The document discusses the evaluation and assessment of patients presenting with respiratory symptoms. It outlines the key components of the history to obtain including symptoms, duration, variability, aggravating/relieving factors, and associated conditions. The physical exam is described involving inspection, palpation, percussion, and auscultation of the chest. Investigations that may be useful are also listed such as sputum examination, spirometry, imaging tests, and microbiological testing. A thorough evaluation of respiratory symptoms is important to make an accurate diagnosis.
Examinating the Resipiratory System.pptxssuser504dda
This document provides guidance on examining the respiratory system through history taking and physical examination. It details what to ask patients regarding symptoms like breathlessness, cough, sputum production, and chest pain. It also explains how to inspect, palpate, percuss and auscultate the chest. Specific tests are described like measuring chest expansion, examining neck veins, and evaluating breath sounds and vocal fremitus. A thorough respiratory exam provides clues to underlying cardiopulmonary conditions.
This document provides guidance on evaluating symptoms related to respiratory system issues during a patient history. It discusses key questions to ask about common symptoms like cough, expectoration, chest pain, dyspnea, and hemoptysis. For each symptom, the document outlines factors to comment on such as timing, character, severity, exacerbating/relieving factors, and associated symptoms. Understanding these details can provide clues to determining possible respiratory conditions. A thorough respiratory exam involves analyzing each symptom and understanding how it relates to potential diagnoses.
Diffuse pulmonary diseases can be classified as either obstructive or restrictive. Obstructive diseases involve increased airflow resistance and include emphysema, chronic bronchitis, and bronchiectasis. Restrictive diseases involve reduced lung expansion and decreased total lung capacity. Common restrictive diseases are interstitial lung diseases which involve fibrosis of the lung parenchyma, such as idiopathic pulmonary fibrosis, sarcoidosis, and pneumoconiosis. Idiopathic pulmonary fibrosis is characterized by a patchy interstitial fibrosis pattern known as usual interstitial pneumonia.
The document discusses several lung diseases including obstructive lung diseases, restrictive pulmonary diseases, pulmonary infections, lung tumors, and diseases of the pleura. It provides details on specific conditions such as atelectasis, chronic obstructive pulmonary disease (COPD), emphysema, chronic bronchitis, asthma, and bronchiectasis. For each condition, it describes the pathogenesis, clinical presentation, morphology, and clinical course. It also compares and contrasts emphysema and chronic bronchitis.
Respiratory System Physical ExaminationSaneesh P J
Dr. Saneesh P J discusses various symptoms of acute shortness of breath including cough, sputum production, hemoptysis, chest pain, breathlessness, and wheeze. He examines the location, quality, timing, and aggravating/relieving factors of each symptom. Dr. Saneesh also evaluates different breathing patterns, histories of underlying lung conditions, and how activity impacts shortness of breath. Based on the symptom details, potential conditions like asthma, COPD, pulmonary embolism, and heart failure are considered.
Haemoptysis, or coughing up blood from the lungs or respiratory tract, can have various causes including infections like tuberculosis, lung cancer, or other chronic lung conditions. The document describes 4 cases of haemoptysis, including a 23-year-old male with a history of TB, a 70-year-old male smoker evaluated for sudden hemoptysis, a 21-year-old male with massive hemoptysis and HIV, and an 80-year-old male referred for dental bleeding workup. Common causes, mechanisms, risk factors, symptoms, and exam findings for haemoptysis are also outlined.
Haemoptysis, or coughing up blood from the lungs or respiratory tract, can have various causes including infections like tuberculosis, lung cancer, or other chronic lung conditions. The document describes 4 cases of haemoptysis, including a 23-year-old male with a history of TB, a 70-year-old male smoker evaluated for sudden hemoptysis, a 21-year-old male with massive hemoptysis and HIV, and an 80-year-old male referred for dental bleeding workup. Causes, risk factors, presentations, signs, and mechanisms of massive haemoptysis are also outlined.
The document discusses cough and its potential causes. Cough can be initiated by airway irritants, inflammation, or compression/constriction of the airways. Common causes of cough include infections, asthma, tumors, granulomas, congestive heart failure, and use of ACE inhibitors. The cough reflex involves both sensory afferent pathways and motor efferent pathways. Evaluation of cough involves considering its chronicity, associated symptoms, seasonality, relationship to postnasal drip or reflux, presence of fever or sputum, and underlying diseases or risk factors of the patient. Diagnostic tests may include imaging, pulmonary function tests, and sputum examination.
Examinating the Resipiratory System.pptxssuser504dda
This document provides guidance on examining the respiratory system through history taking and physical examination. It details what to ask patients regarding symptoms like breathlessness, cough, sputum production, and chest pain. It also explains how to inspect, palpate, percuss and auscultate the chest. Specific tests are described like measuring chest expansion, examining neck veins, and evaluating breath sounds and vocal fremitus. A thorough respiratory exam provides clues to underlying cardiopulmonary conditions.
This document provides guidance on evaluating symptoms related to respiratory system issues during a patient history. It discusses key questions to ask about common symptoms like cough, expectoration, chest pain, dyspnea, and hemoptysis. For each symptom, the document outlines factors to comment on such as timing, character, severity, exacerbating/relieving factors, and associated symptoms. Understanding these details can provide clues to determining possible respiratory conditions. A thorough respiratory exam involves analyzing each symptom and understanding how it relates to potential diagnoses.
Diffuse pulmonary diseases can be classified as either obstructive or restrictive. Obstructive diseases involve increased airflow resistance and include emphysema, chronic bronchitis, and bronchiectasis. Restrictive diseases involve reduced lung expansion and decreased total lung capacity. Common restrictive diseases are interstitial lung diseases which involve fibrosis of the lung parenchyma, such as idiopathic pulmonary fibrosis, sarcoidosis, and pneumoconiosis. Idiopathic pulmonary fibrosis is characterized by a patchy interstitial fibrosis pattern known as usual interstitial pneumonia.
The document discusses several lung diseases including obstructive lung diseases, restrictive pulmonary diseases, pulmonary infections, lung tumors, and diseases of the pleura. It provides details on specific conditions such as atelectasis, chronic obstructive pulmonary disease (COPD), emphysema, chronic bronchitis, asthma, and bronchiectasis. For each condition, it describes the pathogenesis, clinical presentation, morphology, and clinical course. It also compares and contrasts emphysema and chronic bronchitis.
Respiratory System Physical ExaminationSaneesh P J
Dr. Saneesh P J discusses various symptoms of acute shortness of breath including cough, sputum production, hemoptysis, chest pain, breathlessness, and wheeze. He examines the location, quality, timing, and aggravating/relieving factors of each symptom. Dr. Saneesh also evaluates different breathing patterns, histories of underlying lung conditions, and how activity impacts shortness of breath. Based on the symptom details, potential conditions like asthma, COPD, pulmonary embolism, and heart failure are considered.
Haemoptysis, or coughing up blood from the lungs or respiratory tract, can have various causes including infections like tuberculosis, lung cancer, or other chronic lung conditions. The document describes 4 cases of haemoptysis, including a 23-year-old male with a history of TB, a 70-year-old male smoker evaluated for sudden hemoptysis, a 21-year-old male with massive hemoptysis and HIV, and an 80-year-old male referred for dental bleeding workup. Common causes, mechanisms, risk factors, symptoms, and exam findings for haemoptysis are also outlined.
Haemoptysis, or coughing up blood from the lungs or respiratory tract, can have various causes including infections like tuberculosis, lung cancer, or other chronic lung conditions. The document describes 4 cases of haemoptysis, including a 23-year-old male with a history of TB, a 70-year-old male smoker evaluated for sudden hemoptysis, a 21-year-old male with massive hemoptysis and HIV, and an 80-year-old male referred for dental bleeding workup. Causes, risk factors, presentations, signs, and mechanisms of massive haemoptysis are also outlined.
The document discusses cough and its potential causes. Cough can be initiated by airway irritants, inflammation, or compression/constriction of the airways. Common causes of cough include infections, asthma, tumors, granulomas, congestive heart failure, and use of ACE inhibitors. The cough reflex involves both sensory afferent pathways and motor efferent pathways. Evaluation of cough involves considering its chronicity, associated symptoms, seasonality, relationship to postnasal drip or reflux, presence of fever or sputum, and underlying diseases or risk factors of the patient. Diagnostic tests may include imaging, pulmonary function tests, and sputum examination.
This document provides information about Chronic Obstructive Pulmonary Disease (COPD). It defines COPD as a group of lung disorders that cause airflow blockage and breathing-related problems. The main causes of COPD are cigarette smoking, exposure to secondhand smoke, and air pollution. Symptoms include a chronic cough, sputum production, shortness of breath, and wheezing. Diagnosis involves pulmonary function tests, chest x-rays, and arterial blood gas tests. Treatment focuses on quitting smoking, using bronchodilators and steroids, receiving supplemental oxygen, and managing exacerbations.
This document summarizes various lung diseases and respiratory conditions. It is divided into sections covering diseases affecting the airways, alveoli, blood vessels, pleura, chest wall, and respiratory procedures. Key conditions mentioned include asthma, COPD, pneumonia, tuberculosis, lung cancer, pulmonary embolism, pulmonary hypertension, pneumothorax, and respiratory therapy/intubation. The document provides brief descriptions of symptoms and causes for each disease.
This document describes the anatomy and physiology of the upper and lower respiratory tracts. It discusses the structures and functions of the nose, pharynx, larynx, trachea, lungs and associated muscles. It explains the processes of ventilation, gas exchange, oxygen transport and the role of pressure gradients in breathing. It covers clinical assessments of respiratory symptoms like dyspnea, cough and abnormal breath sounds. It also outlines diagnostic tests and treatments for upper respiratory infections.
This document provides information on interpreting chest x-rays in pediatrics. It discusses examining the entire x-ray using the "ABC" approach to systematically evaluate the abdomen, bones, and chest. Common respiratory conditions seen in children are described, including their etiology, pathology, clinical presentation, and key imaging findings. Conditions covered include asthma, atelectasis, bronchiolitis, bronchogenic cyst, croup, cystic fibrosis, and epiglottitis among others. The importance of careful evaluation for foreign body aspiration is also emphasized.
Respiratory failure occurs when the lungs cannot effectively exchange oxygen and carbon dioxide, resulting in hypoxemia (low blood oxygen) and hypercapnia (high blood carbon dioxide). Acute respiratory failure develops suddenly in patients without preexisting lung disease, while chronic respiratory failure is caused by conditions like COPD. Treatment involves oxygen therapy, ventilation if needed, treating the underlying cause, and monitoring vital signs.
This document discusses radiological imaging findings for chronic obstructive airway diseases such as chronic bronchitis and emphysema. Chest x-rays and CT scans can reveal features of chronic bronchitis like hyper-expanded lungs, thickened bronchial walls, and irregular bronchovascular structures. Emphysema appears on CT as destruction of alveolar walls and enlargement of airspaces in various lung regions. Bullae and flattened diaphragms indicate severe COPD. Congenital lobar emphysema involves one lung lobe and appears as unilateral translucency on x-ray or hyperinflation on CT. Pulmonary interstitial emphysema shows air in the interstitium appearing as streak
This document discusses the clinical features of pulmonary tuberculosis. It begins by stating that patients may develop tuberculosis symptoms insidiously, with constitutional symptoms including fatigue, weight loss, and fever. Cough is the most common symptom of tuberculosis and can be productive or dry. Massive hemoptysis, defined as more than 600mL of blood loss in 24 hours, carries a high mortality risk from tuberculosis. Other symptoms include chest pain, dyspnea on exertion, and nonspecific complaints. On physical exam, findings may include decreased breath sounds, lymphadenopathy, and signs of weight loss or malnutrition. Thorough evaluation is needed for any cough lasting more than two weeks to rule out tuberculosis.
Presentation1.pptx, radiological imaging of restrictive lung diseases.Abdellah Nazeer
1. Restrictive lung diseases are characterized by diffuse involvement of the pulmonary connective tissue leading to stiff lungs and reduced expansion.
2. Fibrosis results in the stiffening of the lung tissue, predominantly in the delicate alveolar walls.
3. Common restrictive lung diseases include idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, and pneumoconiosis.
Presentation1.pptx, radiological imaging of copd.Abdellah Nazeer
This document discusses radiological imaging findings for various chronic obstructive airway diseases. Chest x-rays and CT scans can show features of chronic bronchitis like bronchovascular thickening and markings. Emphysema appears on imaging as alveolar destruction and airspace enlargement. Bullous lung disease involves air collections like bullae. Congenital lobar emphysema involves overinflation of one or more lobes. Pulmonary interstitial emphysema shows air within the pulmonary interstitium. Pulmonary hypertension can be seen as enlargement of the pulmonary arteries.
- The document discusses pneumothorax, describing its classification, pathogenesis, clinical presentation, diagnosis, and treatment options.
- Key points include that tension pneumothorax can cause rapid deterioration and requires immediate treatment, while spontaneous pneumothorax is classified as primary or secondary depending on underlying lung health.
- Treatment involves observation for small primary pneumothoraces or procedures like aspiration, chest tube placement, or surgery depending on the size and symptoms.
The document discusses pneumothorax, describing its history, classification, pathogenesis, pathophysiology, clinical presentation, diagnosis, and treatment. Pneumothorax is classified as primary, secondary, traumatic, or iatrogenic. It results from a communication between the lung and pleural space, eliminating the normal negative pressure. Clinical signs depend on factors like underlying lung disease and pneumothorax size. Chest x-ray is used to diagnose, while CT scanning can estimate size. Treatment depends on classification, severity, and recurrence risk.
- This document discusses various respiratory illnesses and lung diseases, including their symptoms, causes, diagnosis, and treatment.
- Common respiratory illnesses covered include asthma, acute bronchitis, COPD (chronic bronchitis, emphysema), bronchiectasis, and various respiratory infections like pneumonia.
- Restrictive lung diseases discussed are idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, and pulmonary eosinophilia.
- Tests like spirometry, lung volumes, and arterial blood gases are used to diagnose and characterize respiratory conditions.
The document defines pneumothorax and pneumomediastinum and classifies pneumothorax into primary spontaneous, secondary spontaneous, traumatic, and tension types. It describes the pathophysiology of each condition and lists potential causes. Signs and symptoms are provided for each type as well as diagnostic approaches including physical exam findings and chest x-ray findings.
This document discusses pneumothorax and hemothorax. It defines pneumothorax as a collection of air in the pleural space, which can be spontaneous or traumatic. Tension pneumothorax is a life-threatening condition where air builds up pressure in the pleural space. Hemothorax is defined as a collection of blood in the pleural space. The document covers causes, pathogenesis, clinical presentations, and treatment approaches for pneumothorax and hemothorax.
The document discusses major lung disease manifestations such as dyspnea, chest pain, cough, and cyanosis. It describes their causes, grading, differential diagnoses, and complications. Dyspnea can result from ventilation or capacity issues. Chest pain may be anginal, pleuritic, or pericardial. Cough can be acute or chronic, productive or not. Cyanosis is a blue skin discoloration from low oxygen levels and can be central or peripheral. The summary provides an overview of key symptoms and issues covered in the long document.
1. Pneumothorax is the presence of air in the pleural space causing lung collapse, and pneumomediastinum is the presence of air in the mediastinum.
2. Pneumothorax can be spontaneous, traumatic, or iatrogenic and is classified as primary or secondary depending on underlying lung conditions. Tension pneumothorax is a life-threatening form caused by trapped air that displaces mediastinal structures.
3. Chest x-ray is used to diagnose pneumothorax by identifying the visceral pleural line and lung collapse. Features of tension pneumothorax on x-ray include mediastinal shift and tracheal deviation. Pneum
This document summarizes various respiratory system conditions and investigation methods. It describes common diagnoses like pneumonia, asthma, COPD and interstitial lung disease. Investigation methods include physical exams, imaging like chest X-rays, CT scans, and lung function tests. Specific conditions are defined, like emphysema causing damage to alveoli walls. Pathogenesis and symptoms of various lung diseases are provided. Diagnosis of conditions like pleurisy involving pleural inflammation are outlined. Pulmonary embolism from blood clots in the lungs is also described.
This document covers several topics related to respiratory pathophysiology:
1. It describes the anatomy and control of breathing, including the medullary respiratory center and pontine and apneustic areas.
2. Various types of breathing patterns are defined, such as Cheyne-Stokes respirations and Biot's respiration, along with the areas of brain injury that cause each pattern.
3. Common respiratory symptoms like cough, dyspnea, and hemoptysis are discussed alongside their typical causes.
4. Physical exam findings on chest auscultation and percussion are outlined, including vocal fremitus and lung sounds.
5. The calculation of the alveolar-arterial oxygen
Cancer chemotherapy and treatment involves several methods. Chemotherapy uses drugs to prevent or treat cancer by killing cancer cells. Common chemotherapies include fluorouracil, capecitabine, and cytarabine which are pyrimidine analogues that interfere with DNA synthesis in cancer cells. These drugs have similar mechanisms of action but different routes of administration and toxicity profiles. Combination chemotherapy uses multiple agents to increase effectiveness while reducing resistance. Careful dosing and administration is needed due to the narrow therapeutic index of chemotherapy drugs.
This document defines and classifies various anxiety disorders. It discusses the neurobiology of anxiety and lists the major neurotransmitters involved. Several specific anxiety disorders are defined, including their clinical features, prevalence, associated features, and diagnostic criteria. These include separation anxiety disorder, selective mutism, specific phobia, social anxiety disorder, panic disorder, agoraphobia, and generalized anxiety disorder. The document also covers substance-induced anxiety disorder and anxiety due to another medical condition. Management of anxiety disorders involves a biopsychosocial approach including psychosocial treatments like counseling and CBT as well as biological treatments like benzodiazepines, SSRIs, and other medications.
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This document provides information about Chronic Obstructive Pulmonary Disease (COPD). It defines COPD as a group of lung disorders that cause airflow blockage and breathing-related problems. The main causes of COPD are cigarette smoking, exposure to secondhand smoke, and air pollution. Symptoms include a chronic cough, sputum production, shortness of breath, and wheezing. Diagnosis involves pulmonary function tests, chest x-rays, and arterial blood gas tests. Treatment focuses on quitting smoking, using bronchodilators and steroids, receiving supplemental oxygen, and managing exacerbations.
This document summarizes various lung diseases and respiratory conditions. It is divided into sections covering diseases affecting the airways, alveoli, blood vessels, pleura, chest wall, and respiratory procedures. Key conditions mentioned include asthma, COPD, pneumonia, tuberculosis, lung cancer, pulmonary embolism, pulmonary hypertension, pneumothorax, and respiratory therapy/intubation. The document provides brief descriptions of symptoms and causes for each disease.
This document describes the anatomy and physiology of the upper and lower respiratory tracts. It discusses the structures and functions of the nose, pharynx, larynx, trachea, lungs and associated muscles. It explains the processes of ventilation, gas exchange, oxygen transport and the role of pressure gradients in breathing. It covers clinical assessments of respiratory symptoms like dyspnea, cough and abnormal breath sounds. It also outlines diagnostic tests and treatments for upper respiratory infections.
This document provides information on interpreting chest x-rays in pediatrics. It discusses examining the entire x-ray using the "ABC" approach to systematically evaluate the abdomen, bones, and chest. Common respiratory conditions seen in children are described, including their etiology, pathology, clinical presentation, and key imaging findings. Conditions covered include asthma, atelectasis, bronchiolitis, bronchogenic cyst, croup, cystic fibrosis, and epiglottitis among others. The importance of careful evaluation for foreign body aspiration is also emphasized.
Respiratory failure occurs when the lungs cannot effectively exchange oxygen and carbon dioxide, resulting in hypoxemia (low blood oxygen) and hypercapnia (high blood carbon dioxide). Acute respiratory failure develops suddenly in patients without preexisting lung disease, while chronic respiratory failure is caused by conditions like COPD. Treatment involves oxygen therapy, ventilation if needed, treating the underlying cause, and monitoring vital signs.
This document discusses radiological imaging findings for chronic obstructive airway diseases such as chronic bronchitis and emphysema. Chest x-rays and CT scans can reveal features of chronic bronchitis like hyper-expanded lungs, thickened bronchial walls, and irregular bronchovascular structures. Emphysema appears on CT as destruction of alveolar walls and enlargement of airspaces in various lung regions. Bullae and flattened diaphragms indicate severe COPD. Congenital lobar emphysema involves one lung lobe and appears as unilateral translucency on x-ray or hyperinflation on CT. Pulmonary interstitial emphysema shows air in the interstitium appearing as streak
This document discusses the clinical features of pulmonary tuberculosis. It begins by stating that patients may develop tuberculosis symptoms insidiously, with constitutional symptoms including fatigue, weight loss, and fever. Cough is the most common symptom of tuberculosis and can be productive or dry. Massive hemoptysis, defined as more than 600mL of blood loss in 24 hours, carries a high mortality risk from tuberculosis. Other symptoms include chest pain, dyspnea on exertion, and nonspecific complaints. On physical exam, findings may include decreased breath sounds, lymphadenopathy, and signs of weight loss or malnutrition. Thorough evaluation is needed for any cough lasting more than two weeks to rule out tuberculosis.
Presentation1.pptx, radiological imaging of restrictive lung diseases.Abdellah Nazeer
1. Restrictive lung diseases are characterized by diffuse involvement of the pulmonary connective tissue leading to stiff lungs and reduced expansion.
2. Fibrosis results in the stiffening of the lung tissue, predominantly in the delicate alveolar walls.
3. Common restrictive lung diseases include idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, and pneumoconiosis.
Presentation1.pptx, radiological imaging of copd.Abdellah Nazeer
This document discusses radiological imaging findings for various chronic obstructive airway diseases. Chest x-rays and CT scans can show features of chronic bronchitis like bronchovascular thickening and markings. Emphysema appears on imaging as alveolar destruction and airspace enlargement. Bullous lung disease involves air collections like bullae. Congenital lobar emphysema involves overinflation of one or more lobes. Pulmonary interstitial emphysema shows air within the pulmonary interstitium. Pulmonary hypertension can be seen as enlargement of the pulmonary arteries.
- The document discusses pneumothorax, describing its classification, pathogenesis, clinical presentation, diagnosis, and treatment options.
- Key points include that tension pneumothorax can cause rapid deterioration and requires immediate treatment, while spontaneous pneumothorax is classified as primary or secondary depending on underlying lung health.
- Treatment involves observation for small primary pneumothoraces or procedures like aspiration, chest tube placement, or surgery depending on the size and symptoms.
The document discusses pneumothorax, describing its history, classification, pathogenesis, pathophysiology, clinical presentation, diagnosis, and treatment. Pneumothorax is classified as primary, secondary, traumatic, or iatrogenic. It results from a communication between the lung and pleural space, eliminating the normal negative pressure. Clinical signs depend on factors like underlying lung disease and pneumothorax size. Chest x-ray is used to diagnose, while CT scanning can estimate size. Treatment depends on classification, severity, and recurrence risk.
- This document discusses various respiratory illnesses and lung diseases, including their symptoms, causes, diagnosis, and treatment.
- Common respiratory illnesses covered include asthma, acute bronchitis, COPD (chronic bronchitis, emphysema), bronchiectasis, and various respiratory infections like pneumonia.
- Restrictive lung diseases discussed are idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, and pulmonary eosinophilia.
- Tests like spirometry, lung volumes, and arterial blood gases are used to diagnose and characterize respiratory conditions.
The document defines pneumothorax and pneumomediastinum and classifies pneumothorax into primary spontaneous, secondary spontaneous, traumatic, and tension types. It describes the pathophysiology of each condition and lists potential causes. Signs and symptoms are provided for each type as well as diagnostic approaches including physical exam findings and chest x-ray findings.
This document discusses pneumothorax and hemothorax. It defines pneumothorax as a collection of air in the pleural space, which can be spontaneous or traumatic. Tension pneumothorax is a life-threatening condition where air builds up pressure in the pleural space. Hemothorax is defined as a collection of blood in the pleural space. The document covers causes, pathogenesis, clinical presentations, and treatment approaches for pneumothorax and hemothorax.
The document discusses major lung disease manifestations such as dyspnea, chest pain, cough, and cyanosis. It describes their causes, grading, differential diagnoses, and complications. Dyspnea can result from ventilation or capacity issues. Chest pain may be anginal, pleuritic, or pericardial. Cough can be acute or chronic, productive or not. Cyanosis is a blue skin discoloration from low oxygen levels and can be central or peripheral. The summary provides an overview of key symptoms and issues covered in the long document.
1. Pneumothorax is the presence of air in the pleural space causing lung collapse, and pneumomediastinum is the presence of air in the mediastinum.
2. Pneumothorax can be spontaneous, traumatic, or iatrogenic and is classified as primary or secondary depending on underlying lung conditions. Tension pneumothorax is a life-threatening form caused by trapped air that displaces mediastinal structures.
3. Chest x-ray is used to diagnose pneumothorax by identifying the visceral pleural line and lung collapse. Features of tension pneumothorax on x-ray include mediastinal shift and tracheal deviation. Pneum
This document summarizes various respiratory system conditions and investigation methods. It describes common diagnoses like pneumonia, asthma, COPD and interstitial lung disease. Investigation methods include physical exams, imaging like chest X-rays, CT scans, and lung function tests. Specific conditions are defined, like emphysema causing damage to alveoli walls. Pathogenesis and symptoms of various lung diseases are provided. Diagnosis of conditions like pleurisy involving pleural inflammation are outlined. Pulmonary embolism from blood clots in the lungs is also described.
This document covers several topics related to respiratory pathophysiology:
1. It describes the anatomy and control of breathing, including the medullary respiratory center and pontine and apneustic areas.
2. Various types of breathing patterns are defined, such as Cheyne-Stokes respirations and Biot's respiration, along with the areas of brain injury that cause each pattern.
3. Common respiratory symptoms like cough, dyspnea, and hemoptysis are discussed alongside their typical causes.
4. Physical exam findings on chest auscultation and percussion are outlined, including vocal fremitus and lung sounds.
5. The calculation of the alveolar-arterial oxygen
Cancer chemotherapy and treatment involves several methods. Chemotherapy uses drugs to prevent or treat cancer by killing cancer cells. Common chemotherapies include fluorouracil, capecitabine, and cytarabine which are pyrimidine analogues that interfere with DNA synthesis in cancer cells. These drugs have similar mechanisms of action but different routes of administration and toxicity profiles. Combination chemotherapy uses multiple agents to increase effectiveness while reducing resistance. Careful dosing and administration is needed due to the narrow therapeutic index of chemotherapy drugs.
This document defines and classifies various anxiety disorders. It discusses the neurobiology of anxiety and lists the major neurotransmitters involved. Several specific anxiety disorders are defined, including their clinical features, prevalence, associated features, and diagnostic criteria. These include separation anxiety disorder, selective mutism, specific phobia, social anxiety disorder, panic disorder, agoraphobia, and generalized anxiety disorder. The document also covers substance-induced anxiety disorder and anxiety due to another medical condition. Management of anxiety disorders involves a biopsychosocial approach including psychosocial treatments like counseling and CBT as well as biological treatments like benzodiazepines, SSRIs, and other medications.
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2. Hernias can be classified based on location, contents, reducibility, and whether the bowel is obstructed or strangulated.
3. Physical exam involves assessing the hernia for size, tenderness, impulse on coughing, and reducibility. Imaging may be used but diagnosis is usually clinical.
4. Treatment involves surgical repair to reinforce the weakened area, with common techniques including Shouldice, McVay, and Bassini repairs.
Obstructed labor occurs when there is a failure of descent of the presenting fetal part despite adequate uterine contractions due to a mechanical obstruction. It is a leading cause of maternal and neonatal morbidity and mortality in developing countries. Management involves timely diagnosis through close monitoring of labor and prompt relief of obstruction, usually via caesarean section if detected early. However, in neglected cases destructive procedures may be required to deliver a dead fetus to prevent further complications in the mother. Prevention focuses on improving access to skilled birth attendance and addressing risk factors like malnutrition and short stature.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
2. Diseases of the respiratory system account for up to a third of deaths in most countries
and for a major proportion of visits to the doctor and time away from work or school.
As with every aspect of diagnosis in medicine, the key to success is a clear and
carefully recorded history; symptoms may be trivial or extremely distressing, but
either may indicate serious and life threatening disease.
Most patients with respiratory disease will present with;
breathlessness,
cough,
excess sputum,
hemoptysis,
wheeze or
chest pain
3. Its mechanisms are complex and not fully understood. It is not due simply to a
lowered blood oxygen tension (hypoxia) or to a raised blood carbon dioxide tension
(hypercapnia), although these may play a significant part. People with cardiac
disease and even non-cardiorespiratory conditions such as anaemia, thyrotoxicosis
or metabolic acidosis may become dyspnoeic as well as those with primarily
respiratory problems
whether there is variability in the symptoms, whether there are good days and
bad days and, very importantly, whether there are any times of day or night that
are usually worse than others. Variable airways obstruction due to asthma is very
often worse at night and in the early morning. By contrast, people with
predominantly irreversible airways obstruction due to chronic obstructive
pulmonary disease (COPD) will often say that as long as they are sitting in bed,
they feel quite normal; it is exercise that troubles them.
4.
5.
6. The symptom of cough can be short lived or last years; cough can be defined as
acute (lasting less than 3 weeks) or chronic (lasting more than 8 weeks)
A cough may be dry or it may be productive with sputum
Acute cough is most commonly caused by recent infection, either viral or bacterial;
however, any cough that is associated with haemoptysis should be a cause for
concern, prompt appropriate assessment and a baseline chest X-ray (CXR) at the
very least. Any patient with a chronic cough, i.e. one that lasts more than 8 weeks,
should be sent for a CXR and spirometry as baseline investigations.
How long has the cough been present?
Is the cough worse at any time of day or night?
Is the cough aggravated by anything
7.
8.
9. Is sputum produced?
What does it look like? its color and consistency. Yellow or green sputum is usually
purulent. People with asthma may produce small amounts of very thick or jelly-like
sputum, sometimes in the shape of a cast of the airways.
How much is produced?
10. Haemoptysis means the coughing up of blood in the sputum.
an attempt to decide if it is fresh or altered blood, how much is produced, when it
started and how often it happens
Always be asked about associated conditions such as epistaxis (nose bleeds) or the
subsequent development of melaena (altered blood in the stool), which occurs in
the case of upper gastrointestinal bleeding
Hemoptysis should be a cause for concern, prompt appropriate assessment and a
baseline chest X-ray (CXR) at the very least should be done.
11.
12. Always ask whether the patient or their partner hears any noises coming from
the chest.
Sometimes stridor may be mistaken for wheezing by both patient and doctor and
indicates narrowing of the larynx, trachea or main bronchi.
It is also usual for patients with a pneumothorax to describe ‘rubbing’ or ‘gurgling’
sounds in their chest which may well be due to the displaced lung
13. Chest pain caused by lung disease usually arises from the pleura. Pleuritic pain is
sharp and stabbing and is made worse by deep breathing or coughing.
It occurs when the pleura is inflamed, most commonly by infection in the underlying
lung.
More constant pain, unrelated to breathing, may be caused by local
invasion of the chest wall by a lung or pleural tumour
A spontaneous pneumothorax causes pain which is worse on
breathing but which may have more of an aching character than the
stabbing pain of pleurisy. If a pulmonary embolus causes infarction
of the lung, pleurisy and hence pleuritic pain may occur, but an
acute pulmonary embolus can also cause pain which is not stabbing
in nature. A large pulmonary embolus causing hemodynamic
disturbance may cause cardiac type chest pain
14. Always take a full smoking and recreational drug history. Age of starting and
stopping if an ex-smoker and average consumption for both current and ex-
smokers are the bare minimum information needed
The family history; There is a strong inherited susceptibility to asthma
The occupational history; Paint sprayers, workers in the electronics, rubber or
plastics industries and woodworkers are relatively commonly affected. Damage
from inhalation of asbestos may take decades to become manifest, most seriously
as malignant mesothelioma.
A change in the voice may indicate involvement of the left recurrent laryngeal
nerve by a carcinoma of the lung. Do not ascribe hoarseness to this cause in older
patients, as carcinoma of the vocal cords can also be present with hoarseness or a
change in the quality of the voice.
18. GENERAL ASSESSMENT….
A flap of the hand may indicate carbon dioxide retention or hypercapnia.
A fine tremor may indicate the use of inhaled β2 agonists, such as salbutamol.
The venous pulses in the neck should be inspected. A raised jugular venous pressure
(JVP) may be a sign of cor pulmonale, right heart failure caused by chronic pulmonary
hypertension in severe lung disease, commonly COPD.
Examination of the eyes may reveal anaemia or, rarely, Horner’s syndrome,
secondary to a cancer at the lung apex (Pancoast tumour) invading the cervical
sympathetic chain.
inspected for central cyanosis, which almost always indicates poor oxygenation of the
blood by the lungs, whereas peripheral cyanosis alone is usually due to poor
peripheral perfusion.
Examine the lymph node in the neck.
21. INSPECTION……
Normal shape is bilaterally symmetrical and elliptical in cross section.
The transverse diameter > anteroposterior
Kyphosis (forward bending) or scoliosis (lateral bending) of the vertebral column will lead
to asymmetry of the chest and, if severe, may significantly restrict lung movement.
Barrel shaped chest: Increase in anteroposterior diameter
Rate and rhythm of respiration: Normal is 14-16 breaths per minute
Symmetry of chest expansion. Lung collapse, pleural effusion and pneumothorax.
Movements of chest wall: presence of intercostal recessions or the use of accessory
muscles. . In COPD, the lower ribs often move paradoxically inwards on inspiration
instead of the normal outwards movement.
22. Gently, check for tenderness which might indicate secondary malignant deposits in the rib,
recent chest trauma.
Surgical emphysema (air in the tissues), which feels like popcorn or bubble paper underneath
the skin, is caused by trauma, pneumothorax, pneumomediastinum and infection, as well as
chest instrumentation.
Palpate for trachea and apex beat (cardiac impulse )
Displacement of the cardiac impulse without displacement of the trachea may be due to
scoliosis, to a congenital funnel depression of the sternum or to enlargement of the left
ventricle. In the absence of these conditions, a significant displacement of the cardiac impulse
or trachea or of both together suggests that the position of the mediastinum has been altered
by disease of the lungs or pleura. The mediastinum may be pushed away from the affected side
(contralateral deviation) by a pleural effusion or pneumothorax. Fibrosis or collapse of the
lung will pull the mediastinum towards the affected side (ipsilateral deviation).
23. Chest expansion( whether its symmetrical or asymmetrical)
Vocal fremitus: Vibration detected by palpation with the palm of the hand when
the patient is asked to say “ninety nine”. Vibrations felt on the two sides of the
chest should be of equal intensity.
24. Dullness occur when;
the underlying lung is more solid than usual, usually because of consolidation or collapse.
the pleural cavity contains fluid, i.e. a pleural effusion is present usually called ‘stony
dullness’.
Hyper-resonance is usually caused by pneumothorax.
25.
26. Wheezes are musical sounds associated with airway narrowing especially in asthma and
COPD.
stridor is usually loudest over the trachea
Crackles are short, explosive sounds often described as bubbling or clicking. Crackles at
the beginning of inspiration are common in patients with chronic obstructive pulmonary
disease. Localized loud and coarse crackles may indicate an area of bronchiectasis.
Crackles are also heard in pulmonary oedema. In diffuse interstitial fibrosis, crackles are
characteristically fine in character and late inspiratory in timing (and said to sound like
rolling your fingers through your hair near your ear).
The pleural rub is characteristic of pleural inflammation and usually occurs in association
with pleuritic pain.
Vocal resonance
27.
28. Sputum examination
Mucoid sputum is characteristic in patients with chronic bronchitis
Mucopurulent or purulent when bacterial infection is present in patients with bronchitis,
pneumonia, bronchiectasis or a lung abscess.
Asthmatics have a yellow tinge to the sputum, owing to the presence of many eosinophils.
Black sputum or sputum with black parts in it in bronchopulmonary aspergillosis.
Pulmonary oedema may bring up pink or white frothy sputum
Rusty-coloured sputum is characteristic of pneumococcal lobar pneumonia
Blood may be coughed up alone or bloodstained sputum produced in bronchogenic carcinoma,
pulmonary tuberculosis, pulmonary embolism, bronchiectasis or pulmonary hypertension
Sputum may be examined under the microscope in the laboratory for the presence of pus cells
and organisms and may be cultured in an attempt to identify the causative agent of an
infection and antibiotic resistance patterns
29. Arterial blood sampling; The normal range PaCO2 is 4.7-6.0 kPa (36-45 mmHg.
The PaO2 is normally in the range 11.3-14.0 kPa (80-100 mmHg). When alveolar
ventilation is reduced, the PaCO2 will rise.
Spirometry;
31. The computed tomography scan especially the staging of lung cancer and
mediastinal involvement.
Radioisotope imaging. In the lungs, the most widely used radioisotope technique is
combined ventilation and perfusion scanning, used to aid the diagnosis of
pulmonary embolism.
Magnetic resonance imaging. It is useful in demonstrating mediastinal
abnormalities and can help evaluate invasion of the mediastinum and chest wall
by tumour.
Ultrasound is recommended that ward-based pleural procedures, such as chest
drain insertion and pleural aspiration or biopsy.
Positron emission tomography (PET) scanning
Flexible bronchoscopy and endobronchial ultrasound (EBUS)
32. Pleural aspiration and biopsy.
Lung biopsy
Immunological tests; eg Mantoux and Heaf skin tests used to detect the presence
of sensitivity to tuberculin protein. Precipitating immunoglobulin G (IgG)
antibodies in the circulating blood are present in patients with some fungal
diseases, such as bronchopulmonary aspergillosis or aspergilloma.
Tests for Tuberculosis (TB); Zeihl-Neelsen or auramine stain to look for the acid-
fast bacilli (AFB).
the polymerase chain reaction (PCR) assay Xpert
33.
34. • Davidson’s principles and practice of medicine, 21st edition
• Hutchison’s clinical methods , an integrated approach to clinical
practice, 24th edition