Question:
An elderly male chronic smoker presents with dyspnea. His FEV1/FVC ratio is 65% and FEV1 is 55% of predicted. According to GOLD criteria he falls into which class?
An elderly male chronic smoker presents with dyspnea. His FEV1/FVC ratio is 65% and FEV1 is 55% of predicted. According to GOLD criteria he falls into which class?
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Remember that while spirometric grading (GOLD 1-4) defines the severity of airflow limitation, modern COPD management also heavily relies on the ABCD assessment tool.
The ABCD tool incorporates the patient's symptom burden (using mMRC or CAT scores) and their history of exacerbations to guide specific pharmacological therapy.
The ABCD tool incorporates the patient's symptom burden (using mMRC or CAT scores) and their history of exacerbations to guide specific pharmacological therapy.
Updated On: Sep 3, 2026
- Mild
- Moderate
- Severe
- Non-severe
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The Correct Option is B
Solution and Explanation
Concept:
The patient presents with symptoms and spirometry findings typical of Chronic Obstructive Pulmonary Disease (COPD).
The diagnosis of airflow obstruction is confirmed by a post-bronchodilator FEV1/FVC ratio of less than 70% (in this case, 65%).
The question asks to classify the severity of the airflow limitation based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria.
Explanation:
• The GOLD classification of airflow limitation severity in COPD is strictly based on the post-bronchodilator FEV1 percentage of the predicted value.
• The standard criteria are structured as follows:
• GOLD 1 (Mild): FEV1 $\geq$ 80% of predicted.
• GOLD 2 (Moderate): 50% $\leq$ FEV1 $<$ 80% of predicted.
• GOLD 3 (Severe): 30% $\leq$ FEV1 $<$ 50% of predicted.
• GOLD 4 (Very Severe): FEV1 $<$ 30% of predicted.
• In this patient, the diagnostic criterion for COPD is met because the FEV1/FVC ratio is 65%, which is below the defined threshold of 70% indicating obstructive lung disease.
• To determine the severity (the GOLD grade), we evaluate the FEV1 % predicted.
• The patient's FEV1 is 55% of the predicted normal value.
• Since 55% is greater than or equal to 50% but strictly less than 80%, it falls perfectly into the GOLD 2 category.
• Therefore, the airflow limitation is classified as "Moderate".
• Option (A) is incorrect as Mild requires FEV1 $\geq$ 80%.
• Option (C) is incorrect as Severe requires FEV1 between 30% and 49%.
• Option (D) is not a standard distinct category in the formal GOLD grading 1-4 system.
Final answer:
Based on an FEV1 of 55%, the patient falls into the Moderate class (GOLD 2).
The patient presents with symptoms and spirometry findings typical of Chronic Obstructive Pulmonary Disease (COPD).
The diagnosis of airflow obstruction is confirmed by a post-bronchodilator FEV1/FVC ratio of less than 70% (in this case, 65%).
The question asks to classify the severity of the airflow limitation based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria.
Explanation:
• The GOLD classification of airflow limitation severity in COPD is strictly based on the post-bronchodilator FEV1 percentage of the predicted value.
• The standard criteria are structured as follows:
• GOLD 1 (Mild): FEV1 $\geq$ 80% of predicted.
• GOLD 2 (Moderate): 50% $\leq$ FEV1 $<$ 80% of predicted.
• GOLD 3 (Severe): 30% $\leq$ FEV1 $<$ 50% of predicted.
• GOLD 4 (Very Severe): FEV1 $<$ 30% of predicted.
• In this patient, the diagnostic criterion for COPD is met because the FEV1/FVC ratio is 65%, which is below the defined threshold of 70% indicating obstructive lung disease.
• To determine the severity (the GOLD grade), we evaluate the FEV1 % predicted.
• The patient's FEV1 is 55% of the predicted normal value.
• Since 55% is greater than or equal to 50% but strictly less than 80%, it falls perfectly into the GOLD 2 category.
• Therefore, the airflow limitation is classified as "Moderate".
• Option (A) is incorrect as Mild requires FEV1 $\geq$ 80%.
• Option (C) is incorrect as Severe requires FEV1 between 30% and 49%.
• Option (D) is not a standard distinct category in the formal GOLD grading 1-4 system.
Final answer:
Based on an FEV1 of 55%, the patient falls into the Moderate class (GOLD 2).
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