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Asthma step-up therapy — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareAsthma step-up therapyUSMLE Step 3

A 24-year-old woman with asthma returns after 2 months of using low-dose inhaled corticosteroid-formoterol as maintenance and reliever therapy. She still awakens twice weekly and uses reliever medication on most days. Spirometry shows reversible obstruction. Inhaler technique and adherence are good. Which of the following would you recommend at the follow-up visit?

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

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Correct answer: A — Increase to medium-dose inhaled corticosteroid-formoterol

Persistent symptoms despite good adherence and technique warrant step-up controller therapy; medium-dose ICS-formoterol is an evidence-based next step.

Reference: GINA Asthma Strategy