Question 1

A patient diagnosed with asthma calls the provider to report having a peak flow measure of 75%, shortness of breath, wheezing, and cough, and tells the provider that the symptoms have not improved significantly after a dose of albuterol. The patient uses an inhaled corticosteroid medication twice daily. What will the provider recommend?

A) Administering two more doses of albuterol
B) Coming to the clinic for evaluation
C) Going to the emergency department (ED)
D) Taking an oral corticosteroid

A

Accepted Answer

A

Question 2

A patient is seen in clinic for an asthma exacerbation. The provider administers three nebulizer treatments with little improvement, noting a pulse oximetry reading of 90% with 2 L of oxygen. A peak flow assessment is 70%. What is the next step in treating this patient?

A) Administer three more nebulizer treatments and reassess.
B) Admit to the hospital with specialist consultation.
C) Give epinephrine injections and monitor response.
D) Prescribe an oral corticosteroid medication.

B

Accepted Answer

The patient has a severe asthma exacerbation with low oxygen saturation, poor response to initial treatment, and low peak flow. Admitting the patient to the hospital with specialist consultation is the appropriate next step to provide more aggressive treatment and monitoring. Continuing with repeated nebulizer treatments or giving epinephrine injections without improvement could delay necessary treatment and potentially lead to respiratory failure. Prescribing an oral corticosteroid medication is also a necessary step, but should be done in conjunction with hospital admission and specialist consultation.

Question 3

An adult develops chronic cough with episodes of wheezing and shortness of breath. The provider performs chest radiography and other tests and rules out infection, upper respiratory, and gastroesophageal causes. Which test will the provider order initially to evaluate the possibility of asthma as the cause of these symptoms?

A) Allergy testing
B) Methacholine challenge test
C) Peak expiratory flow rate (PEFR)
D) Spirometry

D

Accepted Answer

Spirometry is the most appropriate initial test to evaluate for asthma as it assesses lung function and can help diagnose obstructive lung disease. Allergy testing may be helpful in identifying triggers for asthma, but is not an initial diagnostic test. Methacholine challenge testing is typically reserved for patients with normal spirometry but high clinical suspicion for asthma. PEFR can be a useful tool for monitoring asthma symptoms, but spirometry is more sensitive for detecting airway obstruction.

Deck 85: Asthma