High-Yield Video Question Bank: CURB-65 and Pneumonia Management

Overview

• Objective: Train to recognize high-yield patterns to solve exam questions effectively, specifically focusing on pneumonia management.
• Scenario: 66-year-old female with symptoms and findings consistent with pneumonia.
• Core Concept: Use of CURB-65 to determine patient management in pneumonia cases.

Practice Question

• Patient Profile:
  • 66-year-old female
  • Symptoms: Cough with yellow-green sputum for 36 hours
  • Vital Signs: BP 99/70, HR 92, RR 22
  • Labs: BUN 18, Creatinine 0.44, Sodium 140, Potassium 4.0
  • Diagnosis: Pneumonia
• Management Options:
  • A) Outpatient follow-up
  • B) Emergency pulmonology consult
  • C) Observation
  • D) Inpatient general medical floor
  • E) Intensive care unit
• Correct Answer: A) Outpatient follow-up

CURB-65 Scoring System

• Purpose: Determine the appropriate level of care for pneumonia patients.
• Components:
  • Confusion: Yes/No
  • Urea (BUN): ≥20 mg/dL
  • Respiratory Rate: ≥30 breaths/min
  • Blood Pressure: Systolic <90 mmHg or Diastolic ≤60 mmHg
  • Age ≥65 years
• Scoring:
  • 1 point for each affirmative criterion
  • Maximum score: 5 points
• Interpretation:
  • 0-1 points: Outpatient care
  • 2 points: Inpatient general medical floor
  • 3+ points: Intensive Care Unit (ICU)

Application of CURB-65

• Patient Analysis:
  • Age: 66 (Scores 1 point)
  • Confusion: No (Scores 0 points)
  • BUN: 18 (Scores 0 points)
  • Respiratory Rate: 22 (Scores 0 points)
  • Blood Pressure: 99/70 (Scores 0 points)
• Total Score: 1 point

Conclusion

• Management Decision: Outpatient follow-up given the CURB-65 score of 1.
• Key Takeaway: CURB-65 efficiently guides the management of pneumonia through a simple scoring system, critical for exams and clinical practice.
• Memory Aids:
  • Outpatient: O & T represent 0 & 1 in "out"
  • ICU: 3 letters in "ICU" correspond to 3+ points

Exam Importance

• Increasingly common in clinical scenarios on exams.
• Understanding CURB-65 is essential for both Step 1 and higher levels.
• Demonstrating knowledge can impress medical staff and enhance patient management skills.