Professional Documents
Culture Documents
Best inv of BA…………… spirometry before and after SABA (++ FEV1> 15% at least)
If no response…….oral cortisone
First line………….SABA
If still symptomatic………..LABA
Prevention:
Pt with cough and dyspnea. Exam shows dullness to percussion& ++ TVF… Dx:
pneumonia.
Pt with cough and dyspnea. CXR shows pneumonic patch… Dx: pneumonia
Pt with cough and dyspnea. Exam shows dullness to percussion& -- TVF… Dx:
pleural effusion
Best way to give O2 in pneumonia… 1st: mask 2nd: venture (NOT nasal canula)
TTT:
Criteria of severity:
1-confusion/ empyema
2-respiratory distress
3-tachycardia
4-hypoxia or cyanosis
If MRSA………..add vancomycin
If mycoplasma pneumonia….doxycyclin
Pneumonia with dry cough+ skin lesion (EM)… Dx: mycoplasma pneumonia
Tall smoker young male with pneumothorax and no obvious cause… 1ry
pneumothorax (spontaneous pneumothorax)
Middle age male smoker with history of chronic productive cough and and
hyperinflated lung………COPD
Lung compliance……………………………………increased
NORMALLY= NO EXAGGERATION
PO2……….DECREASED
PCO2………INCREASED
PH………….RESPIRATORY ACIDOSIS
PO2……….decreased
PCO2……..INCREASED)
PH………..RESPIRATORY ACIDOSIS
PO2……..INCREASED
PCO2…….INCREASED
PH…….RESPIRATORY ACIDOSIS
If respiratory failure???
PCO2……..INCREASED
PH…………RESPIRATORY ACIDOSIS
First step……..O2
Immigrant from endemic areas came with prolonged cough, dyspnea, night sweat
and wt loss……………… 1st step: chest X-ray
Then;
Immigrant with suspected TB and +ve mantoux test… next step: isolation (before
X-ray)………..VVVVVVVVV IMP
Old smoker with any chest complaint+ wt loss… Dx: lung cancer until proven
Old smoker with weakness, parathesia at hand, CXR shows mass at apex… Dx:
pancost tumor
Old smoker with congested neck veins and arm swelling, CXR shows mass at
apex… Dx: pancost tumor
Asymptomatic pt with small lung mass at CXR… 1st step: ask for old x-ray
Child with FTT+ recurrent chest infection+ steatorrhea… Dx: cystic fibrosis (CF)
Genetic of CF … AR
Child with rectal prolapse, most imp to ask about … Bowel habit (NOT family H/O
of cystic fibrosis
Farmer with cough, dyspnea while on work BUT is free of symptoms on the week
end = hypersensitivity pneumonitis. Most imp advice… Change the job
Second inv……ABG
Management……intubation
MC RF of mesothelioma………..… Asbestosis
Pt with prolonged symptoms of chest infection not responding to abs, CXR shows
pleural effusion… Dx: Empyema