Diagnostic tests for bronchiolitis

 Chest x-ray films- doctor may request a chest X-ray to look for signs of pneumonia.

Results:

o Hyperinflation
o Patchy infiltrates- typically migratory (post-obstructive atelectasis & prebronchial cuffing)

 Complete blood cell (CBC) counts- Occasionally, blood tests might be used to check child's white
blood cell count.

Results:
o An increase in white blood cells is usually a sign that the body is fighting an infection. A
blood test can also determine whether the level of oxygen has decreased in the child's
bloodstream.

 Viral testing - may collect a sample of mucus from the child to test for the virus causing
bronchiolitis. This is done using a swab that's gently inserted into the nose.

Results:
o A positive culture or direct fluorescent antibody test can confirm the diagnosis of RSV
infection

Clinical findings:

 Audible wheezing
 Wheezing with crackles
 Respiratory distress with
 Chest recession
Diagnostic tests for bronchial asthma

 Spirometry: A device known as spirometer is use to measure the breathing capacity of the lungs.

Results:

 Peak expiratory flow: It is done to check how well our lungs are functioning. In this test, patient is
instructed to forcefully exhale out air in a tube to review the expiratory capacity of the lungs.
Results:
o Flow rate lessens when the airways are blocked. If you notice a significant fall in your peak
flow speed, it may be caused by a flare-up in your lung disease. People with asthma may
experience low peak flow rates before they develop breathing symptoms.

 Allergy test: Allergens are injected into the skin in minute quantities to know if there is any
underlying allergic tendency in the body.

Results:

o A high level of IgE can mean you have an allergy.

 Skin Prick Test

Results:

o Dime- sized hive that is red and itchy at the needle prick site indicates the need of follow
up test to check the results.

 Patch test

Results:

o If the skin turns red, gets irritated, and itches, the chances are great that a person has an
allergy.

 Imaging: A chest X-ray or computerized tomography (CT) scan of lungs and sinuses can be done
to identify any other structural abnormalities or to rule out other similar conditions.

Results:

Posteroanterior chest
radiograph
demonstrates a
pneumomediastinum in
bronchial asthma.
Mediastinal air is noted
adjacent to the
anteroposterior window
and airtrapping extends
to the neck, especially
on the right side.
 Lateral chest radiograph demonstrates a
pneumomediastinum in bronchial asthma. Air
is noted anterior to the trachea (same patient
as in the previous image)

 Provocative Test: A provocation test (is a type of lung test that tells how sensitive your lungs are.
These types of tests may also be called challenge or trigger tests. The most common types of
provocation tests are: irritant challenge, exercise challenge, and methacholine challenge

Results:

o Irritant challenge: With an irritant challenge, the doctor will expose you to a specific asthma
trigger to see if your airways react. These might include chemicals, perfume or smoke.
After you are exposed to the trigger, you will take a breathing test to see how you respond.
This test helps your doctor confirm possible asthma triggers
o Exercise challenge: you run on a treadmill while your oxygen and heart rate are monitored.
This will help your doctor determine if exercise triggers your symptoms.
o Methacholine Challenge: type of drug that will make your airways tighten up at a lower
dose if you have asthma or at a higher dose if you do not have asthma. During this test,
your doctor will have you breathe in increasing doses of methacholine. Then they will do a
spirometry test to see if your lung function changes.