**Question:** In a child with exercise-induced asthma, which is done:

A. Withholding all asthma medications
B. Administering short-acting beta2-agonists
C. Administering anticholinergics
D. Administering corticosteroids

**Correct Answer:** B. Administering short-acting beta2-agonists

**Core Concept:** Exercise-induced asthma (EIA) is a transient asthma exacerbation that occurs during or shortly after physical activity. It is typically characterized by symptoms of wheezing, shortness of breath, chest tightness, and reduced exercise capacity.

**Why the Correct Answer is Right:** In the context of EIA, the correct choice for intervention is administering short-acting beta2-agonists, also known as bronchodilators. These medications, such as salbutamol (salmeterol, formoterol), work by selectively relaxing smooth muscles in the airways, leading to bronchodilation and improvement in airflow.

**Why Each Wrong Option is Incorrect:**

A. Withholding all asthma medications: This is incorrect because asthma medications, including beta-agonists, are essential for controlling the underlying inflammation and bronchoconstriction in asthmatic patients. Withholding these medications may lead to worsening of symptoms and potentially life-threatening exacerbations.

B. Administering anticholinergics: Anticholinergics, such as ipratropium bromide, work by blocking the effects of acetylcholine on muscarinic receptors. While they can be used in certain conditions, such as chronic obstructive pulmonary disease (COPD), they are less effective in EIA and may not provide adequate relief for the acute symptoms.

C. Administering corticosteroids: Corticosteroids work by reducing inflammation and suppressing the immune response, which is beneficial in the long term management of asthma but is less effective for acute management of exercise-induced asthma. Also, corticosteroids might not provide the rapid relief required for acute symptoms of EIA.

D. Administering anticholinergics: The explanation for this option is similar to option B (above).

**Clinical Pearl:** In cases of exercise-induced asthma, short-acting beta2-agonists are the first-line treatment for acute symptom relief due to their rapid onset, high efficacy, and safety profile. Anticholinergics, corticosteroids, and withholding asthma medications are less effective and/or not recommended for the management of exercise-induced asthma.