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16 Cards in this Set
- Front
- Back
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Out of the 3 Pneumonia scoring systems, SMART-COP , PSI and CURB-65 , which has not been validated?
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SMART-COP
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In regards to the goals of the pneumonia scoring systems, which of the following is incorrect?
A. They identify low risk patients B. They can guide antibiotic choice and the need for ICU. C. They only guide inpatient Mx. D. They provide "decision support information" when combined with Clinical assessment AND judgement. |
C. Inpatient and outpatient Mx.
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In regards to the SMART-COP scoring system, which of the following is correct?
A. A = albumin < 30 and Respiratory rate > 25 B. It is a mortality predictor C. score 5-6 points = high risk for requiring Intensive respiratory / vasopressor support. D. The highest score is 9 |
C.
A= Albumin < 35 B = It is a clinical deterioration predictor D. 11 |
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In regards to the SMART-COP Pneumonia scoring system, which of the following scores is incorrect?
A. > 7 = very high risk for IVRS B. 0 - 3 = low risk for IRVS C. 3 - 4 = moderate risk ( 1 in 8) of needing IRVS D. 5 - 6 = high risk. |
B. 0-2 = low risk for IRVS (Intensive respiratory of vasopressor support).
3-4 = moderate risk 5-6 = high risk > 7 = very high risk |
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In regards to the PSI and CURB-65, which of the following is incorrect?
A. Both PSI and CURB-65 over-estimate elderly severity B. Both PSI and CURB-65 identify increased mortality . C. Both have RR > 30 in the scoring. D. Both have SBP < 90 and pulse > 125. |
D. CURB-65 has no PR
Confusion Urea > 7 RR > 30 BP < 90 Age > 65 |
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SMART-COP stands for ?
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Systolic BP < 90
Multilobar infiltrates Albumin < 35 RR elevated 25-30 Tachycardia > 125 bpm Confusion (acute) Oxygen low ( PaO2 < 60-70 ; SaO2 < 90-93% ) |
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Which is incorrect regarding the PSI scoring system?
A. It is divided into History, Examination and Investigations, with Classes I -V. B. Urea > 7 and Temp < 35 C. It identifies likelihood of re-admission / mortality . D. Haematocrit and sodium level are part of the scoring. |
B. Urea > 11 (CURB-65 has urea > 7 )
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Which is incorrect regarding the CURB-65 Pneumonia scoring system ?
A. Compared with the PSI, It is better at identifying more severe pneumonia, and discriminates among the more severely ill patients. B. Patients who score 0 , 1 or 2 are at low risk of mortality , and can be treated as outpatients. C. A Score of greater than 2 ( 3,4,5 ) are at high risk, have severe pneumonia, and should be managed in ICU. D. Compared with the PSI scoring system, CURB-65 better identifies patients with a low risk of mortality. |
D. Both PSI and CURB-65 are good predictors of 30-day mortality , but:
- PSI is better at identifying the lower mortality risk patients for outpatient Mx. - CURB-65 is f greater use in the severe pneumonia category, requiring inpatient Mx. |
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When comparing PSI and CURB-65, which of the following is incorrect?
A. Both over-estimate the younger age groups severity of pneumonia. B. Neither tool is perfect for differentiating which patients can be safely discharged. C. A severe score for each system is : > 91 for PSI, and >2 for CURB-65 D. Low risk patients are PSI class I-III and CURB-65 score 0-2. |
A. Underestimate the younger age groups AND over-estimate the Elderly.
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In regards to the CURB-65 pneumonia scoring system which is an incorrect mortality-based score ?
A. 4 =40% B. Severe = 4 or 5 ( 40 % and 60% ) C. 0 = 0.7% D. 3 = 3% |
D. 3 = 15 % ( 1 and 2 = 3% )
0 = 0.7% 1 = 3% 2 = 3% 3 = 15% 4 = 40% 5 = 60% |
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In regards to the PSI Scoring, which is incorrect ?
A. Severe = Classes IV and V = > 91 to > 130 B. Class III = 9.5 % mortality (score 71-90 ) C. Class I mortality = 0.1% (score <51 ) D. Classes I, II and III have mortality < 1 % |
B. Class III has mortality 0.9% mortality ( < 1%)
score 71-90 Class IV has 9.5 % mortality -score 91-130 |
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In regards to PSI, which of the following has a score of 20 ?
A. Neoplastic disease B. Renal Failure C. Liver Disease D. CCF |
C. Liver disease
A = 30* B = 10 D = 10 CVA and Nursing Home Resident = 10 |
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What History factors are utilised in the PSI ?
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Nursing Home Resident (10)
Neoplastic disease (30) CCF / CRF / CVA (10) Liver Disease (20) Females = minus 10 points |
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What Examination features are in the PSI Scoring System (5) ?
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1. BP < 90
2. HR > 125 3. RR > 30 4. Temperature < 35 or > 40 5. Altered Mental Status (AMS) |
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What Investigation features are used in the PSI ? ( 7)
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1. ABG : pH < 7.35
2. ABG : PO2 < 60 3. BSL - Hyperglycaemia 4. Haematocrit < 30 % 5. Urea > 11 6. Sodium < 130 7. CXR: Pleural effusion |
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Which of the following is incorrect regarding the SMART-COP pneumonia scoring system?
A. The Age delineators are < and > 50 years B. The 2 points scores are BP, Hypoxia and RR. C. Respiratory rate and PaO2 differ for age < and > 50. D. the pH is scored if < 7.35 |
B. 2 points for :
1. BP 2. Hypoxia ( PaO2 < 60 for > 50 years ; < 70 for < 50 ) or SaO2 < 90% for > 50 and < 93% for < 50. 3. pH < 7.35 |
