Respiratory

Question 1

Which organism most commonly causes infective exacerbations in COPD?

Answer 1

Haemophilus influenzae

Question 2

Which COPD patients should be referred for assessment for home oxygen?

Answer 2

If peripheral oxygen saturation < 92% on air
Raised JVP or peripheral oedema
Polycythaemia
Cyanosis
Very severe outflow obstruction (FEV1 - <30%) or CONSIDER in severe airflow obstruction (FEV1 30-49%)

Question 3

How is assessment for home oxygen carried out?

Answer 3

Must be done when stable (not during an acute exacerbation) and on optimised COPD treatment

Take 2x arterial blood gases at least 3 weeks apart.

Eligible if pa02 <7.3 kPa
OR
if pa02 <8 kPa with polycythaemia, peripheral oedema or pulmonary hypertension

Contraindications
If SMOKES

They all need a risk assessment before starting home 02.
Need to use it at least 15 hrs per day and ideally 20 hrs per day for maximal benefit

Question 4

What are the Royal College of Physicians 3 questions as it pertains to asthma reviews and what suggests good v poor control?

Answer 4

1. Do your asthma symptoms disrupt your sleep (including cough)?
2. Have you had your usual asthma symptoms during the day?
3. Does your asthma interfere with your usual activities (housework, school, work etc)

No to all 3 = can assume good control
Yes to 2 or 3 = poor control

NOT LICENSED FOR USE IN CHILDREN
for whom either the Childhood Asthma Control Test or the Asthma Control Questionnaire should be used instead