Paeds Vivas · respiratory-sleep-and-airway
Exercise-induced bronchoconstriction — branching viva
Branching viva from the definition and objective confirmation of exercise-induced bronchoconstriction through its osmotic mechanism, the stepwise management that controls the underlying asthma first, the competitive athlete, and the inducible laryngeal obstruction that must not be treated as asthma.
On this page
Study tools
Target exams
RACP DWEMRCPCH ClinicalRCPCH Progress+
Prompt
You are the paediatric registrar in a respiratory clinic. The consultant asks you to talk through four young people: an 8-year-old who wheezes with sport, an adolescent who needs to know how the airway narrows, a competitive athlete needing a management plan, and a runner whose exertional breathlessness does not respond to an inhaler.
Station opening
Examiner: "Define exercise-induced bronchoconstriction and explain how it relates to asthma." [3]
Strong candidate (must-hit)
- Defines exercise-induced bronchoconstriction as transient narrowing of the lower airways provoked by exercise, coming on during or after effort, peaking five to fifteen minutes after it stops, and resolving within thirty to sixty minutes; explains that it is a physiological event, not a disease of its own; states that in most children it occurs as part of asthma and marks inadequate control, while a minority have isolated disease without other asthma features. [3] [5]
Weak candidate
- "It's just asthma that comes on when you run, so you give a blue inhaler." [3]
References6ShowHide
- [2]Anderson SD; Daviskas E The mechanism of exercise-induced asthma is ... J Allergy Clin Immunol, 2000.PMID 10984363
- [3]Parsons JP; Hallstrand TS; Mastronarde JG; Kaminsky DA; Rundell KW; Hull JH; et al An official American Thoracic Society clinical practice guideline: exercise-induced bronchoconstriction. Am J Respir Crit Care Med, 2013.PMID 23634861
- [5]Weiler JM; Brannan JD; Randolph CC; Hallstrand TS; Parsons J; Silvers W; et al Exercise-induced bronchoconstriction update-2016. J Allergy Clin Immunol, 2016.PMID 27665489
- [8]Boulet LP; O'Byrne PM Asthma and exercise-induced bronchoconstriction in athletes. N Engl J Med, 2015.PMID 25671256
- [10]Hallstrand TS; Leuppi JD; Joos G; Hall GL; Carlsen KH; Kaminsky DA; et al ERS technical standard on bronchial challenge testing: pathophysiology and methodology of indirect airway challenge testing. Eur Respir J, 2018.PMID 30361249
- [12]Levy ML; Bacharier LB; Bateman E; Boulet LP; Brightling C; Buhl R; et al Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update. NPJ Prim Care Respir Med, 2023.PMID 36754956