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What additional therapy may be needed for 1 of 24

exacerbations accompanied by peripheral

oedema?

Invasive ventilation
Oral prednisolone
Diuretics
Antibiotics

Correct Answer
Diuretics

Explanation
The text states that peripheral oedema usually responds to diuretics,
indicating that this is the additional therapy needed in such cases.

What characterizes acute exacerbations of 2 of 24

COPD (AECOPD)?
:
 Increase in symptoms
Decrease in lung function
Improvement in health status
No change in symptoms

Correct Answer
Increase in symptoms

Explanation
Acute exacerbations of COPD are specifically characterized by an increase
in symptoms and deterioration in lung function and health status.

What does the BODE index measure in 3 of 24

relation to COPD prognosis?

Body mass index, airflow obstruction, dyspnoea,

exercise capacity
Blood oxygen levels, oxygen saturation, dyspnoea,
exercise capacity
Body mass index, oxygen saturation, dyspnoea, lung
capacity
Bronchodilator response, oxygen saturation,
dyspnoea, exercise capacity

Correct Answer
Body mass index, airflow obstruction, dyspnoea, exercise capacity

Explanation
The BODE index is a composite score that includes body mass index (B),
degree of airflow obstruction (O), measurement of dyspnoea (D), and
:
 exercise capacity (E) to assist in predicting mortality.

What is a common mode of death in 4 of 24

patients with advanced COPD?

Lung cancer
Heart attack
Stroke
Kidney failure

Correct Answer
Lung cancer

Explanation
Lung cancer is one of the common modes of death in patients with
advanced COPD, along with respiratory failure, pneumonia, and cardiac
disease.

What is a common trigger for AECOPD? 5 of 24

Infection
Exercise
Dietary changes
Medication

Correct Answer
Infection

Explanation
:
 Infection is one of the usual triggers for acute exacerbations of COPD,
along with changes in air quality.

What is a potential risk associated with the 6 of 24

use of inhaled glucocorticoids in older

patients?

Improved quality of life

Increased risk of pneumonia
Reduced lung function
Decreased exacerbations

Correct Answer
Increased risk of pneumonia

Explanation
The text mentions that the advantages of combined therapies may be
accompanied by an increased risk of pneumonia, particularly in older
people, making this the correct answer.

What is one of the benefits of home non- 7 of 24

invasive ventilation for patients with

persistent hypercapnia?

Increases sputum production

Improves quality of life
Decreases oxygen saturation
Reduces exercise capacity
:
 Correct Answer
Improves quality of life

Explanation
Home non-invasive ventilation is beneficial for patients with persistent
hypercapnia as it improves their quality of life and prolongs the time to
readmission, making it an important therapeutic option.

What is the primary aim of long term 8 of 24

domiciliary oxygen therapy (LTOT) in

patients with COPD?

To reduce sputum production

To increase PaO2 to at least 8 kPa (60 mmHg)
To improve exercise capacity
To prevent polycythaemia

Correct Answer
To increase PaO2 to at least 8 kPa (60 mmHg)

Explanation
The primary aim of LTOT is to increase the arterial oxygen levels (PaO2) to
at least 8 kPa (60 mmHg) or to maintain oxygen saturation (SaO2) at least
90%, which is crucial for improving the health and survival of patients with
COPD.

What is the primary aim of lung volume 9 of 24

reduction surgery (LVRS)?

:
 To increase lung volume
To reduce hyperinflation
To improve gas transfer
To eliminate pulmonary hypertension

Correct Answer
To reduce hyperinflation

Explanation
The primary aim of LVRS is to resect peripheral emphysematous lung
tissue to reduce hyperinflation and decrease the work of breathing.

What is the primary benefit of combined 10 of 24

inhaled glucocorticoids and

bronchodilators for patients with COPD?

Improve lung function

Increase risk of pneumonia
Contribute to osteoporosis
Reduce social isolation

Correct Answer
Improve lung function

Explanation
The text states that combined therapies improve lung function, reduce the
frequency and severity of exacerbations, and improve quality of life,
making 'Improve lung function' the correct answer.
:
 What is the primary benefit of sustained 11 of 24

smoking cessation in patients with mild to

moderate COPD?

It leads to a complete cure of COPD

It reduces the decline in FEV1
It eliminates the need for bronchodilators
It has no significant impact

Correct Answer
It reduces the decline in FEV1

Explanation
Sustained smoking cessation is shown to reduce the decline in FEV1
compared to persistent smokers, making it a crucial strategy in managing
the natural history of COPD.

What is the recommended dose of oral 12 of 24

prednisolone for improving lung function in

patients with COPD?

10 mg for 5 days
20 mg for 5 days
30 mg for 5 days
40 mg for 5 days

Correct Answer
30 mg for 5 days
:
 Explanation
The text states that doses of 30 mg for 5 days are currently recommended
for oral prednisolone to reduce symptoms and improve lung function.

What is the recommended minimum 13 of 24

duration for using oxygen therapy to

achieve benefits in patients with COPD?

5 hours a day
10 hours a day
15 hours a day
20 hours a day

Correct Answer
15 hours a day

Explanation
Patients should use oxygen for a minimum of 15 hours a day to achieve the
necessary oxygen levels and to see greater benefits, particularly in those
with severe hypoxaemia.

What is the recommended treatment for 14 of 24

many patients experiencing AECOPD?

Increased bronchodilator therapy

Surgery
Long-term oxygen therapy
Physical therapy
:
 Correct Answer
Increased bronchodilator therapy

Explanation
Many patients experiencing AECOPD can be managed at home with
increased bronchodilator therapy, along with a short course of oral
glucocorticoids and, if appropriate, antibiotics.

What is the role of antibiotics in the 15 of 24

treatment of COPD exacerbations

according to the text?

Routine administration is always recommended

They are recommended for all patients
They are recommended for patients with increased
sputum purulence
They should never be used

Correct Answer
They are recommended for patients with increased sputum purulence

Explanation
The text mentions that antibiotics are recommended for patients reporting
an increase in sputum purulence, sputum volume, or breathlessness,
indicating a selective use rather than routine administration.

What is the role of nebulised short acting 16 of 24

bronchodilators in COPD treatment?

:
 They are the first line treatment for all patients
They are used for those unable to take inhalers
They are not effective in managing symptoms
They are only used in emergency situations

Correct Answer
They are used for those unable to take inhalers

Explanation
Nebulised short acting bronchodilators are specifically indicated for
patients who are unable to use inhalers, providing an alternative method of
delivering medication.

What maintenance measures should be 17 of 24

offered to patients with COPD according to

the text?

Pneumococcal vaccination
Oral glucocorticoids
Increased physical activity
Social isolation

Correct Answer
Pneumococcal vaccination

Explanation
The text states that patients with COPD should be offered pneumococcal
vaccination and annual influenza vaccination as part of their maintenance
measures.
:
 What role does pulmonary rehabilitation 18 of 24

play in the management of COPD?

It is not recommended for COPD patients

It focuses solely on medication management
It encourages exercise and reassures patients about
breathlessness
It is only for severe cases of COPD

Correct Answer
It encourages exercise and reassures patients about breathlessness

Explanation
Pulmonary rehabilitation is important in COPD management as it
encourages exercise at all stages and helps reassure patients that
breathlessness can be managed.

What should be monitored when 19 of 24

administering high concentrations of

oxygen to patients with severe COPD?

Heart rate
Respiratory rate
SaO2 or PaO2 levels
Blood pressure

Correct Answer
SaO2 or PaO2 levels
:
 Explanation
When administering high concentrations of oxygen to patients with severe
COPD, it is crucial to monitor SaO2 or PaO2 levels to avoid respiratory
depression and worsening acidosis.

When should non-invasive ventilation 20 of 24

(NIV) be considered in patients with acute

exacerbation of COPD?

When respiratory acidosis is corrected

When respiratory acidosis is not corrected within an hour
of identification
When the patient is stable
When the patient has a high fever

Which medication is mentioned as a 21 of 24

phosphodiesterase inhibitor that improves

lung function in severe COPD patients?

Theophylline
Azithromycin
Roflumilast
Glucocorticoids

Correct Answer
Roflumilast

Explanation
:
 The text specifically identifies Roflumilast as a phosphodiesterase inhibitor
that improves lung function and reduces moderate to severe
exacerbations in patients with severe or very severe COPD.

Which of the following is a condition that 22 of 24

indicates the need for LTOT?

PaO2 > 8 kPa

PaO2 < 7.3 kPa
PaCO2 < 6 kPa
Normal arterial blood gases

Correct Answer
PaO2 < 7.3 kPa

Explanation
LTOT is indicated when a patient has a PaO2 of less than 7.3 kPa (55
mmHg), regardless of the PaCO2 levels, as this indicates severe
hypoxaemia that requires intervention.

Which of the following is a poor prognostic 23 of 24

indicator in COPD?

Increased age
High post bronchodilator FEV1
Weight loss
Improved exercise capacity

Correct Answer
:
 Weight loss

Explanation
Weight loss is considered a poor prognostic indicator in COPD, as it is
associated with a worse prognosis.

Which type of bronchodilator is preferred 24 of 24

for managing breathlessness in COPD

patients?

Short acting bronchodilators only

Long acting beta agonists (LABA)
Combination longer acting bronchodilators
Nebulised short acting bronchodilators only

Correct Answer
Combination longer acting bronchodilators

Explanation
Combination longer acting bronchodilators are preferred for managing
breathlessness in COPD patients, as they provide more effective and
sustained relief compared to short acting options.
: