The FEV1 measured for a 12-year-old child is significantly below the predicted normal value. There is marked improvement following the administration of albuterol via hand held nebulizer. These results would be consistent with which of the following disorders?

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

Answer: (A)

Reversibility of airway obstruction with a bronchodilator is the key idea. In asthma, the airways narrow due to smooth muscle constriction and inflammation, causing a reduced FEV1. When a fast-acting bronchodilator like albuterol is given, it relaxes the airway smooth muscle and opens the airways, leading to a significant increase in FEV1. This brisk, marked improvement after bronchodilation points to a reversible obstructive process, which is classic for asthma in a child.

The other conditions don’t fit this pattern as well. A fixed restrictive issue like kyphosis reduces lung volumes and isn’t expected to show notable improvement in FEV1 after bronchodilators. Pneumonia causes infection-related inflammation and consolidation rather than reversible bronchial constriction, so the response to albuterol would be limited. Atelectasis involves collapsed or airless lung tissue; while there might be some secondary bronchospasm, the primary problem isn’t reversible airway smooth muscle constriction, so the dramatic bronchodilator response is less typical.