The Specialist Forum May 2017 | Page 17

www.specialistforum.co.za PULMONOLOGY Multiple choice questions » Reliever medication < twice/ week » Normal lung function » No exacerbations. SURNAME INITIALS 6. Conclusion Initial assessment of asthma severity and ongoing assessment of asthma control provide guides to asthma therapy, which should be based on GINA guidelines. Medications and delivery devices should be appropriate to meet patients’ needs and circumstances. Anti-inflammatory treatment is recommended for all patients with chronic persistent asthma. Inhaled corticosteroids are still the most widely studied and recommended drugs in this class. Leukotriene modifiers and theophyllines are effective oral forms of treatment, usually combined with inhaled corticosteroids. Long acting beta agnoists and anti- cholinergics provide sustained bronchodilation, only to be used in conjunction with inhaled corticosteroids. Several antibodies such as anti-IgE, anti-IL5 and anti- IL4 have recently been used in asthma therapy in selected patients with more severe asthma. References and Recommended Reading 1. GINA Report 2016. Global Strategy on Asthma Management and Prevention. www.ginasthma.org accessed December 2016 2. Working Group of the South African Thoracic Society: U Lalloo, G Ainslie, M Wong, S Abdool-Gaffar, E Irusen, C Feldman, J O’Brien, C Jack. Guideline for the Management of Chronic Asthma in Adolescents and Adults. ALLSA Handbook 2010 3. South African Childhood Asthma Working Group: Motala C, Green R, Manjra A, Zar H, Kling S et al. YOUR HPCSA REGISTRATION NO. MP Address: Telephone: Fax: E-mail: YES! I would like to receive The Specialist Forum for FREE monthly. Please note that the answer sheet for the CPD article is also available online. To complete the questionnaire go to www.specialistforum.co.za, click on the CPD button and select April. The article and the questionnaire will appear. 1 Surveys indicate that the majority of patients in developed and developing countries do not receive optimal care. a. True b. False 2 A B Avoidance of triggers, wherever possible, helps to minimise asthma severity and reduces asthma exacerbations. This include: a. Tobacco smoke, A pollution and dirt b. Tobacco smoke, dust B mites and sunlight C c. Dust mites, grass and sunlight d. Tobacco smoke, pollen D and dust mites 3 Asthma treatment can be administered in different ways - inhaled, orally, or __________ a. Parentally A b. DTI B c. Exhaled C d. DPI D 4 Inhaled medications for asthma are available as pressurised metered- dose inhalers (pMDIs), breath-actuated MDIs, dry powder inhalers (DPIs), soft mist inhalers, and nebulisers. a. True b. False 5 Controllers are - short- acting bronchodilators with rapid onset of action that provide acute relief of symptoms a. True b. False 6 7 A B A B There are two groups of controllers - those with ________________ (corticosteroids and leukotriene blockers) and those with a ____________________ (e.g. Long-acting β2 agonists). a. Anti-inflammatory action A and sustained anti- bronchodilator action b. Inflammatory action and B sustained bronchodilator action c. Inflammatory action C and sustained anti- bronchodilator action d. Anti-inflammatory D action and sustained bronchodilator action A low starting dose is _______ μg/day of BDP equivalent and a dose above ____ μg/day is considered a high dose. a. 200-250 and 1000 b. 250-500 and 750 c. 200-500 and 1000 d. 250-500 and 750 A B C D 8 Leukotriene modifiers (e.g. montelukast) are parenterally administered and act to antagonise the leukotriene receptor and thus resulting in an anti-inflammatory action via a different pathway to corticosteroids. a. True A b. False B 9 Theophylline can be used in the treatment of asthma mainly as a bronchodilator a. True A b. False B 10 Dupilumab is a fully human monoclonal antibody directed against the following interleukin receptor: a. (IL)-4 A b. (IL)-3 B c. (IL)-2 C d. (IL)-7 D This is to state that I have participated in the CPD-approved programme and that these are my own answers. Guideline for the management of chronic asthma in children- 2009 update. ALLSA Handbook 2010 Signature Date 4. Caminati M, Duric-Filipovic I, Arasi S, Peroni DG, Zivkovic Z, Senna G. Respiratory allergies in childhood: recent advances and future challenges. PAI 2015,26:702. SF The Specialist Forum | Vol. 17 No. 4 INSTRUCTIONS: To complete the questionnaire online, go to www.specialistforum.co.za and click on the CPD articles button. Click on the article on the right to access the online questionnaire. Alternatively, complete the questionnaire manually and submit it via e-mail to [email protected] or fax it through to +270862702680. Your certificate will be send to you within 10-15 working days. May 2017 | 17