American Board of Internal Medicine (ABIM) Certification Practice Exam

What is one of the criteria for ongoing pharmacologic therapy in symptomatic COPD patients?

1. Arterial PO2 of more than 60 mm Hg

2. Maximal pharmacologic therapy effectiveness

3. Significant improvement in quality of life

4. Completed pulmonary rehabilitation

The correct answer is: Completed pulmonary rehabilitation

Ongoing pharmacologic therapy for symptomatic COPD patients is often reassessed based on multiple factors, including the completion of pulmonary rehabilitation. This program is designed to improve the physical and emotional condition of patients with chronic respiratory disease. Completion of pulmonary rehabilitation typically indicates that a patient has engaged in a structured program aiming to enhance exercise tolerance, reduce symptoms, and better their overall quality of life. In the context of COPD management, pulmonary rehabilitation not only provides physical benefits but also helps in assessing the patient’s response to pharmacologic treatments. The effectiveness of the combination of pharmacologic therapy and rehabilitation can be evaluated together. Thus, if a patient has completed this rehabilitation, it serves as a marker of their readiness to continue or adapt their medication regimen based on their individual response and progress. Criteria such as arterial PO2 or maximal pharmacologic therapy effectiveness do not directly indicate whether pharmacologic therapy should continue, as they do not adequately capture the holistic assessment necessary for ongoing treatment. Similarly, while significant improvement in quality of life is important, it alone is not a definitive criterion for continuing pharmacologic therapy without considering the comprehensive results of rehabilitation.