QuestionSBA
QuestionChoice
The patient has a CURB-65 score of 3 and has a higher risk of mortality. Meropenem is a broad-spectrum carbapenem antibiotic that would not be initiated without specialist input from microbiology
33947
c
Admit with meropenem 1g IV TDS
QuestionChoice
This would be a possible option with a CURB-65 of 0. However the patient scores 3 and warrants admission and more intensive treatment
33948
d
Discharge with amoxicillin 500mg PO TDS
QuestionChoice
The patient has a CURB-65 score of 3 and has a higher risk of mortality, thus warranting intensive inpatient treatment with IV antibiotics
33945
a
Admit with co-amoxiclav 1.2g IV TDS and clarithromycin 500mg IV BD
QuestionChoice
This would be a possible option with a CURB-65 of 2. However the patient scores 3 and warrants more intensive treatment
33946
b
Admit with amoxicillin 500mg PO TDS and clarithromycin 500mg PO BD
QuestionChoice
Doxycycline is an acceptable alternative in patients who are penicillin-allergic. However a discharge is inappropriate as the patient has a CURB-65 of 3D
33949
e
Discharge with doxycycline 200mg PO OD and clarithromycin 500mg PO BD
QuestionComment
why is the CURB score 3? i understand 1 point for their urea and resp rate but what's the last point?
6688
QuestionComment
I imagine this is the drowsiness that the patient has presented with. Perhaps this has been interpreted as confusion.
6727
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Uwave Edema
QuestionComment
AMTS score 6/10
44422
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Cystic Tazocin
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Serpiginous Kinase
QuestionComment
Not too sure how the CURB 65 is 3 so please do expand. I got a score of 2 on RR and Urea. BP was ok, No confusion and is under 65? 
6843
QuestionComment
AMTS score was 6/10
8287
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Anterior Supine
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Giggy G
QuestionComment
Confusion is aka AMTS<8 
8300
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Cystic Prognosis
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2733
Community-acquired pneumonia - Abx appropriate to CURB
Topic
9
Internal Medicine
6800
Case Presentation: A 62 year old man is brought to A&E with fever, productive cough and shortness of breath. **PH** Parkinson’s disease, osteoarthritis. **DH** co-careldopa 25/250mg PO TDS, codeine phosphate 30mg PO PRN (max 6-hourly), senna 7.5mg PO BD. NKDA


**O/E**

Drowsy but able to answer in full sentences. Appears sweaty. Peripheries warm, CRT < 2s. Coarse creps L mid to lower zone.

Temperature 38.4°C, HR 112, RR 32, BP 115/78, O2 94% RA, AMTS 6/10

**Investigations**

FBC: Hb 124, WCC 16.3, Plts 203 x 10^9, MCV 82

U&Es: Na 133, K 4.6, Cl 100, Ur 8.1, Cr 117, eGFR 83mL/min/1.73m^2

CRP 155

Question: Select the most appropriate management at this stage.
a