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COPD long-acting bronchodilators — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareCOPD long-acting bronchodilatorsUSMLE Step 3

A 66-year-old former smoker has COPD with exertional dyspnea despite short-acting albuterol. Spirometry shows FEV1/FVC 0.58. He has had no exacerbations requiring steroids or hospitalization. Blood eosinophils are 90/microL. Oxygen saturation is 95% on room air. Which of the following is the most appropriate next step in management?

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Correct answer: B — Start a long-acting muscarinic antagonist

Symptomatic COPD without frequent exacerbations is treated with long-acting bronchodilator therapy; inhaled corticosteroids are reserved for selected exacerbation-prone patients.

Reference: GOLD COPD Report