Afghanistan Specialization Entry Exam Practice Questions - Afghanistan Medical Specialization (Takhasus) Entry Exam

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A 56-year-old male with a 20-pack-year smoking history presents with progressive dyspnea on exertion and chronic morning productive cough. Spirometry reveals a post-bronchodilator FEV1/FVC ratio of 0.58 and an FEV1 of 62% of predicted. He reports two moderate exacerbations in the past year requiring antibiotics. According to GOLD guidelines, what is the most appropriate initial maintenance pharmacotherapy?

Short-acting beta-2 agonist (SABA) as monotherapy on an as-needed basis only Long-acting muscarinic antagonist (LAMA) combined with a long-acting beta-2 agonist (LABA) Inhaled corticosteroid (ICS) monotherapy twice daily Oral systemic corticosteroid combined with low-dose theophylline

Correct Answer:

Long-acting muscarinic antagonist (LAMA) combined with a long-acting beta-2 agonist (LABA)

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