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ENT · Larynx and airway: inhaled steroid and laryngeal candidiasis
Sample itemA man with asthma on high-dose inhaled beclomethasone has persistent hoarseness. Laryngoscopy shows white plaques on the cords. What is the best management?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Antifungal therapy with spacer use and mouth rinsing
Inhaled steroids can cause laryngeal and oral candidiasis. A spacer, rinsing the mouth after use and treating the infection resolve the hoarseness. Stopping asthma treatment is unsafe and oral steroids would worsen candidiasis.
Option by option
A. Antifungal therapy with spacer use and mouth rinsing (correct)
Correct. Treat the candida and reduce deposition with a spacer and mouth rinsing.
B. Voice surgery
Surgery is unnecessary for a treatable infection.
C. Oral steroids
Oral steroids promote fungal overgrowth.
D. Stop all asthma treatment
Stopping asthma treatment risks an exacerbation.
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.
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