American Board of Internal Medicine (ABIM) Certification Practice Exam

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What is the mainstay of treatment for allergic bronchopulmonary aspergillosis?

  1. Aspirin therapy

  2. Standard asthma therapies and systemic glucocorticoids

  3. High-dose antibiotics

  4. Intravenous immunoglobulin therapy

The correct answer is: Standard asthma therapies and systemic glucocorticoids

The mainstay of treatment for allergic bronchopulmonary aspergillosis (ABPA) focuses on managing inflammation and symptoms associated with the condition. This is primarily achieved through the use of standard asthma therapies, such as bronchodilators and inhaled corticosteroids, combined with systemic glucocorticoids, which help reduce airway inflammation and improve respiratory function. Systemic glucocorticoids play a critical role in decreasing the inflammatory response caused by the hypersensitivity to Aspergillus species, which is a key feature of ABPA. This combination helps to control acute exacerbations and prevent long-term lung damage, making it a foundational aspect of care for patients with this condition. It's important to note that while other treatments, such as antibiotics or immunoglobulin therapy, may have roles in different contexts or conditions, they do not address the primary mechanism of allergic bronchopulmonary aspergillosis and are not considered first-line treatments for this specific disorder.