NAECB Signs & Symptoms Of Asthma 3 — Questions and Answers
Question 1: A patient describes chest tightness that is worse in the morning and improves throughout the day. Which asthma symptom pattern does this represent?
- Perennial allergic asthma
- Diurnal variation in symptoms (Correct answer)
- Exercise-induced bronchospasm
- Aspirin-exacerbated respiratory disease
Correct answer: Diurnal variation in symptoms
Diurnal variation with morning worsening reflects circadian changes in airway tone and inflammation that are characteristic of asthma.
Question 2: Which of the following is a symptom of hyperinflation during a severe asthma episode?
- Decreased anteroposterior chest diameter
- Barrel chest appearance (Correct answer)
- Increased breath sounds bilaterally
- Tracheal deviation toward the affected side
Correct answer: Barrel chest appearance
Air trapping during severe asthma causes lung hyperinflation, resulting in a barrel chest with increased anteroposterior diameter.
Question 3: A child with asthma complains of persistent nighttime cough without wheezing. The MOST likely explanation is:
- The child does not have asthma
- Cough-variant asthma where cough is the predominant symptom (Correct answer)
- The child has croup, not asthma
- Cough only occurs in severe persistent asthma
Correct answer: Cough-variant asthma where cough is the predominant symptom
Cough-variant asthma presents with chronic cough as the primary or sole symptom, often worse at night, without typical wheezing.
Question 4: During spirometry, which finding is MOST consistent with asthma?
- Decreased FVC with normal FEV1/FVC ratio
- Decreased FEV1 with low FEV1/FVC ratio that improves ≥12% after bronchodilator (Correct answer)
- Increased FEV1/FVC ratio with reduced TLC
- Flat inspiratory loop on flow-volume curve
Correct answer: Decreased FEV1 with low FEV1/FVC ratio that improves ≥12% after bronchodilator
A reduced FEV1/FVC ratio (obstructive pattern) that improves ≥12% and ≥200 mL after bronchodilator administration confirms reversible airflow obstruction consistent with asthma.
Question 5: Which symptom is MOST likely to suggest allergic (atopic) asthma rather than non-allergic asthma?
- Symptoms triggered by aspirin ingestion
- Symptoms associated with seasonal pollen exposure and other allergic conditions (Correct answer)
- Adult onset with no childhood history
- Symptoms worsened by cold air exclusively
Correct answer: Symptoms associated with seasonal pollen exposure and other allergic conditions
Allergic asthma is associated with sensitization to allergens, often occurring alongside other atopic conditions such as allergic rhinitis and eczema, with seasonal patterns.
Question 6: Which sign of accessory muscle use is commonly observed in adults during moderate asthma exacerbations?
- Clubbing of the fingers
- Sternocleidomastoid and scalene muscle activation (Correct answer)
- Peripheral cyanosis only
- Jugular venous distension
Correct answer: Sternocleidomastoid and scalene muscle activation
During moderate to severe asthma, sternocleidomastoid and scalene muscles are recruited to assist with breathing due to increased airway resistance.
Question 7: A patient's peak expiratory flow (PEF) is 55% of their personal best during an acute asthma episode. This indicates:
- Mild intermittent asthma requiring no treatment change
- Moderate-to-severe exacerbation requiring urgent treatment (Correct answer)
- Normal variability within acceptable limits
- Complete resolution of bronchospasm
Correct answer: Moderate-to-severe exacerbation requiring urgent treatment
A PEF of 40–69% of personal best indicates a moderate-to-severe exacerbation requiring prompt treatment intensification per asthma action plans.
NAECB Signs & Symptoms Of Asthma 3
A patient describes chest tightness that is worse in the morning and improves throughout the day.
Which asthma symptom pattern does this represent?