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Exercise-Induced Bronchoconstriction — RACP Paediatrics MCQ

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HardRespiratoryExercise-Induced BronchoconstrictionRACP Paediatrics

A 14-year-old competitive runner has exertional dyspnoea, normal baseline spirometry and no inspiratory noise. Standardised dry-air exercise challenge produces a reproducible 11% fall in FEV1 at 10 minutes, with stable FVC. How should this be interpreted?

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Reveal the answer and explanation

Correct answer: A — The result supports exercise-induced bronchoconstriction alongside the clinical history

Explanation lettering: B = shown as A · D = shown as B · A = shown as D

B is correct because a reproducible post-exercise fall in FEV1 of about 10% supports exercise-induced bronchoconstriction when symptoms and test quality fit. C uses the wrong variable and threshold. D would be suggested by inspiratory symptoms or laryngoscopy rather than an expiratory FEV1 fall. E substitutes a less reliable measure. A over-interprets one provocation test; background asthma diagnosis and control still require full assessment.

Reference: National Asthma Council Australia, Australian Asthma Handbook—adolescents: https://www.asthmahandbook.org.au/static/files/Australian-Asthma-Handbook-v2.0-Management-%E2%80%93-Adolescents.pdf