Verified Answers
Q1.
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 has a
poor response. He is not able to repeat spirometry and now appears drowsy.
Which one of the following would be consistent with imminent respiratory failure?
ANSWER-E. The absence of wheezes
Q2.
Which one of the following is true regarding leukotriene modifiers for treatment of asthma in
adults?
ANSWER-D. They are less effective than inhaled corticosteroids (ICSs)
Q3.
Chronic low- to medium-dose inhaled corticosteroid use in children is associated with:
ANSWER-E. No long-term adverse effects
Q4.
An 18-year-old female presents with a history of wheezing, coughing, and year-round rhinitis.
Symptoms occur several times a week, nighttime awakening weekly, and she has had 3 courses
of oral steroids this year. Spirometry: FEV1 70% predicted, improves post-bronchodilator.
Best controller treatment?
ANSWER-A. Budesonide/formoterol (Symbicort), with an increase in dosage for
exacerbations
Q5.
, A 28-year-old female with worsening asthma after viral URI, RR 34/min, HR 126/min, SpO2
89%. Not responsive after 1 hour of SABA + ipratropium + prednisone.
Which adjunctive treatment should be considered?
ANSWER-C. Intravenous magnesium sulfate
Q6.
Which one of the following is true regarding regular use of inhaled corticosteroids (ICSs) in
persistent asthma?
ANSWER-A. Oral candidiasis is a potential side effect
Q7.
A 17-year-old male’s asthma worsens each early spring. Which trigger is most likely?
ANSWER-A. Tree pollen
Q8.
A 14-year-old female evaluated for exercise-induced symptoms. Baseline FEV1 = 3.1 L. After
exercise measured at 2.8 L.
Finding consistent with mild exercise-induced bronchospasm?
ANSWER-B. 2.8 L
Q9.
A 14-year-old develops agitation, nightmares, and behavior changes after starting a new
asthma medication.
Which drug is most likely responsible?
ANSWER-D. Montelukast (Singulair)
Q10.
A 22-year-old female with acute asthma attack. Baseline PEF 380 L/min. Now PEF 150 L/min.
After 1 hour of treatment, what finding is most reassuring?
ANSWER-C. A PEF of 310 L/min