23. Regarding the treatment of mental health comorbidities in people with COPD, which one of the following statements is true?  Anxiety symptoms are readily controlled by tricyclic antidepressants.  Panic disorder usually responds to cognitive behaviour therapy.  Chronic disease self-management programmes are more effective at reducing anxiety and depression symptoms in comparison with pulmonary rehabilitation.  All patients demonstrating depressive symptoms should be referred to a psychiatrist or psychoanalyst. 24. How can skeletal muscle strength be best assessed in clinical practice? (Select one of the following.)  It requires high-tech equipment and can hardly be performed in clinical practice.  With a strain gauge and a maximal voluntary contraction.  Using a magnetic or electrical twitch measurement as this avoids motivational bias which would otherwise make results unreliable.  Ask the patient to perform a contraction against manual resistance, scored from 0 (no contraction) to 5 (normal contraction). 25. Which one of the following anabolic drugs could selected patients be currently advised to take to increase skeletal muscle strength?  Testosterone.  Erythropoietin.  Myostatin inhibitors.  Corticosteroids. 26. What is the best way to improve skeletal muscle function in a patient with COPD who is suffering from muscle weakness? (Select one of the following.)  Optimal bronchodilator therapy and inhaled corticosteroids in case of exacerbations.  Adherence to 30 min of physical activity (e.g. walking) per day on most days of the week.  Pulmonary rehabilitation for at least 8 weeks.  Nutritional therapy, including increased protein consumption. 228