ABFM KSA ASTHMA 2025/ACTUAL EXAM QUESTIONS AND
ANSWER/GUARANTEED PASS.
Question 1
A patient with asthma experiences nighttime symptoms weekly, and uses their rescue inhaler
more than twice a week but not daily. Baseline PFTs show FEV1 between 60-80% of predicted.
This patient's asthma is classified as moderate persistent asthma. What medications should she
typically be on as part of her long-term controller regimen?
A) SABA only
B) Low-dose ICS
C) Low-dose ICS + LABA
D) Medium-dose ICS + LABA
E) High-dose ICS + LABA + oral corticosteroids
Correct Answer: D) Medium-dose ICS + LABA
Rationale: Moderate persistent asthma (Stage 3) typically requires a regimen of a medium-
dose inhaled corticosteroid (ICS) combined with a long-acting beta-agonist (LABA) for
optimal control, in addition to a short-acting beta-agonist (SABA) for rescue as needed.
This addresses both inflammation and bronchoconstriction effectively.
Question 2
A patient is suspected of having exercise-induced asthma. Baseline pulmonary function testing
reveals an FEV1 of 3.1 L. After an exercise challenge, what FEV1 measurement would support a
diagnosis of exercise-induced bronchospasm?
A) An increase in FEV1 by 12%.
B) An FEV1 remaining at 3.1 L.
C) An FEV1 less than 2.5 L.
D) An FEV1 of 2.9 L.
E) An FEV1 of 3.5 L.
Correct Answer: C) FEV1 <2.5
Rationale: A diagnosis of exercise-induced bronchospasm (EIB) is supported by a post-
exercise decrease in FEV1 of 15% or more compared to baseline. A baseline FEV1 of 3.1 L
with a 15% decrease would be approximately 0.465 L, leading to a post-exercise FEV1 of
about 2.635 L. Therefore, an FEV1 less than 2.5 L would represent a more significant
decrease (over 15%) and strongly support the diagnosis.
Question 3
Airflow obstruction in asthma is generally defined by an FEV1/FVC ratio less than 70%. Airway
reversibility, a key diagnostic feature of asthma, is defined as an increase in FEV1 or FVC by
how much after administration of a short-acting bronchodilator?
A) 5%
B) 8%
,[Type here]
C) 10%
D) 12% and 200 mL
E) 15%
Correct Answer: D) 12%
Rationale: Airway reversibility, indicative of asthma, is officially defined as an increase in
FEV1 or FVC by at least 12% and 200 mL from baseline after the administration of a
short-acting bronchodilator (e.g., albuterol). The question specifically asks for the
percentage.
Question 4
Which asthma medications are associated with bone loss as a potential long-term adverse effect?
A) Short-acting beta-agonists (SABAs) only.
B) Long-acting beta-agonists (LABAs) only.
C) Both inhaled and oral corticosteroids.
D) Leukotriene inhibitors only.
E) Anticholinergics only.
Correct Answer: C) BOTH INHALED AND ORAL CORTICOSTEROIDS
Rationale: Both inhaled corticosteroids (ICS) and especially oral (systemic) corticosteroids
are associated with a dose- and duration-dependent risk of reduced bone mineral density
and osteoporosis. Oral corticosteroids pose a higher risk due to greater systemic exposure.
Question 5
What is the most common acid-base abnormality found in the early stages of an asthma
exacerbation?
A) Respiratory acidosis.
B) Metabolic acidosis.
C) Respiratory alkalosis.
D) Metabolic alkalosis.
E) Mixed acidosis/alkalosis.
Correct Answer: C) RESPIRATORY ALKALOSIS
Rationale: In the early stages of an asthma exacerbation, increased work of breathing and
hyperventilation (attempting to blow off CO2) often lead to a decrease in PaCO2, resulting
in respiratory alkalosis. As the exacerbation worsens and the patient fatigues, they may
develop respiratory acidosis.
Question 6
Which asthma medication is considered the most effective agent for preventing exacerbations
and controlling persistent asthma?
A) Short-acting beta-agonists (SABAs).
B) Long-acting beta-agonists (LABAs).
,[Type here]
C) Inhaled corticosteroids (ICS).
D) Leukotriene inhibitors.
E) Oral corticosteroids.
Correct Answer: C) ICS
Rationale: Inhaled corticosteroids (ICS) are the most potent and effective anti-
inflammatory medications for the long-term control of persistent asthma. They are the
cornerstone of preventative therapy, significantly reducing airway inflammation and
preventing exacerbations.
Question 7
What is the treatment of choice for aspirin-induced asthma, which is often associated with
rhinitis and nasal polyps?
A) Oral corticosteroids.
B) Short-acting beta-agonists (SABAs).
C) Anticholinergics.
D) Leukotriene inhibitors.
E) Long-acting beta-agonists (LABAs).
Correct Answer: D) LEUKOTRIENCE INHIBITORS
Rationale: Aspirin-induced asthma (AIA), also known as Aspirin-Exacerbated Respiratory
Disease (AERD), is characterized by a hypersensitivity reaction to aspirin and other
NSAIDs, leading to increased leukotriene production. Therefore, leukotriene inhibitors
(e.g., montelukast, zafirlukast, zileuton) are the treatment of choice to block these
inflammatory mediators and improve symptoms.
Question 8
A patient presents with asthma-like symptoms, rhinitis, and nasal polyps. This clinical triad is
strongly suggestive of what specific type of asthma?
A) Allergic asthma.
B) Exercise-induced asthma.
C) Aspirin-induced asthma.
D) Nocturnal asthma.
E) Intrinsic asthma.
Correct Answer: C) ASPIRIN INDUCED ASTHMA
Rationale: The triad of asthma, chronic rhinitis (often with nasal congestion), and nasal
polyps is a classic presentation of Aspirin-Exacerbated Respiratory Disease (AERD), also
known as aspirin-induced asthma.
Question 9
In patients with aspirin-induced asthma, which NSAID can sometimes be used as an alternative
to aspirin with a lower risk of exacerbating symptoms?
, [Type here]
A) Ibuprofen.
B) Naproxen.
C) Salsalate.
D) Celecoxib.
E) Diclofenac.
Correct Answer: C) SALSALATE
Rationale: Salsalate, a non-acetylated salicylate, is an NSAID that often has a lower risk of
triggering symptoms in patients with aspirin-induced asthma compared to other NSAIDs.
Acetaminophen (Tylenol) is also a safe alternative for pain and fever control.
Question 10
A patient is admitted for an asthma exacerbation. According to National Asthma Education and
Prevention Program (NAEPP) guidelines, hospital discharge can be considered once the peak
flow rate rises above a threshold of:
A) >20% of personal best.
B) >40% of personal best.
C) >60% of personal best.
D) >80% of personal best.
E) >420 L/min.
Correct Answer: D) >80% of personal best.
Rationale: NAEPP guidelines for hospital discharge after an asthma exacerbation often
include objective measures. A peak expiratory flow rate (PEFR) or FEV1 consistently
greater than 80% of the patient's personal best (or predicted normal) is a key criterion
indicating sufficient recovery and stability.
Question 11
In patients with inadequately controlled asthma, optimal management of which other
comorbidities can significantly help achieve better asthma control? (Select all that apply)
A) Gastroesophageal Reflux Disease (GERD).
B) Allergic Rhinitis.
C) Obstructive Sleep Apnea (OSA).
D) Allergic bronchopulmonary aspergillosis.
E) All of the above.
Correct Answer: E) All of the above.
Rationale: All of these comorbidities can significantly impact asthma control. GERD can
trigger bronchospasm. Allergic rhinitis often coexists and exacerbates asthma. OSA can
worsen nocturnal asthma. Allergic bronchopulmonary aspergillosis (ABPA) is a fungal
infection that causes severe asthma exacerbations. Addressing these conditions is crucial for
optimal asthma management.
ANSWER/GUARANTEED PASS.
Question 1
A patient with asthma experiences nighttime symptoms weekly, and uses their rescue inhaler
more than twice a week but not daily. Baseline PFTs show FEV1 between 60-80% of predicted.
This patient's asthma is classified as moderate persistent asthma. What medications should she
typically be on as part of her long-term controller regimen?
A) SABA only
B) Low-dose ICS
C) Low-dose ICS + LABA
D) Medium-dose ICS + LABA
E) High-dose ICS + LABA + oral corticosteroids
Correct Answer: D) Medium-dose ICS + LABA
Rationale: Moderate persistent asthma (Stage 3) typically requires a regimen of a medium-
dose inhaled corticosteroid (ICS) combined with a long-acting beta-agonist (LABA) for
optimal control, in addition to a short-acting beta-agonist (SABA) for rescue as needed.
This addresses both inflammation and bronchoconstriction effectively.
Question 2
A patient is suspected of having exercise-induced asthma. Baseline pulmonary function testing
reveals an FEV1 of 3.1 L. After an exercise challenge, what FEV1 measurement would support a
diagnosis of exercise-induced bronchospasm?
A) An increase in FEV1 by 12%.
B) An FEV1 remaining at 3.1 L.
C) An FEV1 less than 2.5 L.
D) An FEV1 of 2.9 L.
E) An FEV1 of 3.5 L.
Correct Answer: C) FEV1 <2.5
Rationale: A diagnosis of exercise-induced bronchospasm (EIB) is supported by a post-
exercise decrease in FEV1 of 15% or more compared to baseline. A baseline FEV1 of 3.1 L
with a 15% decrease would be approximately 0.465 L, leading to a post-exercise FEV1 of
about 2.635 L. Therefore, an FEV1 less than 2.5 L would represent a more significant
decrease (over 15%) and strongly support the diagnosis.
Question 3
Airflow obstruction in asthma is generally defined by an FEV1/FVC ratio less than 70%. Airway
reversibility, a key diagnostic feature of asthma, is defined as an increase in FEV1 or FVC by
how much after administration of a short-acting bronchodilator?
A) 5%
B) 8%
,[Type here]
C) 10%
D) 12% and 200 mL
E) 15%
Correct Answer: D) 12%
Rationale: Airway reversibility, indicative of asthma, is officially defined as an increase in
FEV1 or FVC by at least 12% and 200 mL from baseline after the administration of a
short-acting bronchodilator (e.g., albuterol). The question specifically asks for the
percentage.
Question 4
Which asthma medications are associated with bone loss as a potential long-term adverse effect?
A) Short-acting beta-agonists (SABAs) only.
B) Long-acting beta-agonists (LABAs) only.
C) Both inhaled and oral corticosteroids.
D) Leukotriene inhibitors only.
E) Anticholinergics only.
Correct Answer: C) BOTH INHALED AND ORAL CORTICOSTEROIDS
Rationale: Both inhaled corticosteroids (ICS) and especially oral (systemic) corticosteroids
are associated with a dose- and duration-dependent risk of reduced bone mineral density
and osteoporosis. Oral corticosteroids pose a higher risk due to greater systemic exposure.
Question 5
What is the most common acid-base abnormality found in the early stages of an asthma
exacerbation?
A) Respiratory acidosis.
B) Metabolic acidosis.
C) Respiratory alkalosis.
D) Metabolic alkalosis.
E) Mixed acidosis/alkalosis.
Correct Answer: C) RESPIRATORY ALKALOSIS
Rationale: In the early stages of an asthma exacerbation, increased work of breathing and
hyperventilation (attempting to blow off CO2) often lead to a decrease in PaCO2, resulting
in respiratory alkalosis. As the exacerbation worsens and the patient fatigues, they may
develop respiratory acidosis.
Question 6
Which asthma medication is considered the most effective agent for preventing exacerbations
and controlling persistent asthma?
A) Short-acting beta-agonists (SABAs).
B) Long-acting beta-agonists (LABAs).
,[Type here]
C) Inhaled corticosteroids (ICS).
D) Leukotriene inhibitors.
E) Oral corticosteroids.
Correct Answer: C) ICS
Rationale: Inhaled corticosteroids (ICS) are the most potent and effective anti-
inflammatory medications for the long-term control of persistent asthma. They are the
cornerstone of preventative therapy, significantly reducing airway inflammation and
preventing exacerbations.
Question 7
What is the treatment of choice for aspirin-induced asthma, which is often associated with
rhinitis and nasal polyps?
A) Oral corticosteroids.
B) Short-acting beta-agonists (SABAs).
C) Anticholinergics.
D) Leukotriene inhibitors.
E) Long-acting beta-agonists (LABAs).
Correct Answer: D) LEUKOTRIENCE INHIBITORS
Rationale: Aspirin-induced asthma (AIA), also known as Aspirin-Exacerbated Respiratory
Disease (AERD), is characterized by a hypersensitivity reaction to aspirin and other
NSAIDs, leading to increased leukotriene production. Therefore, leukotriene inhibitors
(e.g., montelukast, zafirlukast, zileuton) are the treatment of choice to block these
inflammatory mediators and improve symptoms.
Question 8
A patient presents with asthma-like symptoms, rhinitis, and nasal polyps. This clinical triad is
strongly suggestive of what specific type of asthma?
A) Allergic asthma.
B) Exercise-induced asthma.
C) Aspirin-induced asthma.
D) Nocturnal asthma.
E) Intrinsic asthma.
Correct Answer: C) ASPIRIN INDUCED ASTHMA
Rationale: The triad of asthma, chronic rhinitis (often with nasal congestion), and nasal
polyps is a classic presentation of Aspirin-Exacerbated Respiratory Disease (AERD), also
known as aspirin-induced asthma.
Question 9
In patients with aspirin-induced asthma, which NSAID can sometimes be used as an alternative
to aspirin with a lower risk of exacerbating symptoms?
, [Type here]
A) Ibuprofen.
B) Naproxen.
C) Salsalate.
D) Celecoxib.
E) Diclofenac.
Correct Answer: C) SALSALATE
Rationale: Salsalate, a non-acetylated salicylate, is an NSAID that often has a lower risk of
triggering symptoms in patients with aspirin-induced asthma compared to other NSAIDs.
Acetaminophen (Tylenol) is also a safe alternative for pain and fever control.
Question 10
A patient is admitted for an asthma exacerbation. According to National Asthma Education and
Prevention Program (NAEPP) guidelines, hospital discharge can be considered once the peak
flow rate rises above a threshold of:
A) >20% of personal best.
B) >40% of personal best.
C) >60% of personal best.
D) >80% of personal best.
E) >420 L/min.
Correct Answer: D) >80% of personal best.
Rationale: NAEPP guidelines for hospital discharge after an asthma exacerbation often
include objective measures. A peak expiratory flow rate (PEFR) or FEV1 consistently
greater than 80% of the patient's personal best (or predicted normal) is a key criterion
indicating sufficient recovery and stability.
Question 11
In patients with inadequately controlled asthma, optimal management of which other
comorbidities can significantly help achieve better asthma control? (Select all that apply)
A) Gastroesophageal Reflux Disease (GERD).
B) Allergic Rhinitis.
C) Obstructive Sleep Apnea (OSA).
D) Allergic bronchopulmonary aspergillosis.
E) All of the above.
Correct Answer: E) All of the above.
Rationale: All of these comorbidities can significantly impact asthma control. GERD can
trigger bronchospasm. Allergic rhinitis often coexists and exacerbates asthma. OSA can
worsen nocturnal asthma. Allergic bronchopulmonary aspergillosis (ABPA) is a fungal
infection that causes severe asthma exacerbations. Addressing these conditions is crucial for
optimal asthma management.
