Chronic Obstructive Pulmonary Disease Treatment (1 to 5 of 10) 29 01 24

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1) A patient with chronic obstructive pulmonary disease (COPD) and chronic carbon dioxide retention is wheezing. The oxygen saturation drops from 93 to 90. Which of the following would be most appropriate?

1 point

a. Increase the oxygen from 2 to 4 liters by nasal cannula

b. Treat with albuterol by nebulizer

c. Give an extra dose of tiotropium

d. Give an extra dose of 2 puffs of beclomethasone

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2) A 71-year-old man with moderate chronic obstructive pulmonary disease presents for routine follow-up. He reports increasing dyspnea with exertion and a chronic, nonproductive cough. His FEV₁ is 62% of predicted. He currently takes salmeterol as maintenance therapy and uses albuterol inhaler as his rescue medication. He has historically needed his rescue inhaler less than once a week, but for the past 3 months, he has needed it 2 to 3 times per day. He has been hospitalized for COPD exacerbations twice in the past 6 months. His blood eosinophil count one month ago was 112 per mm3 (normal range, 0–350). Which medication should be added to this patient's regimen to achieve better control of his symptoms?

1 point

a. Budesonide

b. Prednisone

c. Formoterol

d. Montelukast

e. Tiotropium

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3) A 70-year-old man presents for a follow-up visit. His past medical history is significant for severe COPD and multiple hospital admissions for exacerbations. He uses a budesonide/formoterol combination and tiotropium inhalers. He has a 40-pack-year smoking history. He is up-to-date with his influenza and pneumococcal vaccines. What should be advised to decrease his COPD exacerbations?

1 point

a. Start him on omalizumab.

b. Start him on mepolizumab.

c. Start him on roflumilast.

d. Move to a warm climate.

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4) Which COPD patient groups should receive long-term oxygen therapy (LTOT) for at least 15 hours/day?

1 point

a. Adults with moderate chronic resting room air hypoxemia

b. Adults with severe chronic resting room air hypoxemia

c. Adults with severe exertional room air hypoxemia

d. Adults with dyspnea on exertion without hypoxemia

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5) Patients with COPD who have had ≤ 1 moderate exacerbation, no hospital admission, and score 0-1 on the modified Medical Research Council Dyspnea Questionnaire (mMRC) and < 10 on the COPD Assessment Test (CAT) should receive which initial therapy?

1 point

a. A bronchodilator

b. Dual therapy using a long-acting muscarinic antagonist (LAMA) and long-acting beta-agonist (LABA)

c. Triple therapy using a LAMA, LABA, and inhaled corticosteroid

d. Triple therapy plus azithromycin

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