Written Practice · Acute Asthma
Acute Asthma in a School-Age Child
An 8-year-old presenting with an acute severe asthma exacerbation not responding to his usual reliever inhaler. This mock builds from normal respiratory anatomy and physiology through to three-component pathophysiology, clinical signs, severity assessment, developmental theory, psychosocial care, and MDT management.
8
Questions
2
Parts
~90
Minutes
8
Marking criteria
Patient
Jayden
8 years
Two days of worsening cough, wheeze, and shortness of breath, with the reliever inhaler no longer providing effective relief (2 days)
Observations
Respiratory rate
40 breaths/min
SpO₂
90% on room air
Heart rate
Tachycardic
Peak flow
Significantly reduced from baseline
Clinical Signs
- Intercostal and subcostal recession
- Pronounced expiratory wheeze on auscultation
- Only able to speak in short phrases
- Appears anxious and fatigued
- Overnight breathing became more laboured with coughing disturbing sleep
Diagnosis: Acute severe asthma exacerbation
Family Context
Jayden is an 8-year-old who has been brought to the Emergency Department by his mum, Leanne. Leanne is a single parent with two younger children at home and appears overwhelmed and worried about Jayden’s condition. Jayden has been using his reliever inhaler more frequently over two days, but it is no longer providing effective relief.
What this mock is testing
- Describing normal respiratory anatomy and physiology with accurate terminology
- Explaining the mechanics of ventilation and the significance of airway smooth muscle
- Explaining the three-component pathophysiology of asthma: bronchospasm, mucosal oedema, mucus hypersecretion
- Discussing signs and symptoms of an acute asthma exacerbation with physiological reasoning
- Applying clinical reasoning to Jayden’s breathlessness and its impact on daily activities
- Using developmental theories relevant to an 8-year-old (Erikson, Piaget)
- Addressing psychosocial impact on both child and parent
- Planning MDT-coordinated care including discharge and ongoing support
Skills assessed
What strong answers do
- All three pathophysiological components of asthma are explained — bronchospasm, mucosal oedema, and mucus — not just "airways narrow"
- Clinical signs are explained physiologically: wheeze is described as turbulent airflow through a narrowed bronchiolar lumen, not just named
- The impact of breathlessness on daily functioning is addressed across eating, drinking, speaking, sleep, school, and social life
- Developmental theory is applied to Jayden as an 8-year-old: industry versus inferiority, school, physical activity, and peer identity feature specifically
How Part A builds
Take your time with this scenario. Every detail — the observations, the family context, the clinical signs — will be relevant to your answers.