Ambulatory Care Questions with
100% Correct Answers
K.R., a 20-year-old woman, is admitted to the hospital
in acute respiratory distress. She states that she has been using her boyfriend's
albuterol inhaler on a regular basis for the past 2 years. During the past few
months, she has been using the inhaler throughout the day on a daily basis and
sometimes
at night. Which one of the following best classifies
her asthma severity?
A. Mild intermittent.
B. Mild persistent.
C. Moderate persistent.
D. Severe persistent. Correct Answer: Answer: D
That she uses her inhaler throughout the day, everyday, and sometimes at night
indicates she has daily symptoms. Severe persistent: frequency of symptoms is
throughout the day; nighttime symptoms are often 7 times/week; a SABA
several times a day; normal activity is extremely limited; FEV1 less than 60% of
predicted; FEV1/FVC reduced more than 5%.
Which one of the following is the best maintenance
therapy for K.R.'s asthma?
A. Fluticasone (Flovent) low dose.
,B. Montelukast (Singulair).
C. Fluticasone medium dose plus salmeterol (Advair).
D. Theophylline. Correct Answer: Answer: C
"Severe persistent" initial treatment is step 4 or 5. Step 4 preferred: inhaled steroid
(medium dose) plus a LABA. Alternative: inhaled steroid (medium dose) plus
either an LTM or sustained-release theophylline or zileuton. Step 5 preferred:
inhaled steroid (high dose) plus a LABA.
Which one of the following types of measurement
best classifies the "number of times a short-acting
β2-agonist (SABA) is used in 1 month"?
A. Nominal.
B. Ordinal.
C. Interval.
D. Ratio. Correct Answer: Answer: D
Ratio data are ranked in a specific order with a consistent
level of magnitude difference between units; with an absolute zero.
You are designing a study in which you will compare
the percentage of patients with an asthma related
hospitalization receiving fluticasone/salmeterol
, versus fluticasone alone. Which one of the following statistical tests is best for
analyzing this comparison?
A. ANOVA (analysis of variance).
B. Chi-square.
C. Mann-Whitney U test.
D. Student unpaired t-test. Correct Answer: Answer: B
The percentage of patients receiving fluticasone/salmeterol
who have an asthma-related hospitalization will be compared with the
percentage of patients receiving fluticasone who have an asthma-related
hospitalization. We assume that these two groups are normally distributed. These
data are considered nominal. Chi-square test is appropriate to analyze nominal
or categoric data. Analysis of variance is appropriate when there are more
than two treatment groups. The Student unpaired t-test is used for continuous
data that are normally distributed.
The Mann-Whitney U test is appropriate when continuous data are not normally
distributed.
V.M. is a 22-year-old woman with asthma. Her
medications include albuterol (Ventolin hydrofluoroalkane [HFA]), metered dose
inhaler (MDI)
2 puffs as needed, and fluticasone (Flovent) 110
mcg/puff MDI 2 puffs 2 times/day. She received the influenza vaccine during
last year's influenza season, and her last tetanus vaccine (tetanus, diphtheria,
100% Correct Answers
K.R., a 20-year-old woman, is admitted to the hospital
in acute respiratory distress. She states that she has been using her boyfriend's
albuterol inhaler on a regular basis for the past 2 years. During the past few
months, she has been using the inhaler throughout the day on a daily basis and
sometimes
at night. Which one of the following best classifies
her asthma severity?
A. Mild intermittent.
B. Mild persistent.
C. Moderate persistent.
D. Severe persistent. Correct Answer: Answer: D
That she uses her inhaler throughout the day, everyday, and sometimes at night
indicates she has daily symptoms. Severe persistent: frequency of symptoms is
throughout the day; nighttime symptoms are often 7 times/week; a SABA
several times a day; normal activity is extremely limited; FEV1 less than 60% of
predicted; FEV1/FVC reduced more than 5%.
Which one of the following is the best maintenance
therapy for K.R.'s asthma?
A. Fluticasone (Flovent) low dose.
,B. Montelukast (Singulair).
C. Fluticasone medium dose plus salmeterol (Advair).
D. Theophylline. Correct Answer: Answer: C
"Severe persistent" initial treatment is step 4 or 5. Step 4 preferred: inhaled steroid
(medium dose) plus a LABA. Alternative: inhaled steroid (medium dose) plus
either an LTM or sustained-release theophylline or zileuton. Step 5 preferred:
inhaled steroid (high dose) plus a LABA.
Which one of the following types of measurement
best classifies the "number of times a short-acting
β2-agonist (SABA) is used in 1 month"?
A. Nominal.
B. Ordinal.
C. Interval.
D. Ratio. Correct Answer: Answer: D
Ratio data are ranked in a specific order with a consistent
level of magnitude difference between units; with an absolute zero.
You are designing a study in which you will compare
the percentage of patients with an asthma related
hospitalization receiving fluticasone/salmeterol
, versus fluticasone alone. Which one of the following statistical tests is best for
analyzing this comparison?
A. ANOVA (analysis of variance).
B. Chi-square.
C. Mann-Whitney U test.
D. Student unpaired t-test. Correct Answer: Answer: B
The percentage of patients receiving fluticasone/salmeterol
who have an asthma-related hospitalization will be compared with the
percentage of patients receiving fluticasone who have an asthma-related
hospitalization. We assume that these two groups are normally distributed. These
data are considered nominal. Chi-square test is appropriate to analyze nominal
or categoric data. Analysis of variance is appropriate when there are more
than two treatment groups. The Student unpaired t-test is used for continuous
data that are normally distributed.
The Mann-Whitney U test is appropriate when continuous data are not normally
distributed.
V.M. is a 22-year-old woman with asthma. Her
medications include albuterol (Ventolin hydrofluoroalkane [HFA]), metered dose
inhaler (MDI)
2 puffs as needed, and fluticasone (Flovent) 110
mcg/puff MDI 2 puffs 2 times/day. She received the influenza vaccine during
last year's influenza season, and her last tetanus vaccine (tetanus, diphtheria,
