MSRA - Resp

Question 1

How to distinguish transudate vs exudate

Answer 1

-exudate have protein level >30g/L
-transudates have protein level <30g/L
-use Light’s criteria if protein level 25-35 g/L

Question 2

Light’s criteria

Answer 2

Exudate is likely if at least one of:
-pleural fluid protein/serum protein >0.5
-pleural fluid LDH/serum LDH >0.6
-pleural fluid LDH more than 2/3 upper limits normal serum LDH

Question 3

Indications to place chest drain

Answer 3

-purulent/turbid fluid
-fluid pH <7.2

Question 4

Adult asthma step 1

Answer 4

SABA

Question 5

Adult asthma step 2
(not controlled on 1 or new diagnosis with symptoms >3/week or nocturnal)

Answer 5

SABA + low-dose ICS

Question 6

Adult asthma step 3

Answer 6

SABA + low-dose ICS + LTRA

Question 7

Adult asthma step 4

Answer 7

SABA + low-dose ICS + LABA

+/- LTRA depending on response before

Question 8

Adult asthma step 5

Answer 8

Switch to MART:
-SABA
-MART (LABA + low-dose ICS)
+/- LTRA

Question 9

Adult asthma step 6

Answer 9

• SABA
  -MART (LABA + medium-dose ICS)
  +/- LTRA

Question 10

Adult asthma step 7

Answer 10

-SABA
-High dose ICS
- LABA
+/- LTRA
- trial LAMA/theophylline
-expert help

Question 11

Management of primary pneumothorax

Answer 11

Discharge if rim <2cm and not short of breath

Question 12

Management of secondary pneumothoraz

Answer 12

> 50 and rim >2cm and/pr breathless - chest drain