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Asthma SBAs 1. What type of hypersensitivity reaction is asthma? A. Type 1 B. Type 2 C. Type 0 D. Type 4 E. Type 5 2. A 19-year-old university student presents to his general practitioner (GP) with a 3-month history of breathlessness and chest tightness when playing sports. He also has a nocturnal cough. What is the most appropriate initial pharmacological treatment for his suspected condition? A. Long-acting muscarinic antagonist B. Leukotriene receptor antagonist C. Long-acting beta-agonist D. Short-acting beta agonist + inhaled corticosteroid E. Short-acting beta agonist 3. Which receptor does the drug terbutaline target? A. Alpha-1 B. Alpha-2 C. Beta-1 D. Beta-2 E. Glucocorticoid receptor 4. Which one of these is a side effect of salbutamol? A. Agitation B. Bradycardia C. Cardiomyopathies D. Hyperkalaemia E. Cushing’s syndrome 5. Which one of these drugs is associated with an increased risk of osteoporosis? A. Salbutamol B. Formoterol C. Acetaminophen D. Zafirlukast E. Fluticasone 6. Which one of these conditions is a relative contraindication to a SABA? A. Hypothyroidism B. Diabetes insipidus C. Hyperkalaemia D. Epilepsy E. SIADH 7. Which class of antibody is involved in asthma? A. IgA B. IgB C. IgC D. IgD E. IgE 8. What is the name of the enzyme inhibited by NSAIDs such as aspirin? A. Lipoxygenase B. Tyrosine kinase C. Acetylcholinesterase D. Cycloxygenase E. Leukotriene synthase 9. Which molecule is the precursor for leukotriene synthesis? A. Prostaglandin H2 B. Arachidonic acid C. Phospholipase A2 D. Thromboxane A2 E. Cholesterol 10. Which of these is a serious side effect of a leukotriene receptor antagonist? A. Nausea B. Diarrhoea C. Headaches D. Mood changes E. Fever ASTHMA SAQ (6 marks) 1. Name 2 symptoms of asthma ( 1 mark). 0.5 marks for each correct answer • Wheeze • Dyspnoea • Cough • Chest tightness • Diurnal variation • Any other sensible answer (but question asks for symptoms not signs so answers should not include signs such as reduced FEV1, eosinophilia or a wheeze only heard on auscultation) 2. Describe the mechanism of action of an inhaled corticosteroid and give an example (3 marks). Fluticasone is an example of an inhaled corticosteroid (0.5 marks). It binds to and activates the glucocorticoid receptor (0.5 marks) on eosinophils, mast cells and other inflammatory cells (0.5 marks). This leads to a decreased number of cytokines and inflammatory cells (0.5 marks) reducing bronchoconstriction (0.5 marks). 3. List 4 advantages of delivering medication in a nebuliser (2 marks). 0.5 marks each 4 from: Many drug solutions Can deliver combinations Minimal patient cooperation required Can deliver to all ages Concentration and dose can be modified Normal breathing pattern Any other sensible answer