Pulmonology End of Class Review

Which of the following would not support the diagnosis of asthma?

• Symptoms occur variably over time and vary in intensity

• Symptoms include a continuous inspiratory wheeze

• Symptoms are often worse at night, while exercising, with exposure to allergens, or in cold air

• Symptoms worsen with viral infections

Based on the following spirometry values, what is the most likely diagnosis?

FEV1/FVC 0.65

methacholine challenge causes FEV1 reduction by 24%

Bronchodilator increases FEV1 by 15%

• restrictive lung disease

• COPD

• Asthma

• Cystic fibrosis

Which are part of Sampter's triad?

• Aspirin sensitivity

• Eczema

• nasal polyps

• asthma

Classify the severity of asthma if the patient has daily symptoms, uses his inhaler daily, and wakes up twice a week with symptoms.

• intermittent

• mild persistent

• moderate persistent

• severe persistent

What is the mainstay of treatment for asthma?

• SABA

• LABA

• ICS

• SAMA

A patient comes into the ER with an acute exacerbation of asthma. Along with your physical exam you also order an ABG. What might their ABG results show?

• Respiratory alkalosis

• Respiratory acidosis

• Metabolic alkalosis

• Metabolic acidosis

Sam is a 25 year old male with a history of moderate persistent asthma. Following GINA 2024 guidelines, you prescribed him low dose ICS formoterol as a daily controller and reliever treatment. You also prescribed a peak flow monitor so he can monitor his baseline FEV1, and use to assess during an exacerbation. Using the peak flow monitor, when would Sam know when to go to the ER?  

• Never

• Peak flow in green zone >80%

• Peak flow in yellow zone

  50-80%

• Peak flow in red zone

  <50%

Which test can reliably exclude the diagnosis of asthma if negative?

• Chest CT

• Peak flow

• Methacholine challenge

• allergy skin patch testing

Which of the following findings would you expect to find on pulmonary function testing in a patient with asthma? 

• Increased FEV1/FVC ratio

• Decreased FEV1 with improvement of >12% after bronchodilator therapy 

• Normal FEV1/FVC during an exacerbation

• Decreased TLC

What is the pathophysiology of airway obstruction in asthma?

• Destruction of alveoli resulting in reduced gas exchange

• Chronic fibrosis of lung tissue

• smooth muscle contraction, mucus plugging, and bronchial edema

• hyperplasia of alveolar epithelium