skip to main content

COPD exacerbation with hypercapnic respiratory failure — ABIM Board MCQ

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

HardPulmonary/Critical CareCOPD exacerbation with hypercapnic respiratory failureABIM Board

A 68-year-old man with severe COPD presents with somnolence and dyspnea. Respiratory rate is 28/min, oxygen saturation is 86 percent on room air, and ABG on 2 L oxygen shows pH 7.27, PaCO2 68 mm Hg, and PaO2 62 mm Hg. Chest radiograph shows hyperinflation without infiltrate. Which of the following is the most likely diagnosis?

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

Reveal the answer and explanation

Correct answer: D — Acute hypercapnic respiratory failure from COPD exacerbation

Somnolence, acidemia, and elevated PaCO2 in severe COPD identify acute hypercapnic respiratory failure from COPD exacerbation. Noninvasive ventilation is appropriate when contraindications are absent.

Reference: GOLD COPD Report; ATS/ERS Noninvasive Ventilation Guideline