Resp Medicine - pleural disease

Question 1

causes of transudative pleural effusion?

Answer 1

• heart failure
• liver failure
• renal failure
• hypoalbuminemia

Question 2

what does CURB-65 predict?

Answer 2

30 day mortality and treatment guidance

Question 3

CURB-65 components?

Answer 3

C - confusion
U- urea > 7 mmol/L
R - RR > 30
B - BP < 90 or 60 
65 - over 65 year old

Question 4

how to interpret CURB 65?

Answer 4

0-1 - mild pneumonia
2 - moderate pneumonia
3-5 - severe pneumonia

Question 5

Acute management of pneumonia

Answer 5

• ABCs
• SEPSIS 6 within 60 minutes
• oxygen
• fluids - vasopressors if needed
• ICU for intubation if severe hypoxemia

Antibiotic treatment

• co amixoclav for CAP
• piperacillin-tazobactam +- vancomycin for HAP

Question 6

medium term managmenet of pneumonia in hosptial?

Answer 6

• chest physiotherapy
• nebulized saline to help clear secretions
• DVT prophylaxis with LMWH
• optimize nutrition

Question 7

should you follow up with a patient who had pneumonia?

Answer 7

yes - followup CXRAY in 8 weeks especially in smokers > 50