Question of the Week # 470

470) An 11-year-old with a history of asthma and seasonal allergies is currently using albuterol to manage asthma symptoms. Recently his use of albuterol has increased from 1-2 days per week to 4 times per week for several weeks, though does not experience his symptoms daily. On physical examination, you find that his vital signs are within normal limits. Auscultation of his lungs reveals mild end expiratory wheezing. Given his persistent symptoms, what change should be made to his current treatment regimen?

A. Add salmeterol twice daily

B. Add montelukast 10mg daily

C. Add fluticasone daily

D. Add formoterol + budesonide twice daily

E. Add tiotropium

Question of the Week # 469

A study is performed to evaluate the incidence of peri-operative stroke during a carotid endarterectomy based on whether the surgeon uses a shunt during the procedure or not. The authors calculate the odds ratio of suffering from stroke if the surgeon uses a shunt is 0.84 (95% CI: 0.72 – 1.12) compared to when the surgeon does not use a shunt. What is the most appropriate interpretation of this finding?
A. Use of shunt decreases risk of stroke by 84%
B. Use of a shunt does not decrease or increase risk of stroke
C. Use of shunt does not decreases the risk of stroke
D. Use of shunt decreases risk of stroke with a 0.84 odds ratio
E. Use of shunt decreases risk of stroke by 16%
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