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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.
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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
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