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A 17-year-old girl with a history of asthma presents to your office with complaints of wheezing and shortness of breath. She reports experiencing symptoms approximately 3-4 times per week, requiring use of her short-acting beta agonist inhaler. She has also woken up at night four times during the month with shortness of breath and occasionally experiences dyspnea during her daily walks. Which of the following is the most effective management?

A. Add a low-dose inhaled glucocorticoid
B. Add a low-dose inhaled glucocorticoid plus long-acting beta agonist
C. Continue use of short-acting beta agonist only
D. Start an oral course of glucocorticoids

Answer :

Final answer:

In case of frequent and severe asthma symptoms, a combination of low dose inhaled glucocorticoid and long-acting beta agonist is recommended. This treatment offers dual therapy and helps manage symptoms and prevent future asthma attacks.

Explanation:

The most effective management for a 17-year-old girl with a history of asthma, presenting symptoms of wheezing and shortness of breath approximately 3-4 times per week and waking up with shortness of breath at night, would be option B: add a low dose inhaled glucocorticoid plus long-acting beta agonist. Considering the frequency and intensity of her symptoms, this course of treatment is recommended. This approach offers dual therapy, coupling an anti-inflammatory effect with bronchodilation, which should effectively manage her symptoms and help prevent future asthma attacks. The management of her condition should also take into account the effect asthma is having on her daily activities and sleep, as indicated by the night awakenings and dyspnea during her daily walk.

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