QuestionSBA
QuestionChoice
The first step of asthma management is a SABA (salbutamol) and an inhaled corticosteroid, rather than a preventer inhaler alone.
50440
b
Prescribe regular low dose inhaled corticosteroid
QuestionChoice
This is a combination inhaler which is first line management in patients >12 years old, and may be considered as part of a MART regimen if this patient's symptoms remain uncontrolled.
50443
e
Prescribe formoterol/beclometasone combined inhaler
QuestionChoice
Salbutamol monotherapy is no longer recommended at any stage of asthma treatment across all age groups.
50441
c
Prescribe salbutamol inhaler
QuestionChoice
This would be inappropriate as he is not suffering an acute exacerbation and should be managed with inhaled corticosteroids.
50442
d
Prescribe oral prednisolone
QuestionChoice
This is the first step in management of asthma in children over 5 years of age. Salbutamol monotherapy is no longer recommended. Indications for escalating treatment if symptoms remain uncontrolled include: using an inhaled short-acting beta2 agonist three times a week or more, having symptoms of asthma three times a week or more, or waking at night due to asthma symptoms at least once a week.
50439
a
Prescribe salbutamol and a regular low dose inhaled corticosteroid 
QuestionComment
are the new MART guidelines only for over 12yos?
61351
QuestionComment
arghhhh what is going on 
61886
User
subscriber
Defibrillator Dominant
User
subscriber
Vaccine Complement
QuestionComment
Was surprised I chose a "1%" answer. 
It seems as if the boy has not yet been prescribed an inhaler, as he is using his brothers. So of course prescribe salbutamol, however not sure why we giving ICS already.
BNFc states- "A paediatric low-dose of ICS should be started as maintenance therapy in children who present with any one of the following features: using an inhaled short-acting beta2 agonist three times a week or more, symptomatic three times a week or more, or waking at night due to asthma symptoms at least once a week."
None of these features were apparent in this tiny stem, so didn't think he needs it?
If evident in the BNF, could someone show it here?
61893
User
subscriber
placementpals
Concept
Chapter
Osteoporosis, otherwise known as thin bones, is a condition associated with high risk of low trauma fractures due to reduced bone mineral density. Osteoclast activity exceeds osteoblast activity, meaning that bone resorption is occurring at a greater rate than bone formation.

**Symptoms and Signs**

- Generally asymptomatic until a fragility fracture occurs
- Back pain
- Kyphosis (stooped posture)
- Fragility fractures

**Risk factors**

- Female sex
- Increasing age
- Smoking
- Corticosteroid use
- Low BMI (< 20-25kg/m<sup>2</sup>)
- Low body weight (<58kg)
- Vitamin D deficiency

**Protective factors**

- Higher BMI
- Exercise - mechanical loading stimulates bone formation

**Diagnosis**
Osteoporosis can be detected on dual-energy x-ray absorptiometry (DEXA) scan.
A T score of < -2.5 indicates osteoporosis

**Management**

- Fall prevention
- Vitamin D and calcium supplementation
- Hormone replacement therapy (postmenopausal women)
- Oral bisphosphonates
2657
3671
Asthma if not controlled, based on PEFR and symptoms, requires movement up the asthma treatment ladder
Topic
91
Paediatrics
10142
Case Presentation:  A 9-year-old boy attends an asthma clinic with his mother following a new diagnosis. She explains that he is still feeling short of breath despite using his brother's blue inhaler. 


**PMH**
Asthma

**DH**
None

Question: Select the most appropriate decision option based on this data
a