NAECB COPD Management 4

Question 1

During an acute COPD exacerbation requiring hospitalization, systemic corticosteroids should be given for approximately how many days?

Accepted Answer

5 days

Answer

Evidence from the REDUCE trial supports a 5-day course of systemic corticosteroids for COPD exacerbations, which is as effective as longer courses with fewer side effects.

Question 2

A COPD patient uses a metered-dose inhaler (MDI) without a spacer and coordinates poorly. What is the most appropriate intervention?

Accepted Answer

Add a valved holding chamber (spacer) to improve lung deposition

Answer

A valved holding chamber eliminates the need for precise actuation-inhalation coordination, significantly improving drug delivery to the lungs.

Question 3

The mMRC Dyspnea Scale score of 2 means a patient experiences breathlessness when:

Accepted Answer

Walking on level ground at own pace or climbing a slight hill

Answer

mMRC grade 2 describes breathlessness causing the patient to walk slower than peers on level ground or requiring rest when walking at their own pace.

Question 4

Alpha-1 antitrypsin deficiency (AATD) testing is recommended in which COPD patients?

Accepted Answer

All patients with COPD, especially those under age 45 or with early-onset disease

Answer

GOLD guidelines recommend AATD testing for all COPD patients, with particular emphasis on younger patients or those with early-onset emphysema where genetic deficiency is more likely.

Question 5

Which surgical intervention is most appropriate for a carefully selected COPD patient with predominantly upper-lobe emphysema and low exercise capacity despite maximal medical therapy?

Accepted Answer

Lung volume reduction surgery (LVRS)

Answer

The NETT trial showed that LVRS improves survival and exercise capacity in patients with upper-lobe predominant emphysema and low post-rehabilitation exercise capacity.

NAECB Exam Practice Test

NAECB Exam Practice Test

NAECB COPD Management 4