Page 1 of 59
KSA Asthma Exam A&B ALL QUESTIONS AND
CORRECT ANSWERS LATEST UPDATE THIS
YEAR
KSA Asthma Exam A
1. A 26-year-old male presents with severe asthma: shortness of breath, difficulty speaking in
sentences, diminished breath sounds, FEV1 15% predicted, pCO2 45 mm Hg, poor response to
albuterol. Which is consistent with imminent respiratory failure?
A. Audible wheezes
B. Mild dyspnea
C. Normal FEV1
D. Tachycardia
E. Absence of wheezes ✅
Rationale: In severe asthma exacerbations, airway obstruction may be so complete that
wheezes are absent (“silent chest”), signaling imminent respiratory failure.
2. Leukotriene modifiers for asthma are:
A. More effective than inhaled corticosteroids
B. First-line therapy in all patients
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, Page 2 of 59
C. Only used for acute exacerbations
D. Less effective than inhaled corticosteroids ✅
Rationale: Leukotriene modifiers are adjunctive therapy and are not as effective as ICS for
controlling persistent asthma.
3. Chronic low- to medium-dose inhaled corticosteroids in children are associated with:
A. Significant growth retardation
B. Permanent adrenal suppression
C. High risk of osteoporosis
E. No long-term adverse effects ✅
Rationale: Evidence suggests ICS at low-to-medium doses in children is safe with minimal long-
term adverse effects.
4. An 18-year-old female with frequent symptoms and an Asthma Control Test score of 17
should have which therapy initiated?
A. Budesonide/formoterol (Symbicort), with dose adjustment for exacerbations ✅
B. Short-acting β-agonist only
C. Montelukast monotherapy
D. Oral corticosteroids
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Rationale: Combination ICS/LABA therapy is appropriate for moderate persistent asthma and
can be used for maintenance and symptom-driven exacerbations.
5. A 22-year-old female with acute asthma exacerbation after a viral URI shows PEF
improvement from 150 L/min to 310 L/min after therapy. This indicates:
A. Poor response to therapy
B. Need for mechanical ventilation
C. Good response to therapy ✅
D. Requirement for antibiotics
Rationale: Significant improvement in peak expiratory flow indicates effective response to
treatment.
6. Regarding asthma action plans:
A. They are optional with minimal benefit
B. They are primarily for pediatric patients
C. They replace regular clinic visits
D. Lack of a written plan is a risk factor for death from asthma ✅
Rationale: Written asthma action plans improve outcomes and reduce risk, including mortality.
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7. For a patient not responding to initial SABA plus oral prednisone in severe asthma, an
appropriate adjunctive therapy is:
A. Nebulized saline
B. IV antibiotics
C. Intravenous magnesium sulfate ✅
D. Oral antihistamines
Rationale: Magnesium sulfate can relax airway smooth muscles and is used for severe,
refractory asthma exacerbations.
8. A common side effect of regular ICS use is:
A. Oral candidiasis ✅
B. Hypertension
C. Diabetes
D. Tachycardia
Rationale: Local fungal infections are common with ICS; rinsing the mouth reduces risk.
9. A 17-year-old male with asthma worse in early spring is most likely triggered by:
4
KSA Asthma Exam A&B ALL QUESTIONS AND
CORRECT ANSWERS LATEST UPDATE THIS
YEAR
KSA Asthma Exam A
1. A 26-year-old male presents with severe asthma: shortness of breath, difficulty speaking in
sentences, diminished breath sounds, FEV1 15% predicted, pCO2 45 mm Hg, poor response to
albuterol. Which is consistent with imminent respiratory failure?
A. Audible wheezes
B. Mild dyspnea
C. Normal FEV1
D. Tachycardia
E. Absence of wheezes ✅
Rationale: In severe asthma exacerbations, airway obstruction may be so complete that
wheezes are absent (“silent chest”), signaling imminent respiratory failure.
2. Leukotriene modifiers for asthma are:
A. More effective than inhaled corticosteroids
B. First-line therapy in all patients
1
, Page 2 of 59
C. Only used for acute exacerbations
D. Less effective than inhaled corticosteroids ✅
Rationale: Leukotriene modifiers are adjunctive therapy and are not as effective as ICS for
controlling persistent asthma.
3. Chronic low- to medium-dose inhaled corticosteroids in children are associated with:
A. Significant growth retardation
B. Permanent adrenal suppression
C. High risk of osteoporosis
E. No long-term adverse effects ✅
Rationale: Evidence suggests ICS at low-to-medium doses in children is safe with minimal long-
term adverse effects.
4. An 18-year-old female with frequent symptoms and an Asthma Control Test score of 17
should have which therapy initiated?
A. Budesonide/formoterol (Symbicort), with dose adjustment for exacerbations ✅
B. Short-acting β-agonist only
C. Montelukast monotherapy
D. Oral corticosteroids
2
, Page 3 of 59
Rationale: Combination ICS/LABA therapy is appropriate for moderate persistent asthma and
can be used for maintenance and symptom-driven exacerbations.
5. A 22-year-old female with acute asthma exacerbation after a viral URI shows PEF
improvement from 150 L/min to 310 L/min after therapy. This indicates:
A. Poor response to therapy
B. Need for mechanical ventilation
C. Good response to therapy ✅
D. Requirement for antibiotics
Rationale: Significant improvement in peak expiratory flow indicates effective response to
treatment.
6. Regarding asthma action plans:
A. They are optional with minimal benefit
B. They are primarily for pediatric patients
C. They replace regular clinic visits
D. Lack of a written plan is a risk factor for death from asthma ✅
Rationale: Written asthma action plans improve outcomes and reduce risk, including mortality.
3
, Page 4 of 59
7. For a patient not responding to initial SABA plus oral prednisone in severe asthma, an
appropriate adjunctive therapy is:
A. Nebulized saline
B. IV antibiotics
C. Intravenous magnesium sulfate ✅
D. Oral antihistamines
Rationale: Magnesium sulfate can relax airway smooth muscles and is used for severe,
refractory asthma exacerbations.
8. A common side effect of regular ICS use is:
A. Oral candidiasis ✅
B. Hypertension
C. Diabetes
D. Tachycardia
Rationale: Local fungal infections are common with ICS; rinsing the mouth reduces risk.
9. A 17-year-old male with asthma worse in early spring is most likely triggered by:
4
