CPS/Canadian thoracic society

Question 1

what are 4 reasons to refer to an asthma specialist

Answer 1

1. diagnostic uncertainty
2. > 2 exacerbations requiring oral steroids or frequent symptoms (>8d/month) despite 200-250ug ICS
3. Admission to PICU
4. Need allergy testing

Question 2

What is considered moderate dose ICS for <5 yo for ciclesonide and fluticasone

Answer 2

ciclesonide- 200mcg

fluticasone- 200-250mcg

Question 3

what are the 5 components of PRAM score

Answer 3

oxygen saturation
air entry
wheeze
suprasternal retractions
scalene muscle retractions

Question 4

what is mild, moderate, severe PRAM score

Answer 4

mild: 0-3
moderate: 4-7
severe: 8-12

Question 5

how many puffs of Ventolin should be used for your therapeutic trial of airflow reversibility

Answer 5

≥ 4 puffs

Question 6

what are the 3 diagnostic criteria required for a diagnosis of asthma

Answer 6

1. documentation of airflow obstruction
2. documentation of reversibility of airflow obstruction
3. no evidence of an alternative diagnosis

Question 7

what is the preferred first line management for asthma

Answer 7

lowest effective dose of ICS

Question 8

first episode of wheeze in a child <1 year of age

Answer 8

bronchiolitis

Question 9

what is the treatment for mild exacerbation? moderate exacerbation?

Answer 9

mild- trial of SABA

moderate- SABA + oral corticosteroid

Question 10

when would you consider a trial of 3 months of ICS

when should you see them in followup

Answer 10

frequent symptoms
previous mod- severe exacerbation
see them in 6 weeks and 3 months