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Mild persistent asthma reliever strategy — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareMild persistent asthma reliever strategyUSMLE Step 3

A 45-year-old man with episodic wheezing uses albuterol 4 days each week and wakes with cough twice monthly. He has no prior intubations. Spirometry shows reversible obstruction. He is not using controller therapy and asks for a simple regimen that reduces exacerbation risk. Which of the following is the most appropriate next step in management?

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

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Correct answer: A — Start as-needed low-dose budesonide-formoterol

Current asthma strategy prefers anti-inflammatory reliever therapy with low-dose ICS-formoterol for many adults and adolescents because it reduces severe exacerbation risk compared with SABA-only treatment.

Reference: GINA asthma strategy