Asthma CMS 250
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What finding on spirometry supports a diagnosis of asthma?

  • FEV1/FVC ratio above 0.7 (correct)
  • Reversibility with a decrease in FEV1 after bronchodilators
  • FEV1 ≥70% of predicted
  • Increased FEV1

    • In spirometry, what defines a mild exacerbation in asthma?

  • Symptoms only with activity and FEV1 ≥70% of predicted (correct)
  • FEV1 <40% of predicted
  • Dyspnea at rest and FEV1 80% predicted
  • FEV1/FVC ratio above 0.7

    • Which test is recommended to determine the severity of airflow obstruction in asthma?

  • Body plethysmography
  • Spirometry (correct)
  • Peak expiratory flow
  • Blood eosinophil count

    • What indicates a moderate exacerbation on spirometry in asthma?

    <p>Dyspnea at rest and dyspnea that interferes with conversation</p> Signup and view all the answers

    What is the significance of a 200 mL increase in FEV1 and >12% improvement after bronchodilator use in spirometry for asthma?

    <p>It supports a diagnosis of asthma</p> Signup and view all the answers

    What is a common general finding on physical examination that suggests airflow obstruction in asthma?

    <p>Wheezing</p> Signup and view all the answers

    In mild asthma, what might be observed during chest examination between exacerbations?

    <p>Normal chest exam</p> Signup and view all the answers

    Which of the following is a possible sign of severe airway obstruction in asthma?

    <p>Stridor</p> Signup and view all the answers

    What can be an indication of allergic asthma during physical examination?

    <p>Eczema or atopic dermatitis</p> Signup and view all the answers

    Which physical exam finding is characteristic of a bronchoprovocation challenge test for diagnosing asthma?

    <p>Decreased systolic blood pressure during inspiration</p> Signup and view all the answers

    Which of the following conditions may mimic the clinical presentation of asthma?

    <p>Vocal cord paralysis</p> Signup and view all the answers

    What diagnostic procedure is commonly used to differentiate asthma from other conditions?

    <p>Spirometry</p> Signup and view all the answers

    Which of the following conditions is NOT typically associated with poor fetal outcomes in pregnant women with poorly controlled asthma?

    <p>COPD exacerbation</p> Signup and view all the answers

    Which test is commonly used to diagnose asthma by measuring how much and how fast air can be exhaled from the lungs?

    <p>Spirometry</p> Signup and view all the answers

    In addition to asthma, which condition can alter the response to asthma therapies due to smoking?

    <p>Chronic bronchitis</p> Signup and view all the answers

    What is the purpose of a bronchoprovocation challenge test in diagnosing asthma?

    <p>To trigger airway narrowing to confirm asthma diagnosis</p> Signup and view all the answers

    Which test involves inhaling increasing concentrations of a substance (e.g., methacholine) to see if it causes narrowing of the airways, helping diagnose asthma?

    <p>Bronchoprovocation challenge</p> Signup and view all the answers

    What is the main function of a peak flow meter in managing asthma?

    <p>Assess lung function changes</p> Signup and view all the answers

    Which of the following symptoms is NOT commonly associated with asthma?

    <p>Rapid weight gain</p> Signup and view all the answers

    During a physical exam for diagnosing asthma, which of the following signs may a healthcare provider listen for using a stethoscope?

    <p>Airway wheezing or crackling sounds</p> Signup and view all the answers

    Which of the following is a characteristic feature that helps differentiate asthma from COPD?

    <p>Spirometry often normalizes</p> Signup and view all the answers

    What is a common clinical symptom that supports the diagnosis of asthma?

    <p>Intermittent and variable symptoms</p> Signup and view all the answers

    In diagnosing asthma, which of the following statements is true regarding physical examination findings?

    <p>Absence of wheezing does not rule out asthma</p> Signup and view all the answers

    Which diagnostic test is commonly used to support the diagnosis of asthma?

    <p>Bronchoprovocation challenge</p> Signup and view all the answers

    What is a key difference between the disease course of asthma and COPD?

    <p>COPD symptoms are often stable with exacerbations</p> Signup and view all the answers

    Which of the following symptoms has the highest sensitivity for the diagnosis of asthma?

    <p>Wheezing without URI symptoms</p> Signup and view all the answers

    Which respiratory symptom has the highest specificity for the diagnosis of asthma?

    <p>Wheezing and nocturnal chest tightness</p> Signup and view all the answers

    Which symptom combination has the highest positive likelihood ratio (LR+) for diagnosing asthma?

    <p>Wheezing and nocturnal chest tightness</p> Signup and view all the answers

    Which symptom combination has the lowest negative likelihood ratio (LR-) for diagnosing asthma?

    <p>Nocturnal dyspnea</p> Signup and view all the answers

    Which of the following symptoms is associated with a moderate positive likelihood ratio (LR+) for diagnosing asthma?

    <p>Wheezing without URI symptoms</p> Signup and view all the answers

    What type of test is commonly used to diagnose asthma by measuring how much and how quickly air can move in and out of the lungs?

    <p>Spirometry</p> Signup and view all the answers

    Which of the following investigations is specifically aimed at diagnosing asthma by measuring lung volume and airway resistance?

    <p>Body plethysmography</p> Signup and view all the answers

    What type of test can help in identifying specific allergens that trigger asthma symptoms?

    <p>Skin tests</p> Signup and view all the answers

    Which investigation involves inhaling substances known to trigger asthma symptoms to observe airway reactions?

    <p>Bronchial challenge testing</p> Signup and view all the answers

    What test helps evaluate how well a person's asthma is controlled and how their lungs respond to treatment?

    <p>Spirometry</p> Signup and view all the answers

    In diagnosing asthma, which test checks for markers of inflammation and allergic response in the blood?

    <p>Blood tests</p> Signup and view all the answers

    Which investigation helps determine how much air remains in your lungs after a complete exhalation?

    <p>Body plethysmography</p> Signup and view all the answers

    For which of the following investigations is the primary purpose to evaluate the bronchial reactivity to specific triggers?

    <p>Bronchial challenge testing</p> Signup and view all the answers

    Which test involves measuring how much air you can exhale after a deep breath and how quickly you can exhale that air?

    <p>Spirometry</p> Signup and view all the answers

    What type of test helps determine lung volume and airflow resistance by sitting inside a sealed chamber?

    <p>Body plethysmography</p> Signup and view all the answers

    Which physical exam finding suggests severe airway obstruction in asthma and is characterized by a decrease of more than 10 mmHg in systolic blood pressure during inspiration?

    <p>Pulsus paradoxus</p> Signup and view all the answers

    What lung sound may be heard in mild asthma exacerbations despite the presence of airflow obstruction?

    <p>Prolonged expiration</p> Signup and view all the answers

    Which of the following chest signs is NOT typically observed in patients with allergic asthma?

    <p>Pulsus paradoxus</p> Signup and view all the answers

    During severe asthma exacerbations, which lung sound may be absent due to limited airflow?

    <p>Wheezing</p> Signup and view all the answers

    Which physical exam finding suggests severe airway obstruction in infants or children with asthma and is characterized by noisy breathing caused by obstruction in the upper airway?

    <p>Stridor</p> Signup and view all the answers

    What is a common finding on physical examination in asthmatic patients when assessing lung sounds?

    <p>Wheezing sounds</p> Signup and view all the answers

    In spirometry, what defines a severe exacerbation in asthma?

    <p>FEV1 decrease of more than 50%</p> Signup and view all the answers

    Which of the following is a common symptom observed in asthmatic patients during a physical exam?

    <p>Cyanosis</p> Signup and view all the answers

    After initial spirometry, which test might be recommended to assess airway inflammation in asthma?

    <p>Exhaled nitric oxide measurement</p> Signup and view all the answers

    During a bronchial challenge test for diagnosing asthma, what would be an expected response to a trigger substance in a positive result?

    <p>Airway constriction</p> Signup and view all the answers

    Which physical exam finding in asthma is suggestive of severe airway obstruction?

    <p>Bilateral fine crackles in the lungs</p> Signup and view all the answers

    In spirometry, what finding supports a diagnosis of asthma exacerbation?

    <p>FEV1 &lt; 40% of predicted</p> Signup and view all the answers

    Which lung sound is not typically associated with asthma exacerbations?

    <p>Stridor upon inspiration</p> Signup and view all the answers

    Which symptom pattern is characteristic of mild persistent asthma?

    <p>Symptoms once a day and twice a week, asymptomatic between exacerbations</p> Signup and view all the answers

    Which further testing is specifically aimed at assessing allergic responses in asthma?

    <p>Blood eosinophil count</p> Signup and view all the answers

    What is a key characteristic of lung sounds in asthma exacerbations?

    <p>Wheezing or high-pitched whistling sounds upon auscultation</p> Signup and view all the answers

    During a physical exam for asthma, what might be a characteristic finding related to the chest?

    <p>Chest retractions with intercostal muscle indrawing</p> Signup and view all the answers

    Which symptom is often seen in severe asthma exacerbations?

    <p>Audible wheezing during normal breathing</p> Signup and view all the answers

    Which diagnostic test is typically used to assess airway inflammation in asthma?

    <p>Measurement of exhaled nitric oxide levels</p> Signup and view all the answers

    What is the purpose of a bronchoprovocation challenge test in diagnosing asthma?

    <p>To evaluate bronchial reactivity to specific triggers</p> Signup and view all the answers

    Which physical examination finding in asthma is characterized by a prolonged forced expiration phase with wheezing that persists throughout exhalation?

    <p>Rhonchi</p> Signup and view all the answers

    During an asthma exacerbation, which lung sound is most commonly heard on auscultation and typically indicates severe airway obstruction?

    <p>Stridor</p> Signup and view all the answers

    Which of the following symptoms is a common presenting feature of asthma in infants that may often be misinterpreted as recurrent bronchiolitis?

    <p>Cough and wheezing</p> Signup and view all the answers

    In diagnosing asthma, which of the following findings on chest radiography is typically observed and helps differentiate it from other conditions such as COPD?

    <p>Hyperinflation with increased retrosternal space</p> Signup and view all the answers

    During a bronchoprovocation challenge test for diagnosing asthma, what substance is commonly used to assess airway reactivity and narrowing of the bronchi?

    <p>Mannitol</p> Signup and view all the answers

    What is NOT a common physical examination finding in asthma?

    <p>Hyperresonance on percussion</p> Signup and view all the answers

    Which of the following indicates a severe exacerbation in asthma?

    <p>FEV1 (Forced Expiratory Volume in 1 second) &lt;50% predicted</p> Signup and view all the answers

    Which of the following lung sounds is typically NOT associated with asthma?

    <p>Pleural rub</p> Signup and view all the answers

    Which of the following symptoms is NOT commonly seen in asthma exacerbations?

    <p>Bradycardia</p> Signup and view all the answers

    What test is used to evaluate bronchial reactivity by measuring how much air can be exhaled after taking a deep breath and then blowing it out as fast as possible?

    <p>Methacholine challenge test</p> Signup and view all the answers

    Which physical exam finding in asthma is characterized by wheezing immediately after exercise?

    <p>Exercise-induced asthma</p> Signup and view all the answers

    What lung sound is most likely to be heard in a patient with severe airway obstruction in asthma?

    <p>Stridor</p> Signup and view all the answers

    Which characteristic feature decreases the likelihood of asthma diagnosis?

    <p>Chronic sputum production</p> Signup and view all the answers

    What symptom combination has the highest LR+ for diagnosing asthma according to the data?

    <p>Wheezing and dyspnea</p> Signup and view all the answers

    Which test is recommended for evaluating bronchial reactivity to specific triggers in diagnosing asthma?

    <p>Bronchoprovocation challenge test</p> Signup and view all the answers

    In spirometry, what defines a moderate exacerbation in asthma?

    <p>$10-30$% decrease in FEV1 or peak flow, increase in respiratory rate or heart rate</p> Signup and view all the answers

    What symptom is associated with a moderate positive likelihood ratio (LR+) for diagnosing asthma?

    <p>Wheezing and nocturnal chest tightness</p> Signup and view all the answers

    Which diagnostic test is commonly used to differentiate asthma from other conditions?

    <p>$&gt;12$% improvement after bronchodilator use in spirometry</p> Signup and view all the answers

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