skip to main content

Bronchoscopic lung volume reduction — SCE Respiratory MCQ

Instant feedback + full explanation. One question, done properly.

HardCOPDBronchoscopic lung volume reductionSCE Respiratory

A 61-year-old man with heterogeneous upper-lobe emphysema remains severely limited despite smoking cessation, pulmonary rehabilitation and maximal inhaled therapy. FEV1 is 31% predicted, RV is 195% predicted, TLCO is 38% predicted and PaCO2 is 5.8 kPa. CT fissure analysis suggests intact interlobar fissures and ventilation-perfusion scanning shows a poorly perfused right upper lobe. He asks about bronchoscopic options. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Endobronchial valve assessment for lung volume reduction

The best answer is “Endobronchial valve assessment for lung volume reduction”. Endobronchial valve assessment for lung volume reduction is the recommended next management step after the clinical severity, prior treatment and contraindications in the stem are taken into account. The alternatives are either insufficient, unnecessarily invasive, or reserved for a different physiological or risk profile. The remaining choices—“Bullectomy in the setting of diffuse non-bullous emphysema”, “Immediate bilateral lung transplantation listing”, “Pleurodesis to improve dynamic hyperinflation”, “Long-term domiciliary NIV as primary emphysema treatment”—are credible in related respiratory presentations, but each addresses a different diagnostic, staging or management decision and does not fit the decisive findings and pathway position in this stem.

Reference: NICE NG115 chronic obstructive pulmonary disease: https://www.nice.org.uk/guidance/ng115/chapter/Recommendations