Distinguishing asthma and COPD can at times be problematic and the asthma-COPD overlap picture is even less clear. Check your recall of GINA/GOLD guidelines on all 3.
Symptoms of asthma and COPD can sometimes overlap, complicating diagnosis and treatment, and particularly in persons who smoke and in older adults. The term asthma-COPD overlap does not describe a single disease entity; it likely includes patients with different disease phenotypes caused by a range of disease mechanisms.
This quiz tests your knowledge of guideline-recommended issues surrounding diagnosis of asthma, COPD and asthma/COPD overlap and is based on the joint recommendations compiled in 2017 by the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).
Answer: B. Persistent airflow limitation. According to 2017 GINA/GOLD guidelines on the diagnosis and treatment of asthma/COPD and asthma/COPD overlap, features on the table across the this and the next slide are features of asthma compared to COPD.
Answer: C. Post-bronchodilator FEV1/FVC <0.7. According to GOLD criteria, post-bronchodilator FEV1/FVC <0.7 is required for a diagnosis of COPD. Per the 2017 GINA/GOLD guidelines, other differences in spirometric measures between asthma and COPD include include those listed in the table here and continued on the next 2 slides.
3. Which of the inflammatory cells listed above can be seen in the sputum of a patient with asthma-COPD overlap?
Answer: D. Both A (eosinophils) and C (neutrophils) can be seen in the sputum of a patient with asthma-COPD overlap. The role of inflammatory cells in the differential diagnosis of asthma vs COPD has not been established.