USMLE Asthma management question

[cbrons]

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Answer choices:

A.) Albuterol 1x day
B.) Inhaled glucocorticoids 1x a day
C.) No long-term pharmacotherapy
D.) Oral prednisone 1x day
E.) Oral zafirlukast 1x day
F.) Salmetrol inhaler 1x day

The answer given is "C.) No long-term pharmacotherapy."

I think the answer to this question is wrong. Having symptoms "1 to 2 times per week" is technically mild-persistent asthma. The nocturnal symptoms listed in the question stem are quite vague. Regardless, because of the occurrence more than once per week, she is mild-persistent category and should get a long-acting inhaled corticosteroid (answer B).

Am I right or wrong???

 

[cbrons]

@jdh71 can you help me with this trash question

 

[animando]

check the guidelines, symptoms on 2 or less days per week + 2x or less nocturnal symptoms a month + normal lung parameters are still considered intermittent asthma.
She responded well to Ventolin, did not need IV steroids, does not report disturbances in daily activities.

 

[jdh71]

@jdh71 can you help me with this trash question

The question is just playing around with some technical nonsense. Always remember any doctor that CAN be replaced by an algorithm, SHOULD be. You're treating patients and the overall clinical picture. The patient described in the stem is way too symptomatic overall to go without having any long term controller medication. The appropriate thing in her situation would be adding in an inhaled corticosteroid, checking symptoms in 6 weeks, and then again in three months, then attempt at deescalation from that point.

 

[jdh71]

The question is like asking how many times do you think it's ok for a patient to feel like they are drowning?

 

[Journeyofwisdom]

Shouldn't zafirluksst be a better intial therapy in a young person if we are choosing to go long term pharmcotherapy?