LUNG

Question 1

explain the CURB 65 scoring?

Answer 1

Confusion (new onset)
Urea >7mmol/l
Respiratory Rate 30+/min
BP below 90mmHg (systolic) or 60mmHg (diastolic)
65+ (age)

Question 2

if CURB65 score is 0 or 1 what should you do?

patient doesn’t need IV

Answer 2

amoxicillin 1g TDS PO
for 5 days
(penicillin allergic:
doxycycline 200mg PO day 1 
100mg PO days 2-4)

Question 3

if CURB65 score is 0 or 1 what should you do?

patient needs IV

Answer 3

amoxicillin 1g TDS IV
for 5 days
(penicillin allergic:
clarithromycin 500mg BD IV
for 5 days)

Question 4

if CURB65 score is 2 what should you do?

patient doesn’t need IV

Answer 4

amoxicillin 1g TDS PO
for 5 days
(penicillin allergic:
doxycycline 200mg PO day 1
100mg PO days 2-4)

Question 5

if CURB65 score is 2 what should you do?

patient needs IV

Answer 5

amoxicillin 1g TDS IV
for 5 days
(penicillin allergic:
clarthromycin 500mg BD IV
for 5 days)

Question 6

if CURB65 score is 3+ what should you do?

Answer 6

co-amoxiclav 1.2g TDS IV
PLUS
clarithromycin 500mg BD IV
or
doxycycline 100mg BD PO
for 7 days
(penicillin allergic:
levofloxacin 500mg BD IV
monotherapy for 7 days)

Question 7

what is the antibiotic treatment for an acute exacerbation of COPD?
(no sputum purulence or signs of pneumonia clinically/on CXR)

Answer 7

none

Question 8

what is the antibiotic treatment for an acute exacerbation of COPD?
(sputum purulence or signs of pneumonia clinically/on CXR)

Answer 8

first line:
amoxicillin 500mg TDS
for 5 days
second line:
doxycycline 200mg on day 1, 100mg days 2-5