Asthma Diagnosis and Assessment

Question 1

James is a 7 month old boy admitted to hospital with his fourth episode of acute wheezing without crackles heard on auscultation. His mother has asthma. She did not smoke in pregnancy. He has rhinovirus identified by PCR on nasal swab. Which ONE of the following is the STRONGEST PREDICTOR that he is at risk of asthma?

Question 1Select one:

a.
Rhinovirus on nasal swab

b.
No smoking in pregnancy

c.
Age less than 12 months

d.
History of maternal asthma

Answer 1

History of maternal asthma

Question 2

A 4 year old child comes to CAA with acute wheezing. He has had 5 previous episodes of wheezing, each associated with a virus infection. What is the most likely cause of acute wheezing at this age?

Question 2Select one:

a.
Acute atopic asthma

b.
Acute RSV bronchiolitis

c.
Non-atopic asthma

d.
Transient infant wheeze

Answer 2

Non-atopic asthma

Question 3

A 6-month-old boy, Sam, has been admitted to hospital twice for acute wheezing illnesses. WHICH ONE of the following factors is the STRONGEST PREDICTOR that he will continue to wheeze by school age?

Question 3Select one:

a.
Absence of crackles on auscultation

b.
Mother smoked in pregnancy

c.
RSV negative on both admissions

d.
Inflamed eczema on the trunk

Answer 3

Inflamed eczema on the trunk

Question 4

Isaac is a 7-year-old boy with asthma who recently completed a clinical trial of a new drug, during which he performed regular supervised peak flow readings for 6 weeks. His mother continued to keep a peak flow diary since the trial. In summary this shows:

Best ever peak flow: 170 l/min
Worst recent peak flow: 130 l/min
Average morning peak flow: 160 l/min (range 150 –160 l/min)
Average afternoon peak flow: 165 l/min (range 160 – 170 l/min)
Predicted peak flow for age and height = 200 l/min
What is your assessment of his asthma severity/control based on this data?

Question 4Select one or more:

a.
Severe chronic asthma: low baseline and high peak flow variability

b.
Mild chronic asthma: baseline and peak flow variability are normal

c.
Moderate chronic asthma: normal baseline but increased variability

d.
Indeterminate: insufficient information to asses severity of asthma

Answer 4

Indeterminate: insufficient information to asses severity of asthma

Question 5

A 4-year-old boy, James, comes to see you with asthma that is concerning his mother. Which is the MOST INFORMATIVE METHOD to assess his overall level of asthma severity?

Question 5Select one:

a.
Office spirometry followed by peak flow diary

b.
Examination for chest hyperexpansion, and wheezing

c.
Peak flow in the office with follow-up diary recordings

d.
History of interval symptoms with follow-up symptom diary

Answer 5

History of interval symptoms with follow-up symptom diary

Question 6

Timothy is 6 months hold and has been admitted to hospital with acute wheezing and respiratory distress. His mother has no experience or family history of wheezing and wants to know what is it that causes this sound in his breathing. What is the explanation of what is happening in the airways?

Question 6Select one:

a.
Turbulence at blocked airways

b.
Vibration of infant vocal cords

c.
Turbulence at narrow airways

d.
Vibration of narrow airways

Answer 6

Vibration of narrow airways