Respiratory: asthma step-up: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Respiratory: asthma step-up

Sample item

A 7-year-old with persistent asthma has daytime symptoms 3 times a week while using low-dose inhaled budesonide. What is the best next step?

AStop inhaled steroidsBCheck adherence and technique, then increase the controller or add a LABA or leukotriene antagonistCAntibioticsDDaily oral prednisolone

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Check adherence and technique, then increase the controller or add a LABA or leukotriene antagonist

Before stepping up therapy, adherence, inhaler technique and trigger exposure are reviewed. Control is then improved by increasing the inhaled steroid dose or adding a second controller. Long-term oral steroids are avoided because of side effects.

Option by option

A. Stop inhaled steroids
Stopping the controller would worsen asthma.
B. Check adherence and technique, then increase the controller or add a LABA or leukotriene antagonist (correct)
Correct. Confirm adherence then step up.
C. Antibiotics
Antibiotics have no role in asthma control.
D. Daily oral prednisolone
Chronic oral steroids cause growth suppression.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Check adherence and technique, then increase the controller or add a LABA or leukotriene antagonist. Before stepping up therapy, adherence, inhaler technique and trigger exposure are reviewed.

Why is "Stop inhaled steroids" not the answer?

Stopping the controller would worsen asthma.

Why is "Antibiotics" not the answer?

Antibiotics have no role in asthma control.

Why is "Daily oral prednisolone" not the answer?

Chronic oral steroids cause growth suppression.

What concept does this question test?

It tests Respiratory: asthma step-up in Pediatrics. Control is then improved by increasing the inhaled steroid dose or adding a second controller. Long-term oral steroids are avoided because of side effects.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Respiratory: asthma step-up?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.