A 68-year-old ex-smoker with known COPD (FEV1 45 percent predicted) presents with increased breathlessness, green sputum and wheeze for 3 days. Observ...

Question

A 68-year-old ex-smoker with known COPD (FEV1 45 percent predicted) presents with increased breathlessness, green sputum and wheeze for 3 days. Observations: respiratory rate 20, temperature 37.8 degrees Celsius, oxygen saturations 93 percent on air, no confusion, and no signs of consolidation. What is the most appropriate initial management in primary care?

Accepted Answer

Start oral Prednisolone 30 mg daily for 5 days and prescribe an appropriate oral antibiotic

Answer

Admit urgently for intravenous antibiotics and nebulised bronchodilators

Answer

Start long-term oral Prednisolone 10 mg daily

Answer

Prescribe a high-dose inhaled corticosteroid only

Answer

Withhold steroids because of infection and observe

uk-plab-1 MCQ (SBA): Acute exacerbation of COPD