their life or at least 2 wheezing episodes in the past year. The compliant chest wall of younger children makes it more likely that signs of respiratory distress, such as retractions and nasal flaring, will be easily seen. In children aged <2 years, wheezing is most likely related to viral bronchiolitis and should not be treated with oral corticosteroids, bronchodilators, or antibiotics. The “silent chest,” where minimal air movement is auscultated, can be a warning sign of asthma in adolescents.
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