Diseases

Question 1

Classify severe asthma

Answer 1

cannot complete sentences in one breath 
respiration rate >/or equal to 25
pulse >/or equal to 110
use of accessory muscles 
Peak flow less than 50% of predicted value/ best known value

Question 2

How would you classify life-threatening asthma?

Answer 2

Peak expiratory flow less than 33% of predicted or best known
SpO2 less than 92%
Silent chest, cyanosis, feeble respiratory effort
Too dyspnoeic to speak
Bradycardia or hypotension
exhaustion, confusion,coma

Question 3

What first line investigations would you do before treatment in severe asthma?

Answer 3

Peak expiratory flow

Oximetry

Question 4

What immediate treatment would you do in severe or life-threatening asthma?

Answer 4

Oxygen
Salbutamol give via oxygen nebuliser
Prednisolone tablets

Question 5

What other investigations would you consider in acute severe asthma?

Answer 5

Chest X-Ray (to exclude pneumothorax or consolidation)
U and E
FBC

Question 6

Define mild asthma?

Answer 6

Dyspnoea only with exertion
Peak expiratory flow rate (PEFR) >70% of predicted or personal best
Oxygen saturation >95%
Prompt relief with inhaled short-acting beta-2 agonist

Question 7

Define moderate asthma?

Answer 7

Dyspnoea limits usual daily activity
PEFR 40% to 69% of predicted or personal best
Oxygen saturation 91% to 95%
Relief from frequent inhaled short-acting beta-2 agonist
Some symptoms last for 1 to 2 days after treatment is started

Question 8

How to you treat mild intermittent asthma?

Answer 8

short acting beta agonist

Question 9

Define mild persistent asthma?

Answer 9

Symptoms >2 times a week but <1 time a day
 Exacerbations may affect activity
 Night-time symptoms >2 times a month
 FEV1 ≥80% of predicted
 PEFR variability between 20% and 30%

Question 10

How do you treat moderate persistent asthma?

Answer 10

low dose inhaled corticosteroids and LABA and SABA

OR medium dose inhaled corticosteroid and SABA

Question 11

Define moderate persistent asthma

Answer 11

Daily symptoms
Use of short-acting beta agonists daily
Attacks affect activity
Exacerbations ≥2 times a week and may last for days
Night-time symptoms >1 time a week
FEV1 greater than 60% to <80% of predicted
PEFR variability >30%

Question 12

How do you treat moderate persistent asthma?

Answer 12

low dose inhaled corticosteroids and LABA and SABA

OR medium dose inhaled corticosteroid and SABA

Question 13

Define severe persistent asthma?

Answer 13

Continual symptoms
 Limited physical activity
 Frequent exacerbations
 Frequent night-time symptoms
 FEV1 ≤60% of predicted
 PEFR variability >60%.

Question 14

How do you treat severe persistent asthma?

Answer 14

medium dose inhaled corticosteroids and LABA and SABA

Question 15

Define mild intermittent asthma

Answer 15

Symptoms ≤2 times a week
Asymptomatic and normal peak expiratory flow rate (PEFR) between attacks
Attacks are brief with varying intensity
Night-time symptoms ≤2 times a month
Forced expiratory flow at 1 second (FEV1) or PEFR ≥80% of predicted
PEFR variability <20%