COPD

Question 1

What is the most common symptom of COPD?

Answer 1

Cough, then dyspnea, then increased sputum production

Question 2

What is the key test for diagnosis of COPD

Answer 2

Spirometry - REQUIRED for diagnosis

FEV1/FVC < 0.70

Question 3

When should you obtain alpha-1 antitrypsin deficiency screening?

Answer 3

when COPD develops in patients of caucasian descent under 45 years, or strong family history of COPD

Question 4

What FEV1 defines mild COPD according to the GOLD staging system?

Answer 4

FEV1 > 80% predicted

Question 5

What FEV1 defines moderate COPD according to the GOLD staging system?

Answer 5

50% < FEV1 < 80% predicted

Question 6

What FEV1 defines severe COPD according to the GOLD staging system?

Answer 6

30% < FEV1 < 50% Predicted

Question 7

What FEV1 defines very severe or “end stage” COPD according to the GOLD staging system?

Answer 7

FEV1 < 30% predicted

Question 8

What four elements should be evaluated in each COPD patient?

Answer 8

• airflow limitation using spirometry
• symptoms using mMRC dyspnea scale
• risk of exacerbations: 2+ per year or one hospitalization
• comorbidities

Question 9

Which two therapies have been proven to prolong survival of patients with COPD

Answer 9

O2 and smoking cessation

Question 10

What are the management steps in COPD?

step 1
step 2
step 3
step 4

Answer 10

1: SABA or LABA
2: LAMA
3: LAMA/LABA (preferred) or LABA/ICS
4: triple therapy (LAMA/LABA/ICS) Daliresp and oxygen

Question 11

At what stage of COPD is pulmonary rehab indicated

Answer 11

All stages in stable patients

Question 12

What symptoms warrant antibiotics in COPD exacerbation?

Answer 12

• increased dyspnea
• increased sputum volume
• increased sputum purulence