KSA Asthma Exam| Questions And Verified
Answers | Latest Update|Score 100%
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 he has a poor
response. He is not able to repeat the spirometry and he now appears drowsy.
Which one of the following would be consistent with imminent respiratory
failure? - CORRECT ANSWER- E. The absence of wheezes
Which one of the following is true regarding leukotriene modifiers for treatment
of asthma in adults? - CORRECT ANSWER- D. They are less effective than
inhaled corticosteroids (ICSs)
Chronic low- to medium-dose inhaled corticosteroid use in children is
associated with - CORRECT ANSWER- 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 - CORRECT ANSWER- 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? - CORRECT ANSWER-
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? - CORRECT ANSWER- 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? - CORRECT ANSWER- C. Intravenous magnesium sulfate
Which one of the following is true regarding regular use of inhaled
corticosteroids (ICSs) in patients with persistent asthma? - CORRECT
ANSWER- 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? - CORRECT ANSWER- 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? - CORRECT ANSWER- 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.
Which one of the following asthma medications is most likely to have
precipitated these symptoms? - CORRECT ANSWER- D. Montelukast
(Singulair)
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
Answers | Latest Update|Score 100%
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 he has a poor
response. He is not able to repeat the spirometry and he now appears drowsy.
Which one of the following would be consistent with imminent respiratory
failure? - CORRECT ANSWER- E. The absence of wheezes
Which one of the following is true regarding leukotriene modifiers for treatment
of asthma in adults? - CORRECT ANSWER- D. They are less effective than
inhaled corticosteroids (ICSs)
Chronic low- to medium-dose inhaled corticosteroid use in children is
associated with - CORRECT ANSWER- 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 - CORRECT ANSWER- 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? - CORRECT ANSWER-
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? - CORRECT ANSWER- 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? - CORRECT ANSWER- C. Intravenous magnesium sulfate
Which one of the following is true regarding regular use of inhaled
corticosteroids (ICSs) in patients with persistent asthma? - CORRECT
ANSWER- 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? - CORRECT ANSWER- 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? - CORRECT ANSWER- 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.
Which one of the following asthma medications is most likely to have
precipitated these symptoms? - CORRECT ANSWER- D. Montelukast
(Singulair)
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
