• For chronic thromboembolic pulmonary disease, CTA for PE is not a good test - V/Q scan is better and preferred
  
  

  Posted 12/12/16 11:18:39 AM by Anna Krigel

• SOFA Severity Score - Sequential Organ Failure Assessment
  • Scores calculated 24 hour after admission to the ICU and every 48 hours thereafter, the mean and the highest scores are most predictive of mortality
  • Validated score with superior predictive validity of in-hospital mortality compared to SIRS
  • qSOFA (quick SOFA) - proposed as a tool to identify sepsis in patients outside of the ICU, not yet prospectively validated
    • RR > 22/min
    • Altered mentation
    • Systolic blood pressure less than or equal to 100mmHg
  
  

  Posted 12/12/16 11:30:09 AM by Anna Krigel

• CT head before LP in Adult Patients with Suspected Meningitis needed when...
  • Immunocompromised State
  • History of CNS Disease
  • New Onset seizure (within 1 week of presentation)
  • Papilledema
  • AMS
  • Focal Neurological Deficit
  
  

  Posted 12/12/16 11:33:00 AM by Anna Krigel

• Empiric Antibiotic Coverage for Bacterial Meningitis
  • Third generation cephalosporin - good CSF penetration and activity against major pathogens including Strep pneumo, Neisseria, and Haemophilus
  • Vancomycin - used for beta-lactam resistant strep
  • Ampicillin - coverage for Listeria monocytogenes in adults over age 50
  • Adjunctive dexamethasone - early IV steroids used to diminish neurologic complications of bacterial meningitis and decreased mortality in patients with strep pneumo meningitis
  
  

  Posted 12/12/16 02:30:40 PM by Anna Krigel

• Mallampati classification - provides an estimate of space available for oral intubation
  
  

  Posted 12/12/16 02:32:57 PM by Anna Krigel

• Subglottic stenosis - most common manifestation of tracheobronchial granulomatosis with polyangiitis (Wegener's granulomatosis)
  
  

  Posted 12/12/16 02:37:10 PM by Anna Krigel

• For further reading...

  Dexamethasone in Adults with Bacterial Meningitis (NEJM)
  Sepsis-3 (JAMA 2016)
  
  

  Posted 12/12/16 02:40:27 PM by Anna Krigel

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