Asthma

Question 1

How do you treat suspected asthma?

Answer 1

SABA + very low dose ICS (+ monitoring variability/bronchodilator reversibility)

Question 2

How do you treat newly Dx asthma in the first instance in children <5y/o?

Answer 2

SABA + LTRA

Question 3

What is the next step of treatment for children <5y/o after SABA + LTRA?

Answer 3

SABA + LTRA + very low dose ICS

Question 4

What is the next step of treatment for children >5y/o after SABA + very low dose ICS

Answer 4

SABA + very low dose ICS + inhaled LABA

Question 5

How do you treat newly Dx asthma in the first instance in children >5y/o?

Answer 5

SABA + very low dose ICS

Question 6

What is step 3 of asthma management when there is no response at all to LABA?

Answer 6

Stop LABA and increase dose of ICS to low dose

Question 7

What is step 3 of asthma management where there is some benefit to LABA but control is still inadequate

Answer 7

Continue LABA and increase dose of ICS to low dose
OR
Continue LABA and ICS but consider trial of other therapy, e.g. LTRA

Question 8

What is step 4 of asthma management?

Answer 8

Increasing ICS dose to medium
OR
Addition of 4th drug - SR theophylline

Question 9

What is step 5 of asthma management?

Answer 9

Daily oral prednisolone + maintain medium dose of ICS

Question 10

When should children be referred to a paediatric asthma specialist?

Answer 10

Step 4 and step 5

Question 11

What are the signs of a child with an acute severe asthma attack?

Answer 11

SpO2 <92%
PEF 33-50%
Can't complete sentance in one breath/or too breathless to talk/feed
HR 125 when >5y/o, or >140 when 1-5y/o
RR >30 when >5y/o, or >40 when 1-5y/o

Question 12

What are the signs of a child with a life-threatening asthma attack?

Answer 12

SpO2 <92%
PEF <33% best/predicted
Silent chest
Cyanosis
Poor respiratory effort
Hypotension
Exhaustion
Confusion