The 2020 focused updates to the asthma management guidelines recommend which
one of the following allergen avoidance measures as part of a multifaceted,
comprehensive approach for patients sensitive to house dust mite allergens?
Give this one a try later!
A. Encasing pillows and mattresses in an allergen-impermeable cover
,A 25-year-old female with a history of mild persistent asthma presents to the
emergency department with a 5-day history of increasing cough, wheezing, and
shortness of breath. Her asthma regimen of daily inhaled corticosteroids has not
changed recently, and she has not recently taken systemic corticosteroids. On
examination she is slightly agitated with a pulse rate of 110 beats/min. Examination of
the lungs reveals loud expiratory wheezing on auscultation, and you observe that she
has suprasternal retractions. Her FEV1 is 1.71 L (63% of predicted) and her oxygen
saturation is 94% on room air.
Which one of the following would be the most appropriate next step in the
management of this patient?
Give this one a try later!
B. An inhaled short-acting β-agonist, with up to three treatments in the first
hour
You see a 24-year-old male with moderate persistent asthma treated with a high-dose
inhaled corticosteroid combined with a long-acting β-agonist. He reports that his
cough and wheezing have improved but he continues to require daily use of an
albuterol (Proventil, Ventolin) inhaler. He notes that he did not require the use of his
albuterol rescue inhaler even once during a recent 1-week vacation in Maui.Reviewing
his medication adherence and assessing for specific asthma triggers reveals no
specific modifiable exposure. His total serum IgE level is 130 IU/mL (N 6-97). Specific
allergy immunoassay testing does not reveal a confirmed allergen.
Which one of the following would be most appropriate at this time?
Give this one a try later!
C. Add omalizumab (Xolair)
, A 45-year-old male who recently moved to your area sees you for the first time for a
health maintenance examination. His past medical history includes asthma and GERD.
He was hospitalized for asthma at age 6 but his symptoms gradually disappeared
during high school and college and he did not require any controller therapy for 20
years. His only current medication is omeprazole (Prilosec).After moving to his new
home, which is in a rural area, he began noticing wheezing during exercise and
recently has had to use albuterol (Proventil, Ventolin) on a daily basis. He does not
notice wheezing in the evening or after meals. His symptoms are worse with stress,
upper respiratory infections, exercise, and being around friends' pets. His current
asthma regimen includes low-dose fluticasone propionate/salmeterol (Advair Diskus),
with as-needed albuterol. He has had two exacerbations this year requiring oral
prednisone. Last week he was seen at a local urgent care facility for another
exacerbation.
You order allergy testing and suggest which one of the following regimens?
Give this one a try later!
B. An ICS and formoterol in a single inhaler as both a daily controller and
reliever therapy
A 15-year-old male with a history of asthma presents to your office with worsening
asthma symptoms. He reports wheezing episodes 5-6 days per week and nighttime
awakenings that have increased in frequency to 1-2 nights per week. He went to an
urgent care center 6 months ago for an upper respiratory infection with a severe
cough, which was his second asthma exacerbation this year. His FEV1 in your office is
70% of predicted.
This patient's asthma should be categorized as
Give this one a try later!
D. moderate persistant
one of the following allergen avoidance measures as part of a multifaceted,
comprehensive approach for patients sensitive to house dust mite allergens?
Give this one a try later!
A. Encasing pillows and mattresses in an allergen-impermeable cover
,A 25-year-old female with a history of mild persistent asthma presents to the
emergency department with a 5-day history of increasing cough, wheezing, and
shortness of breath. Her asthma regimen of daily inhaled corticosteroids has not
changed recently, and she has not recently taken systemic corticosteroids. On
examination she is slightly agitated with a pulse rate of 110 beats/min. Examination of
the lungs reveals loud expiratory wheezing on auscultation, and you observe that she
has suprasternal retractions. Her FEV1 is 1.71 L (63% of predicted) and her oxygen
saturation is 94% on room air.
Which one of the following would be the most appropriate next step in the
management of this patient?
Give this one a try later!
B. An inhaled short-acting β-agonist, with up to three treatments in the first
hour
You see a 24-year-old male with moderate persistent asthma treated with a high-dose
inhaled corticosteroid combined with a long-acting β-agonist. He reports that his
cough and wheezing have improved but he continues to require daily use of an
albuterol (Proventil, Ventolin) inhaler. He notes that he did not require the use of his
albuterol rescue inhaler even once during a recent 1-week vacation in Maui.Reviewing
his medication adherence and assessing for specific asthma triggers reveals no
specific modifiable exposure. His total serum IgE level is 130 IU/mL (N 6-97). Specific
allergy immunoassay testing does not reveal a confirmed allergen.
Which one of the following would be most appropriate at this time?
Give this one a try later!
C. Add omalizumab (Xolair)
, A 45-year-old male who recently moved to your area sees you for the first time for a
health maintenance examination. His past medical history includes asthma and GERD.
He was hospitalized for asthma at age 6 but his symptoms gradually disappeared
during high school and college and he did not require any controller therapy for 20
years. His only current medication is omeprazole (Prilosec).After moving to his new
home, which is in a rural area, he began noticing wheezing during exercise and
recently has had to use albuterol (Proventil, Ventolin) on a daily basis. He does not
notice wheezing in the evening or after meals. His symptoms are worse with stress,
upper respiratory infections, exercise, and being around friends' pets. His current
asthma regimen includes low-dose fluticasone propionate/salmeterol (Advair Diskus),
with as-needed albuterol. He has had two exacerbations this year requiring oral
prednisone. Last week he was seen at a local urgent care facility for another
exacerbation.
You order allergy testing and suggest which one of the following regimens?
Give this one a try later!
B. An ICS and formoterol in a single inhaler as both a daily controller and
reliever therapy
A 15-year-old male with a history of asthma presents to your office with worsening
asthma symptoms. He reports wheezing episodes 5-6 days per week and nighttime
awakenings that have increased in frequency to 1-2 nights per week. He went to an
urgent care center 6 months ago for an upper respiratory infection with a severe
cough, which was his second asthma exacerbation this year. His FEV1 in your office is
70% of predicted.
This patient's asthma should be categorized as
Give this one a try later!
D. moderate persistant
