Respiratory

Question 1

Life threatening asthma management

Answer 1

O2 to maintain sats > 94%
Nebulised salbutamol 5mg continuous
Atrovent 500mcg x 3
Hydrocortisone 100mg IV
IV MgSO4 2g bolus
IM adrenaline 500mcg and consider infusion
IV aminophylline 6mg/kg
IV salbutamol 200mcg

Question 2

Pleural fluid

Answer 2

Blood

Chyle

Transudate
- increased hydrostatic pressure: failures, cardiac, cirrhosis, fluid overload

• reduced oncotic pressure: losing protein, nephrotic syndrome
• negative pleural

Exudate
- parapneumonic effusion, emphyema, pancreatitis

Question 3

Lights criteria

Answer 3

> 5cm or significant distress need sample

• presence of exudate
• protein and LDH
• serum to pleural protein > 0.5
• Serum LDH to protein LDH > 0.6
• Pleural fluid > 2/3 LDH
• Serum albumin