A physician-validated, board-style question from the Active Transport QBank. Try it, then check the reasoning for every option.
A 45-year-old woman with a history of asthma presents with worsening shortness of breath, cough, and wheezing over the past 24 hours. She reports having a mild cold with nasal congestion and headache for the past 5 days. She has no fever or chest pain. Her temperature is 37.0°C (98.6°F), pulse is 96/min, respirations are 20/min, and blood pressure is 118/76 mmHg. Pulmonary examination reveals diffuse wheezing. Which of the following is the most likely trigger for her asthma exacerbation?
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A
Exposure to allergensIncorrect. Allergen exposure typically lacks preceding cold symptoms like nasal congestion and headache.
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B
Adenovirus infectionIncorrect. Adenovirus more often causes pharyngoconjunctival fever or pneumonia, not classic asthma exacerbation triggers.
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C
Influenza virus infectionIncorrect. Influenza usually presents with high fever and myalgias, absent in this afebrile patient.
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D
Bacterial sinusitisIncorrect. Bacterial sinusitis produces facial pain and purulent discharge, neither described here.
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E
Rhinovirus infectionCorrect. Rhinovirus is the most common viral trigger of asthma exacerbations following mild cold symptoms.
↑ Tap an answer to reveal the reasoning
Answer: E. The patient has asthma exacerbation with preceding symptoms of a mild cold, which is typically caused by a viral upper respiratory infection. Rhinovirus is a common trigger for asthma exacerbations. Bacterial sinusitis would likely present with facial pain and purulent nasal discharge, which are absent here. Adenovirus and influenza can cause respiratory symptoms, but rhinovirus is the most common cause of exacerbations of asthma.