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Uncontrolled asthma — SCE Respiratory MCQ

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EasyAsthmaUncontrolled asthmaSCE Respiratory

A 34-year-old woman with asthma has daily symptoms despite low-dose budesonide/formoterol used as maintenance and reliever therapy. Inhaler technique is good, adherence is confirmed and there are no occupational triggers. Spirometry remains obstructed with 16% reversibility and FeNO is 46 ppb. What is the most appropriate management?

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Correct answer: D — Increase to moderate-dose ICS/formoterol MART

Persistent symptoms with objective asthma despite good technique and adherence should be managed by stepwise escalation of ICS/formoterol MART. Regular nebulised SABA and ICS withdrawal worsen risk, while maintenance oral steroid is not a routine early escalation. Bronchial thermoplasty is considered only in selected severe asthma after specialist review, not before optimising inhaled therapy.

Reference: BTS/NICE/SIGN Asthma Guideline NG245