COPD data interpretation (2026)

Candidate instuctions

Patient: Kelly Bricknall is a 70 year old female patient, who has been admitted to medicine with breathlessness. She has a medical history of type 2 diabetes, COPD and hypertension. She takes metformin, amlodipine and Symbicort inhaler. Her chest sounds wheezy on examination.

Observations: RR28, BP 120/78, HR 120, Saturations 87% on room air, temperature 37.0

Task: This is a data interpretation station. You will be presented information by the examiner.

Note to actor

There is no patient present in this station.
The examiner will present information to the candidate. Please give information in a neutral manner and do not probe or question answers given.

Mark sheet	😊	😃
Given the history presented, which investigations would you like to request? Chest x-ray Arterial blood gas Electrocardiogram (ECG) Blood tests (FBC, U&E, CRP, LFT)	3	4
The patient's chest radiograph is shown. Please comment on the film. Notes name, hospital number and date missing Assesses film adequacy - Rotation, Inspiration, Area, and Exposure Airway - trachea central Breathing - lung fields clear Circulation - no cardiomegaly Diaphragm - no costaphrenic angle blunting/effusions Extras - no rib fractures/soft tissue swelling	3	5
What is your overall impression of the chest x-ray? Hyperexpanded lungs (consistent with COPD) No consolidation/pneumothorax	1	2
An ECG is performed. Please review the patient's ECG. Notes name, hospital number and date missing Calibration correct (25mm/s speed, 10mm/mV) HR = 90bpm (total R waves on ECG multiplied by 6) Rhythm = sinus but with multiple atrial ectopics Normal axis Peaked p waves (P pulmonale) Normal PR interval Normal beats have normal QRS duration No ischaemic changes	5	7
What is your overall impression of the ECG? P pulmonale (right atrial dilatation in COPD) Multiple atrial ectopics	1	2
You perform an arterial blood gas. What is the abnormality? Decompensated respiratory acidosis Type 2 respiratory failure	1
Which treatments would you prescribe? Controlled oxygen therapy Salbutamol 5mg NEB, repeated as necessary Prednisolone 30mg PO Ipratropium 500micrograms NEB	2	3
You give her medical management and a repeat ABG shows no improvement, what would you do now and why? Refer to respiratory HDU or equivalent Patient needs non-invasive ventilation (BiPAP) She has T2RF with acidosis despite optimal medical management	1	2

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COPD data interpretation

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