Seasonal Allergic Rhinitis Reports in Medicine / Internal Medicine — 58yo Woman | Respiratory / Pulmonology | SMLE Q#11870

SMLE Question #11870

Medicine / Internal Medicine Respiratory / Pulmonology

Objective: OBJ-123

Last updated: February 2026
A 58-year-old woman with seasonal allergic rhinitis reports wheezing, chest tightness, and shortness of breath for 1 month, occurring 3–4 days per week with occasional nighttime symptoms. She uses a salbutamol inhaler several times weekly with partial relief. Chest examination shows diffuse expiratory wheezes. Spirometry shows FEV1 85% predicted with 18% improvement after bronchodilator. What is the most appropriate next step in management?

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