Page 46 - Demo

MCQ 8: Breathlessness in End-Stage COPDA 75-year-old man with end-stage COPD is experiencing severe breathlessness at rest, despite being on maximum bronchodilator therapy. What is the most appropriate next step to manage his breathlessness?A. Start continuous oxygen therapyB. Initiate non-invasive ventilationC. Start oral morphineD. Increase inhaled corticosteroidsE. Start antibioticsAnswer: Start oral morphineExplanation: In palliative care for end-stage COPD, oral morphine is effective in relieving the sensation of breathlessness, even when oxygen saturation is adequate. It reduces respiratory drive and anxiety associated with breathlessness. Continuous oxygen is only beneficial if the patient is hypoxic. Non-invasive ventilation is generally not recommended in endstage palliative care. Increasing inhaled corticosteroids or starting antibiotics would not address the immediate symptom of breathlessness in this context.