Diagnosis
Best initial test
Spirometry
What are the 3 GOLD groups of exacerbation
A, B, & E
Initial treatment for GOLD Group A
bronchodilator monotherapy (Salbutamol or ipratropium as-needed)
Name at least 2 non-pharmacological management for COPD
-smoking cessation
-vaccination
-structured patient education
-self-management support
-regular physical activity
Rome proposal classification groups for COPD exacerbation
Mild, Moderate, & Severe
Validated tools in form of health questionnaires recommended by GOLD 2026 to improve symptom evaluation
Any one of the following:
-mMRC
-CAT
-CAAT
-SGRQ
In GOLD 2026 update, Group E includes any patient with at least how many exacerbations in the previous 12 months, regardless of their baseline symptom severity.
1 moderate or severe exacerbation
What's the triple therapy, designated by GOLD as the preferred next step for Group E patients who continue to experience exacerbations despite optimized LABA/LAMA treatment
ICS/LABA/LAMA
Oxygen saturation target range in COPD patients
88%-92%
How many days of systemic Corticosteroids are recommended for moderate exacerbations
5 days
Blood eosinophil count is a strong indicator of exacerbation risk in COPD, with elevated levels, particularly ......, consistently associated with increased frequency and severity of exacerbations.
≥300 cells/μL
What distinguishes GOLD Group B from A
Group A comprises patients who are characterized by having minimal symptoms and no exacerbations requiring treatment in the preceding year.
Group B comprises patients with a higher symptom burden, but who have not experienced any recent exacerbations.
Cytokine targeted by mepolizumab
interleukin-5
non-invasive respiratory support recommended for chronic hypercapnia, particularly following life-threatening exacerbations.
NIV or BiPAP
Mild exacerbations management
increasing short-acting bronchodilator treatment.
New small airway function test that may offer further insight into the early stages of the disease in select patients.
impulse oscillometry
CAAT score .... or mMRC .... that are assigned to Group B.
≥10 or ≥2
A biologic that inhibits interleukin (IL)-4/IL-13 signaling as an additional treatment option for patients with COPD, chronic bronchitis, and BECs of at least 300 cells/μL who remain uncontrolled on triple therapy.
dupilumab
Indications for lung volume reduction procedures, whether surgical or bronchoscopic
Predominant upper lobe emphysema
Name at least 2 conditions that mimics COPD exacerbation
Heart failure & pneumonia
In 2021, the ERS/ATS Task Force recommended defining bronchodilator reversibility as a change in FEV1 or FVC of more than ......
10% of the predicted value
Name one of the large phase III trials which designates triple therapy as the preferred next step for Group E patients who continue to experience exacerbations despite optimized LABA/LAMA treatment
IMPACT, ETHOS, TRINITY, and TRIBUTE studies
Which trial(s) support using mepolizumab
METREX, METREO, and MATINEE trials
What is the 2026 update on recommendation of pulmonary rehabilitation compared to the GOLD 2025 report?
It expands eligibility to include all individuals with exertional dyspnea, deconditioning, or recent exacerbations.
Per Rome classification, what are the ABG parameters for severe exacerbation
PaO2 ≤60 mmHg and/or PaCO2 > 45 mmHg and pH <7.35