NAECB Signs & Symptoms Of Asthma 4 — Questions and Answers
Question 1: Which symptom is described by patients as 'chest tightness' in asthma and is caused by:
- Pleural effusion compressing the lung
- Bronchoconstriction increasing airway resistance and triggering sensory nerve activation (Correct answer)
- Cardiac enlargement pressing on airways
- Pneumothorax reducing lung volume
Correct answer: Bronchoconstriction increasing airway resistance and triggering sensory nerve activation
Chest tightness in asthma results from bronchoconstriction stimulating sensory C-fibers in airway walls, creating a sensation of constriction or pressure.
Question 2: Exercise-induced bronchoconstriction (EIB) symptoms typically occur:
- Immediately at the start of exercise and resolve during activity
- 5–10 minutes after stopping strenuous exercise (Correct answer)
- Only in patients with severe persistent asthma
- Exclusively during cold weather exercise
Correct answer: 5–10 minutes after stopping strenuous exercise
EIB symptoms typically begin 5–10 minutes after stopping exercise as airway cooling and drying trigger mast cell mediator release and bronchoconstriction.
Question 3: Hypoxemia in acute severe asthma is PRIMARILY caused by:
- Diffusion impairment across the alveolar membrane
- Ventilation-perfusion (V/Q) mismatch from uneven airway obstruction (Correct answer)
- Reduced hemoglobin oxygen-carrying capacity
- Right-to-left cardiac shunting
Correct answer: Ventilation-perfusion (V/Q) mismatch from uneven airway obstruction
V/Q mismatch occurs when obstructed airways lead to underventilated but still-perfused lung units, resulting in hypoxemia during acute asthma.
Question 4: Which respiratory pattern is characteristic of a moderate asthma exacerbation?
- Bradypnea with deep breathing
- Tachypnea with prolonged expiratory phase (Correct answer)
- Cheyne-Stokes breathing
- Kussmaul breathing with rapid deep breaths
Correct answer: Tachypnea with prolonged expiratory phase
Moderate asthma exacerbations produce tachypnea with a prolonged expiratory phase due to air trapping and expiratory flow limitation.
Question 5: A patient with asthma who is speaking in phrases rather than full sentences during an acute attack is classified as having:
- Mild exacerbation
- Moderate exacerbation (Correct answer)
- Severe exacerbation
- Life-threatening exacerbation
Correct answer: Moderate exacerbation
The ability to speak in phrases but not full sentences indicates a moderate asthma exacerbation; inability to speak indicates severe exacerbation.
Question 6: Which finding on auscultation would be expected during the expiratory phase of a mild asthma episode?
- Inspiratory crackles throughout both lung fields
- End-expiratory wheeze (Correct answer)
- Absent breath sounds bilaterally
- Bronchial breath sounds at the bases
Correct answer: End-expiratory wheeze
In mild asthma, wheezing may only be detectable at the end of expiration when airway narrowing is less severe but still present.
Question 7: Nasal polyps in a patient with asthma and aspirin sensitivity describes which clinical triad?
- Löfgren syndrome
- Samter's triad (aspirin-exacerbated respiratory disease) (Correct answer)
- Churg-Strauss syndrome
- Kartagener syndrome
Correct answer: Samter's triad (aspirin-exacerbated respiratory disease)
Samter's triad consists of asthma, nasal polyps, and aspirin/NSAID sensitivity, and is associated with particularly severe or difficult-to-control asthma.
NAECB Signs & Symptoms Of Asthma 4
Which symptom is described by patients as 'chest tightness' in asthma and is caused by: