Asthma USMLE Step 1 Practice Question
A 28-year-old man with well-controlled asthma on low-dose inhaled corticosteroid presents with persistent nocturnal cough and awakening 4 nights per week due to wheezing. Vital signs: BP 118/76, HR 82, RR 16, SpO2 98% on room air. Daytime symptoms are minimal with no acute dyspnea. FEV1 is 82% predicted. Chest radiograph is normal. Which of the following changes would be most appropriate?
Answer choices
- ASwitch to a higher dose of inhaled corticosteroid monotherapy
- BRefer to sleep medicine for obstructive sleep apnea evaluation
- CAdd a long-acting beta-2 agonist to the regimenCorrect answer
- DDiscontinue inhaled corticosteroid and use only albuterol as needed
- ERecommend smoking cessation and allergy testing only
- FAdd tiotropium as a long-acting muscarinic antagonist for step-up therapy
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