Why hello there, future Registered Respiratory Therapist!

Thank you so much for downloading this cheat sheet. This one is all about asthma! Here below, I’ve
listed out a few practice questions about ‘What is Asthma?’ and some of the things you need to
know about it as an RT Student, and also some things to remember for when you start practicing as
a licensed Respiratory Therapist.

Asthma Practice Questions:

1. What is the definition of Asthma?
A respiratory disorder characterized by recurring episodes of paroxysmal dyspnea, wheezing on
expiration or inspiration caused by constriction of the bronchi, coughing, and viscous mucoid
bronchial secretions. The episodes may be precipitated by inhalation of allergens or pollutants,
infection, cold air, vigorous exercise, or emotional stress. It’s essentially hyperreactivity of the
airways.

2. What does hyperractivity of the airways lead to?

Bronchoconstriction & bronchospasm, mucosal swelling, and increased production of thick
tenacious mucus.

3. What are the two types of asthma?

Extrinsic and Intrinsic.

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4. What kind of asthma is extrinsic?
It is considered type-one or allergenic asthma.

5. What kind of asthma is intrinsic?

It is considered type-two or non-allergenic asthma.

6. What can cause the onset of extrinsic asthma?

Pollen, mold, dander, or different foods.

7. What can cause the onset intrinsic asthma?

Stress, cold or dry air, smoke, anxiety, viruses, or infections.

8. What are signs, symptoms, and observations of asthma?

Increased respiratory rate, work of breathing, heart rate, cardiac output, and blood pressure. The
patient may also have a prolonged (forceful) expiration and a decreased peak expiratory flow rate.

9. What are the breath sounds of a patient with asthma?

Wheezing – you will always hear on expiration. If heard on inspiration, it’s a more serious case of
asthma.

10. What does it mean when you do not hear wheezes when listening to an asthma patient who
is clearly in distress?

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This means that there is no air movement and is amongst the most serious cases of asthma. This
could be life-threatening and may require intubation and mechanical ventilation.

11. What are the ABG results associated with asthma?

Here are the ABG results that you will likely see for a patient having an asthma attack:

For a mild asthma attack, the pH may be increased with a low PaCO2 due to the patient
hyperventilating.

For a moderate asthma attack, you the pH is normal and the patient’s oxygen level (PaO2) is
starting to decrease, while the PaCO2 and HCO3 are still in the normal ranges.

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For a severe asthma attack, the pH is decreased, the PaO2 is severely decreased, and the PaCO2 is
increased. This is a case of impending respiratory failure.

12. What happens when mediators are released in asthma?

Bronchoconstriction, bronchospasm, pulmonary vasodilation, airway inflammation, and increased
mucus production.

13. If the PaCO2 rises drastically and suddenly during an asthma attack, what does that mean?
It likely means that the patient isn’t moving any air and may be going into respiratory failure. This is
a very dangerous situation and may require intubation and mechanical ventilation.

14. What will a chest X-ray show with a patient with asthma?
You may see no significant changes. It may be slightly darkened. Also, you may see an increased
capacity due to air trapping.

15. What happens to the systolic blood pressure during an asthma attack?
It will decrease during inspiration by 10-20 mmHg.

16. Which WBC increases during an asthma attack?

Eosinophils.

17. What will a PFT test show on an asthmatic?

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Decreased airflow, low peak flows, and an increased residual volume. The FVC may be decreased
due to air trapping, and the FEV1/FVC ratio is decreased.

18. What is the first treatment when it comes to asthma?

Prevention; avoid triggers if possible.

19. What are some medical treatments with patient that have asthma?
The patient will undergo a preventative asthma action plan and also immunotherapy.

20. What is immunotherapy?

It’s a form of antigen extract to desensitize the patient to asthma triggers. It can help to reduce
asthma symptoms, as well as the need for medications. It can also help reduce the risk of severe
asthma attacks after future exposure to the allergen. It has been shown to possibly be as effective
as inhaled steroids.

21. What is the 1st line of defense in asthma?

Maintenance with long-acting beta-2 agonists and inhaled corticosteroids.

22. What is the 2nd line of defense in asthma?

Fast-acting medication (Beta-2 agonists) such as: albuterol, xopenex, etc., as well as anticholinergic
medications like ipratropium bromide.

23. What is the 3rd line of defense in asthma?

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Emergency oral and intravenous steroids.

24. What is the 4th line of defense in asthma?

Xanthines such as aminophylline, magnesium sulfate via an IV, as well as Heliox.

25. What are some special medications used in asthma?

Luekotriene antagonist, Montelukast Sodium (Singulair).

26. What are some prophylactic medications used in asthma?

Cromolyn (intal) and Nedocromil (tilade).

27. When would you use xolair (omalizumab) to treat asthma?

It can be used to treat patient that are 12 years of age and above. They must have a moderate to
severe persistent asthma have asthma triggered by year-round allergens in the air, and continue to
have asthma symptoms even though they are taking inhaled steroids.

28. What are other treatment considerations for asthma patient?

In the emergency department, back-to-back continuous short-acting bronchodilators may be give
to the patient to help alleviate bronchospasm. This is often termed as a continuous breathing
treatment.

29. True or False: A methacholine challenge test can be used in the diagnoses of asthma.

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True. A methacholine challenge test is performed to determine how reactive or responsive your
lungs are to different asthma triggers in the environment. The test can help your doctor evaluate
symptoms suggestive of asthma and help diagnose whether or not the patient has it.

Final Thoughts
So there you have it! That’s wraps up this little cheat sheet about Asthma and I hope it was able to
teach you a thing or two. Having a good knowledge and understanding about asthma is very
important for a Respiratory Therapists because we deal with asthma patients on a daily basis. And
what a better time to learn and understand it than now? Breathe Easy!

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