Rotations 2.0 Episode 13 Pneumonia

Episode 13 Pneumonia

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Intro: Rock Christmas/ Christmas Music by tramp963

Outro: Winner Main by Gand Project

Courtesy of Pixabay for non-commercial educational use

 Produced by: Todd Fredricks DO MSS

Edited by: Todd Fredricks DO MSS

Questions and Answers from Episode 12 COPD

Question 1

A 62-year-old male with a 40-pack-year smoking history presents to the primary care clinic complaining of progressive shortness of breath during exercise and a chronic cough productive of sputum for the past 3 years. Spirometry reveals a post-bronchodilator FEV₁/FVC ratio of 0.65 and an FEV₁ of 55% predicted. He reports two episodes of acute worsening of symptoms in the past year requiring oral corticosteroids. According to the GOLD ABCD assessment tool, which group should this patient be classified into?

D. Group D 

Question 2

A 58-year-old female with a confirmed diagnosis of COPD presents for a follow-up visit. She reports persistent dyspnea despite adherence to a long-acting muscarinic antagonist (LAMA). Her blood eosinophil count is 350 cells/mm³, and she experienced one moderate exacerbation in the past 12 months treated with antibiotics. Based on current GOLD guidelines, which of the following is the most appropriate next step in her pharmacological management?

C. Add a long-acting β₂-agonist (LABA) to the LAMA
 
Question 3

A 70-year-old male with severe COPD (FEV₁ 35% predicted) and a history of recurrent respiratory infections is admitted to the hospital with acute respiratory failure. Physical examination reveals cyanosis, a respiratory rate of 28 breaths per minute, and oxygen saturation of 88% on room air. Arterial blood gas analysis shows a PaO₂ of 7.5 kPa and a PaCO₂ of 7.0 kPa. According to the classification of COPD exacerbations, which of the following best describes this patient’s current condition?

C. Severe exacerbation

Paper for Next Week

SCOTT KINKADE, and NATALIE A. LONG, Acute Bronchitis, American Family Physician, October 1, 2016, 94:7 560-565

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