ABFM KSA ASTHMA CORRECT EXAMS ANSWERS
AND QUESTIONS SET A+
✔✔A 13-year-old male with a history of moderate persistent asthma presents to the
emergency department with a 2-day history of worsening dyspnea despite frequent use
of an inhaled β-agonist. An examination reveals a restless patient with a respiratory rate
of 35/min, obvious suprasternal retractions, and loud inspiratory and expiratory
wheezes. His peak flow is 250 L/min (49% of personal best). His oxygen saturation is
89%.
Which one of the following management options would be most effective for preventing
hospitalization in this patient? - ✔✔C. An inhaled anticholinergic agent in combination
with a short-acting β-agonist
✔✔A 42-year-old female sees you for follow-up of her asthma. Since her diagnosis at
the age of 19 she has required controller therapy except for several years when she
lived in Arizona. She had been doing well on fluticasone propionate/salmeterol (Advair
Diskus), 250/50 µg, and montelukast (Singulair). Over the past 6 months her control has
worsened, and you changed her regimen to a medium-dose inhaled corticosteroid
(ICS)/formoterol daily and as needed, in addition to the montelukast.She is adherent to
her medications and demonstrates proper inhaler technique in the office. However, she
now has asthma symptoms daily and awakens because of asthma about twice a week.
She smokes 5-8 cigarettes daily despite your recommendations to quit. She also has a
cat that she knows she is allergic to, but is unwilling to give up. Her serum IgE level is
150 IU/mL.
You continue efforts to promote smoking cessation and environmental mi - ✔✔C. A
daily medium-dose ICS, a LABA, and a long-acting muscarinic antagonist, with a short-
acting β-agonist as needed
✔✔A 30-year-old female has a 3-year history of chronic nasal congestion and rhinitis.
She has described this as a frequent "cold" that won't go away and has noticed
progressive anosmia. She has used nasal corticosteroids in the past for polyps. Over
the past few months she has noted intermittent episodes of chest tightness and
shortness of breath.She began taking ibuprofen 2 days ago for an acute knee strain.
Today she presents with an increasing nonproductive cough and a new onset of
dyspnea. On examination she is afebrile with normal vital signs but appears to be
, working to breathe. Auscultation of the lungs reveals diffuse wheezes. A physical
examination is otherwise normal.
Which one of the following is true regarding this situation? - ✔✔B. Leukotriene modifiers
would be particularly effective for managing her symptoms
✔✔A 19-year-old male has severe persistent asthma treated with high-dose inhaled
corticosteroids and a long-acting inhaled β-agonist. For the past few months he has
experienced daily wheezing and is using his albuterol (Proventil, Ventolin) inhaler
several times per day. His past medical history is notable for a history of perennial
allergic rhinitis related to a cockroach allergy.
According to National Asthma Education and Prevention Program guidelines, which one
of the following adjunctive therapies would most likely be of benefit? - ✔✔C.
Omalizumab (Xolair)
✔✔A 7-year-old is brought to the emergency department with a severe asthma
exacerbation that does not respond to a combination of oxygen and continuous short-
acting β-agonists plus ipratropium. Oral corticosteroids have been given.
Which one of the following medications has been shown to be effective as adjunctive
therapy to improve lung function and decrease hospitalizations? - ✔✔E. Intravenous
magnesium sulfate
✔✔While some facets of asthma are reversible, changes seen in chronic, uncontrolled
asthma may be irreversible. Which one of the following histologic features of irreversible
airway remodeling is seen in patients with chronic asthma? - ✔✔B. An increased
proportion of myofibroblasts
✔✔Which one of the following sports is most likely to precipitate bronchospasm in a
patient with exercise-induced asthma? - ✔✔A. Cross-country skiing
✔✔A patient sees you because of almost daily episodes of cough, dyspnea, and
occasional wheezing, which began a few months after she started working in a bakery.
She has a history of mild intermittent asthma that has required minimal intervention due
to infrequent symptoms. You suspect occupational asthma.
Which one of the following is true about this condition? - ✔✔E. Serial measurements of
peak expiratory flow rates at work and away from work are helpful in the diagnostic
evaluation
✔✔You see a 14-year-old female with moderate persistent asthma who has had two
emergency department visits in the last 3 months for asthma exacerbations. During the
discussion with the patient and her father about how they are monitoring her symptoms
and what steps they are taking to actively manage her disease at home, they indicate
that they would benefit from more information. You develop an asthma action plan with
them.
AND QUESTIONS SET A+
✔✔A 13-year-old male with a history of moderate persistent asthma presents to the
emergency department with a 2-day history of worsening dyspnea despite frequent use
of an inhaled β-agonist. An examination reveals a restless patient with a respiratory rate
of 35/min, obvious suprasternal retractions, and loud inspiratory and expiratory
wheezes. His peak flow is 250 L/min (49% of personal best). His oxygen saturation is
89%.
Which one of the following management options would be most effective for preventing
hospitalization in this patient? - ✔✔C. An inhaled anticholinergic agent in combination
with a short-acting β-agonist
✔✔A 42-year-old female sees you for follow-up of her asthma. Since her diagnosis at
the age of 19 she has required controller therapy except for several years when she
lived in Arizona. She had been doing well on fluticasone propionate/salmeterol (Advair
Diskus), 250/50 µg, and montelukast (Singulair). Over the past 6 months her control has
worsened, and you changed her regimen to a medium-dose inhaled corticosteroid
(ICS)/formoterol daily and as needed, in addition to the montelukast.She is adherent to
her medications and demonstrates proper inhaler technique in the office. However, she
now has asthma symptoms daily and awakens because of asthma about twice a week.
She smokes 5-8 cigarettes daily despite your recommendations to quit. She also has a
cat that she knows she is allergic to, but is unwilling to give up. Her serum IgE level is
150 IU/mL.
You continue efforts to promote smoking cessation and environmental mi - ✔✔C. A
daily medium-dose ICS, a LABA, and a long-acting muscarinic antagonist, with a short-
acting β-agonist as needed
✔✔A 30-year-old female has a 3-year history of chronic nasal congestion and rhinitis.
She has described this as a frequent "cold" that won't go away and has noticed
progressive anosmia. She has used nasal corticosteroids in the past for polyps. Over
the past few months she has noted intermittent episodes of chest tightness and
shortness of breath.She began taking ibuprofen 2 days ago for an acute knee strain.
Today she presents with an increasing nonproductive cough and a new onset of
dyspnea. On examination she is afebrile with normal vital signs but appears to be
, working to breathe. Auscultation of the lungs reveals diffuse wheezes. A physical
examination is otherwise normal.
Which one of the following is true regarding this situation? - ✔✔B. Leukotriene modifiers
would be particularly effective for managing her symptoms
✔✔A 19-year-old male has severe persistent asthma treated with high-dose inhaled
corticosteroids and a long-acting inhaled β-agonist. For the past few months he has
experienced daily wheezing and is using his albuterol (Proventil, Ventolin) inhaler
several times per day. His past medical history is notable for a history of perennial
allergic rhinitis related to a cockroach allergy.
According to National Asthma Education and Prevention Program guidelines, which one
of the following adjunctive therapies would most likely be of benefit? - ✔✔C.
Omalizumab (Xolair)
✔✔A 7-year-old is brought to the emergency department with a severe asthma
exacerbation that does not respond to a combination of oxygen and continuous short-
acting β-agonists plus ipratropium. Oral corticosteroids have been given.
Which one of the following medications has been shown to be effective as adjunctive
therapy to improve lung function and decrease hospitalizations? - ✔✔E. Intravenous
magnesium sulfate
✔✔While some facets of asthma are reversible, changes seen in chronic, uncontrolled
asthma may be irreversible. Which one of the following histologic features of irreversible
airway remodeling is seen in patients with chronic asthma? - ✔✔B. An increased
proportion of myofibroblasts
✔✔Which one of the following sports is most likely to precipitate bronchospasm in a
patient with exercise-induced asthma? - ✔✔A. Cross-country skiing
✔✔A patient sees you because of almost daily episodes of cough, dyspnea, and
occasional wheezing, which began a few months after she started working in a bakery.
She has a history of mild intermittent asthma that has required minimal intervention due
to infrequent symptoms. You suspect occupational asthma.
Which one of the following is true about this condition? - ✔✔E. Serial measurements of
peak expiratory flow rates at work and away from work are helpful in the diagnostic
evaluation
✔✔You see a 14-year-old female with moderate persistent asthma who has had two
emergency department visits in the last 3 months for asthma exacerbations. During the
discussion with the patient and her father about how they are monitoring her symptoms
and what steps they are taking to actively manage her disease at home, they indicate
that they would benefit from more information. You develop an asthma action plan with
them.
