COPD/Pneumonia PBL

Question 1

Diagnostic workup for pneumonia

Answer 1

Sx

CXR

sputum Gram stain + culture

blood cultures

urinary antigen testing (for Legionella and S. pneumoniae)

Question 2

Chronic vs acute alcoholism liver metabolism

Answer 2

chronic: CYP450 inducer
acute: CYP450 inhibitor

Question 3

Stage I COPD

Answer 3

FEV1 ≥ 80%

Tx: short acting bronchodilator

Question 4

Stage II COPD

Answer 4

50% < FEV1 < 80%

Tx: add long-acting bronchodilator

Question 5

Stage III COPD

Answer 5

30% < FEV1 < 50%

Tx: add inhaled corticosteroid

Question 6

Stage IV COPD

Answer 6

FEV1 < 30% or FEV1 < 50% + chronic respiratory failure

Tx: long-term O₂ supplementation, consider sugrical options