On this page
Study tools
Write your answer
Saved on this device. No marking — you are the marker.
Q1: Definition and pathophysiology (2 min)
"What is asthma, and what is the key pathophysiological triad?"
- Chronic airway disease with variable expiratory airflow limitation and airway hyper-responsiveness.
- Triad: airway inflammation, bronchoconstriction, and mucus hypersecretion / airway remodelling in chronic disease.
- Distinguish T2-high (eosinophilic, allergic, high FeNO/IgE) from T2-low phenotypes — guides biologics.
Q2: Acute severity grading (2 min)
"How do you tell moderate, acute severe, and life-threatening asthma apart?"
- Use PEF, RR, HR, speech, SpO2, and clinical features (BTS/SIGN-style).
- Acute severe: PEF 33–50%, RR ≥25, HR ≥110, cannot complete sentences.
- Life-threatening: PEF <33%, SpO2 <92%, silent chest, cyanosis, exhaustion, arrhythmia, hypotension, altered consciousness, normal/raised PaCO2.
- Emphasise that a "normal" PaCO2 in a tachypnoeic asthmatic is ominous.
Q3: First-hour treatment (3 min)
"Give exact drugs and doses for acute severe asthma."
- Oxygen to SpO2 93–95%.
- Salbutamol 5 mg neb q15–20 min ± continuous.
- Ipratropium 500 mcg neb.
- Prednisolone 40–50 mg PO or hydrocortisone 100 mg IV.
- IV magnesium 1.2–2 g over 20 min if poor response.
- Senior/ICU early if life-threatening features or prior near-fatal asthma.
Q4: Stable therapy ladder (2 min)
"Why is SABA-only treatment discouraged in modern GINA?"
- SABA-only is linked to higher exacerbation and death risk.
- Prefer ICS-containing reliever (ICS-formoterol MART track) or ensure ICS whenever SABA is used.
- Step up by increasing ICS dose / adding LABA / LAMA; phenotype for biologics at step 5.
Q5: Special situations (2 min)
"Asthma in pregnancy — do you stop inhaled steroids?"
- No — uncontrolled asthma harms the fetus more than ICS.
- Continue ICS ± LABA; treat exacerbations aggressively with systemic steroids when needed.
- Avoid experimental step-down if control is fragile.