MRCP UK EXAMINATIONS

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RESPIRATORY

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
For COPD patients with chronic hypercapnic respiratory failure (chronic hypercapnic respiratory failure), which of the following is correct? ①Set the respirator so that the patient’s PaCO2 is as close to the normal value as possible (PaCO2:40 mmHg) ②Even if the respirator is used, the patient should try to exercise the limbs as much as possible ③Train without the respirator, T-piece is easier than pressure support Disengage from the respirator ④ If the patient develops hypokalemia (hypokalemia), after excluding various factors, the PEEP setting of the respirator should be increased
A
①②
B
②③
C
③④
D
①④
Explanation: 

Detailed explanation-1: -Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder that may lead to gas exchange abnormalities, including hypercapnia. Chronic hypercapnia is an independent risk factor of mortality in COPD, leading to epithelial dysfunction and impaired lung immunity.

Detailed explanation-2: -Type II respiratory failure involves low oxygen, with high carbon dioxide (pump failure). It occurs when alveolar ventilation is insufficient to excrete the carbon dioxide being produced. The most common cause is chronic obstructive pulmonary disease (COPD).

Detailed explanation-3: -Hypercapnic respiratory failure (type II) is characterized by a PaCO2 higher than 50 mm Hg. Hypoxemia is common in patients with hypercapnic respiratory failure who are breathing room air. The pH depends on the level of bicarbonate, which, in turn, is dependent on the duration of hypercapnia.

Detailed explanation-4: -In COPD with acute hypercapnic respiratory failure, non-invasive ventilation is highly recommended, particularly in patients with mild to moderate respiratory acidosis.

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