CURB 65 SCORE
Confusion ( AMT<8)
Urea >7
RR>=30
Bp<90/60
65 or older
score of 0 = home with amoxicillin
pleural effusion trasudative or exudative ?
exudative > 30g/L
transudative <30g/L
Adult asthma management
1) SABA
2)+ ICS
3)+ LTRA
4) SABA+ICS+LABA
sarcoid features and treatment
+ erythema nodosum
+fever
+joint pain
+ lymphadenopathy
+bilateral hilar lymphadenopathy
Less common :
+ lupus pernio
+ splenomegaly
Acute bronchitis
management
Patients typically present with an acute onset of:
cough: may or may not be productive
sore throat
rhinorrhoea
wheeze
tends to be self limiting
Doxycycline is 1st line
Small cell lung cancer paraneoplastic features
- ACTH secreting ( low k+, HT, hyperglycaemia )
- Lambert eaton syndrome
Squamous cell cancer paraneoplastic features
- PTH-rp secretions
- clubbing
- HPOA ( osteoarthropathy)
- Hyperthyroidism due to ectopic TSH
COPD general management
- SMOKING CESSATION
- annual influenza
- one of pneumococcal vaccine
- pulmonary rehab
1) SABA OR SAMA
2) ASTHMA=> LABA+ ICS
3)no asthma => LAMA+ LABA
prophylactic
- Azithromycin
primary pneumothorax treatment
- less than 2cm and not SOB then discharge
-otherwise aspiration 16G cannula
Secondary pneumothorax treatment
if age above 50 and air > 2cm or SOB = chest drain
if 1-2cm = aspiration
if less than 1cm then admit and oxygen
most common lung cancer in non smokers
Adenocarcinoma
Pulmonary fibrosis
features and diagnostic test
Older patient , progressive exertion dyspnoea , dry cough , clubbing , non smoker
-> Idiopathic pulmonary fibrosis
+ fine bi-basal end inspiratory crackles
HIGH RESOLUTION CT = honey combing
Pneumonia most likely with COPD
Haemophilus Influenzae
heart failure diagnostic scan ?
Transthoracic echo
bronchiectasis
permanent dilation of the bronchi and bronchioles
+ yellow sputum
+blood in sputum
+ Finger clubbing
+Coarse inspiratory crackles
+Wheeze
Lower zone fibrosis causes
RAIDS
RA
Asbestosis
Idiopathic
Drugs
Sarcoid
Pulmonary embolisms
features
management
- sudden SOB
-Pleuritic chest pain
-Haemoptysis
-Tachycardia, Tachypnoea, hypoxia
CT PA
V/Q - preggers
1) DOAC or LMWH if renal function is severely reduced
MASSIVE PE :
- unstable
-IV Alteplase
Sarcoidosis features
- Fever
- polyarthralgia
- Erythema Nodosum
- RAISED ACE and Increased Ca2+
- Bilateral Hilar lymphadenopathy
- Bilateral parotid gland swelling
ARDS features
Bilateral pulmonary infiltrates without other features of heart failure
+ tachypnoea
+ sever SOB
+. Confusion
+
