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Pulmonology - ABIM
Asthma
| Question | Answer |
|---|---|
| Asthma symptoms less than two times per week | Intermittent asthma, FEV1 > 80% |
| Asthma symptoms 2 to 6 times per week | Mild persistent asthma, FEV1 > 80% |
| Daily asthma symptoms | Moderate persistent asthma, FEV1 60 to 80% |
| Continuous asthma symptoms | Severe persistent asthma, FEV1 <60% |
| Treatment for intermittent asthma | Albuterol |
| Treatment for mild persistent asthma | Albuterol plus inhaled corticosteroid or leukotriene receptor agonist such as montelukast |
| Treatment for moderate persistent asthma | Albuterol plus inhaled corticosteroid plus long-acting beta agonist |
| Treatment for severe persistent asthma | Albuterol plus inhaled corticosteroid plus long-acting beta agonist, plus PO steroids |
| Name the FEV1 for the different asthma categories | FEV1> 80% – intermittent and mild persistent asthma. FEV1 60 to 80% - moderate persistent asthma; FEV1 <60% - severe persistent asthma |
| When to use omalizumab in asthma? | In moderate persistent or severe persistent asthma if the patient has high levels of IgE. it is a humanized antibody that decreases the patient's sensitivity to antigens. |
| When to use cromolyn and what is its mechanism? | Use if patient's asthma is exercise induced. It stabilizes mast cells. |
| What can be used to decrease a patient's steroid usage? | montelukast |
| Nighttime symptoms less than two times per month | Intermittent asthma, FEV1 > 80% |
| Nighttime symptoms from 2 to 5 times a month | Mild persistent asthma, FEV1 > 80% |
| Nighttime symptoms greater than five times per month | Moderate persistent asthma, FEV1 60 to 80% |
| Nighttime symptoms very frequent | Severe persistent asthma, FEV1 <60% |