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Acute severe asthma exacerbations in children younger than 12 years
1.
2. Objectives
! PRESENT: Key recommendations for diagnosis & management of acute severe
asthma in children.
! EMPHASIS ON: Confirming diagnosis of asthma, to avoid both under- and over-
treatment.
9. Lazaar AL and Panettieri RA, Am J Med, 2003;115:652-659
10. Lazaar AL and Panettieri RA, Am J Med, 2003;115:652-659
11. Lazaar AL and Panettieri RA, Am J Med, 2003;115:652-659
Potential Influences:
— Increase in the irreversible component of airway obstruction
— Accelerated decline in pulmonary function
— Persistence of airway hyperresponsiveness
— Promote severe bronchospasm through:
! Loss of airway distensibility
! Increased contractile response
! Loss of elastic recoil
67. Q. 1
— When a patient is diagnosed with acute severe asthma, which of the following is TRUE:
A. IV aminophylline is recommended as a first line drug in acute asthma management in children.
B. IV magnesium sulphate can be used in young children during acute severe asthma attacks.
C. Ipratropium bromide has a mild additional bronchodilating effect when added to β2-agonists that
may only be significant in severe asthma.
D. Immediate administration of IV Methylprednisolone is critical to early management of life-threatening
asthma.
68. Q. 2
— Severe asthma is a subset of difficult-to-treat asthma that remains uncontrolled
despite:
A. Increasing dosage of medicine
B. Hospitalizing following serious exacerbation
C. Treating contributory factors such as inhaler technique and adherence
D. Ignoring underlying environmental allergens
69. Q. 3
— PICU admission for child with acute severe asthma is indicated in the following situations
EXCEPT:
A. Increasing dosage of medicine.
B. When the PEF or FEV1 after treatment is greater than 50% of the predicted value but
less than 70% of the predicted value.
C. Treating contributory factors such as inhaler technique and adherence.
D. Ignoring underlying environmental allergens.
70. Q. 3
— PICU admission for child with acute severe asthma is indicated in the following situations
EXCEPT:
A. Increasing dosage of medicine
B. When the PEF or FEV1 after treatment is greater than 50% of the predicted value but less
than 70% of the predicted value.
C. Treating contributory factors such as inhaler technique and adherence
D. Ignoring underlying environmental allergens
71. Q. 3
— Hospitalization in an PICU for child with acute severe asthma is indicated in the
following situations EXCEPT:
A. Increasing dosage of medicine
B. When the PEF or FEV1 after treatment is greater than 50% of the predicted value but less
than 70% of the predicted value.
C. Treating contributory factors such as inhaler technique and adherence
D. Ignoring underlying environmental allergens
72. Q. 5
— In childhood asthma:
A. Over 90% of patients show exercise-induced bronchoconstriction
B. Hypercapnia is the first physiological disturbance in status asthmaticus
C. Infants are unresponsive to bronchodilators
D. Spontaneous cure occurs before adolescence
E. Cough may be the only symptom
73. Q. 6
— Bronchoconstriction is a recognized side effect of:
A. Captopril
B. Atenolol
C. Ibuprofen
D. Paracetamol
E. Salbutamol
74. Q. 7
— Adverse effects of frequently administered β2-agonist therapy in acute severe asthma
include all the following EXCEPT :
A. Tremor
B. Irritability
C. Tachycardia
D. Hypokalemia
E. Mouth dryness
75. Q. 8
— In emergency department, the patient may be discharged to home if there is symptomatic
improvement. Of the following, the MOST likely discharge medication used is:
A. Inhaled β-agonist only
B. Oral corticosteroid only
C. inhaled corticosteroid only
D. inhaled β-agonist plus oral corticosteroid
E. oral β-agonist plus inhaled corticosteroid