Exercise-induced bronchoconstriction — SCE Respiratory MCQ

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HardMedical Conditions in SportExercise-induced bronchoconstrictionSCE Respiratory

A triathlete reports wheeze and chest tightness during cold-weather cycling. Baseline spirometry is normal and competition documentation may be needed for inhaler use. What is the most appropriate investigation?

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Correct answer: B — Exercise challenge or bronchoprovocation testing

The best answer is “Exercise challenge or bronchoprovocation testing”. Exercise challenge or bronchoprovocation testing is the investigation that most directly resolves the remaining diagnostic or staging uncertainty at this point in the pathway. The alternatives address different questions, have lower expected yield, or would be premature before this result. The remaining choices—“Chest radiograph as the diagnostic standard”, “Serum creatine kinase after cycling”, “Resting oxygen saturation alone”, “CT pulmonary angiography, after safety review”—are credible in related respiratory presentations, but each addresses a different diagnostic, staging or management decision and does not fit the decisive findings and pathway position in this stem.

Reference: BTS/NICE/SIGN asthma guideline NG245: https://www.nice.org.uk/guidance/ng245/chapter/Recommendations