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COPD — RCPSC IM MCQ

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ModerateRespirologyCOPDRCPSC IM

A 72-year-old former smoker with COPD has an FEV1 of 38 percent predicted. She has had three treated exacerbations and one hospital admission in the past year despite tiotropium and salbutamol. Eosinophils are 0.35 x 10^9/L, oxygen saturation is 92 percent at rest, and she has no history of pneumonia. What is the most appropriate management?

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Correct answer: E — Escalate to inhaled corticosteroid, LABA and LAMA triple therapy

Frequent COPD exacerbations despite long-acting bronchodilator therapy and a higher eosinophil count support escalation to triple inhaled therapy. Long-term oral corticosteroids are avoided; resting saturation alone does not establish an indication for home oxygen.

Reference: Canadian Thoracic Society COPD pharmacotherapy guideline 2023