CS- Asthma

1.

In a patient with poorly controlled severe asthma, what possible treatment should you give?

A.

High dose inhaled corticosteroid (such as fluticasone, budesonide, or triamcinolone)
B.

Ipratropium bromide (anticholinergic)
C.

Albuterol (short acting beta agonist)
D.

Salmeterol (a long acting beta agonist)
E.

Omalizumab (an immunomodulator)
F.

Predisone (an oral steroid)
G.

Reassess in 2-6 weeks
H.

Reassess in 1-4 weeks

Correct Answer(s)
A. High dose inhaled corticosteroid (such as fluticasone, budesonide, or triamcinolone)
D. Salmeterol (a long acting beta agonist)
E. Omalizumab (an immunomodulator)
F. Predisone (an oral steroid)
H. Reassess in 1-4 weeks

2.

Fluticasone, budesonide, triamcinolone are examples of what type of drug?

A.

LABA
B.

Oral Corticosteroids
C.

Immunomodulators
D.

Inhaled Corticosteroids
E.

SABA

Correct Answer
D. Inhaled Corticosteroids

Explanation
LABA:
Oral Corticosteroids: Predinsone
Immunomodulators:
SABA: alBUTEROL, levALBUTEROL, PirBUTEROL

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3.

33 y/o male with a history of asthma says he uses his inhaler about 2 times a week, wakes up “almost once a week, but not quite” coughing, takes a whiff from his inhaler and is able to go back to sleep. He has a normal FEV1/FVC ratio. How would you classify his asthma?

A.

Intermittent
B.

Mild persistent
C.

Moderate persistent
D.

Severe persistent

Correct Answer
B. Mild persistent

Explanation
In a mild persistent case...Symptoms > 2 days/week (not daily), Nighttime awakenings occur 3-4x/month, they use SABA Albuterol inhalers > 2days/week (not daily). Interference with activity is Minor. The FEV1 > 80%, and FEV1/FVC > normal. Exacerbations > 2 in a year

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4.

33 y/o male with a history of asthma says he uses his inhaler about 2 times a week, wakes up “almost once a week, but not quite” coughing, takes a whiff from his inhaler and is able to go back to sleep. He has a normal FEV1/FVC ratio. What type of treatment is most appropriate?

A.

A low dose corticosteroid, such as fluticasone, budesonide, or triamcinolone.
B.

A long acting beta agonist, such as salmeterol
C.

A long acting beta agonist + fluticasone
D.

A short acting beta agonist such as Albuterol

Correct Answer
A. A low dose corticosteroid, such as fluticasone, budesonide, or triamcinolone.

Explanation
This patient has mild persistent asthma, he should follow step 2 treatment which is a low dose ICS.

a LABA cannot be prescribed on it's own, it must be in conjunction with an inhaled corticosteroid.
A SABA would be used in a patient who has intermittent asthma, nor mild persistent.

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5.

16 y/o male has episodic wheezing, and dyspnea. His mother tells you that he wakes up about twice a week coughing. He is unable to keep up with the rest of the kids on the baseball team because of shortness of breath. You perform a PFT, and find out the FEV1 is 77%. How would you classify his asthma?

A.

Intermittent
B.

Mild Persistent
C.

Moderate Persistent
D.

Severe Persistent

Correct Answer
C. Moderate Persistent

6.

16 y/o male has episodic wheezing, and dyspnea. His mother tells you that he wakes up about twice a week coughing. He is unable to keep up with the rest of the kids on the baseball team because of shortness of breath. You perform a PFT, and find out the FEV1 is 77%. What are possible options to treat his asthma?

A.

A medium dose Inhaled Corticosteroid (Fluticasone, Budesonide, or Triamcinolone )
B.

A low dose inhaled corticosteroid ( fluticasone) + a long acting beta agonist (salmeterol).
C.

Give him a medium dose inhaled corticosteroid (such as Fluticasone, Budesonide, or Triamcinolone) in conjunction with a Long Acting Beta Agonist (such as Salmeterol).
D.

Short Acting Beta Agonist, such as Albuterol
E.

Omalizumab

Correct Answer(s)
A. A medium dose Inhaled Corticosteroid (Fluticasone, Budesonide, or Triamcinolone )
B. A low dose inhaled corticosteroid ( fluticasone) + a long acting beta agonist (salmeterol).
C. Give him a medium dose inhaled corticosteroid (such as Fluticasone, Budesonide, or Triamcinolone) in conjunction with a Long Acting Beta Agonist (such as Salmeterol).

Explanation
Omalizumab is an immunomodulator and should be considered with severe persistent asthma

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7.

24 year old female presents with shortness of breath, wheezing, flaring of nostrils. Says she has these symptoms once every couple of weeks, on a rare occasion she will wake up in the middle of the night with these symptoms. Measured forced expiratory Volume is 82%. How would you classify this patients asthma?

A.

Intermittent
B.

Mild Persistent
C.

Moderate Persistent
D.

Severe Persistent

Correct Answer
A. Intermittent

8.

What is the most appropriate prescription for a patient who has intermittent asthma?

A.

Fluticasone
B.

Salmeterol
C.

Albuterol
D.

Triamcinolone
E.

Omalizumab

Correct Answer
C. Albuterol

Explanation
For a patient with intermittent asthma, the most appropriate treatment would be a short acting beta agonist, such as alBUTEROL.

Fluticasone, Budesonide (not listed), and triacinolone are inhaled corticosteroids (ICS) and are given for patients with mild -severe persistent asthma (dose increases with severity)

Salmeterol is a Long Acting Beta Agonist which is combined with an ICS to treat moderate persistent asthma

Omalizumab is an immunomodulator and should be considered in cases of severe persistent asthma

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9.

What is the most appropriate prescription(s) for a patient that has moderate persistent asthma?

A.

Fluticasone
B.

Albuterol
C.

Omalizumab
D.

Salmeterol

Correct Answer(s)
A. Fluticasone
D. Salmeterol

Explanation
There are three options for moderate persistent asthma: low dose ICS +LABA, medium dose ICS, or Medium dose ICS +LABA. LABAs include Salmeterol, ICSs include Fluticasone, Budesonide, and triacinolone

Albuterol is a short acting beta agonist that is used for patients with intermittent asthma
Omalizumab is an immunomodulator and should be considered in cases of severe persistent asthma

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10.

What is the best prescription(s) for a patient who has severe persistent asthma

A.

Albuterol
B.

Salmeterol
C.

Omalizumab
D.

Predinsone for 2 weeks
E.

Predinsone for 5 days
F.

Fluticasone

Correct Answer(s)
B. Salmeterol
C. Omalizumab
E. Predinsone for 5 days
F. Fluticasone

Explanation
For patients with severe persistent asthma: High dose ICS + LABA + (oral corticosteroid if severe enough), Consider omalizumab

For intermittent: SABA (albuterol)
For mild persistent: Low Dose ICS
For Moderate: ICS + LABA or medium ICS,

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Cs- Asthma

In a patient with poorly controlled severe asthma, what possible treatment should you give?

Fluticasone, budesonide, triamcinolone are examples of what type of drug?

33 y/o male with a history of asthma says he uses his inhaler about 2 times a week, wakes up “almost once a week, but not quite” coughing, takes a whiff from his inhaler and is able to go back to sleep. He has a normal FEV1/FVC ratio. How would you classify his asthma?

33 y/o male with a history of asthma says he uses his inhaler about 2 times a week, wakes up “almost once a week, but not quite” coughing, takes a whiff from his inhaler and is able to go back to sleep. He has a normal FEV1/FVC ratio. What type of treatment is most appropriate?

What is the most appropriate prescription for a patient who has intermittent asthma?

What is the most appropriate prescription(s) for a patient that has moderate persistent asthma?

What is the best prescription(s) for a patient who has severe persistent asthma