American Board of Internal Medicine (ABIM) Certification Practice Exam

According to the 2017 GOLD guidelines, which group of patients should enroll in a pulmonary rehabilitation program?

1. Patients with group A stage COPD

2. Patients with group B, C, or D stage COPD

3. Only patients requiring hospitalization

4. All smokers with a cough

The correct answer is: Patients with group B, C, or D stage COPD

The correct choice focuses on patients classified as group B, C, or D COPD according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. These groups correspond to patients who exhibit more significant symptoms and/or have had exacerbations that impact their quality of life and functional capacity. Pulmonary rehabilitation is a structured program that includes exercise training, education, and behavior change to help patients manage their symptoms effectively. The evidence supports that individuals in these groups typically experience persistent symptoms and may struggle with activities of daily living due to their lung disease. Therefore, enrolling these patients in pulmonary rehabilitation can improve their physical and emotional well-being, enhance exercise tolerance, and potentially reduce the frequency of exacerbations. In contrast, patients in group A have mild COPD symptoms and a low risk of exacerbations; they may not experience significant limitations in their daily activities and might not benefit as much from a structured rehabilitation program. The other options do not align with the guideline recommendations, as they either encompass categories of patients who are not prioritized for rehabilitation or represent a broader population that lacks the specific considerations outlined in the guidelines.