Mount Carmel Health Partners Clinical Guidelines Chronic Obstructive Pulmonary Disease | Page 2

Modified British Medical Research Council Questionnaire (mMRC)
Please “X” in the box that applies to you (only one box) (Grades 1-4)
mMRC 0 I only get breathless with strenuous exercise.
mMRC 1 I get short of breath when hurrying on the level or walking up a slight hill.
mMRC 2 I walk slower than people of the same age on the level because of breathlessness, or I have to stop for
breath when walking on my own pace on the level.
mMRC 3 I stop for breath after walking about 100 meters or after a few minutes on the level.
mMRC 4 I am too breathless to leave the house or l am breathless when dressing or undressing .
*Flecher CM. BMJ 1960, 2: 1662
COPD Assessment Test (CAT)
For each item below, place a mark (X) in the box that best describes you currently. Be sure to only select on response for
each question.
Example: I am very happy
0
X
2
3
4
5
I am very sad
Score
I cough all the time
I never cough 0 1 2 3 4 5 I have no phlegm (mucus) in
my chest at all 0 1 2 3 4 5 My chest does not feel tight
at all 0 1 2 3 4 5 When I walk up a hill or one
flight of stairs I am not
breathless 0 1 2 3 4 5 I am not limited doing any
activities at home 0 1 2 3 4 5 I sleep soundly 0 1 2 3 4 5 I don't sleep soundly because of my lung condition
I have lots of energy 0 1 2 3 4 5 I have no energy at all
My chest is completely full of phlegm (mucus)
My chest feels very tight
When I walk up a hill or one flight of stairs I am very
breathless
I am very limited doing activities at home
Total Score
*The COPD Assessment Test was developed by a multi-disciplinary group of international experts in COPD supported by GSK.
Reference: Jones et al. ERJ 2009; 34 (3); 648-54
Initial Visit
1.Obtain and perform detailed medical history and physical with a focus on the following:
• Pattern of symptom development
• History of exacerbations
• Patient’s quality of life
• Patient’s support system
• Exposure to risk factors (i.e.tobacco use, environmental/occupational risk factors)
• Neck vein distension, accessory muscle use
• Abdominal examination for hepatomegaly
• Peripheral edema
• Digital clubbing is not typical in COPD and suggests other diagnoses (lung cancer, bronchiectasis, pulmonary fibrosis)
• Cyanosis
• Gallop rhythm (S3 or S4)
• Displaced PMI (point of maximum impulse)
COPD - 2