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Pediatric asthma — USMLE Step 3 MCQ

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HardPediatrics (well-child, chronic management)Pediatric asthmaUSMLE Step 3

A 28-year-old has mild persistent asthma with symptoms twice weekly and no recent exacerbation. She prefers not to take a daily controller. Under the NHLBI focused updates, which alternative controller strategy may be used with albuterol?

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Correct answer: D — Take an inhaled corticosteroid whenever albuterol is used for symptoms

The best answer is “Take an inhaled corticosteroid whenever albuterol is used for symptoms”. For patients at least 12 years old with mild persistent asthma, NHLBI permits either daily low-dose ICS plus as-needed SABA or concomitant as-needed ICS and SABA used for worsening symptoms. SABA-only and LABA monotherapy omit anti-inflammatory controller treatment.

Reference: NHLBI 2020 Focused Updates to the Asthma Management Guidelines: https://www.nhlbi.nih.gov/health-topics/asthma-management-guidelines-2020-updates