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Asthma Management (GINA) – Worksheet Questions

Total questions: 13

Worksheet time: 7mins

Name
Class
Date
1.

Which statements regarding preferred reliever therapy according to GINA are CORRECT?

a)

As-needed low-dose ICS–formoterol is preferred in adults and adolescents at all treatment steps

b)

As-needed ICS–formoterol is universally preferred in children 6–11 years

c)

Formoterol is suitable as a reliever due to its rapid onset of action

d)

SABA-only reliever therapy increases risk of severe exacerbations

e)

Salmeterol may be used as a reliever if combined with ICS

2.

Why is montelukast considered inferior to ICS as monotherapy in asthma?

a)

Poor oral bioavailability

b)

Lack of bronchodilator effect

c)

Limited anti-inflammatory spectrum

d)

Short half-life

3.

Which pharmacodynamic property makes formoterol suitable for both maintenance and reliever therapy in asthma?

a)

High intrinsic activity with slow onset

b)

Partial agonism at β2-receptors

c)

Rapid onset with long receptor residence time

d)

Non-selective β-agonism

4.

Increasing the dose of inhaled corticosteroids during an acute asthma exacerbation is preferred over initiating systemic corticosteroids.

a)

True

b)

False

5.

Leukotriene receptor antagonists (e.g., montelukast) are less effective than inhaled corticosteroids in preventing asthma exacerbations.

a)

True

b)

False

6.

In GINA Step 2 treatment, what is the preferred dosing strategy for adults and adolescents?

a)

Daily SABA plus as-needed ICS

b)

As-needed low-dose ICS–formoterol

c)

Daily high-dose ICS

d)

Daily LABA monotherapy

7.

A patient using budesonide–formoterol as maintenance and reliever therapy (MART) exceeds the recommended daily inhalations. What is the primary concern?

a)

Loss of bronchodilator efficacy

b)

Increased risk of β2-agonist adverse effects

c)

Acute adrenal suppression

d)

Reduced inhaled corticosteroid absorption

8.

According to GINA, which of the following represents a low daily dose of inhaled budesonide in children aged 6–11 years, compared with adults?

a)

Children: 100–200 mcg/day; Adults: 200–400 mcg/day

b)

Children: 200–400 mcg/day; Adults: 400–800 mcg/day

c)

Children: 50–100 mcg/day; Adults: 100–200 mcg/day

d)

Children and adults have the same low-dose range

9.

Which of the following are appropriate step-up options for a patient uncontrolled on low-dose ICS–LABA? Select ALL that apply.

a)

Increase to medium-dose ICS–LABA

b)

Add tiotropium (LAMA)

c)

Switch to LABA monotherapy

d)

Assess adherence and inhaler technique before stepping up

e)

Add a leukotriene receptor antagonist

10.

Which conditions must be met before stepping down asthma treatment? Select ALL that apply.

a)

Good control maintained for ≥3 months

b)

No recent exacerbations

c)

Patient has good inhaler technique and adherence

d)

Gradual dose reduction rather than abrupt stopping

11.

According to GINA, which statements regarding reliever therapy and Step 1–2 treatment in adults/adolescents and children aged 6–11 years are CORRECT? Select ALL that apply.

a)

In adults and adolescents, as-needed low-dose ICS–formoterol is preferred over SABA because it reduces severe exacerbations even in patients with infrequent symptoms.

b)

In children aged 6–11 years, taking low-dose ICS whenever SABA is taken is preferred to daily ICS at Step 1.

c)

SABA-only therapy remains acceptable in adolescents who have normal lung function and no history of exacerbations.

d)

As-needed ICS–formoterol is not recommended as a reliever option in children aged 6–11 years at Steps 1–2.

12.

Which statements regarding controller escalation and Maintenance-and-Reliever Therapy (MART) are CORRECT according to GINA? Select ALL that apply.

a)

MART is preferred at Step 3 for adults and adolescents using low-dose ICS–formoterol.

b)

Only ICS–LABA combinations containing formoterol are suitable for MART.

c)

MART may be considered in children aged 6–11 years at Step 4 under specialist supervision.

13.

Which of the following represents a high daily dose of fluticasone propionate in adults?

a)

200 mcg/day

b)

400 mcg/day

c)

500 mcg/day

d)

100 mcg/day