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Chronic obstructive pulmonary disease — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareChronic obstructive pulmonary diseaseUSMLE Step 3

A 63-year-old man with COPD comes for routine follow-up. He has daily dyspnea walking uphill and two exacerbations treated with prednisone during the past year. Spirometry shows FEV1/FVC of 0.58. He uses albuterol several times weekly and continues to smoke. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Begin long-acting bronchodilator therapy and smoking cessation treatment

Symptomatic COPD with exacerbations is treated with long-acting bronchodilation, and smoking cessation is disease-modifying.

Reference: GOLD COPD strategy; USPSTF tobacco cessation recommendation