Question 1

Which of the following is the best definition of asthma?&#10;A) An episodic lung disease characterized by shortness of breath, hypoxia, and anxiety&#10;B) A chronic lung disease characterized by inflammation, bronchoconstriction, and mucus production&#10;C) A chronic lung disease characterized by a history of smoking and nonreversible airway obstruction&#10;D) A short-term lung disease characterized by reversible airway obstruction, cough, and wheezing

Accepted Answer

Asthma is a chronic lung disease marked by inflammation, bronchoconstriction, and increased mucus production, leading to symptoms like wheezing and shortness of breath.

Question 2

Who is more likely to be diagnosed with asthma?&#10;A) Children from low-income families&#10;B) Asian children&#10;C) Non-Hispanic black children&#10;D) a and c&#10;E) a and b

Accepted Answer

Children from low-income families and non-Hispanic black children are more likely to be diagnosed with asthma due to factors such as environmental exposures, access to healthcare, and socioeconomic disparities.

Question 3

Which of the following medications should a child with moderate persistent asthma first be started on?&#10;A) Albuterol hydrofluoroalkanes (HFA) alone&#10;B) Albuterol HFA and omalizumab&#10;C) Albuterol HFA and an inhaled corticosteroid&#10;D) Albuterol HFA and a long-acting beta agonist&#10;E) None of the above

Accepted Answer

For moderate persistent asthma, the recommended initial treatment is a combination of a short-acting beta agonist like albuterol for quick relief and a daily inhaled corticosteroid to control inflammation and prevent symptoms.

Question 4

What is included in the differential diagnosis for asthma?&#10;A) GERD, foreign body, allergic rhinitis&#10;B) Habit cough, chronic abdominal pain, upper respiratory infection&#10;C) Tuberculosis, sinusitis, otitis media&#10;D) Laryngotracheomalacia, tonsilar enlargement, croup

Accepted Answer

GERD, foreign body, and allergic rhinitis are all conditions that can cause symptoms similar to asthma, such as wheezing, coughing, and shortness of breath.

Question 5

Which of the following is an appropriate diagnostic test used in the evaluation of asthma?&#10;A) Spirometry&#10;B) Skin testing&#10;C) Chest x-ray&#10;D) Tuberculosis skin test&#10;E) All of the above

Accepted Answer

Spirometry, skin testing, and chest x-rays are all appropriate diagnostic tests used in the evaluation of asthma. Spirometry measures lung function, skin testing can identify allergens that trigger asthma, and chest x-rays can rule out other conditions that may mimic asthma.

Question 6

The goals of clinical management for children with asthma are all of the following except:&#10;A) Few or no daytime symptoms&#10;B) No nighttime awakening caused by asthma&#10;C) Child should not miss school due to asthma and parent/guardian should not need to miss work&#10;D) Child should be allowed to sleep with pets if desired&#10;E) Child should be able to perform normal activities for age, including full participation in sports

Accepted Answer

Allowing a child with asthma to sleep with pets is not a goal of clinical management, as it may exacerbate asthma symptoms due to potential allergens.

Question 7

Which of the following is true regarding allergy skin tests to detect specific IgE sensitization?&#10;A) Helpful in detecting airborne allergies such as dust and cat dander but not helpful in detecting food allergies&#10;B) Can be done on children of any age&#10;C) Will be more accurate if an antihistamine is taken the morning of the test&#10;D) Will not be useful if child has taken an inhaled corticosteroid in the past 6 hours

Accepted Answer

Allergy skin tests can be performed on children of any age. They are useful for detecting both airborne and food allergies, and taking antihistamines before the test can interfere with results, making them less accurate. Inhaled corticosteroids do not affect the results of skin tests.

Question 8

How soon after being started on a controller medication or after having the dose of a controller medication increased should a child's asthma be reevaluated?&#10;A) In 24 hours&#10;B) In 7 to 10 days&#10;C) In 2 to 6 weeks&#10;D) In 1 to 6 months

Accepted Answer

Asthma control should be reassessed in 2 to 6 weeks after starting or adjusting controller medication to ensure effectiveness and make necessary adjustments.

Question 9

A comparison of the results of spirometry performed on a 10-year-old before and after administration of a bronchodilator evaluates airway obstruction and assesses reversibility. What spirometry result shows significant reversibility and is diagnostic for asthma?

A) Increase in the forced vital capacity (FVC) to a normal value for a 10-year-old
B) Increase in the forced expiratory volume (FEV)1/FEV ratio from 70% to 85% predicted
C) Increase in the peak flow results of 20% or more
D) Increase of at least 12% in the FEV1

Accepted Answer

An increase of at least 12% in the FEV1 after bronchodilator administration indicates significant reversibility of airway obstruction, which is diagnostic for asthma.

Question 10

According to the National Institutes of Health (NIH) guidelines, when classifying asthma severity a component of severity known as "risk" needs to be considered. "Risk" refers to which of the following?

A) Number of asthma exacerbations requiring oral corticosteroids within a certain period of time
B) Family history of asthma, allergic rhinitis, or atopic dermatitis
C) Child's exposure to environmental triggers such as tobacco smoke, air pollution, or toxins
D) Past health history of prematurity, gastroesophageal reflux, or wheezing in the first year of life

Accepted Answer

"Risk" in the NIH guidelines for asthma severity refers to the likelihood of future exacerbations, which is often assessed by the number of asthma exacerbations requiring oral corticosteroids within a certain period of time.

Deck 10: Childhood Asthma