Asthma

Question 1

What are some common examples of asthma triggers?

Answer 1

• Environmental triggers leading to increased mucosal inflammation
• Exercise
• Beta-blockers
• Aspirin
• NSAIDs

Question 2

What is diurnal variation in asthma?

Answer 2

• Due to diurnal circadian release of cortisol
• Symptoms worse upon waking and may cause nocturnal coughing/waking

Question 3

How is asthma typically diagnosed?

Answer 3

• Clinical history
• Decreased Peak expiratory flow rate with >15% reduction in PEFR with stimulus challenge or improves with bronchodilators

Question 4

What is typical management of childhood asthma?

Answer 4

• Avoid triggers
• Beta-agonist enhalers
• Lowest possible dose of inhaled steroids if required

Question 5

What’s an example of a short-acting and long-acting beta-agonist?

Answer 5

Short-acting - albuterol, salbutamol

Long-acting - salmeterol

Question 6

What is the management of severe acute asthma?

Answer 6

• Nebulised salbutamol
• Oral prednisone or IV hydrocortisone

If no improvement
* Nebulised Ipratropium bromide
* Oxygen
* Monitoring

If no improvement
* IV magnesium sulphate
* Continued nebulised salbutamol + ipratropium bromide
* Continued steroid

Question 7

What is the general management of chronic asthma and treatment progression?

Answer 7

1. Short-acting beta agonist PRN
2. Low dose inhaled corticosteroid
3. Low dose combined long-acting beta agonist/inhaled corticosteroid
4. Medium dose combined long-acting beta agonist/inhaled corticosteroid