Passmedicine Extras

Question 1

How should differentiate between lower lobe consolidation and pleural effusion on XR?

Answer 1

try to look for clear fluid level (meniscus)

- if present then think pleural effusion

Question 2

When should non-invasive ventilation be considered in COPD exacerbation?

Answer 2

in patients with persistent hypercapnic (type 2) respiratory failure despite optimal medical treatment

Question 3

What type of non-invasive ventilation should be offered in

a) type 1 resp failure
b) type 2

Answer 3

a) CPAP (e.g. pulmonary oedema)

b) BiPAP (e.g. COPD exacerbation)
- > for maximum stenting open of alveoli during inspiration but not continuous as could increase hyperinflation of alveoli with continuing high pressure during expiration