Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the second step in the treatment of asthma?

1. Oral corticosteroids

2. SABA + ICS

3. Leukotriene receptor antagonists

4. Long-acting beta agonists

The correct answer is: SABA + ICS

The second step in the treatment of asthma, particularly when referring to the stepwise approach to managing the condition, involves the combination of a Short-Acting Beta Agonist (SABA) with an Inhaled Corticosteroid (ICS). This combination is critical because SABA provides quick relief from acute asthma symptoms by relaxing bronchial smooth muscle, while ICS targets the underlying inflammation that plays a significant role in asthma. This approach is effective in addressing both immediate symptoms and long-term management, making it a foundational aspect of asthma care. Using a combination of these medications helps optimize treatment, as ICS helps prevent future exacerbations and improves overall lung function, while SABA alleviates symptoms when they arise. In contrast, other options may be relevant in asthma management but do not represent the immediate second step according to established guidelines after the initiation of therapy with a SABA alone. Oral corticosteroids are generally reserved for more severe exacerbations rather than as a standard second step. Leukotriene receptor antagonists and long-acting beta agonists have their roles in asthma management but are typically considered in later steps or specific circumstances rather than being classified as the second step after initiating treatment.