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COPD Exacerbation — UKMLA MCQ

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MediumRespiratory MedicineCOPD ExacerbationUKMLAMRCGP AKTPARAMRCEM SBAMRCP Part 1

A 65-year-old woman with known COPD presents with a 3-day history of increased breathlessness, increased sputum volume, and sputum purulence. Her oxygen saturation is 90% on room air. Chest X-ray shows no consolidation. Which intervention is most indicated according to NICE guidelines for managing this exacerbation?

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Correct answer: B — Prescribe oral prednisolone

NICE NG202 recommends oral corticosteroids (e.g., Prednisolone 30mg daily for 5 days) for exacerbations of COPD associated with significant increase in breathlessness interfering with daily activities. Antibiotics are indicated if sputum is purulent AND there is increased sputum volume OR increased breathlessness. Salbutamol is used for symptom relief but steroids address inflammation. LTOT has specific criteria not met here acutely. Spirometry is not useful during an acute exacerbation. Prophylactic antibiotics are considered for frequent exacerbations, not standard acute management.

Reference: NICE NG202: Chronic obstructive pulmonary disease