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COPD exacerbation — MCCQE Part 1 MCQ

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ModerateDyspneaCOPD exacerbationMCCQE Part 1

A 71-year-old former smoker with COPD has increased dyspnoea, sputum volume and sputum purulence, oxygen saturation 86% and diffuse wheeze. Which of the following is the most appropriate next step?

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Correct answer: B — Give controlled oxygen, bronchodilators, systemic corticosteroids and antibiotics

Give controlled oxygen, bronchodilators, systemic corticosteroids and antibiotics is the single best answer because the age, timing, examination findings and investigations in the vignette fit COPD exacerbation better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to CTS COPD guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: CTS COPD guidance