Page 1 of 38
KSA Asthma Exam ALL QUESTIONS AND
CORRECT ANSWERS LATEST UPDATE THIS
YEAR
QUESTION: 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.
Which one of the following should you consider as a possible adjunctive treatment? - ANSWER-
C. Intravenous magnesium sulfate
QUESTION: Which one of the following is true regarding regular use of inhaled corticosteroids
(ICSs) in patients with persistent asthma? - ANSWER-A. Oral candidiasis is a potential side effect
of ICS use
1
, Page 2 of 38
QUESTION: You have recently opened a new practice in western North Carolina. In your first
week of seeing patients, a 17-year-old male reports that his asthma is usually worse in the early
spring.
Which one of the following is most likely triggering his symptoms at that time of year? -
ANSWER-A. Tree Pollen
QUESTION: A 14-year-old female presents with a recent history of cough and shortness of
breath with exercise. Baseline pulmonary function testing reveals an FEV1 of 3.1 L and a peak
expiratory flow of 600 L/min. Exercise testing is scheduled.
If measured within 30 minutes of exercise, which one of the following FEV1 values would
support a diagnosis of mild exercise-induced bronchospasm in this patient? - ANSWER-B. 2.8L
QUESTION: A 14-year-old female with a history of asthma presents to your office for follow-up.
Her mother reports that the patient has become increasingly agitated during the day and has
frequent nightmares, which she never had before. When asking about any other changes to her
routine, family stressors, or medication changes you learn that she was seen by an allergy
specialist 2 months ago and was given a new prescription to help with her asthma
management. Her mother cannot recall the name of this new medication and it is not in your
electronic medical record.
2
, Page 3 of 38
Which one of the following asthma medications is most likely to have precipitated these
symptoms? - ANSWER-D. Montelukast (Singulair)
QUESTION: A 35-year-old male who was admitted to the intensive-care unit with a severe
asthma exacerbation has failed to improve with aggressive bronchodilator therapy and
systemic corticosteroid therapy. For the past 10 minutes he has appeared more fatigued, but
less wheezing is heard and his pulsus paradoxus, which had been 30 mm Hg, is <10 mm Hg. His
pO2 is 75 mm Hg and his pCO2 is 48 mm Hg on 6 L/min of oxygen.
Which one of the following interventions would be the most appropriate next step in the
management of this patient? - ANSWER-E. Intubation and Mechanical Ventilation
QUESTION: A 24-year-old female has a long history of asthma, which was previously
categorized as mild persistent. In the last several months she has noted daily symptoms, with
nighttime awakening once or more each week, each requiring use of a short-acting β-agonist
rescue inhaler. She is also using a low-dose inhaled corticosteroid twice daily. You determine
that it is time to step up her therapy to include a long-acting β-agonist (LABA).
When counseling this patient about the use of LABAs, which one of the following would be
appropriate advice? - ANSWER-D. They are beneficial when used in conjunction with inhaled
corticosteroids
3
, Page 4 of 38
QUESTION: A 25-year-old female with a history of mild persistent asthma presents to the
emergency department with a 5-day history of increasing cough, wheezing, and shortness of
breath. Her asthma regimen of daily inhaled corticosteroids has not changed recently, and she
has not recently taken systemic corticosteroids. On examination she is slightly agitated with a
pulse rate of 110 beats/min. Examination of the lungs reveals loud expiratory wheezing on
auscultation, and you observe that she has suprasternal retractions. Her FEV1 is 1.71 L (63% of
predicted) and her oxygen saturation is 94% on room air.
Which one of the following would be the most appropriate next step in the management of this
patient? - ANSWER-B. An inhaled short-acting β-agonist, with up to three treatments in the first
hour
QUESTION: A 47-year-old female with moderate severe asthma presents with a recent history
of more frequent exacerbations now accompanied by expectoration of brown mucus plugs,
intermittent fever, and increasing fatigue. She is afebrile today and her wheezing is minimal. A
chest radiograph shows opacities in the parenchyma of the upper lobes, with evidence of
atelectasis.
Which one of the following is true regarding the diagnosis of this condition? - ANSWER-B.
Laboratory evaluation will show a total serum IgE concentration >1000 ng/mL (N 0-430)
4
KSA Asthma Exam ALL QUESTIONS AND
CORRECT ANSWERS LATEST UPDATE THIS
YEAR
QUESTION: 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.
Which one of the following should you consider as a possible adjunctive treatment? - ANSWER-
C. Intravenous magnesium sulfate
QUESTION: Which one of the following is true regarding regular use of inhaled corticosteroids
(ICSs) in patients with persistent asthma? - ANSWER-A. Oral candidiasis is a potential side effect
of ICS use
1
, Page 2 of 38
QUESTION: You have recently opened a new practice in western North Carolina. In your first
week of seeing patients, a 17-year-old male reports that his asthma is usually worse in the early
spring.
Which one of the following is most likely triggering his symptoms at that time of year? -
ANSWER-A. Tree Pollen
QUESTION: A 14-year-old female presents with a recent history of cough and shortness of
breath with exercise. Baseline pulmonary function testing reveals an FEV1 of 3.1 L and a peak
expiratory flow of 600 L/min. Exercise testing is scheduled.
If measured within 30 minutes of exercise, which one of the following FEV1 values would
support a diagnosis of mild exercise-induced bronchospasm in this patient? - ANSWER-B. 2.8L
QUESTION: A 14-year-old female with a history of asthma presents to your office for follow-up.
Her mother reports that the patient has become increasingly agitated during the day and has
frequent nightmares, which she never had before. When asking about any other changes to her
routine, family stressors, or medication changes you learn that she was seen by an allergy
specialist 2 months ago and was given a new prescription to help with her asthma
management. Her mother cannot recall the name of this new medication and it is not in your
electronic medical record.
2
, Page 3 of 38
Which one of the following asthma medications is most likely to have precipitated these
symptoms? - ANSWER-D. Montelukast (Singulair)
QUESTION: A 35-year-old male who was admitted to the intensive-care unit with a severe
asthma exacerbation has failed to improve with aggressive bronchodilator therapy and
systemic corticosteroid therapy. For the past 10 minutes he has appeared more fatigued, but
less wheezing is heard and his pulsus paradoxus, which had been 30 mm Hg, is <10 mm Hg. His
pO2 is 75 mm Hg and his pCO2 is 48 mm Hg on 6 L/min of oxygen.
Which one of the following interventions would be the most appropriate next step in the
management of this patient? - ANSWER-E. Intubation and Mechanical Ventilation
QUESTION: A 24-year-old female has a long history of asthma, which was previously
categorized as mild persistent. In the last several months she has noted daily symptoms, with
nighttime awakening once or more each week, each requiring use of a short-acting β-agonist
rescue inhaler. She is also using a low-dose inhaled corticosteroid twice daily. You determine
that it is time to step up her therapy to include a long-acting β-agonist (LABA).
When counseling this patient about the use of LABAs, which one of the following would be
appropriate advice? - ANSWER-D. They are beneficial when used in conjunction with inhaled
corticosteroids
3
, Page 4 of 38
QUESTION: A 25-year-old female with a history of mild persistent asthma presents to the
emergency department with a 5-day history of increasing cough, wheezing, and shortness of
breath. Her asthma regimen of daily inhaled corticosteroids has not changed recently, and she
has not recently taken systemic corticosteroids. On examination she is slightly agitated with a
pulse rate of 110 beats/min. Examination of the lungs reveals loud expiratory wheezing on
auscultation, and you observe that she has suprasternal retractions. Her FEV1 is 1.71 L (63% of
predicted) and her oxygen saturation is 94% on room air.
Which one of the following would be the most appropriate next step in the management of this
patient? - ANSWER-B. An inhaled short-acting β-agonist, with up to three treatments in the first
hour
QUESTION: A 47-year-old female with moderate severe asthma presents with a recent history
of more frequent exacerbations now accompanied by expectoration of brown mucus plugs,
intermittent fever, and increasing fatigue. She is afebrile today and her wheezing is minimal. A
chest radiograph shows opacities in the parenchyma of the upper lobes, with evidence of
atelectasis.
Which one of the following is true regarding the diagnosis of this condition? - ANSWER-B.
Laboratory evaluation will show a total serum IgE concentration >1000 ng/mL (N 0-430)
4
