08/01

Question 1

What are the features indicative of life threatening asthma?

Answer 1

Any one of the following features

• PEFR <33% best or predicted
• Sats <92%
• Normal pCO2
• Silent chest, cyanosis or poor resp effort
• bradycardia, dysrhythmia, hypotension
• exhaustion, confusion or coma

Question 2

When should abx be given in acute exacerbations of COPD?

Answer 2

If purulent sputum or clinical signs of pneumonia

Question 3

What is the management of a primary pneumothorax?

Answer 3

If rim of air <2cm and pt not SoB then discharge considered

If not then aspirate

If aspiration fails (>2cm or still SoB) then chest drain should be inserted

Question 4

Which form of NIV is most effective in COPD?

Answer 4

BiPap

Question 5

When should long term oxygen therapy be commenced in COPD?

Answer 5

Chronic hypoxia/polycythaemia/pulmonary HTN or peripheral oedema