RESPIRATORY
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
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Question
[CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
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Level 1-2
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Levels 2-5
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Levels 1-5
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Level 3-5
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Detailed explanation-1: -The 2019 Global Initiative for Asthma (GINA) guidelines recommend that all asthma patients be treated with inhaled corticosteroids taken daily or as needed; this improves symptoms and outcomes, even in those with mild disease.
Detailed explanation-2: -Currently, asthma severity is assessed retrospectively from the level of treatment (p. 18) required to control symptoms and exacerbations. Mild asthma is asthma that can be controlled with Step 1 or 2 treatment. Severe asthma is asthma that requires Step 5 treatment.
Detailed explanation-3: -Consider stepping down when asthma is well-controlled for 3 months. Choose an appropriate time (e.g. not travelling, no respiratory infection, not pregnant). Reduce ICS dose by 25– 50% at 2–3 month intervals. Confirm patient has a written action plan, monitor closely and book a follow-up visit.
Detailed explanation-4: -An ACT score of ≤19 (not well-controlled asthma) correctly predicted GINA-defined partly controlled/uncontrolled asthma 94% of the time, while an ACT score of ≥20 predicted GINA-defined controlled asthma 51% of the time, with kappa statistic of 0.42, representing moderate agreement.