Respiratory medicine: aspirin-exacerbated respiratory disease: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Respiratory medicine: aspirin-exacerbated respiratory disease

Sample item

A 35-year-old woman with asthma and recurrent nasal polyps develops severe bronchospasm with rhinorrhoea within an hour of taking ibuprofen. Which drug is a suitable add-on for her long-term control?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Montelukast

Cyclo-oxygenase inhibition diverts arachidonic acid towards the 5-lipoxygenase pathway, and the excess cysteinyl leukotrienes cause bronchospasm. A leukotriene receptor antagonist is therefore a logical add-on to inhaled steroids, and cyclo-oxygenase inhibitors should be avoided.

Option by option

  • A. Cromolyn sodium

    Cromolyn stabilises mast cells and has a minor role in adult asthma.

  • B. Tiotropium

    Tiotropium is a long-acting antimuscarinic and does not target the leukotriene mechanism.

  • C. Montelukast (correct)

    Correct. A leukotriene receptor antagonist blocks the mediators that drive this phenotype.

  • D. Theophylline

    Theophylline is a weak bronchodilator with a narrow therapeutic window and no specific benefit here.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Montelukast. Cyclo-oxygenase inhibition diverts arachidonic acid towards the 5-lipoxygenase pathway, and the excess cysteinyl leukotrienes cause bronchospasm.

Why is "Cromolyn sodium" not the answer?

Cromolyn stabilises mast cells and has a minor role in adult asthma.

Why is "Tiotropium" not the answer?

Tiotropium is a long-acting antimuscarinic and does not target the leukotriene mechanism.

Why is "Theophylline" not the answer?

Theophylline is a weak bronchodilator with a narrow therapeutic window and no specific benefit here.

What concept does this question test?

It tests Respiratory medicine: aspirin-exacerbated respiratory disease in General Medicine. A leukotriene receptor antagonist is therefore a logical add-on to inhaled steroids, and cyclo-oxygenase inhibitors should be avoided.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Respiratory medicine: aspirin-exacerbated respiratory disease?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.