QuestionSBA
QuestionChoice
It is important to first trial a long-acting B2-agonist like salmeterol. A high-dose steroid may be considered later in the management plan if salmeterol is not considered sufficient.
10007565
e
High dose steroid
QuestionChoice
This patient requires additional treatment for her chronic asthma.  She is already taking a short-acting inhaled B2-agonist (salbutamol) and a low-dose inhaled corticosteroid (beclomethasone dipropionate). As per the NICE guidelines, the next step in treatment is to add a leukotriene receptor antagonist first, and then trial a long-acting B2 agonist such as  Salmeterol.
10007561
a
Salmeterol
QuestionChoice
The patient is taking a short-acting inhaled B2 agonist as well as a low-dose inhaled corticosteroid. The next step would be to add a long-acting B2 agonist like salmeterol alongside the low-dose inhaled corticosteroid.
10007564
d
Stop beclomethasone dipropionate and begin salmeterol
QuestionChoice
Adding an oral leukotriene receptor antagonist would be appropriate at this stage, as per the NICE guidelines. 
10007563
c
Montelukast
QuestionChoice
This patient is apyrexial and her symptom exacerbation is chronic in nature, making an infective picture less likely. Poorly controlled asthma is the most likely underlying diagnosis. Therefore the best treatment option would be to manage this patient with salmeterol, a long-acting B2-agonist.
10007562
b
Oral antibiotics
Concept
Chapter
2693
4480
Asthma
Topic
162
General practice
14059
A 19-year-old female attends her asthma review complaining of worsening shortness of breath and chest tightness for the past 3 months, as well as a dry cough that is worse at night. She has a beclomethasone dipropionate inhaler which she takes as instructed, as well as a salbutamol inhaler to use as required. She has been needing to use her salbutamol inhaler almost every day to get on top of her symptoms.

All observations are normal: she is apyrexial and feeling otherwise well. She has no other medical conditions.

Which of the following is the most appropriate management?
c