Test-takers in IM are having obstructive airway problems this week. 😀
Their percentage correct is beating FM and EM this week though, so there’s that.
The most common answer is the LABA, with a lot of inhaled corticosteroids answers too.
There aren’t any exam tricks on this question, it’s just a test of familiarity with COPD and the COPD guidelines. A straightforward question where the learning objective of the exam question is simply to determine how well the guidelines are known.
(The last GOLD report was 182 pages, in case you wondered).
#4 - LABA’s - are a reasonable option, but the guidelines favor LAMAs as the initial choice for moderate COPD with increased symptoms, with a long-acting bronchodilator added as indicated.
#1 - No, inhaled corticosteroids are not indicated as monotherapy in moderate COPD without a history of frequent exacerbations.
#2 - Prednisone - oral corticosteroids are reserved for acute exacerbations, and not suitable for long-term management.
The number of LABA answers indicates some familiarity, and LABAs are probably more widely discussed than LAMAs. The nuances of when to use what are probably not known well enough to the test-takers, indicating a guideline familiarity problem.
If you picked prednisone, you probably confused the presentation, and picked the drug for an acute exacerbation, rather than the correct long-term management option.
Here’s a similar question for you:
This question appears in Med-Challenger Internal Medicine Exam Review with CME
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