1.
Fluticasone, budesonide, triamcinolone are examples of what type of drug?
Correct Answer
D. Inhaled Corticosteroids
Explanation
LABA:
Oral Corticosteroids: Predinsone
Immunomodulators:
SABA: alBUTEROL, levALBUTEROL, PirBUTEROL
2.
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?
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
3.
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?
Correct Answer
C. Moderate Persistent
Explanation
Based on the information provided, the patient experiences episodic wheezing and dyspnea, wakes up coughing twice a week, and has difficulty keeping up with physical activities due to shortness of breath. The FEV1 value of 77% indicates moderate impairment of lung function. These symptoms and lung function results suggest that the patient's asthma is classified as moderate persistent.
4.
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?
Correct Answer
A. Intermittent
Explanation
Based on the given information, the patient experiences symptoms of shortness of breath, wheezing, and flaring of nostrils once every couple of weeks, with occasional nighttime symptoms. The measured forced expiratory volume is 82%. According to the Global Initiative for Asthma (GINA) guidelines, this pattern of symptoms and lung function measurement falls under the classification of intermittent asthma. Intermittent asthma is characterized by symptoms occurring less than twice a week, nighttime symptoms less than twice a month, and normal lung function between episodes.
5.
What is the most appropriate prescription for a patient who has intermittent asthma?
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
6.
What is the most appropriate prescription(s) for a patient that has moderate persistent asthma?
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
7.
What is the best prescription(s) for a patient who has severe persistent asthma
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,