COPD Comorbidities: A 5-question Quiz

Test your knowledge of COPD comorbidities with this 5-question quiz. (Image: ©Vitte Yevhen/stock.adobe.com)

Comorbidities are frequent in chronic obstruct pulmonary disease (COPD) and can negatively impact a patient's quality of life. Put your knowledge of COPD comorbidities to the test with this quick, 5-question quiz on prevalence, mortality risk, assessment tools, and more. 

1. Among patients with COPD, which of the following comorbidities is most prevalent?

A. Benign prostatic hypertrophy (BPH)
B. Heart failure
C. Gastroesophageal reflux disease (GERD)
D. Lung cancer

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Answer: A. BPH. According to a 2014 literature review, the top 5 most prevalent comorbidities among patients with COPD are hyperlipidemia (~46%), hypertension (~ 43%), anxiety (~38%), BPH (~30%), and ischemic heart disease (~28%). The prevalence of heart failure, GERD, and lung cancer in COPD patients is approximately 18%, 12%, and 9%, respectively.¹

2. Which of the following is a major cause of death in patients with mild-to-moderate COPD?

A. Substance abuse
B. Lung cancer
C. Chronic kidney disease
D. Prostate cancer

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Answer: B. Lung cancer. Lung cancer and cardiovascular disease are the major causes of death in early stage COPD. Reduced lung function from COPD can limit the operability and radiation therapy options in lung cancer. Individuals with COPD are at increased risk for lung cancer, which may be related to smoking, chronic inflammation, and genetic susceptibility. Respiratory failure is the major cause of death in late-stage COPD.¹

3. Which of the following is NOT a tool developed specifically to assess comorbidity and its impact on prognosis in COPD?

A. COmorbidity TEst (COTE)
B. Comorbidity, airway Obstruction, Dyspnea, and previous Exacerbation (CODEx)
C. COMorbidities in Chronic Obstructive Lung Disease (COMCOLD)
D. Charlson Comorbidity Index (CCI)

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Answer: D. Charlson Comorbidity Index (CCI). The CCI is a more general index that is not specific to COPD; it is the most commonly used index for predicting overall survival related to a wide range of comorbidities. The COTE was the first index developed to assess mortality risk in relation to comorbidities in COPD. The CODEx index is used in patients who have been hospitalized with COPD exacerbations to help predict death, hospital readmission, and a composite of these two 3-12 months after discharge. The COMCOLD index evaluates the impact of common COPD-related comorbidities on a range of patient-reported outcomes.²

4. COPD and asthma are mutually exclusive.

A. True
B. False

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Answer: B. False. Smokers and individuals exposed to other noxious agents may develop a mixed picture, with airflow limitation suggestive of COPD accompanied by both asthma- and COPD-like inflammation. Elderly patients and some patients with chronic asthma may exhibit asthma-COPD overlap. Drawing a clear distinction between asthma and COPD in these patients may be difficult using current imaging techniques and physiologic testing.³

5. Which of the following patients with COPD are at increased risk for osteoporosis?

A. A 64-year-old woman
B. A 64-year-old man
C. A 64-year-old man with reduced 6-minute walk distance
D. All of the above

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Answer: D. All of the above. Both men and women with COPD are at increased risk for osteoporosis. Risk factors like age, smoking, systemic inflammation, decreased physical activity, and steroid therapy may increase risk for osteoporosis. Patients with COPD and osteoporosis may have more severe disease, as indicated by higher dyspnea scores, decreased 6-minute walk distance, and lower body mass index.³

References:

1. Smith MC, Wrobel JP. Epidemiology and clinical impact of major comorbidities in patients with COPD. Int J Chron Obstruct Pulmon Dis. 2014;9:871-888.
2. Negewo NA, Gibson PG, McDonald VM. COPD and its comorbidities: Impact, measurement and mechanisms. Respirology. 2015;20:1160-1171.
3. Hillas G, Perlikos F, Tsiligianni I, Tzanakis N. Managing comorbidities in COPD. Int J Chron Obstruct Pulmon Dis. 2015;10:95-109.