1 - What is the cut off value of ferritin for IDA? 15, but up to 30 can also be IDA.

2 - What is the tumor marker for medullary thyroid cancer? calcitonin.

3 - How is sickle cell disease diagnosed? Hb electrophoresis.
4 - What is the most common enzymopathy that can lead to hemolysis? G6PD deficiency.
5 - Which test is employed to differentiate between alpha and beta thalassemias; and what are the results? For alpha, DN
6. HgH b4 Tetrad...3gene deletion.....only microcytic anemia with raise retic count
B12 def ...gives a hemolysis peripheral picture except retic count which remains low
B12 def ...Rx raises retic count first in 3 days and hypersegmented neutrophils disappear in 10-14days.
Parvo virus...... freezes cells at Pro-normoblast stage.
Aplastic anemia Rx less than 50yrs...Allogenic BMT and more than 50 yrs ATG(Anti-thymocyte globulin)
11 - Bone mets come from? Blastic from prostate, small cell lung cancer, renal cell cancer and Hodgkin's. Lytic from
12 - Name 3 anti-emetics used in patients on chemo, and what is their MOA? Metoclopromide is a prokinetic central and
13 - What are the 2 main management options for ocular melanomas? Asymptomatic, diameter <10 mm and thickness <
14 - What are the 3 tests used to diagnose Heparin induced thrombocytopenia? Serotonin release assay (Gold std)
15 - Name the benign calcification patterns of a lung nodule. Popcorn, hamartomas, concentric, laminated, central,
Most accurate test for Hereditary Spherocytosis ....... Eosin-5-maleimide binding test
HUS blood picture.......Dec. Plt....dec RBC....inc. Urea....schistocytes+
HUS blood coagulation....... PT/PTT normal
PNH ...Eculizumab prevents complement activation of C5
TRALI .....Donor antibody against rrecipient's WBC
21 - Increased iron concentration in bone marrow seen in which 3 diseases? Hemochromatosis, anemia of chronic disea
22 - Name 5 drugs causing folate deficiency. Phenytoin, primidone, phenobarbital, TMP, methotrexate
23 - Name 3 main causes of sideroblastic anemias. Lead, alcohol, INH
24 - Name 3 diseases with spherocytes. Hereditary spherocytosis, G6PD deficiency, AIHA
25 - Name 4 diseases a/w AML. PNH, sideroblastic anemia, myelodysplasia, PCV
coomb's test is done when....MCV is normal and retic count is high spherocytes+
autoimmune hemolysis...rx steroids which dec ab production or I/V IGs
warm IgG -E.g..SLE,CLL,Lymphoma
cold-Ig M e.g Mycoplasma,EBV,Syphillis,Hep.C
Hairy cell leukemia...no lymphadenopathy....rx cladarabine.....TRAP+
31 - DD HELLP and DIC. 1) HELLP is idiopathic 2) HELLP has normal PT/PTT
32 - Management of Hereditary spherocytosis. 1) Folate 2) splenectomy 3) transfusions for anemia
33 - Universal screening of iron deficiency anemia. CBC at age 9 - 12 months - Hb <11 and MCV <80
34 - Acute severe anemia in sickle cell patients. 1) Splenic sequestration 2) aplastic crisis 3) hyperhemolytic crisis 4) rar
35 - Indications of exchange transfusion in sickle cell patients and target. 1) Stroke 2) retinal infarct 3) pulmonary infarc
dec. retic count in sickle cell pt. ....either Parvo virus or folate def
more than 4 vaso-occlusive crisis in sickle cell pt.....then give prophylactic hydroxyurea...that inc. Hb F
Dec. LAP score ....PNH,CML
M.Myeloma....diagnostic test....Bone marrow biopsy with more than 10% plasma cells
polycythemia vera...erythromylalgia...Rx with histamine blocker and asprin
41 - What is sickle cell-beta (+) thalassemia and what are the types? It is a kind of sickle disease with some beta chains.
42 - First thing to do if routine CBC screen in infant shows MCV <80 or Hb <11? Start a trial of ferrous sulphate with vit c
43 - Mentzer index in IDA? >13
44 - Why does cows milk given to <1 y/o cause microcytic hypochromic anemia? Because it causes chronic bleeding, eve
45 - Why is iron added to an infants diet only after 6 months and not before? Because breast milk provides enough iron
febrile non-hemolytic Tx reaction ....to prevention leuko-reduction
Anaphylactic reaction....Rx 1/1000 subcutaneous epinephrine
AML - over produces inc. Thromboplastin which causes DIC
CML prone to GISST(Gastro-intestinal stromal tumors) as BCR/ABL induces tyrosine kinase
Myelodysplasia....peripheral picture....tear-drop cells, pelger-huet cells(bilobed neutrophils)
51 - What are the 2 peripheral smear findings on sickle cell disease? Sickled cells and Howell Jolley bodies
52 - Maintenance therapy of sickle cell patients. Folate, Hydroxyurea, vaccines, PCN till age 5.
53 - Autosplenectomy in sickle cell predisposes them to which infections? Pneumococcus, meningococcus. H. influenza
54 - Mechanism and complications of radiation therapy on the heart. MOA is d/t fibrosis of all the heart structures. Com
55 - How does anthracycline affect the heart? It causes dose dependent decline in ejection fraction, thus leading to dilate
CLL.....Retic count 2%.....think of autoimmune hemolytic anemia Rx ...prednisolone
Felty's Synd.... Spleenomegaly, R.A titre inc, neutropenia less than 1500
APLA ...+ Anti-cardiolipin ab....inc. aPTT
APLA ....DVT with false positive VDRL
Pernicious anemia ass with Polyglandular Autoimmune Synd-1 eg. Type 1 D.M.,Hashimotos,vitiligo etc
61 - Post transfusion sepsis - which organism to think of? Pseudomonas
62 - SVC syndrome best diagnostic tool. CT chest + neck with contrast
63 - Diagnostic modality of ocular melanoma? And staging modality? USG for diagnosis, MRI for staging
64 - Treatment of warfarin induced bleeding. 1) Stop warfarin 2) Prothrombin complex concentrate is the 1st line. FFP is
65 - Drug to reverse dabigatran. Idarucizumab
Most common complication of Polycythemia.....HTN
Most accurate test for iron def.anemia......Persian Blue Stain of Bone marrow sample.
Complication of B12 replacement.....Hypokalemia
Hereditary Spherocytosis...most common complication......Bilirubin gallstones (inc. MCHC,inc. RDW)
G-6 PD peripheral smear.....Heinz bodies + bite cells
71 - Distinguishing features for all subtypes of AML = Auer rods, MPO +ve, esterase +ve
72 - Distinguishing features of M3 subtype of AML = a/w DIC, Rx with ATRA, t(15;17)
73 - Poor prognostic factor in myelodysplastic syndrome and its treatment. 5q deletion = poor prognosis. Treat with Len
74 - Uses of Lenalidomide. 1) Myelodysplastic syndrome 2) Myelofibrosis 3) Multiple myeloma 4) Waldenstrom
75 - JAK 2 mutations seen in. 1) Myelofibrosis 2) PCV 3) Essential thrombocytopenia
 t are the results? For alpha, DNA sequencing. For beta, Hb electrophoresis.

in 10-14days.

ocyte globulin)
ncer and Hodgkin's. Lytic from MM, non-small cell lung cancer and non-Hodgkin's. Both from breast.
mide is a prokinetic central and peripheral D2 receptor blocker, ondansetron is a 5HT3 serotonin receptor antagonist and aprepitant
meter <10 mm and thickness < 3mm = follow up in 3 months and then every 6 months. Symptomatic, diam 10 mm or more, thicknes
onin release assay (Gold std), heparin induced platelet aggregation assay and heparin-PF4 antibody ELISA.
oncentric, laminated, central, diffuse homogenous.

atosis, anemia of chronic disease, sideroblastic anemia

methotrexate

3) hyperhemolytic crisis 4) rarely co-existing G6PD deficiency

nal infarct 3) pulmonary infarct with pleuritic pain and abnormal CXR 4) priapism. Decrease HbS to 30-40%

hat inc. Hb F

isease with some beta chains. Hence HbA and HbS are both present. Type 1 has 3-5% HbA, Type 2 has 8-14% HbA and Type 3 has 1
 al of ferrous sulphate with vit c assuming it is IDA.

e it causes chronic bleeding, eventually leading to IDA

ast milk provides enough iron with good bioavailability

well Jolley bodies

meningococcus. H. influenza
of all the heart structures. Complications are 1) myocardial ischemia/infarct 2) restrictive cardiomyopathy with diastolic dysfunction
n fraction, thus leading to dilated cardiomyopathy.

os,vitiligo etc

MRI for staging

oncentrate is the 1st line. FFP is PCC not available 3) i.v. Vit K to reverse warfarin effect

poor prognosis. Treat with Lenalidomide

loma 4) Waldenstrom
ptor antagonist and aprepitant.
diam 10 mm or more, thickness 3 mm or more = radiotherapy

s 8-14% HbA and Type 3 has 18-25% HbA.

athy with diastolic dysfunction 3) constrictive pericarditis 4)valvular abnormalities (MS, MR, AS, AR) 5) conduction defect (sick sinu
5) conduction defect (sick sinus syndrome or variable degrees of heart block)
1 - Best donor for kidneys? Sibling with no HLA mismatches
2 - What are the C.I. to being a kidney donor? Age <18, Diabetes, HTN with end organ damage
3 - What are the risk factors that can precipitate contrast induced nephropathy? GFR <40, Creatinine >1.5, patient on diu
4 - If a chronic alcoholic is being re-fed, which electrolyte to keep an eye on? And why? Phosphate because these pts have
5 - Mx of postop oliguria/anuria. 1st do an US to see if bladder if full. If yes, Foleys cathether.
Tamm-harsfall protien......30-50mg/24hr of protien excreted normally.
Orthostatic protienuria....adolescent boys.....get protien-to-cr ratio
orthostatic protienuria....adolescent boys......Rx self limiting ...benign
UTI in less than 2yr old...first time....Rx with abx...if 2nd time get US of kidney
Post residual vol. more than 50ml.....get US to check for obstruction.....
11 - Best means of diagnosis for urethral diverticula. Transvaginal US & MRI
12 - Drugs causing SIADH. SSRIs (fluoxetine, sertraline), chlorpropamide, carbamazepine, cyclophosphamide
13 - Risk factors for urologic malignancies. Age >35, smokers, chronic analgesic use, pelvic irradiation, chemical exposur
14 - What are the 2 typical physical findings seen in renovascular disease? Asymmetric renal size with a difference of >1
15 - Diagnostic test for renovascular hypertension. Renal Doppler US (best initial) and non-contrast MR angiography
UTI WBC activity....Leukocyte estrase and Nitrites indicate gram -ve bacteria that reduce nitrate to nitrite
Bacteriuria in pregnancy....30% progress to pyelonephritis due to progesterone which relaxes the ureters
Positive dipstick for hematuria....Next step is to confirm by microscopic examination
sickle cell nephro complications....Isothenuria, papillary necrosis and medullary infarct
Pt ingests ethylene glycol....what are effects on kidney.....Ca+oxalate crystals....enveloped shaped
21 - 6 indications for cystoscopy. 1) gross hematuria with no evidence of glomerular disease 2) microscopic hematuria w
22 - Test to best visualize upper urinary tract and lower urinary tract. Upper = CT urogram with contrast. Lower = Cysto
23 - Plasma osmolality formula. 2xNa + glucose/18 + BUN/2.8
24 - Treatment of hyponatremia: Up to 125 - nothing. 124-115 water restriction <115 Hypertonic saline 3%
25 - 3 DDs for cola colored urine following exercise. 1) myoglobinuria from rhabdomyolysis - no RBCs seen on microscop
what level of K+ we get dialysis.....7meq
Acute allergic interstitial nephritis presentation.....Fever,rash,eosinophilia and eosinophiluria
most common acute glomerulonephritis....IgA Nephropathy ass with Henoch scholen pupura
Alport synd affects ...type 4 collagen in glomerular disease with sensorineural hearing loss and visual disturbances.
Most common cause of death in end stage renal disease is......Cardiac complications like MI
31 - Which organ is never involved in drug induced lupus (as opposed to SLE)? Kidneys.
32 - Antibiotic prophylaxis in women with recurrent UTI indication and drugs used. >2 in 6 months or >3 in a year. Use T
33 - Diagnostic test for kidney stones. Non contrast helical CT
34 - What are the potassium-induced ECG changes? Peaked T waves > prolongation of PR interval and QRS complex
35 - Rx of UTI in pregnancy. Nitrofurantoin, Amoxicillin, Cephalexin
Renal cell ca signs and smx.....Left sided vericocele,inc. Hb,inc.Plt,Hematuria,FUO inc.Ca+
Phases of ATN...Prodromal phase....Oliguria....Post-oliguria phase.....
pt. hx of M.M admitted for chemo...2days later cr rises....Tumor lysis synd...Rx with allopurinol,hydration,resburicase
Post-urethral valves...diagnostic test.....voiding cystourethrogram
Nephrotic synd......thrombosis of renal vein
41 - Evaluation of renal colic in pregnancy. 1) H&P, UA, BMP 2) renal and pelvic USG 3) transvaginal USG 4) treat empiric
42 - Routine gonorrhea and chlamydia screen. Sexually active, <25 y/o. Done yearly
43 - Indications for urology consult in symptomatic ureteral stones. 1) urosepsis, acute renal failure, complete obstructio
44 - Gestational complications in a kidney donor. Fetal loss, preeclampsia, gestational diabetes, gestational hypertension
45 - Stages and treatments of renal cell cancer. Stage 1 = within renal capsule = partial nephrectomy. Stage 2 = extends th
pre-renal azotemia .....shows hyaline casts
Hepato-renal synd...diagnostic test......i/v colloid albumin
Most common nephrotic synd....Focal segmental
Acute hypo-natriia......esctasy less than 36hrs
Thyroid pt. with hyponatremia.....correct thyroid hormone levels with levothyroxine...
51 - Typical presentation of IgA nephropathy. Asian, 5 days after a viral URI, painless hematuria
52 - Mx of IgA nephropathy. Just control proteinuria with steroids, ACEI. Fish oil might help slow progression.
53 - Mx of PSGN. PCN to eradicate strep. For HT or fluid overload - diuretics
54 - DD Churg Strauss from good pasture: eosinophilia
55 - Indications for dialysis: Hyperkalemia >6.5, metabolic acidosis <7.1, uremic encephalopathy/pericarditis/malnutrit
RTA Type 1...e.g. SLE,Sjogren synd,Sickle cell des and apmpho-B
NSAIDs affect .... which part of kidneys......paillary necrosis first do ...U/A and then CT-scan kidney.....no specific t
Hx of recurrent hematuria after URTI.....ig A nephropathy 1-2days after hx of URTI
nephrotic synd specific U/A finding......Maltasecrosses lipid deposit
SLE..type GMN membranoproliferative membranous most common type
61 - Treatment of cryoglobulinemia = treat Hep C with ledipsavir and sofosbuvir for type 1, ribavirin and sofosbuvir for o
62 - Indications of biopsy in PSGN: acute renal failure, nephrotic syndrome, absence of ASO or normal complement level
63 - If pt. on genta or pt. who gets contrast develops ATN, always check for which electrolyte? Mg
64 - NSAIDs effect on kidneys: ATN, AIN, nephrotic syndrome, renal insufficiency by decreasing GFR
65 - Lupus nephritis types and treatments. 1) sclerosis only - no treatment 2) mild/early/non-proliferative - prednisone
 Creatinine >1.5, patient on diuretics or metformin.
osphate because these pts have 1-low vit D intake so low P absorption 2-low P intake d/t chronic diarrhea 3-low vit D gives low Ca w

, cyclophosphamide
c irradiation, chemical exposure
nal size with a difference of >1.5 cm, abdominal bruit
n-contrast MR angiography
nitrate to nitrite
axes the ureters

ase 2) microscopic hematuria with no evidence of glomerular disease or infection but increased risk for malignancy 3) recurrent UTI
m with contrast. Lower = Cystoscopy

pertonic saline 3%
is - no RBCs seen on microscopy 2) march hemoglobinuria from RBC trauma - RBC casts seen 3) exercise induced hematuria - dx of e

s and visual disturbances.

6 months or >3 in a year. Use TMP-SMX, nitrofurantoin or fluoroquinolones

PR interval and QRS complex > disappearance of P waves > sine wave.

inol,hydration,resburicase

nsvaginal USG 4) treat empirically for stone + observe OR MR urogram OR low dose CT urogram (only in 2nd and 3rd trimester)
nal failure, complete obstruction 2) stone size 10mm or more 3) despite medical management, pt. has uncontrolled pain OR no ston
betes, gestational hypertension
phrectomy. Stage 2 = extends through capsule but not beyond Gerotas fascia = radical nephrectomy. Stage 3 = invasion of major VV, a

lp slow progression.

lopathy/pericarditis/malnutrition/neuropathy/bleeding, fluids overload, toxicity with lithium/aspirin/methanol/ethylene glycol/is

n CT-scan kidney.....no specific treatment

1, ribavirin and sofosbuvir for other types

O or normal complement levels, presents > 2 months after infection

non-proliferative - prednisone 3) severe/advanced/proliferative - mycophenolate/cyclophosphamide + prednisone. Cyclophospham

rhea 3-low vit D gives low Ca which give high PTH which loses P 4-refeeding with insulin pushes P intracellularly

or malignancy 3) recurrent UTIs 4) obstructive symptoms with suspicion for stricture, stone 5) irritative symptoms without urinary

cise induced hematuria - dx of excusion

y in 2nd and 3rd trimester)

s uncontrolled pain OR no stone passage in 4-6 weeks.

tage 3 = invasion of major VV, abdominal LN, adrenal glands = radical + consider debulking, chemo and immuno therapies.

n/methanol/ethylene glycol/isopropranolol.

e + prednisone. Cyclophosphamide is less effective

ve symptoms without urinary infection 6) abnormal bladder imaging or urine cytology
d immuno therapies.
1 - SIRS. Temp < 2 - SIRS. Temp < 3 - SIRS. Temp < 4 - SIRS. Temp < 5 - SIRS. Temp < 6 - SIRS. Temp <
2 - In septic shock, what is the fluid replacement goal? Till central venous pressure is in 8-12 mmHg range
3 - Diagnostic test in a patient with recurrent pneumonia in the same location. CT chest
4 - At what volumes is air detected on lateral decubitus, upright and supine X-rays? Lateral decubitus = 5 ml, Upright (te
5 - Asthma test for initial diagnosis in symptomatic patient and asymptomatic patient. For symptomatic, give albuterol a
ARDS severe ....PaO2/FiO2 ratio less than 300mmhg
COPD pts. generally have hypoxia and inc.CO2 so never give too much Oxygen for hypoxia correction...the oxy hb goal is
Asthma pt. on Albuterol-B2 agonist .....now has weakness of limbs...due to dec.K+
indications for abx use in COPD pt. 1)Cough 2)inc. sputum,3)dyspnea4) mechanical ventilation
Atypical pneumonia is called atypical because the organisms are not detected on sputum gram stain and culture,with an
11 - Classification of asthma in adults: Intermittent is 2 days or less a week of SABA use, 2 nights or less a month nighttim
12 - Stepwise management of asthma: Step 1: SABA PRN. Step 2: Add low dose ICS. STEP 3: Add (low dose ICS + LABA) O
13 - Dx of cystic fibrosis: sweat chloride test > 60
14 - 2 major side effects of SABA. Tachycardia and tremors
15 - s/s of respiratory failure in asthma (11): accessory muscle use with suprasternal retractions, cyanosis, diaphoresis,
Bronchiectasis ...C-Xray findings....(Tram-tracking) Linear atelectasis and irregular peripheral opacities....CT-Scan finding
Best indicator of acute asthma severety is ...PEF and ABGs
Poor prognosis of COPD pt. .....FEV1 less than 40%
Most reliable method for ETT placement is....Capnography
Bronchiectasis ....Rx.....rotating antibiotics ...Chest physio
21 - Screening for lung cancer age, who to screen: 55-80, smokers 30 years or quit <15 years, annually
22 - Treatment of oral thrush. Topical nystatin
23 - Palivizumab indications: Preterm < 29 wks, chronic lung disease of prematurity, hemodynamically significant conge
24 - Complications of RSV bronchiolitis. Apnea if <2 months, respiratory failure
25 - Diagnosis of TB pleural effusion in HIV. Pleural biopsy
Pulmonary HTN 25mmHg
Acute COPD exacebation Mx after Abx ....always get a trial of PPV for 2hrs before getting him on Mechanical vent.
Admission criteria for pneumonia -CURB-65......Cnfusion,Urea more than 17mg/dl,Resp. more than 30breaths/min,B.P. le
ARDS Mx low tidal vol. (6ml) and High PEEP
Aspiration pneumonia diagnostic test ......Videofloroscopicnswallowing study
31 - Management of asthma exacerbation in pregnancy: oxygen to maintain SaO2 95% or above, Neb or inhaled albutero
32 - Definition of respiratory acidosis in pregnant vs non-pregnant women. pCO2 > 35 in preg and > 40 in non-pregnant
33 - Dx of ABPA. Skin prick test > if positive, do IgE and Abs against Aspergillus
34 - Treatment of ABPA. oral prednisone, +/- itraconazole
35 - What are the shockable rhythms on ACLS? V.Fib and pulseless V.Tach.
EKG findings of P.embolism .....non-specific ST-wave changes
COPD PTs home O2 therapy .....all pts. if PaO2 less than 55, SaO2 less than 88%, if COPD with pulm.HTN/cor-pulmonale..
Most accurate diagnosis for sarcoidosis...L.Node biopsy....1)any palpable L.Node2) subcutaneous nodule except erythe
Sarcoidosis pts(all) get an annual eye exam to check for ant.uvieitis
Hepato-pulmonary synd.....cardinal symp. is Platypnea which is dyspnea on upright position that relieves when pt. lying
41 - Only ILD we can treat. Berrylliosis - steroids
42 - Treatment of pulmonary HT. Bosantan to inhibit endothelin - 1, epoprostenol and treprostinil for PC analogues, silde
43 - Lights criteria for pulmonary effusion. exudate >0.5 pleural:serum protein, >0.6 pleural:serum LDH, or pleural LDH
44 - Outpatient Mx of CAP. Levofloxacin/azithromycin/doxycycline
45 - Which TB cases are treated longer than 6 months? Osteomyelitis, meningitis, miliary, cavitary, pregnancy
Pulmonary HTN ....is cause by endothelin-1 vasoconstrictor....that's why Rx is Bonsantan
Berylliosis is only one condition that responds to treatment.i.e. steroids
Classic sign of interstitial lung desease...Bi-basilar end inspiratory crackles..."velcro"
Caplan syn. ..Rheumatoid nodules with R.A.and coal wokers pneumonia +ANA & C3 decreases.
Silicosis pts. need to get PPD annually and if more than 10mm then treatment with INH for 9months
Bulls eye calcification .....granuloma
Pop corn calcification ......Hemartoma
Lung nodule size 5-7mm in a 60 yr old......serial Ct scan
Multi-drug resistant pts are resistant to INH and Rifampin
Difference b/w para-pneumonic effusion and empyema is G stain + and culture + in empyema and absent in para-pneum
 7 - SIRS. Temp < 8 - SIRS. Temp < 9 - SIRS. Temp < 10 - SIRS. Temp <11 - SIRS. Temp <12 - SIRS. Temp < 36 or > 38, HR > 9
-12 mmHg range

al decubitus = 5 ml, Upright (test of choice) = 50 ml and Supine = 500 ml

r symptomatic, give albuterol and if PEFR or FEV1 increases by 12% or 200 ml or more. For asymptomatic patient, give methacholine

correction...the oxy hb goal is 90-93% or SaO2 60-70mmHg

hanical ventilation
gram stain and culture,with an atypical C-Xray
nights or less a month nighttime, rx with step 1. Mild persistent is > 2 days a week but not daily SABA use, 3-4 nights a month, rx wi
3: Add (low dose ICS + LABA) OR medium dose ICS. Step 4: Add (medium dose ICS + LABA). Step 5: Add (high dose ICS + LABA) AND

ractions, cyanosis, diaphoresis, exhaustion or extreme fatigue, marked tachycardia, pulsus paradoxus, pco2 42 or more, peak expirato
eral opacities....CT-Scan findings...bronchial wall thickening

ars, annually

odynamically significant congenital heart disease

im on Mechanical vent.
more than 30breaths/min,B.P. less than 90mmhg and age-65yrs

above, Neb or inhaled albuterol, inhaled ipratropium > oral prednisone > MgSO4 or terbutaline > intubation
preg and > 40 in non-pregnant

ith pulm.HTN/cor-pulmonale...PaO2 less than 60 and SaO2 less than 90%

utaneous nodule except erytheme nodosum 3)Enlarged parotid 4)Lacrimal gland

on that relieves when pt. lying on bed

prostinil for PC analogues, sildenafil and CCB
ral:serum LDH, or pleural LDH >2/3 of upper limit of serum

cavitary, pregnancy

ema and absent in para-pneumonic effusion

SIRS. Temp < 36 or > 38, HR > 90, RR > 20 or pCO2 < 32, WBC < 4000 or > 12000 or > 30% bands. 2 = SIRS. 2 + infection = sepsis. 2 +

matic patient, give methacholine and if PEFR or FEV1 decreases by 20% or more

A use, 3-4 nights a month, rx with step 2. Moderate persistent: daily SABA use, >1 night a week but not every night, rx with step 3. Sev
d (high dose ICS + LABA) AND consider omalizumab for patients with allergies. Step 6: Add (high dose ICS + LABA + oral prednisone

pco2 42 or more, peak expiratory flow PEF <25%, confusion and drowsiness, depressed respiratory drive, severe hypoxemia

> intubation
SIRS. 2 + infection = sepsis. 2 + infection + organ dysfunction = severe sepsis. 2 + infection + organ dysfunction + hT = septic shock

every night, rx with step 3. Severe persistent: throughout the day, 4-7 nights a week, rx with step 4 or 5
e ICS + LABA + oral prednisone) AND consider omalizumab for patients with allergies.

rive, severe hypoxemia

function + hT = septic shock