American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended treatment for COPD GOLD Stage D?

1. Inhaled glucocorticoid with Long-acting β2-agonist

2. Inhaled glucocorticoid with short-acting β2-agonist

3. Long-acting anticholinergic alone

4. Long-acting β2-agonist alone

The correct answer is: Inhaled glucocorticoid with Long-acting β2-agonist

The recommended treatment for COPD (Chronic Obstructive Pulmonary Disease) at GOLD Stage D typically involves a combination of inhaled glucocorticoids with long-acting beta2-agonists. This combination therapy is particularly beneficial for patients in this stage, as they often experience more severe symptoms and exacerbations. Inhaled glucocorticoids help reduce inflammation in the airways, leading to improved lung function and a decrease in the frequency of exacerbations. When paired with long-acting β2-agonists, which provide bronchodilation and help keep the airways open for an extended period, this combination maximizes symptom control and enhances overall patient quality of life. At GOLD Stage D, patients show persistent symptoms and may have a history of frequent exacerbations, making the use of inhaled glucocorticoids critical in preventing these exacerbations. The synergy of these medications, addressing both inflammation and airflow limitation, is essential in managing advanced COPD effectively. The other options do not encompass the comprehensive treatment approach necessary for Stage D patients, as they either rely on mono-therapy or involve short-acting medications that are less effective for managing chronic symptoms and preventing exacerbations in this advanced stage of the disease.