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COPD maintenance — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)COPD maintenanceUSMLE Step 3

A 69-year-old former smoker with COPD uses albuterol daily and has dyspnea walking one block. Spirometry showed FEV1/FVC 0.58. He had one outpatient exacerbation last year and no hospitalizations. Oxygen saturation is 94% at rest. Which of the following is the most appropriate next step in management?

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Correct answer: B — Start a long-acting bronchodilator inhaler

Symptomatic COPD is managed with long-acting bronchodilator therapy; oxygen is reserved for severe resting hypoxemia.

Reference: GOLD COPD strategy report: https://goldcopd.org/