skip to main content

Eosinophilic COPD phenotype — SCE Respiratory MCQ

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

HardCOPDEosinophilic COPD phenotypeSCE Respiratory

A 63-year-old man has wheeze and exertional breathlessness. He smoked 30 pack-years but stopped 12 years ago. Spirometry shows FEV1 1.75 L (58% predicted), FVC 3.1 L (82% predicted), FEV1/FVC 0.56; FeNO is 64 ppb and blood eosinophils are 0.48 x 10^9/L. He has two steroid-responsive exacerbations each winter despite LABA/LAMA. What is the most likely diagnosis?

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

Reveal the answer and explanation

Correct answer: C — COPD with eosinophilic or asthma-like treatable trait

Persistent airflow obstruction confirms COPD physiology, while high FeNO, eosinophilia and steroid-responsive exacerbations identify an eosinophilic or asthma-like treatable trait. Pure emphysema would not explain the inflammatory biomarkers and steroid responsiveness. ILD and CTEPH would usually produce restrictive or vascular physiology rather than reversible inflammatory obstructive disease.

Reference: NICE NG115; BTS/NICE/SIGN Asthma Guideline NG245