American Board of Internal Medicine (ABIM) Certification Practice Exam

Patients with COPD should have what type of assessment for airflow obstruction?

1. Routine laboratory tests

2. Imaging studies like CT scans

3. Spirometry assessment

4. Bronchoscopy

The correct answer is: Spirometry assessment

In the assessment of patients with Chronic Obstructive Pulmonary Disease (COPD), spirometry is the gold standard for evaluating airflow obstruction. This pulmonary function test measures the volume of air a patient can inhale and exhale, as well as how quickly they can exhale. The results help in determining the presence and severity of obstructive airway disease, which is a hallmark of COPD. Spirometry provides specific measurements, such as Forced Expiratory Volume in one second (FEV1) and Forced Vital Capacity (FVC). The ratio of these values is critical for diagnosing COPD; an FEV1/FVC ratio of less than 0.70 indicates airflow limitation. This objective measurement is vital for confirming a diagnosis of COPD, guiding management, and monitoring disease progression. Other assessment methods, such as routine laboratory tests and imaging studies, do not directly evaluate airflow obstruction. While CT scans can be informative for assessing lung structure and other complications, they are not routinely used to assess airflow obstruction in COPD. Bronchoscopy may have its indications, such as in the evaluation of lung masses or for obtaining tissue samples, but it is not a standard tool for assessing airflow obstruction in COPD patients. Thus, spirometry assessment stands as the primary and most effective