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COPD exacerbation with acute hypercapnic respiratory failure — RCPSC IM MCQ

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HardRespirologyCOPD exacerbation with acute hypercapnic respiratory failureRCPSC IM

A 72-year-old man with severe COPD presents with increased sputum and drowsiness. Respiratory rate is 30/min, oxygen saturation is 86% on room air, and chest radiograph shows no pneumonia. ABG after controlled oxygen shows pH 7.27, PaCO2 72 mmHg and PaO2 62 mmHg. He is using accessory muscles. What is the most likely diagnosis?

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

Increased sputum, wheeze history, acidemia with elevated PaCO2 and no radiographic pneumonia support acute hypercapnic respiratory failure due to COPD exacerbation.

Reference: Canadian Thoracic Society COPD guidance