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Obesity hypoventilation syndrome — SCE Respiratory MCQ

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HardSleep MedicineObesity hypoventilation syndromeSCE Respiratory

A patient with advanced COPD has ankle oedema from cor pulmonale. Right-heart catheterisation shows pulmonary hypertension attributable to lung disease, without left-heart failure. Which treatment principle is appropriate?

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Correct answer: A — Correct qualifying hypoxaemia and use cautious diuresis for oedema

Management of COPD-related cor pulmonale centres on optimising lung disease, correcting qualifying hypoxaemia and cautious diuresis for symptomatic fluid retention. NICE does not recommend routine use of PAH-targeted vasodilators, ACE inhibitors, calcium-channel blockers or digoxin solely for cor pulmonale.

Reference: NICE NG115 recommendations for COPD (Updated 26 July 2019): https://www.nice.org.uk/guidance/ng115/chapter/Recommendations; NICE NG115 rationale for COPD recommendations (Updated 26 July 2019): https://www.nice.org.uk/guidance/ng115/chapter/Rationale-and-impact