Which of the following is an exacerbating condition for asthma?

• A. Exercise-induced bronchoconstriction
• B. Chronic obstructive pulmonary disease
• C. Pulmonary edema
• D. Pneumonia

Answer: (A)

Exercise-induced bronchoconstriction is the trigger that most directly worsens asthma. When someone with asthma engages in strenuous or prolonged exercise, rapid, deep breathing cools and dries the airways. This changes the airway surface environment, prompting release of mediators from Mast cells and other inflammatory cells, which leads to bronchial smooth muscle constriction, airway edema, and mucus production. The result is acute narrowing of the airways during or soon after activity, a classic pattern of asthma exacerbation that is often preventable with pre-exercise inhaled short-acting beta-agonists and by maintaining good overall asthma control.

COPD, pulmonary edema, and pneumonia can all worsen breathing in general, but they are not the typical asthma-specific exacerbating trigger like exercise-induced bronchoconstriction.