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Unilateral pleural effusion — RCPSC IM MCQ

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HardRespirologyUnilateral pleural effusionRCPSC IM

A patient with severe eosinophilic asthma has frequent oral-corticosteroid bursts despite verified inhaler technique, high-dose ICS/LABA adherence and smoking cessation. Blood eosinophils are repeatedly elevated. What is the next management principle?

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Correct answer: E — Refer for phenotype-directed biologic therapy assessment

Persistent severe eosinophilic asthma despite optimized inhaled treatment merits specialist biologic assessment. Chronic antibiotics, stopping ICS, indefinite steroids without a steroid-sparing strategy, or reliever escalation alone do not address the phenotype.

Reference: Canadian Thoracic Society, Guideline Library: https://cts-sct.ca/guideline-library/