ABFM KSA ASTHMA EVALUATION EXAMS
ANSWERS AND QUESTIONS SET A+
✔✔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 - ✔✔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.
Which one of the following should you consider as a possible adjunctive treatment? -
✔✔C. Intravenous magnesium sulfate
✔✔Which one of the following is true regarding regular use of inhaled corticosteroids
(ICSs) in patients with persistent asthma? - ✔✔A. Oral candidiasis is a potential side
effect of ICS use
✔✔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? -
✔✔A. Tree Pollen
✔✔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? -
✔✔B. 2.8L
✔✔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.
ANSWERS AND QUESTIONS SET A+
✔✔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 - ✔✔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.
Which one of the following should you consider as a possible adjunctive treatment? -
✔✔C. Intravenous magnesium sulfate
✔✔Which one of the following is true regarding regular use of inhaled corticosteroids
(ICSs) in patients with persistent asthma? - ✔✔A. Oral candidiasis is a potential side
effect of ICS use
✔✔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? -
✔✔A. Tree Pollen
✔✔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? -
✔✔B. 2.8L
✔✔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.
