MTM Respiratory Disease Management 2

Question 1

A patient's asthma is uncontrolled despite adherence to Step 3 therapy (low-dose ICS/LABA). Per GINA guidelines, what is the appropriate next step?

Accepted Answer

Step up to medium-dose ICS/LABA

Answer

GINA Step 4 involves increasing ICS dose while maintaining LABA, advancing from low-dose to medium-dose ICS/LABA combination therapy.

Question 2

Which inhaler device requires the LEAST patient coordination between actuation and inhalation?

Accepted Answer

Nebulizer

Answer

Nebulizers continuously convert liquid medication to fine mist, requiring minimal patient coordination and making them ideal for patients with poor inhaler technique.

Question 3

A COPD patient with blood eosinophils of 350 cells/μL continues to exacerbate frequently despite LABA/LAMA therapy. What is the most appropriate add-on treatment?

Accepted Answer

Adding ICS to create LABA/LAMA/ICS triple therapy

Answer

GOLD guidelines recommend adding ICS to LABA/LAMA (triple therapy) in COPD patients with eosinophils ≥300 cells/μL who continue to exacerbate on dual bronchodilation.

Question 4

A patient with severe persistent asthma requires antihypertensive therapy. Which antihypertensive class is CONTRAINDICATED due to risk of bronchospasm?

Accepted Answer

Non-selective beta-blockers

Answer

Non-selective beta-blockers block beta-2 receptors in bronchial smooth muscle, precipitating life-threatening bronchospasm in asthma patients.

Question 5

An MTM pharmacist reviews a patient's peak flow diary showing morning dipping greater than 20%. This finding is MOST consistent with which condition?

Accepted Answer

Poorly controlled asthma

Answer

Morning dipping in peak expiratory flow >20% (diurnal variation) is a hallmark of poorly controlled asthma reflecting significant airway variability.

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

MTM Respiratory Disease Management 2