A 60-year-old smoker (45 pack-years) presents with progressive dyspnea, chronic cough with sputum, and recurrent exacerbations. Spirometry post-bronchodilator shows FEV1/FVC 0.61 and FEV1 48% predicted. Based on GOLD criteria, which grade of COPD is this?
- A GOLD Grade 1 (Mild)
- B GOLD Grade 3 (Severe) ✓
- C GOLD Grade 2 (Moderate)
- D GOLD Grade 4 (Very Severe)
Correct answer: B. GOLD Grade 3 (Severe)
Explanation
GOLD spirometric grading is based on post-bronchodilator FEV1% predicted in patients with FEV1/FVC < 0.70: Grade 1 ≥80%, Grade 2 50–79%, Grade 3 30–49%, Grade 4 <30%. This patient's FEV1 of 48% falls into Grade 3 (Severe). The overall GOLD group (A/B/E) additionally incorporates symptom burden (CAT score/mMRC) and exacerbation history, which guides therapeutic escalation.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.