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Stable COPD — SCE Respiratory MCQ

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ModerateCOPDStable COPDSCE Respiratory

A 70-year-old man with COPD remains breathless walking 80 metres despite smoking cessation, pulmonary rehabilitation and a short-acting bronchodilator. Post-bronchodilator FEV1 is 48% predicted. He has no asthmatic features and blood eosinophils are 0.06 x 10^9/L. What is the most appropriate management?

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Correct answer: C — Start LABA/LAMA inhaled maintenance therapy

For symptomatic COPD without asthmatic features, dual long-acting bronchodilation with LABA/LAMA is the preferred maintenance escalation. LABA/ICS is more appropriate when asthmatic features or eosinophilic exacerbation risk are present, and oral prednisolone is not maintenance COPD therapy. Home oxygen requires formal assessment of resting hypoxaemia rather than symptom-based prescribing.

Reference: https://www.brit-thoracic.org.uk/quality-improvement/guidelines/