Respi

Question 1

Lights crireria

Answer 1

exudates have a protein level of >30 g/L, transudates have a protein level of <30 g/L
if the protein level is between 25-35 g/L, Light’s criteria should be applied. An exudate is likely if at least one of the following criteria are met:

pleural fluid protein divided by serum protein >0.5

pleural fluid LDH divided by serum LDH >0.6

pleural fluid LDH more than two-thirds the upper limits of normal serum LDH

Question 2

Acute asthma: Moderate

Answer 2

PEFR 50-75% best or predicted
Speech normal
RR < 25 / min
Pulse < 110 bpm

Question 3

Asthma attack: Severe

Answer 3

PEFR 33 - 50% best or predicted
Can’t complete sentences
RR > 25/min
Pulse > 110 bpm

Question 4

Asthma attack: Life Threatning

Answer 4

PEFR < 33% best or predicted
Oxygen sats < 92%
‘Normal’ pC02 (4.6-6.0 kPa)
Silent chest, cyanosis or feeble respiratory effort
Bradycardia, dysrhythmia or hypotension
Exhaustion, confusion or coma

Question 5

Near-fatal asthma

Answer 5

characterised by a raised pC02 and/or requiring mechanical ventilation with raised inflation pressures.

Question 6

The British Thoracic Society (BTS) state that the following are the main indications for placing a chest tube in pleural infection:

Answer 6

Patients with frankly purulent or turbid/cloudy pleural fluid on sampling should receive prompt pleural space chest tube drainage.
The presence of organisms identified by Gram stain and/or culture from a non-purulent pleural fluid sample indicates that pleural infection is established and should lead to prompt chest tube drainage.
Pleural fluid pH < 7.2 in patients with suspected pleural infection indicates a need for chest tube drainage.