NAECB COPD Management 3

Question 1

A COPD patient presents with increased sputum purulence, worsening dyspnea, and increased sputum volume. These three features together define which clinical condition?

Accepted Answer

Type 1 (Anthonisen) acute exacerbation of COPD

Answer

The Anthonisen criteria define a Type 1 exacerbation when all three cardinal symptoms (increased dyspnea, sputum volume, and sputum purulence) are present.

Question 2

Long-term oxygen therapy (LTOT) in COPD is indicated when resting SpO2 is at or below what threshold?

Accepted Answer

88%

Answer

LTOT is indicated when resting SpO2 is ≤88% (or PaO2 ≤55 mmHg) on room air, as this level of hypoxemia is associated with increased mortality.

Question 3

Which roflumilast mechanism makes it useful in preventing COPD exacerbations in severe disease?

Accepted Answer

Selective phosphodiesterase-4 inhibition reducing airway inflammation

Answer

Roflumilast selectively inhibits PDE-4, reducing cAMP breakdown and thereby dampening airway inflammation without direct bronchodilatory effects.

Question 4

When teaching pursed-lip breathing to a COPD patient, what is the primary therapeutic goal?

Accepted Answer

Slow exhalation to prevent dynamic airway collapse and reduce air trapping

Answer

Pursed-lip breathing slows exhalation and creates back-pressure that splints small airways open, reducing dynamic collapse and improving air emptying.

Question 5

In COPD management, the LAMA class of medications primarily works by:

Accepted Answer

Blocking muscarinic receptors to reduce bronchoconstriction and mucus secretion

Answer

Long-acting muscarinic antagonists (LAMAs) block M3 receptors in airway smooth muscle and mucus glands, producing prolonged bronchodilation and reduced secretions.

NAECB Exam Practice Test

NAECB Exam Practice Test

NAECB COPD Management 3