Chapter·Internal MedicinePulmonology (COPD, asthma, interstitial lung disease)

Asthma management and exacerbationsDownloads

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Sample Questions

1

A 21-year-old woman comes to the physician for the evaluation of dry cough and some chest tightness for the past several weeks. The cough is worse at night and while playing volleyball. She frequently has a runny nose and nasal congestion. Her mother has systemic lupus erythematosus. The patient has smoked one pack of cigarettes daily for the last 5 years. She does not drink alcohol. Her only medication is cetirizine. Her vital signs are within normal limits. Pulse oximetry on room air shows an oxygen saturation of 98%. The remainder of the examination shows no abnormalities. Which of the following is the most appropriate next step in management?

ACT scan of the chest

BSpirometry

CLaboratory studies

DMethacholine challenge test

EBlood gas analysis

2

A 13-year-old boy with a history of asthma and seasonal allergies is currently using albuterol to manage his asthma symptoms. Recently, his use of albuterol increased from 1–2 days/week to 4 times/week over the past several weeks, though he does not experience his symptoms daily. The vital signs include: temperature 36.7°C (98.0°F), blood pressure 126/74 mm Hg, heart rate 74/min, and respiratory rate 14/min. His physical examination shows clear, bilateral breath sounds and normal heart sounds. What change should be made to his current treatment regimen?

AAdd tiotropium

BAdd formoterol + budesonide twice daily

CAdd montelukast 5 mg daily

DAdd fluticasone daily

EAdd salmeterol twice daily

3

A 28-year-old man makes an appointment with his general practitioner for a regular check-up. He has recently been diagnosed with asthma and was given a short-acting β2-agonist to use during acute exacerbations. He said he usually uses the medication 1–2 times per week. Which of the following is the most appropriate treatment in this case?

AHe should start using a short-acting β2-agonist every day, not just when he has symptoms.

BLong-acting β2-agonists should be added to his treatment regimen.

CInhaled corticosteroids should be added as controller therapy.

DSystemic corticosteroids should be added to his treatment regimen.

EHe should continue with current treatment.

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