(2026) Q&A
1. Which of the following best describes the primary pathophysiological feature of
asthma?
A) Reversible airflow obstruction with airway hyperresponsiveness and chronic
inflammation
B) Fixed and irreversible airflow limitation due to parenchymal destruction
C) Excessive mucus production without underlying airway inflammation
D) Restrictive lung disease caused by decreased lung compliance
Correct Answer: A) Reversible airflow obstruction with airway hyperresponsiveness
and chronic inflammation
Rationale: Asthma is characterized by chronic airway inflammation, airway
hyperresponsiveness, and reversible airflow obstruction. COPD involves fixed,
irreversible airflow limitation. The other options do not accurately describe asthma's
core pathophysiology.
2. What is the first-line treatment for an acute asthma exacerbation in an adult?
A) Inhaled corticosteroids
B) Oral corticosteroids
C) Short-acting beta-agonists (SABAs) such as albuterol
D) Long-acting beta-agonists (LABAs)
Correct Answer: C) Short-acting beta-agonists (SABAs) such as albuterol
,Rationale: SABAs are the first-line treatment for acute asthma exacerbations due to
their rapid bronchodilatory effects, with onset within 5-15 minutes. Inhaled
corticosteroids are for chronic control, oral corticosteroids are for moderate-to-
severe exacerbations, and LABAs are not for acute relief.
3. A 2-year-old child presents with an increased cough at night and audible wheeze
almost daily, with short relief from a short-acting beta-agonist. How should these
moderate persistent asthma symptoms be treated?
A) Adding an oral antihistamine for the cough daily
B) Adding an Advair 100/50 (fluticasone/salmeterol) diskus BID
C) Adding 1.0 mg Pulmicort respules (budesonide) via nebulizer BID
D) Adding Atrovent 2.0% (ipratropium bromide) solution via nebulizer TID
Correct Answer: C) Adding 1.0 mg Pulmicort respules (budesonide) via nebulizer BID
Rationale: For moderate persistent asthma in a child, the recommended treatment is
a low-dose inhaled corticosteroid such as budesonide. Antihistamines do not treat
asthma inflammation. Advair is a combination ICS/LABA, which is step-up therapy,
and ipratropium is not first-line for asthma.
4. A patient with moderate persistent asthma is prescribed an inhaled corticosteroid.
What is the most important instruction to provide regarding medication
administration?
A) Take the medication only when symptoms occur
B) Rinse the mouth with water and spit after each use
C) Use the inhaler immediately before exercise
D) Double the dose if symptoms worsen
Correct Answer: B) Rinse the mouth with water and spit after each use
, Rationale: Rinsing the mouth after using an inhaled corticosteroid prevents oral
candidiasis (thrush), a common local adverse effect. Inhaled corticosteroids are daily
controller medications, not rescue drugs, and should not be doubled without
provider guidance.
5. A 20-year-old female with intermittent asthma controlled with albuterol has a
positive home pregnancy test. What instruction should be provided as part of the
treatment plan?
A) Discontinue all asthma medications during pregnancy
B) Avoid using the albuterol inhaler during the first trimester
C) Maintain current asthma management during the pregnancy
D) Have the OB/GYN manage the asthma independently
Correct Answer: C) Maintain current asthma management during the pregnancy
Rationale: Uncontrolled asthma poses greater risks to the mother and fetus than
asthma medications. Albuterol is considered safe during pregnancy. Patients should
continue their maintenance and rescue medications as prescribed.
6. A 10-year-old boy with intermittent asthma and environmental allergies reports
using his albuterol inhaler before PE class to avoid shortness of breath. Which
medication might be considered for exercise-induced bronchospasm?
A) Montelukast (Singulair)
B) Fluticasone (Flovent)
C) Theophylline
D) Ipratropium (Atrovent)
Correct Answer: A) Montelukast (Singulair)