PRESENTATION IS COMPACT AND INFORMATIVE. HAS FLOWCHARTS AND DIAGRAMS. REFERENCE IS FROM LATEST ARTICLES AND STANDARD TEXTBOOKS. SERVES A GREAT DEAL TO BRUSH UP THE THEORETICAL KNOWLEDGE .

2. Pulm involvement
KNON AETIOLOOGY UNKNOWN AETIOLOGY
ABPA LOFFLERS SYNDROME
TOPICAL PULM EOSINOPHILIA TOPICAL PULM EOSINOPHILA
EOSINOPHILIA MYALGIA SYBNDROME HYPEREOSINOPHILIA SYNDROME

3. MIDZONE INVOLVEMENT
• ARDS
• BRONCHIESCTASIS RIGHT

4. BROCHIECTASIS
• RSV
• TB ( INDIA )
• COARSE LEATHERY CREPITATION
• CLUBBINTG
• HRCT

5. TRANSUDATTE EXUDATE
CHF UNFECTION
CIRRHOSIS MALIGNANCY
NEPHROTIC CONNECTIVE TISSUE DISORDER
MYXEDEMA PANCREATITIS
ESOPHAGEAL PERFORATION
MEIGS SYNDROME

6. HIGH AMYLASE EOSINOPHILIA
DPANCREATITIS DRUG ( NITROFURANTION )
1. BROMOCRYPTINE (PARKINSONISM)
2. MEHTYSERGIDE (MIGRAINE )
3. AMIODARONE (AMIADARNE )
ESOPHAGEAL PERFORATION
MALIGNANCY

7. PULM ALVEROLAR PROTIENOSIS PULM LYMPHANGIOMATOSIS
MALE FEMALE
NONSMOOKER CYSTIC LUNG DESTRUCTION
CHILDHOOD / ADOLESCENT PREGNANCEY WORSTEN
BAL –PROTENACEOUS MATERIAL BIOPSY
BAL THERAPEUTIC STEROIDS
TRANSPALANT TRANSPLANT

8. OBSTRUCTIVE SSLEEP APNEA
• APNEA HYPOPNEA INDEX >5
• RESPIRATORY DISTRESS INDEX >5
• APNEA +HYPOPNEA +RERA
• LIFE LONG CPAP

9. PNEUMONIA
• MCC STREP PNEUMONIAE
• MCC IN ALCOHOL STREP PNEUMONIAE
• MSC FOR ALCOHOLIC KLEBSIELLA
• STRUCTURAL LUNG D PSEUDO>STAPH
• MOIST /HAIRY CELL LEGIONELLA
• HIV >200 STREP PNEUMONIAE
• 50-200 PCJ
• <50 ATM

10. CLASSICAL ATYPICAL
STREP MYCOPLASMA
STAPH LEGIONELLA
KLEBSIELLA CORONA
PSEUDOMONAS PCJ
HISTOPLASMA

11. CURB 65
C CONFUSSION
U UREA >7
R RR >30
B BP <90/60
65 65 ANGE > 65
MILD MODERATE SEVER
FLUROQUINONES 3RD GEN CEPHALOSPORIN
FLUROQUINOLONES
PIPERACILIN
FLUROQUINOLONES
AMINOGLYCOSIDE
AMOXICLAVE
FLUROQUINOLONES
IMEPENAM
FLUROQUINOLONES
AMINOGLYCOSIDE
ASPIRATION METRONIDAZOLE
ATYPICAL AZITHROMYCIN

12. Emphysema
Pus +++++
Gram stain +++++
Culture ++++
Ph <7.2
P.GLU <60MG
PMN >1000

13. LEGIONELLA SIADH AZYTHROMYCIN
FLUROQUINOLONE
PCJ PAUCITY OF SIGNS COTRIMOXAZOLE
CLINDAMYCIN

14. OLD CRITERIA NEW CRITERIA
CXR
PERIHILAR
B/L
PATCHY INFILTRATE
(FLUFFY NODULAR SHADOW )
CXR
PaO2 /FiO2
<200----ARDS
>200----ACUTE LUNG INJURY
PaO2/FiO2
<100---SEVER
100-200 -----MODERATE
>200-------MILD
PCWP <18 ECHO

15. INITIATION PHASE CONTROLLED MANDATORY VENTILATION
MAINTAINANCE ASSISTED CONTROL VENTILATION
SYNCHRONISED INTERMITENT MANDATORY VENTILATION
WEANING MODE CPAP
BiPAP
TYPE 1 RF INVERSE RATIO VENTILATION (I:E =2:1)
EXTRACORPORIAL MEMBRANE VENTILATION
ARDS LOW TIDAL VOLUME VENTILATION (4-6 ML /KG )
HIGH PEEP VENTILATION
RECRUITMENT MANOUVER ---↑RR (40)------↑TV ( +20 )
ARDS PRONE POSSITION VENTIOLATION

16. ANTIBIOTIC ASSOCIATED DIARRHEA
CACA CACA
CLINDAMYCIN
AMOXICILIN
CLOXAACILLIN
AMPICILLIN
METONIDAZOLE DOC
AUTOLOGUS FECAL TRANSPLANTAION

17. INTERSTITIAL LUNG DISEASE
C/F RADIOLOGICAL
DRY COUGH
ACUTE EXACERBATION
CLUBBING ---GRADE 1 OR 2
BIBASILLAR RETICULONODULAR PATTERN
MILD INSP RALES ------VELCRO CREITATION
A/W SMOKING
F>>>M
GROUND GLASS APPEARANCE
MOSAIC PATTERN

18. FIBROSI PREDOMINANT INFLAMATION PREDOMINAN
KNOWN AETIOLOGY SILICOSIS
ASBESTOSIS
HYPERSENSITIVITY
PNEUMONITIS
UBKOWN AETIOLOGY IPF / UIP AIP
COP (BOOP)
DIP
NSIP

19. FARMERS LUNG THERMOPHILUS ACTINOMYUCES
BAGASOSIS THERMOPHYLUS ACTINOMYCES
BYSINOSIS COTTON WOOL FIBER
FAMILIAL HYPERSENSITIVITY PNEUMONITIS BACILLUS SUBTILIS (WOODEN MOULD )
BIRD FANCIRES AVIAN DROPPINGS
TOBACCO FACTORY `ASPERGILLUS FUMIGATUS
HOT TUB LUNG MYCOBACTERIUM AVIUM COMPLEX

20. SILICOSIS DAPICAL NODULAR FIBROSIS
EGG SHELL CALCIFICATION
MILLIARY MOTTLING
ASBESTOSI PLEURAL CALCIFICATION
ADENO CARCINOMA > MESOTHELIOMA
SARCOIDOSIS HEER FORDT SYUNDROME
LOFGREN SYNDROME
LUPUS PERNIAO
ERYTHEMA MNODOSUM
EGG SHELL CALCIFICATION
IPF /UIP B/L HONEY COOMB APPEARANCE
PERFINADONE ( ANTI FIBROTIC )
NINETADANIB ( ANTI VEGF )
DIP SMOOKERS
AIP / HAMMAN RICH SYNDROME MIMIC ARDS
COP / BOOP MIMIC BRONCHO PNEUMONIA
NON SPECIFIC INTERSTITIAL PNEUMONIA A/W CONNECTIVE TISSUE DISORDER

21. NON SMALL CELL LUING CANCER SMALL CELL LUNG CANCER
SQUAMOUS CELL ADENO LARGE CELL ALVEOLAR
MC INDIA
MALE
SMOKER
MC WORLD
FEMALE
NONSMOKER
CENTRALLY PERIPHERAL PERIPHERAL CENTRAL
EARLY
PRESENTATION
LATE
PRESENTATION
MCC – SVC SYNDROME
MCC – TUMOR EMBOLISM
>70% 1YEAR RECURENCE
PROGNOSIS
Sq > SMALL > ADENO
CAVITATION METASTASIS
BEST
PROGNOSIS
WORST
PROGNOSIS
MCA
HYPERCALCEMIA
MCA ===== PNS
1. CNS –LEMS
2. CUSHINGS
POOR CHEMO RADIO SENSITIVE == SURGICAL RESECTION CHEMO RADIO SENSITIVE
SURGERY GEFITINIB
(CANT DO SURGERY )

22. PRIMARY PULM HTN
1. DOC BOSENTAN
» ENDOTHILIN RECEPTOR ANTAGONIST
2. CCB –NIFEDIPINE
3. EPOPROSTINOL
» SUDDEN DEATH WITH DISCONTINUATION
4. SILDENAFIL
5. LUNG TRANSPLANT

23. PTE
• WESTERMARK SIGN
• HAMPTOM HUMP SIGN
• PALA SIGN
• S1Q3T3
• GOLD CT ANGIOGRAPHY
• IOC MDCT
• IOC IN PREG V/Q SCAN
• ECHOCARDIOGRAPHY MC CONEL SIGN
• 6MONTJH ANTICOAGULATION / TPA

25. IMMUNODEFECIENCY IMMUNO EXCESS
INNATE IMMUNITY ADAPTIVE IMMUNITY
NEUTROPENIA SEVER COMBINED
IMMUNO DEFECIENCY
ASPLEENISM DI GEORGE SYNDROME
WISKOT ALDRICH
LEUCOCYTE ADHESION
DEFECT
BRUTONS
AGAMAGLOBULINEMIA
COMMON VARIABLE
IMMUNO DEFECIENCY
IgA DEFECIENCY
COMPLEMENT DEFECIENCY
CHRONIC
GRANULOMATOSIS
MENDELIAN
SUSSCEPTIBILITY TO MTB
CHEDIAK HIGASHI

26. FAMILIAL MEDETERANIAN DISEASE
SEROIDS
INFLAMASOME
PYRIN GENE DEFECT

27. SLE
PREDNISOLONE (DOC )
AZATHIOPRIME
CYCLOPHOSPHAMIDE
MYCOPHENOLATE
ACUTE
TREX 1 GENE
KLIENFELTER
TOXIC INHALATION
NON ERROSIVE ARTHRITIS
END
METHYL PREDNISOLONE
IVIG/PLASMAPHERESIS
RITUXIMAB /CYCLOPHOSPHAMIDE
No Yes

28. APLA
VDRL
DIAGNOSIS
>2 ARTERY / VEIN THROMBOSIS
RECURRENT T1 ABORTION (MCC)
ANTI GLYCOPROTIEN Ab
20-40
ASPIRIN
ASPIRIN + LMWH
IVIG / PPLASMAPHERESIS
DRVVT
Musculoskeletal symptom
Painless loss of vission
Mayalgia arthralgia

29. Scleroderma
CREST
(ANTI CENTROMERE)
P HTN
RENAL
INFECTION (PVB19/CMV)
SILICOSIS
TOXIC OIL (OLIVE/RAPSEED )
30-50Y
SYMPTOMATIC
SYSTEMIC SCLEROSIS
(ANTI TOPOISOMERASE )
No Yes
D PENECILLAMINE
BOTULINUM A /CCB
PPI/PROKINETICS
ONLY SKIN ---MORPHEA

30. Sjogresns
Primary
60%
Autoimmune
disease
ROSE BENGAL CORNEAL EROSSION
SCHIMMERS
PAROTID BIOPSY
30-50Y
SUPPORTIVE
Secondary
40%
No Yes
Lacrimal
Salivary
Pancreatic
SSa/SSb ----ANTI Ro/ANTI La

31. MIXETE CONNECTIVE TISSUE
DISORDER
SLE PREDOMINANT
TYPES
V1 RNP
SPECIFIC ANTIBODY
30-50Y
STEROIDS
RA PREDOMINANT
SLE
SCLERODERMA
SJOGRENS
RA
V1 RNP
DMARD

32. MIXETE CONNECTIVE TISSUE
DISORDER
SLE PREDOMINANT
TYPES
V1 RNP
SPECIFIC ANTIBODY
30-50Y
STEROIDS
RA PREDOMINANT
SLE
SCLERODERMA
SJOGRENS
RA
V1 RNP
DMARD

33. AS/BECHETROWS/MARRY STRUMPLE
DISEASE
SIJ
AXIAL DOMINANT
ENTHESITIS
MARROW EDEMA
SYNDESMOPHYTES
FUSSION
20-40Y
ANT UVEITITS
CROHNS DISEASE
M>FGOUT /PSEUDOGOUT
NSAID
….DMARDS

34. PSORIATIC ARTHRITIS
NSAID
INDOMETHACIN
PENCIL IN CUP
GUTTATE PSORIASIS
NAIL PITTING
ARTHRITIS
1. SYM POLY
2. ASYM OLIGO
3. AXIAL
4. ISOLATED DIP
5. ARTHRITIS MUTILIANS
WRIGHT AND MOLE
….DMARDS
….BIOLOGICAL

35. REACTIVE ARTHRITIS
NSAID
INDOMETHACIN
ASYM OLIGO
URETHRITIS
CONJUNCTIVITIS
ARTHRITIS
1. GONOCOCCUS (OLD)
2. S.TYPHI(URBAN)
3. SHIGELLA (TRAVELLER )
4. CHLAMYDIA (F+UTI)
KERATODERMA
BLENORHAGICA

36. IBD ASSOCIATED ARTHRITIS
NSAID
5ASA
SYM POLY
LARGE JOINYTS
1. DIARRHEA
2. UVITIS
ULCERATIVE COLLITIS

37. CHARCOTS JOINT
ANKLE
LOOSE BODIES
PAINLESS
DESTRUCTION OF
JOINT
1. TABES DORSALIS
2. MOTOR NEURON DISEASE
3. SYRINGOMYELIA
4. AMYLOIDOSIS
5. LEPROSY
ULCERATIVE COLLITIS
REASSURANCE

38. FIBROMYALGIA
TCA
SSRI
11/18
ACHES AND PAIN
>3MONTH
DISTURBED SLEEP
30-50
1. REDUSED CORTISOL RESPONSE TO
PAIN
2. REDUCED BLOOD FLOW TO
THALAMUS
PAIN SENSITIVITY
SUNDROME
GABAPENTIN
PREGABALIN

39. CHRONIC FAIGUE SYNDROME
CLINICAL
FATTIGUE
>6WEEKS MONTH
1. OBESITY
2. ALCOHOL ADDICTION
3. MEDICAL CAUSE
LIFE STYLE
MODIFICATION
EXCLUDE

41. Gaint cell arteritis Polymayalgia rheumatic Temporal artery
Takayasu arteritis Multiple stenosis Subclavian
PAN Mononeuritis multiplexa Hep B
SKIN BIOPSY
WEGENERS MULTIPLE LUNG ABCESS NASAL STAPHYLOCOCAL
M PAN LEUCOCYTOCLASTIC C ANCA
CHURG STRAUSS EOSINOPHILIA MONTELEUCAST WORSTEN
HNEOCHSHOLEIN PURPURA SYNPHARYNGITIS PALPABLE PURPURA
ABDOMINAL DISCOMFORT
ESSENTIAL
CRYOGLOBULINEMIA
COLD ----SKIN NECROSIS SKIN BIOPSY NECROTIC AREA
RELAPSING POLY
CHAONDRITIS
AURAL AND NASAL MIMIC OTITIS EXTERNA