Acute Asthma and Status Asthmaticus in Children

What this deck covers

Acute Asthma and Status Asthmaticus in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Single words and a frightened face
2. The first two things given
3. How to give it when time is short
4. Forty minutes in, still no steroid
5. When the first hour is not enough
6. Quiet chest after a full hour
7. Deciding where he sleeps tonight
8. Sharp pain on one side only
9. Do we need an antibiotic for this?
10. The gas that looks reassuring
11. The chest that went quiet
12. Shaking hands and a low result
13. A number that looks like shock
14. What has to happen before he leaves
15. Why this teenager worries you most
16. Back within four hours
17. Wheezing after a biscuit
18. Do we need to come down slowly?

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: The oxygen saturation of 89 per cent in air, A dry powder device, Give oral prednisolone now, An oral leukotriene receptor antagonist, Give a single intravenous dose of magnesium sulfate, On the paediatric ward with hourly observations, A blood gas taken from a peripheral artery, Too little air is moving for a wheeze to be produced, Rising blood sugar requiring an insulin infusion, The number of different drugs he has been prescribed, Nebulised bronchodilator driven by high-flow oxygen.

Clinical pearls from this deck

• Record the saturation in air before you give oxygen, or you lose the number that grades him.
• Drive the nebuliser with oxygen. Air-driven treatment in a hypoxic child makes him worse.
• A spacer is not the poor relation of a nebuliser. In a moderate attack it is the better choice.
• Steroid takes four hours to work. That is the argument for giving it in the first one.
• Ipratropium is an early add-on for the poor responder, not a drug to reach for at hour four.
• Phone intensive care as you start the magnesium, not when it has not worked.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Respiratory Board Questions case decks · pediatric reference values.