Chest

Question 1

Acute asthma initial management

Answer 1

SABA

• 1 puff salbutamol via spacer, every 60 second
• 10 puffs

Repeat every 10-20 mins

Question 2

After good response to acute asthma management, what should be prescribed on discharge?

Answer 2

Oral prednisolone 30mg 3/7

or

Quarduple ICS

Question 3

Follow up for acute asthma occurs within…

And involves…

Answer 3

Within 48 hours

• Monitor PEFR= seek advice if decreases
• Admission if no response to steroids.

Question 4

Features to assess asthma exacerbation

Answer 4

Sleeping

Interference with usual activities

Recent hospital admissions

Triggers

Chest pain

Question 5

Features to assess asthma control

Answer 5

Drug changes

Allergies

Inhaler adherence

Correct technique

Use of space

Prophylatic immunisations

Question 6

Asthma management steps

Answer 6

1. SABA reliever (<3x a week)+ ICS preventer
2. Increase ICS dose
3. Add LABA/ LTRA
4. Try other option
5. MART + low dose ICS. 6= increase ICS
6. Muscarinic receptor antagonist/ theophylline.

Question 7

Asthma management in age<5

Answer 7

1. Moderate dose ICS for 8 weeks.
   - Start low dose ICS if symptoms resolve then reoccur within 4 weeks.
   - Moderate dose ICS for 8 weeks if symptoms reoccur after 4 weeks.
2. Add LTRA to low dose ICS
3. If uncontrolled= refer to specialist

Question 8

Signs of life-threatening asthma

• O2
• Speech/ respiratory effort
• RR
• Pulse

Answer 8

O2< 92

Cyanosis, silent chest/ poor resp effort

Hypotension

Exhaustion/ altered GCS

Question 9

Signs of severe asthma

• O2
• Speech/ respiratory effort
• RR
• Pulse

Answer 9

O2 <92

Cannot complete sentences

RR>25

Pulse >110