COPD

Question 1

Which two questionnaires are used to assess a patient’s COPD symptoms?

Answer 1

MRC and CAT.

Question 2

What does the MRC questionnaire assess?

Answer 2

Dyspnoea (breathlessness).

Question 3

What does the CAT questionnaire assess?

Answer 3

General COPD symptoms.

Question 4

What is one major drawback to using inhaled corticosteroids in COPD?

Answer 4

Greater risk of URTIs.

Question 5

In the NICE guidelines, what does ‘features suggesting steroid responsiveness’ mean?

Answer 5

High eosinophil count.

Question 6

What is the first line pharmacological treatment suggested by NICE for the treatment of COPD?

Answer 6

Offer SABA or SAMA to use as needed.

Question 7

Which two organisations provide guidelines for the treatment of patients with COPD?

Answer 7

NICE and GOLD.

Question 8

If a patient with COPD is limited by symptoms or has exacerbations despite treatment, and has no features suggesting asthma or steroid responsiveness, what treatment should be offered?

Answer 8

Offer LAMA and LABA.

Question 9

If a patient with COPD has been given a LAMA and a LABA and still has symptoms that adversely impact their quality of life, what should be considered?

Answer 9

A 3-month trial of LABA, LAMA and ICS.

Question 10

If a patient with COPD is limited by symptoms or has exacerbations despite treatment, and has features suggesting asthma or steroid responsiveness, what treatment should be considered?

Answer 10

LABA and ICS.

Question 11

If a patient with COPD and asthmatic or steroid responsiveness features has been given a LABA and an ICS but still has symptoms adversely impacting their QOL or they have exacerbations (1 severe or 2 moderate) in a year, what should be considered?

Answer 11

LAMA, LABA and ICS.

Question 12

What are some causes of exacerbations in COPD?

Answer 12

URTI. Exposure to certain compounds (pollution). Severe allergic responses. Weather changes. Overexertion. Lack of sleep. Stress/anxiety.

Question 13

What are some factors which influence the progression and development of COPD?

Answer 13

Diet and nutrition. Low socioeconomic status. Physical activity. Genetics. Lung growth and development in gestation. Frequent RTIs in childhood. Age. Asthma.

Question 14

How is diagnosis and initial assessment of COPD made?

Answer 14

Spirometry. Incidental findings from other tests. Sputum culture. Bronchodilator reversibility test. History taking.

Question 15

How frequent is follow up carried out for patients with stages 1 to 3 COPD?

Answer 15

Every year.

Question 16

How frequent is follow up carried out for patients with stage 4 COPD?

Answer 16

At least twice a year.

Question 17

What is the greatest cause of COPD?

Answer 17

Smoking.

Question 18

Describe cor pulmonale.

Answer 18

Abnormal enlargement of the right side of the heart due to disease of the lungs or pulmonary blood vessels.

Question 19

If a patient with COPD presents with cor pulmonale, what course of action should be taken?

Answer 19

Referral to a specialist.

Question 20

How is peripheral oedema secondary to COPD treated?

Answer 20

With furosemide.

Question 21

If a patient with a COPD presents with abnormal BMI, what course of action should be taken?

Answer 21

Referral to dietician.

Question 22

If a patient with COPD presents with a BMI lower than 18.5, what course of action would a dietician take?

Answer 22

Nutritional supplementation.

Question 23

If a patient with COPD presents with a BMI higher than 25, what course of action would a dietician take?

Answer 23

Weight loss.

Question 24

What may be used to treat a chronic productive cough in a patient with COPD?

Answer 24

A mucolytic e.g. carbocisteine.

Question 25

If a patient presents with severe COPD and hypoxaemia, what treatment is required?

Answer 25

Long term oxygen therapy (15 hours a day).

Question 26

Describe the treatment required when a patient presents with an exacerbation of COPD.

Answer 26

Nebulised bronchodilators (ipratropium or salbutamol). Antibiotics if suspected infection. 7–14-day course of oral corticosteroids if breathlessness interferes with day-to-day life.