USMLE Forum Archives - USMLE Step 2 CK - IM- Chr. Bronchitis
IM- Chr. Bronchitis
HIV - 01-02-08 13:04
A 55-year-old man with a long smoking history comes to the clinic for evaluation of a chronic cough. The cough has bothered him for at least 3 years now. It is productive of thick white or yellow sputum and occurs on most days. He sheepishly admits that he has a long history of tobacco use, having smoked at least a pack a day for the last 40 years. Physical examination reveals some mild wheezes on expiration and coarse upper respiratory breath sounds. Pulse oximetry is remarkable for an oxygen saturation of 93%, which drops to 91% with exercise. Pulmonary function tests reveal a decreased forced expiratory volume in 1 second with a relatively preserved forced vital capacity, increased lung volumes, and a moderately reduced diffusion lung capacity of CO. In addition to smoking cessation, which of the following is the most effective and appropriate long-term outpatient medical treatment for this patient?
A) Albuterol
B) Flunisolide
C) Ipratropium
D) Oxygen therapy
E) Prednisone
HIV - 01-02-08 13:04
A 55-year-old man with a long smoking history comes to the clinic for evaluation of a chronic cough. The cough has bothered him for at least 3 years now. It is productive of thick white or yellow sputum and occurs on most days. He sheepishly admits that he has a long history of tobacco use, having smoked at least a pack a day for the last 40 years. Physical examination reveals some mild wheezes on expiration and coarse upper respiratory breath sounds. Pulse oximetry is remarkable for an oxygen saturation of 93%, which drops to 91% with exercise. Pulmonary function tests reveal a decreased forced expiratory volume in 1 second with a relatively preserved forced vital capacity, increased lung volumes, and a moderately reduced diffusion lung capacity of CO. In addition to smoking cessation, which of the following is the most effective and appropriate long-term outpatient medical treatment for this patient?
A) Albuterol
B) Flunisolide
C) Ipratropium
D) Oxygen therapy
E) Prednisone
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#3
Re: IM- Chr. Bronchitis 8401glacieres - 01-09-08 06:50 D-O2 theraphy
As all other optios are mostly used for acute management, particularly ALUBETROL--used in ED.
Flunisolide is corticoteroid which is used in chronic management of chronic asthma but not COPD as in this patient.
Much is discussed in litreature about anti-cholinergics use in long term management of COPD.
Prednisone is used in acute management of asthma and to a lesser extent in COPD, which is follwed by a tapering dose.But inhaled steroids are useful in long term management of asthama.
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