🏥 USMLE Exam Prep

A 72-year-old man with a history of chronic obstructive pulmonary disease (COPD) presents to the clinic with progressive shortness of breath, increased cough, and yellow sputum production over the past 3 days. He uses supplemental oxygen at home. On examination, he has expiratory wheezes and prolonged expiration. Which of the following is the most appropriate initial pharmacologic therapy?

A Systemic corticosteroids
B Inhaled long-acting beta-agonist (LABA)
C Oral azithromycin
D Nebulized albuterol

✓ Correct Answer: Option A

This patient is experiencing an acute exacerbation of COPD (AECOPD) with increased sputum and dyspnea. Systemic corticosteroids are a cornerstone of treatment for AECOPD, significantly reducing recovery time and risk of treatment failure. Nebulized albuterol is also used, but systemic corticosteroids are crucial.

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