GP - Resp

Question 1

What is the management for asthma in children?

Answer 1

1. SABA
2. SABA + low-dose ICS
3. SABA + low-dose ICS + LTRA
4. SABA + low-dose ICS + LABA
5. SABA + low-dose ICS MART
6. SABA + moderate-dose ICS MART or separate LTRA
7. Increase ICS dose + refer

Question 2

What is the management for asthma in children >5 years?

Answer 2

1. SABA
2. SABA + 8-week trial of moderate-dose ICS
3. SABA + low-dose ICS + LTRA
4. Refer

Question 3

What is the management for asthma in adults?

Answer 3

1. SABA
2. SABA + low-dose ICS
3. SABA + low-dose ICS + LTRA
4. SABA + low-dose ICS + LABA
5. SABA +/- LTRA + low-dose ICS MART
6. SABA +/- + moderate-dose ICS MART
7. Increase ICS dose and refer

Question 4

What are features of moderate acute asthma?

Answer 4

• PEFR 50-75%
• Speech normal
• RR <25/min
• Pulse <110bpm

Question 5

What are features of severe acute asthma?

Answer 5

• PEFR 33-50%
• Can’t complete sentences
• RR >25/min
• Pulse >110bpm

Question 6

What are features of life-threatening acute asthma?

Answer 6

• PEFR <33%
• O2 sats <92%
• Silent chest/cyanosis/feeble respiratory effort
• Bradycardia/dysrhythmia/hypotension
• Exhaustion/confusion/coma

Question 7

What is the management for acute asthma?

Answer 7

O SHIT ME
- Oxygen
- Salbutamol
- Hydrocortisone IV or oral prednisolone
- Ipratropium bromide nebulisers
- Theophylline/aminophylline
- Magnesium sulphate IV
- Escalate

Question 8

Give an example of each type of asthma medication

Answer 8

• SABA = salbutamol
• ICS = budesonide/beclomethasone
• LTRA = montelukast
• LABA = formoterol

Question 9

What are the investigations for COPD?

Answer 9

• Spirometry = FEV1/FVC <70%
• Chest x-ray = hyperinflation/bullae/flat hemidiaphragm
• FBC (exclude secondary polycythaemia)
• BMI

Question 10

When do you give each type of oxygen therapy?

Answer 10

Type 1 respiratory failure (normal CO2) = CPAP

Type 2 respiratory failure (high CO2) = BiPAP