Which early respiratory symptom is commonly expected in a 2-year-old child with cystic fibrosis?

• A. Barrel-shaped chest
• B. Chronic productive cough
• C. Bronchiectasis
• D. Wheezing respirations

Answer: (D)

Airways in young children with cystic fibrosis are inflamed and filled with thick, sticky mucus, especially in the small airways. This mucus plugging narrows the airways and creates turbulent airflow, which shows up as an audible wheeze. In a 2-year-old, this obstructive pattern is a common early respiratory clue because the small airways are easily affected by the thick secretions and by viral infections that increase mucus production.

Barrel-shaped chest happens later as air trapping and lung hyperinflation develop over time. Bronchiectasis is a later structural change resulting from ongoing infection and inflammation. A chronic productive cough can occur, but the hallmark early feature in toddlers is wheezing from small-airway obstruction due to mucus plugging and inflammation.