NAECB Signs & Symptoms Of Asthma 2 — Questions and Answers
Question 1: Which characteristic of asthma wheezing helps distinguish it from other respiratory conditions?
- It is loudest during inspiration only
- It is typically polyphonic and diffuse (Correct answer)
- It is confined to a single lobe
- It disappears immediately after coughing
Correct answer: It is typically polyphonic and diffuse
Asthma wheezing is typically polyphonic (multiple pitches) and diffuse, reflecting widespread airway narrowing throughout the lungs.
Question 2: A patient reports that symptoms worsen when exposed to cold air and improve in warm, humid environments. This pattern is MOST consistent with:
- Cardiac asthma
- Exercise-induced bronchospasm
- Allergic asthma triggered by temperature (Correct answer)
- Occupational asthma
Correct answer: Allergic asthma triggered by temperature
Cold, dry air is a known non-allergic trigger that causes airway hyperresponsiveness, and symptom relief in warm, humid air supports an asthma diagnosis.
Question 3: Which sign indicates increased work of breathing in a pediatric asthma patient?
- Bradycardia
- Intercostal retractions (Correct answer)
- Decreased respiratory rate
- Prolonged inspiratory phase
Correct answer: Intercostal retractions
Intercostal retractions indicate accessory muscle use and increased negative intrathoracic pressure, signaling significant respiratory distress in children.
Question 4: A patient with asthma develops a 'silent chest' during an acute attack. This finding indicates:
- Symptom resolution
- Severe obstruction with minimal air movement (Correct answer)
- Successful bronchodilator response
- Mild intermittent asthma
Correct answer: Severe obstruction with minimal air movement
A silent chest in an asthma attack is an ominous sign indicating such severe obstruction that there is insufficient airflow to generate wheeze.
Question 5: Which symptom pattern is MOST characteristic of nocturnal asthma?
- Symptoms peak at noon and resolve by evening
- Coughing and wheezing that wake the patient between 2–4 AM (Correct answer)
- Symptoms present only during exercise
- Morning symptoms that resolve after breakfast
Correct answer: Coughing and wheezing that wake the patient between 2–4 AM
Nocturnal asthma classically causes symptoms in the early morning hours (2–4 AM) due to circadian dips in cortisol and epinephrine and increased airway inflammation.
Question 6: Pulsus paradoxus greater than 12 mmHg during an asthma attack suggests:
- Mild disease well-controlled by inhaler
- Cardiac tamponade only
- Severe bronchospasm with significant intrathoracic pressure swings (Correct answer)
- Normal physiologic response to breathing
Correct answer: Severe bronchospasm with significant intrathoracic pressure swings
An exaggerated pulsus paradoxus (>12 mmHg) during acute asthma reflects large swings in intrathoracic pressure from severe airflow obstruction.
Question 7: Which symptom distinguishes asthma from chronic obstructive pulmonary disease (COPD) in terms of reversibility?
- Symptoms in asthma are irreversible with treatment
- Asthma symptoms and airflow obstruction are largely reversible with bronchodilators (Correct answer)
- COPD symptoms fully reverse after corticosteroids
- Both conditions show identical reversibility patterns
Correct answer: Asthma symptoms and airflow obstruction are largely reversible with bronchodilators
A hallmark feature of asthma is that airflow obstruction and associated symptoms are largely reversible either spontaneously or with bronchodilator treatment.
NAECB Signs & Symptoms Of Asthma 2
Which characteristic of asthma wheezing helps distinguish it from other respiratory conditions?