American Board of Internal Medicine (ABIM) Certification Practice Exam

What is a criterion for lung transplant in COPD patients?

1. History of first-degree relatives with COPD

2. CHRONIC bronchitis as the main cause

3. FEV1 less than 20% of predicted

4. Patients with stable oxygen levels

The correct answer is: FEV1 less than 20% of predicted

In the context of lung transplantation for patients with Chronic Obstructive Pulmonary Disease (COPD), having a forced expiratory volume in one second (FEV1) of less than 20% of the predicted value is an important criterion. This level of lung function indicates severe airflow limitation and is associated with significant impairment in quality of life, reduced exercise capacity, and increased risk of mortality. Candidates with such severe impairment may be evaluated for lung transplantation as a crucial intervention to improve their prognosis and overall health status. The other options may not be as directly relevant to the criteria used for lung transplantation in this specific patient population. Family history, the presence of chronic bronchitis, or stable oxygen levels alone do not provide that same level of justification for the necessity of transplant. Instead, they may be considered in a broader clinical context but do not meet the specific criteria established for lung transplant eligibility in COPD patients.