A 63-year-old smoker presents with productive cough and wheeze. Spirometry shows FEV₁/FVC 0.58 and FEV₁ 55% predicted. Persistent dyspnea and 2 exacer...

Question

A 63-year-old smoker presents with productive cough and wheeze. Spirometry shows FEV₁/FVC 0.58 and FEV₁ 55% predicted. Persistent dyspnea and 2 exacerbations last year despite LAMA. Next-step pharmacologic therapy?

Accepted Answer

Add ICS/LABA to LAMA (triple therapy)

Answer

Switch to SABA-only

Answer

Start theophylline

Answer

Add chronic macrolide without assessment

Answer

Start oral prednisone chronically

us-abfm MCQ (SBA): COPD

A 63-year-old smoker presents with productive cough and wheeze. Spirometry shows FEV₁/FVC 0.58 and FEV₁ 55% predicted. Persistent dyspnea and 2 exacerbations last year despite LAMA. Next-step pharmacologic therapy?