Question

A 72-year-old man with known COPD (FEV1 40% predicted) presents with increased breathlessness, wheeze and purulent sputum for 3 days. He is afebrile, oxygen saturation is 91% on room air and chest X-ray shows no new consolidation. Which is the most appropriate initial management of this acute exacerbation in the emergency department?

Accepted Answer

Start oral prednisolone and increase inhaled bronchodilators; treat with antibiotics if clinically indicated

Answer

Increase his short-acting beta2 agonist only and discharge without systemic steroids

Answer

Commence high-dose inhaled corticosteroid alone

Answer

Admit and start long-term oxygen therapy without bronchodilator adjustment

Answer

Start IV aminophylline as first-line therapy

Practice question