A 69-year-old man comes to the emergency department with severe shortness of breath for the past 12 hours. He is heavy smoker. The patient is using accessory muscles and has expiratory wheezing bilaterally. Noninvasive positive-pressure ventilation is initiated along with short acting beta agonist and muscarinic antagonist. Which of the following additional therapies is most likely to benefit this patient ?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Methylprednisolone
This is an acute COPD exacerbation. Alongside bronchodilators and NIV, systemic corticosteroids (IV methylprednisolone or oral prednisone) improve FEV1 and oxygenation and shorten recovery and hospital stay. Inhaled fluticasone is a chronic maintenance drug with no evidence in acute exacerbations and should not replace systemic steroids; salmeterol (LABA) is also maintenance therapy, and furosemide has no role.
ليش كل خيار صح أو غلط
-
A
ليش غلط
There is no evidence for inhaled corticosteroids in acute exacerbations; they should not be used instead of systemic corticosteroids.
✓ Step Up To Medicine 6th Edition 2024 (COPD).pdf · p. 12 -
B
ليش صح
Systemic glucocorticoids (e.g. IV methylprednisolone) improve FEV1 and oxygenation and shorten recovery time and hospital stay in AECOPD.
✓ COPD.pdf · p. 12 -
D
ليش غلط
Salmeterol is a LABA, used for patients who need frequent bronchodilator use in chronic therapy; he is already on a SABA and a muscarinic antagonist, and the missing add-on is systemic steroids.
✓ Step Up To Medicine 6th Edition 2024 (COPD).pdf · p. 7
- المصدر
- COPD.pdf · p. 12
Step Up To Medicine 6th Edition 2024 (COPD).pdf · p. 12 - المحاضرة
- COPD Exacerbation · Pulmonology · Module B
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