A 12-year-old with reduced FEV1 that improves with albuterol: which disorder?

• A. Asthma
• B. Kyphosis
• C. Pneumonia
• D. Atelectasis

Answer: (A)

Reversible airway obstruction that responds to a bronchodilator is the hallmark here. In a 12-year-old, seeing FEV1 improve after giving albuterol points to asthma, because albuterol relaxes bronchial smooth muscle via beta-2 receptors, reducing airway resistance and increasing expiratory flow. This bronchodilator responsiveness reflects the common asthma pattern of airway hyperreactivity and reversible obstruction.

Other conditions don’t fit this pattern as neatly. Kyphosis causes a restrictive chest-wall limitation, not primarily due to reversible bronchoconstriction, so albuterol wouldn’t markedly boost FEV1. Pneumonia involves an infection with infiltrates and impaired gas exchange rather than reversible bronchoconstriction. Atelectasis can cause reduced volumes, sometimes with mucus plugging, but the dramatic improvement with a bronchodilator is less typical.