KSA Asthma Exam Questions and correct answers| Latest Update

KSA Asthma Exam Questions and correct answers| Latest Update A 26-year-old male with asthma is seen in the emergency department. He is short of breath to a degree that makes it difficult to speak in sentences and he appears tired. On examination you note diminished breath sounds with an occasional wheeze. His FEV1 is 15% of predicted and his pCO2 is 45 mm Hg. He is given albuterol (Proventil, Ventolin) over the next hour but he has a poor response. He is not able to repeat the spirometry and he now appears drowsy. Which one of the following would be consistent with imminent respiratory failure? E. The absence of wheezes Which one of the following is true regarding leukotriene modifiers for treatment of asthma in adults? D. They are less effective than inhaled corticosteroids (ICSs) Chronic low- to medium-dose inhaled corticosteroid use in children is associated with E. no long-term adverse effects An 18-year-old female presents to your office with a history of wheezing, coughing, and year-round symptoms of rhinitis. She reports that her symptoms occur several times a week but rarely more than once a day, except in the last year, when she has had to intermittently use albuterol (Proventil, Ventolin) every day for a week at a time. She wakes up with nighttime coughing weekly, with no fever or other symptoms, and tells you that the coughing is severe enough to make her cat jump off the bed. Albuterol helps her symptoms temporarily. She has been treated with oral corticosteroids on three occasions this past year, most recently 6 weeks ago. Her Asthma Control Test score is 17. Pre- and postbronchodilator spirometry results are shown below. Initial testing FVC............2.0 L (80% of predicted) FEV1............1.4 L (70% of predicted) FEF 25-75............1.5 L/sec (89% of predicted) 15 minutes post bronchodilator administration FVC............2.3 L (105% of predicted) FEV1............2.0 L (100% of predicted) FEF 25-75............1.9 L/sec (100% of predicted) Which one of the following would be most appropriate to add at this time? A. Budesonide/formoterol (Symbicort), with an increase in dosage for exacerbations A 22-year-old female presents to your office with an acute asthma attack that developed 2 days after the onset of a viral upper respiratory infection. Her asthma is usually well controlled, with a personal best peak expiratory flow (PEF) of 380 L/min. On initial evaluation by the nurse she has a pulse rate of 120 beats/min, a respiratory rate of 32/min, and an oxygen saturation of 92% on room air. On examination she is very dyspneic with diffuse inspiratory and expiratory wheezing and she is using accessory muscles to breathe. Her PEF is 150 L/min. Inhaled β-agonists and systemic corticosteroids are administered and she is reevaluated 1 hour later. Which one of the following would provide the most reassurance that she is responding to therapy? C. A PEF of 310 L/min You are counseling a patient with moderate persistent asthma about the value of following a written asthma action plan. To encourage her to use an asthma action plan you share the results of studies that document their benefit in optimizing asthma control and reducing future risk. Which one of the following is an accurate statement regarding asthma action plans? D. The lack of a written asthma action plan is a risk factor for death from asthma A 28-year-old female presents with progressively worsening asthma after a recent viral upper respiratory infection. When you enter the room, she appears in distress and is only able to talk in words, not sentences. Her respiratory rate is 34/min and her heart rate is 126 beats/min. Her oxygen saturation before oxygen was administered was 89%. You begin treatment with a nebulized short-acting β-agonist (SABA) plus ipratropium and give an initial dose of oral prednisone. After one hour her symptoms are not responsive to initial treatment efforts.