Normal in patients with exercise-induced dyspnea

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1. The physical exam is typically normal in patients with exercise-induced dyspnea. Even in cases of exercise-induced asthma, the lungs will be clear unless the patient is having a current asthma exacerbation. Which of the following symptoms more likely would support a diagnosis of asthma?

a) Signs of atopy.
b) The child says, "I can't breathe."
c) Rapid onset of wheezing during exercise.
d) The area of airflow obstruction feels like it is in the neck, not the chest.

2. Which of the following accurately describes symptoms that differentiate exercise-induced bronchospasm from other causes of exercise-induced dyspnea?

a) Shortness of breath that lasts one hour after 45 minutes of moderate to intense exercise.
b) Slow onset of coughing, wheezing, chest tightness, and shortness of breath during six to eight minutes of vigorous exercise.
c) Coughing, wheezing, and chest tightness, with associated stridor, that resolve quickly with rest.
d) Immediate coughing, wheezing, chest tightness, and shortness of breath occurring at the onset of exercise.

3. Which of the following is an example of non-medication therapy before exercise to treat exercise-induced bronchospasm?

a) Short exercise warm-up of medium to low intensity.
b) Hypnotherapy, used in conjunction with visualization.
c) A series of deep knee bends, followed by breathing exercises.
d) Breathing exercises alone.

4. Exercise-induced bronchospasm also can be treated with medication, including short-acting B-agonists, mast cell stabilizers, and controller therapies. Under what circumstances are controller therapies used?

a) As an adjunct therapy to short-acting B-agonists.
b) When the child also has been treated with chemotherapy.
c) When mast cell stabilizers have been ineffective.
d) When symptoms outside of exercise warrant their use, or when non-medication therapies and short-acting preventive medications do not control the symptoms.

5. Amanda has a history of exercise-induced bronchospasm, and when she experiences symptoms of shortness of breath, coughing, and wheezing, she is removed from play on the volleyball court. Amanda's peak expiratory flow (PEF) measures 10 to 15 percent below baseline. According to the Return-to-Play algorithm, what should happen next?

a) Amanda's condition should be treated as a respiratory emergency; she should be transferred from the sidelines to an emergency department.
b) Amanda should receive two puffs of a short-acting B-agonist.
c) Amanda may return to play.
d) Amanda's PEF should be repeated at five minutes.

6. Which of the following is an example of a prototypical patient with vocal cord dysfunction?

a) Obese boy or girl with a stutter.
b) Adolescent boy or girl with possible gastroesophageal reflux disease (GERD) whose breathing difficulties occur while playing competitive sports.
c) Adolescent boy in emergency treatment for gastroenteritis.
d) Child or adolescent with cardiac disease.

7. Henry is an 11-year-old who complains of difficulty breathing when he plays soccer. His medical history and physical exam show no abnormalities, but his symptoms do not relent when he tries a short-acting B-agonist before playing soccer. According to the referral algorithm in the module, which of the following steps should his health-care provider take next?

a) Refer Henry to an asthma specialist.
b) Schedule bronchoprovocation testing.
c) Diagnose asthma.
d) Diagnose vocal cord dysfunction.

Reference no: EM133845753

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