Which pathophysiological feature is most directly associated with wheezing in asthma?

• A. Bronchial dilation
• B. Alveolar rupture
• C. Narrowing of the airway
• D. Mucus plug in the alveoli

Answer: (C)

Wheezing in asthma comes from air having to pass through narrowed airways. In asthma, inflammation causes swelling of the airway walls, bronchoconstriction, and increased mucus, all of which shrink the airway lumen. That narrowed pathway makes the airflow turbulent and creates the high-pitched whistling sound we recognize as wheezing. So narrowing of the airway is the feature most directly responsible for wheezing.

Bronchial dilation would open the passages and tend to reduce wheeze. Alveolar rupture leads to air leaking into the chest cavity or tissues rather than producing a wheeze. A mucus plug in the alveoli isn’t the right location for causing wheeze, since wheezing reflects obstruction and turbulence in the airways rather than distal alveolar plugging.