American Board of Internal Medicine (ABIM) Certification Practice Exam

In patients with COPD, arterial blood gas analysis is critical to assess what?

1. Chronic respiratory acidosis

2. Oxygen saturation level

3. Carbon dioxide retention

4. Fever analysis

The correct answer is: Carbon dioxide retention

In patients with chronic obstructive pulmonary disease (COPD), arterial blood gas (ABG) analysis is vital for assessing carbon dioxide retention. This is particularly important because COPD often leads to impaired ventilation, resulting in the accumulation of carbon dioxide (hypercapnia). ABGs provide valuable information about the levels of carbon dioxide in the blood, enabling healthcare providers to evaluate the severity of respiratory failure and the effectiveness of treatment strategies such as supplemental oxygen or mechanical ventilation. Monitoring carbon dioxide retention is crucial in this patient population, as it can significantly impact acid-base balance, manifesting as respiratory acidosis. The analysis allows clinicians to determine if the patient is adequately ventilating and if they may require interventions to improve gas exchange. Additionally, assessing carbon dioxide levels helps in predicting potential complications, guiding proper management to prevent further deterioration. While oxygen saturation levels are also important in managing COPD, they are typically evaluated through pulse oximetry rather than ABG analysis. Chronic respiratory acidosis can be inferred from elevated carbon dioxide levels, but the primary focus of ABG analysis in this context remains on direct assessment of carbon dioxide retention. Fever analysis is not relevant in this context as it does not provide insights specific to COPD management.