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Common asthma exam questions for medical finals, OSCEs and MRCP PACES


Question 1. Non-invasive ventilation in asthma

How should NIV be used in acute asthma?

  • If NIV is to be used it should be trialled in ITU setting with low threshold for intubation

Question 2. Discharge post-asthma

What needs to be in place on discharge from hospital?

  • A robust self-management plan should be in place, preferably from specialist nurse
  • Ensure the patient has enough medications
  • Review and correct inhaler technique
  • Review within 30 days by a clinician with expertise in asthma management

Question 3. Asthma in pregnancy

What are the changes to asthma management in pregnancy?

  • Beta 2 agonists, inhaled steroids, theophyllines and leukotriene receptor antagonists can be used throughout pregnancy and labour
  • If oral steroids are required clinically then they can be given as likely that benefit will outweigh harm
  • If anaesthesia is required then local blockade is preferable to general
  • Avoid use of prostaglandins as they can induce bronco-constriction
  • Encourage women with asthma to breast-feed