Big Concepts

Question 1

What is Wells criteria for PE?

Answer 1

1) clinically suspected DVT — 3.0 points
2) alternative diagnosis is less likely than PE — 3.0 points
3) tachycardia (heart rate > 100) — 1.5 points
4) immobilization (≥ 3d)/surgery in previous four weeks — 1.5 points
5) history of DVT or PE — 1.5 points
6) hemoptysis — 1.0 points
7) malignancy (with treatment within 6 months) or palliative — 1.0 points

> 4 points = likely PE; image

Question 2

What is HIT?

Answer 2

fall of platelets by at least 50% within 5-14 days of starting heparin tx

Question 3

What are the PFT abnormalities associated with COPD?

Answer 3

1) increased RV
2) decrease in FEV1 (which determines stages: >80, 50-80, 30-50, <30)
3) decrease in FEV1/FVC
4) decrease in FEF 25-75
5) normal to increased FRC
6) reduced diffusion capacity

Question 4

What are the stages and treatments for asthma?

Answer 4

Stage 1: intermittent (sx 2x/week but not daily; nighttime wakenings <4x/month): low dose ICS
Stage 3: moderate persistence: (sx daily; nighttime wakenings frequently but not nightly; PFTs affected): low dose ICS + LABA, medium dose ICS + LABA
Stage 4: severe persistent: daily sx, nightly awakenings = high dose ICS + LABA w/w/o oral systemic corticosteroid