Things to learn

1. Management of acute exacerbations of chronic obstructive pulmonary disease
Global Initiative for Chronic Obstructive Lung Disease (GOLD) defines an exacerbation of chronic obstructive pulmonary disease (COPD) as an acute increase in symptoms beyond normal day-to-day variation and includes one or more of following cardinal symptoms: cough increases in frequency and severity, sputum production increases in volume and/or changes character and dyspnea increases. Constitutional symptoms, an unchanged chest radiography, a variable decrease in pulmonary function and tachypnea are typical in acute exacerbations. Est that 70-80% of COPD exacerbations are due to respiratory infections. Viral and bacterial infections cause most exacerbations. Others are due to environmental pollutants or unknown etiology.

2. Serum creatinine
Serum creatinine = ARF - 1) Pre-renal 2) Vascular 3) Renal 4) Post-renal

3. http://medresidents.stanford.edu/TeachingMaterials/Shock%20and%20Sepsis/Sepsis%20and%20SIRS%20Examples%20-%20Key.doc
Sepsis: In patient with sever sepsis/septic shock, in fact in Jefferson hospital, the antibiotic being used is Vanc + Zosyn (Piperacillin and Tazobactam Injection). Vanc to cover Gram-positive while either a beta-lactam/beta-lactamase inhibitor (Piperacillin and Tazobactam), a third or fourth-generation cephalosporin (ceftriaxone) or a carbapenem such as imipenem for Gram-negative coverage.

4. Still disease
aka Systemic-onset juvenile arthritis
Early pattern of prominent systemic complaints and extra-articular involvement. Boys more common.