Fast Five Quiz: COPD Key Aspects

*Which of the following is recommended, according to 2018 guidelines on antimicrobial prescribing in patients with acute exacerbations of COPD from the National Institute for Health and Care Excellence (NICE)?

First-line options for oral antibiotics in adult patients with acute COPD exacerbations include amoxicillin, doxycycline, and clarithromycin

Recommended first-choice oral antibiotics include the following:

• Amoxicillin: 500 mg three times a day for 5 days

• Doxycycline: 200 mg on the first day, then 100 mg once a day for a 5-day course in total

• Clarithromycin: 500 mg twice a day for 5 days

*Which of the following is recommended in the treatment and management of COPD, according to 2018 guidelines from the Global Initiative for Chronic Obstructive Lung Disease (GOLD)?

In patients with stable COPD, combinations of short-acting beta₂-agonists and short-acting antimuscarinics are recommended over monotherapy with either class of agent

*Which of the following is recommended regarding the screening and workup of patients with suspected COPD?

Lung volume measurements in patients with COPD often show an increase in total lung capacity, functional residual capacity, and residual volume

*Physical examination findings can allow differentiation between COPD that is predominantly chronic bronchitis and COPD that is predominantly emphysema. Which of the following characteristics is more typically associated with emphysema?

Hyperresonant chest and distant heart sounds

Chronic bronchitis characteristics include the following:

• Patients may be obese.

• Frequent cough and expectoration are typical.

• Use of accessory muscles of respiration is common.

• Coarse rhonchi and wheezing may be heard on auscultation.

• Patients may have signs of right heart failure (ie, cor pulmonale), such as oedema and cyanosis.

Emphysema characteristics include the following:

• Patients may be very thin, with a barrel chest.

• Patients typically have little or no cough or expectoration.

• Breathing may be assisted by pursed lips and use of accessory respiratory muscles; patients may adopt the tripod sitting position.

• The chest may be hyper resonant, and wheezing may be heard.

• Heart sounds are very distant.

• Overall appearance is more like that of a classic COPD exacerbation.

*Which of the following is most accurate about the presentation of patients with COPD?

Depression and mild cognitive impairment have been associated with COPD

Symptoms include the following:

• Productive cough or acute chest illness

• Breathlessness

• Wheezing

A productive cough or an acute chest illness is common. The cough is usually worse in the mornings and produces a small amount of colorless sputum.