A 56-Year-Old Woman Comes to the Office Due to Progressive

question 1150

Multiple Choice

A 56-year-old woman comes to the office due to progressive asthma symptoms.  The patient describes nighttime cough and wheezing that have increased in recent months.  Sometimes she has to use her albuterol inhaler right after a meal.  She also reports feeling tired each morning as she works late and has no time to relax after dinner.  The patient has no dyspnea on exertion but says that her throat has been sore lately and describes hoarseness in the morning that clears during the day.  She has gained 5 kg (11 lb) over the last 6 months.  Her medical history is significant for bronchial asthma, type 2 diabetes mellitus, and hypertension.  Medications include low-dose inhaled fluticasone, an albuterol inhaler, lisinopril, amlodipine, and aspirin with no change in her medications for years.  Blood pressure is 140/90 mm Hg, pulse is 80/min, and respirations are 16/min.  BMI is 32 kg/m².  Lung auscultation indicates normal breath sounds without wheezing.  Heart sounds are normal.  Which of the following is the most appropriate next step in management of this patient?

• A)Add benzocaine lozenges
• B)Add diphenhydramine
• C)Add esomeprazole
• D)Add oral corticosteroids
• E)Discontinue aspirin
• F)Discontinue lisinopril

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Definitions:

Brain Waves

Patterns of electrical activity in the brain, measured by EEG, that reflect different states of consciousness or mental activities.

Cocaine

A powerful stimulant drug derived from the leaves of the coca plant, often used recreationally and known for its addictive properties.

Psychedelic Drug

Substances that alter perception, mood, and a variety of cognitive processes, often used in research or therapy.

Cognitive Functioning

The mental processes involved in gaining knowledge and comprehension, including thinking, knowing, remembering, judging, and problem-solving.