A 45-year-old woman with newly diagnosed asthma presents for evaluation of recurrent symptoms over the past 2 months. She reports wheezing and dyspnea triggered by exposure to air conditioning, spring pollen, and her cat at home. Symptoms occur approximately 2-3 times per week and occasionally wake her from sleep once monthly. She uses albuterol inhaler 2-3 times weekly and reports no systemic corticosteroid use. Vital signs are stable with SpO2 98% on room air. Spirometry shows FEV1 82% predicted with reversibility noted on bronchodilator testing. Chest examination reveals end-expiratory wheeze bilaterally. Which of the following is the most appropriate initial controller medication for this patient?

  1. A)Short-acting beta-2 agonist as needed
  2. B)Long-acting beta-2 agonist monotherapy
  3. C)Leukotriene receptor antagonist monotherapy
  4. D)Inhaled corticosteroid monotherapyGABARITO
  5. E)Combination inhaled corticosteroid/long-acting beta-2 agonist

Explicação

This patient has mild persistent asthma (symptoms 2-3 times/week with occasional nocturnal symptoms) requiring controller therapy beyond rescue inhalers alone. GINA and NAEPP guidelines recommend inhaled corticosteroids as first-line controller therapy for per... Ver explicação completa e trilha adaptativa →

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