A 62 year old man is being assessed in the pulmonary clinic for follow-up regarding his COPD for which he is being treated maximally with LAMA-LABA-ICS triple therapy and chronic macrolide therapy. He quit smoking about 3 years ago. He continues to experience intermittent symptoms of shortness of breath when ambulating hurrying up on a flat surface and has not been able to keep pace with his wife when walking in the mall. On physical examination you noticed His oxygen saturation is about 85% on room air, and his chest examination dislclosed only expiratory wheezes and distant breath sounds. Which of the following is the next step in managing this patient's COPD has the greatest impact on his outcome?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: D. Long-term oxygen therapy
His resting SpO2 is 85% on room air, which meets the criterion for long-term oxygen therapy (PaO2 ≤55 mmHg or SaO2 ≤88% at rest). In COPD, LTOT decreases mortality in chronic resting hypoxaemia, so it has the greatest impact on outcome. Pulmonary rehabilitation mainly improves exercise tolerance, functional status and quality of life; it is useful but not the main survival intervention here. Vaccination prevents exacerbations, and roflumilast reduces exacerbations, but neither corrects hypoxaemia. An older bank changed the key to C, but the COPD lecture supports D.
ليش كل خيار صح أو غلط
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A
ليش غلط
Vaccination reduces the risk of respiratory infections and complications, but it does not correct his resting hypoxemia.
✓ COPD.pdf · p. 7 -
B
ليش غلط
A PDE4 inhibitor (roflumilast) is an optional add-on for persistent exacerbations; his problem is resting hypoxemia, not exacerbations.
✓ COPD.pdf · p. 8 -
C
ليش غلط
Pulmonary rehabilitation mainly improves exercise tolerance, functional status and quality of life; it only may reduce mortality after hospital discharge.
✓ Step Up To Medicine 6th Edition 2024 (COPD).pdf · p. 8 -
D
ليش صح
SaO2 85% at rest meets the LTOT criterion (SaO2 ≤ 88%), and LTOT increases survival in severe resting hypoxemia.
✓ COPD.pdf · p. 9
- المصدر
- COPD.pdf · p. 9
Step Up To Medicine 6th Edition 2024 (COPD).pdf · p. 8 - المحاضرة
- COPD · Pulmonology · Module B
- ظهر في
- Respi bank · MED43 ♀ Quiz B · MED43 ♀ Compre · MED41 ♂ EOM B