Respiratory medicine: long-term oxygen therapy: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Medicine · Respiratory medicine: long-term oxygen therapy

Sample item

A 67-year-old ex-smoker with severe COPD, stable on optimal treatment, has a resting PaO2 of 52 mmHg on two occasions three weeks apart and mild ankle oedema. Which intervention is proven to improve his survival?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Long-term oxygen therapy for at least 15 hours a day

Long-term oxygen therapy prolongs survival in COPD patients with chronic hypoxaemia, defined as PaO2 of 55 mmHg or less, or up to 60 mmHg with cor pulmonale, polycythaemia or pulmonary hypertension. The benefit depends on duration, and at least 15 hours a day is needed. Smoking cessation is essential for safety and benefit.

Option by option

  • A. Oxygen for 6 hours at night only

    Nocturnal oxygen alone was inferior in the trials; the benefit scales with hours of use.

  • B. Long-term oral prednisolone

    Chronic systemic steroids cause myopathy and infections without improving survival.

  • C. Regular oral theophylline

    Theophylline gives modest bronchodilation but has no survival benefit and is toxic.

  • D. Long-term oxygen therapy for at least 15 hours a day (correct)

    Correct. Prolonged daily oxygen reduces pulmonary hypertension and improves survival.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Long-term oxygen therapy for at least 15 hours a day. Long-term oxygen therapy prolongs survival in COPD patients with chronic hypoxaemia, defined as PaO2 of 55 mmHg or less, or up to 60 mmHg with cor pulmonale, polycythaemia or pulmonary hypertension.

Why is "Oxygen for 6 hours at night only" not the answer?

Nocturnal oxygen alone was inferior in the trials; the benefit scales with hours of use.

Why is "Long-term oral prednisolone" not the answer?

Chronic systemic steroids cause myopathy and infections without improving survival.

Why is "Regular oral theophylline" not the answer?

Theophylline gives modest bronchodilation but has no survival benefit and is toxic.

What concept does this question test?

It tests Respiratory medicine: long-term oxygen therapy in General Medicine. The benefit depends on duration, and at least 15 hours a day is needed. Smoking cessation is essential for safety and benefit.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Respiratory medicine: long-term oxygen therapy?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.