Wrreraeeesreeeaeaeaeeee ~wRRAR! Amrraree @ obstr difuyS a Giilor geriene. . hiperreoctiv. bronsic® @ iaflam bronsics © ones es oe x ning wend PALI Ae J ‘se asociaya Clie extravoyare plas pals extem fupertrohe cel. mus netede, depen de corggen (ony. Oe ematical’ | dkpuri de mucus injure epitetiald obstr br i revensibildf = Key. | 2 + t agree Fam. eo avn init nemodel® ai calor aetiene —Aesitut. prich® |. hrimale nsecte| — enitom tray cin aekmul de Lunges aGleenicom| | 2 tn duet) ~acami-dengen |. eFiyice. Cera specie sa = (cas virale. Sene'biliyand ir ocupationali > pau fa 197ain cayurile deal Wheering-ul ineusae fort > apane in mad caractenistic uPA efont Mon geneticeale eny.amiox dante > se asxiaya cu form a, < may seyehe de atm @mteuraned PEF ~ latreyire, y ~ Tnargie de culcane. - } 4 mas, = clupt admin.uuu GS + Maintea admin. yan. imine > ind. bunal activ. avtiuler; allele ATA MM A AWWHWHAWHHHHRHW ane ] Spirometrie. eau lestu/de prov.br.cu H/S/metacoli ng @Jratamentu! ce prob cucs Prednison dong anal yi -2 Set SE cominud Tu cay de Tap. fav. cu CS inhalatar’ ® Oxiaul nitric ain acu! expiraé (MOS. iWFLAN. COilor QEWenNe eval. hdsp le CS © Teste eg. vi din sputt! > Eo sputer-ane perfdg. mai make @ Rx torazic. > fiperinFl ia ep tamute /fonm&ecr. were @ Teste cutanate. = se Fac in TOATE cayurrile. @ Teste de provcare alergenica nececohe 7m susp.ae atm aupafional, Puatyrvedt Cruaoterapia aubbingvall cu acatiens die proful de cost — & exacenba nile fa cop — x lo colulte igti ai © P2-adrenergici selectivitate pt trhesp. ~ neloxeays Amuse netede, bronyice XK ef.ps inflam, wibiacenti ecu cunatd scurta de achune > Sal buts mol 400 ig x Tendutaling 280 Jug ax put Ia nevoie “G + cu durafe dung’ de acliune -» Salmeteral au Formarerd: J oluuxald cle acl. de pana fe 2h > 1/2 «140 se osataya cu CS inh. > combin doye fixe TU ac. dispay. inkalatoh‘ ‘iprapional de. béclomefayona -> cel mai utili yat Budesanid ., 59, (00,200,259 jug [pu Propionatul de fluifcayona d turoatul de fluticayond ‘Furaatul de mamefayons Triamernolonul hadv: candidoya ohale 1 _, disfonia Ske cajanacte caps.- rake ,gpare la vonst nici 5 clateasti gua ctups ovteopahaya ~ doar Ia obye. de @d0/ btesoniad = saglee ‘ Tmanyiehea Mpa tenmen scynt ( >400 Me I> molt finale b> dloon ta copii nu a foxt chert. CS onali' #1 a9. imunosup! alternatvi mec. Tex exacerbOhi acute, esec al altar reg fekop rus ovkmul corticadlep x Maidan: Hetatrexat < terap. bralogics Giefasporin evar. mencel nal [cAniag. @ pt Gucoiriene | = pe ® cdeinil (74 Hontelvkost heart Praniukast oral, 50 face probs 4 Spt @afirlukast — axtm necontrofat cu cs inh wa clove mici-maolunat® — sntolenanJe Ja aspiring = pac cu avtmn 4 reinits — copii cu art # wheenoy, pov-aral Pranhodilatataare anticalinegice] Ty Ipatroplom. > drat sii, netulryane Thotropium. b dutalts aug Aclidiaium > in exacenby ti acule were, > X fa pre lo care odiuul aw econtrolet eu keropie tandary III J MaLalleallallelladlldblilb AAA A DSSMed. anti-iaflamatarii Cromaglicatul ofisoolia ~~» au previn aetivanea LF Nedbétomilu! sadic. . ve (] <>bloch. influx.fe Ca => previr activahen loch un canal de Ci =7lach. influx. ofe Ca => preven re tee Tn forme yscane,olar nu 7a med obigauit \ Omatizumad ~ leagts al delg€ libere V ar. yy Cetv x bayofilelor morstocit lor 6,0, lq 24 Siplimdne ~7n for_ole niv ole (9E w Bch) Mepottyumab Resiiyumah > ach. Fmpatniva i-6 f@ ec Denraliyumad ef. 7a astmul eoyinorilic, Fenmoplastia bren sii > ovkm pensident modlenat- suet Exacenbinite astmatice. > @ inwiee precace a ut trot cu CSoal’ >}ednison 2o-comg PEF > ISoL/min > torep onus uebuliyohe Astpt X inteknate Ecancenbaren severis PEF ambuianta 4 Salbutamol Smg /Teitbutalin& Ao ma>nebultyohe. 09%} 2. Wigrocortiyon: iv. 200 mg 3: Oxygen 407601. 4. Phednison 60 mg oral pp) fa spital: heevaluake. 4. OXIQeN LO-G07 Q. mByunTm PEF % sat O2 3 Salbutamal Sq [Teroutaliny Ao ma > 0 clade , duepd tot ¢ 1a Hohe, °b. , SUN VUE EEUU | 4. Bromur’ide iprotromium 45mg( 5. Hidrecortiyan 200 mg.iv. 6. Pregnison 4O-¢ min.5 yile + Facor > 60mm Ha => venti], mec 8. Rx pulm ; 9. Xameliotahe=> MgSO, ae v. Tr 20 minute. noornnopanwan ma hmm mmt@nanhoditatatearne # Ag. Paddrenergici ~ Sal butamo! ae. ea 4-6 ameli Oneaee dispneeo, © med.anti coli nergice. ww cduratt longi ae act > T fed. puims cal. (Viortrapi Viehis Wdispreea | NU Previne Aeclinul VENS e TEOFling ~benef.y Tinh de Tostadiestenayack: Rotlueni |ast — Prep.antiintiam. adjuvant \a gac VENS < 607. din\al p. si bronntd or i VEMS < 0%. olin Val. p- bs. ap orer) biopsia endlabronsic® predominant eeucofic > cicatniyahen sp, fibrora in ! SN smal = macrofageloi ilar aetucne Mic disthugehea per alvedlori => emfiyem, t = dlistensia anohmal’ % pekmanenta a spt. _ aehiene atuate distal de. bnohhiola tenminala dtstraigenea per. acestor sai hidla. An fet erimimal® ee CeNTNE -acinah = distemsa 4 divtkugekeo }. pulmonar Mgurul bhonhiblatenminale. duct atv. — cea mai frecuent® fonme ‘sac all. enuf e Sechestratia plamani, dec: pate oa limitane expiratone. “ e 5 epan-acinar i enekeguiat def.de o t-antitripsing ak 0 Forepele cove itinanul devine & 5 Prmcatecyee de oule. obstr. sevend de.seen ventilate! pertuyie, feta dite b nenehmutul & pancelars Wb 50mLfan a VENS Tu OPAC VS V2OmL/an la SSB lowe& sistemice ( H ipertensiune, Cnsut.cara.de. Gerdere mast pond.& muse. Qcteoporoyt Deoresic Aistenie fiyict Semne forme uscaKe -> semne absente /ralurt sibilante. forme seuehe'-> palipnee expir prelungit * m.acesorii +irg) intercostal ‘aspir expit cu buye pensate. stant crio-stennala excursii costale Y matitate 9 ¥ © -aosente, tack ntfsp. 1a Cz @ conservat = alispnee. . } fahcanoya dacd devin rnsenwibili la cee —> edeme +cianoya hah dispnee Hippie > vd perif + puls amplu asterixis sSomnolentS pr See ea Fem SEVERE donme auansate: ¢ iRegtcard pulmonar + Hip > cel mai 7 CLINIC. RAR AA AR AAR AD Aw AHA yeWWWUUUUUEUUWTUD UPN | ( “ee » OULU Sy —-we i Va Al/ RY , fobare - < bronbopnevmoniee Ss y “tuse, el == €URB-65 a am + hem e + dispnee ontuyie: preyent’i(sconul testutur mental a.<8/t0) + febr? 1 REE ross BRMMBLAELY mmol/L) +fr.ple * manif. EF ata Peselt.: SBOnese/ min «arte Clood encecires TASEBamm Hy TABSEommHg ~ Pe ES varstar secant «aif manken’ ~ cefal Rxth = S60 ipa => amoutatsr en — mea hence - host alte comorbiditak. x Febra lo varsinici tobi pacientii rntennal 7 spital thebuie 83 et: Rx analiyesc teste mnobiofagice. Rx th has ad normal Ia prey? se Repel dup’ 2-3 yile, 7n susp.clinrc 2 PO se repela la 6 capt pia exclude uu cc xsbiacent bronbic Analiye sange HLG,Cn, ionoghama,biachimia, PCR, x i dg 5 Grpmeumonie: Leu> 45 x10°/uL (neutrofilie doy. PCR 100 neutro ilie doy) VSH 100. . deu-N * dach epkey aneme> Coombs din mE.0, - 11a Hee legionella: ir Popenie \x leuicadtays marcate TASAT, ALAT hiopaAlo Gayomethia anteriala® se face doah act uiei 9, saNest Sato e wb mortglitate ‘mai mare @laioin bem i mai sevensTTT TT | ) ( ? aaN N CULM yg f, lobar zs ara NG < bronkopneumonie. @ + hemoptiyie, 7 * dispnee + febr& dactt e asiilanta, ae, gandim la ua empiem « durere toracicl oe noturd euritice® fr. pleuralé (7 faya vaifrala @ 60!) + manif. EP + paakipesmcgy morgan 56 a [HuebgiaSma = pericarait&, miocardita Mycoplasma = cefolee JLegicnella () = durere aba; aianee, vars (9) patita -» Legronella = meaciivarea HSV labial. pneumacoc,. {relat ?) ~ hosh-uri eutanate: eritem paltmonf ,nodos (SS) Hycoplasma G nave tofi pactentin intennali 7: gpital thebuie a et: Rx th a a 4 gut a ied 7 aah la pr ey? se nepett aupa 2-3 yile, 7n susp.c (inva ole PO se hepeta (a 6 capt pla exclude uu cc swabiacent bronprc Anoliye sange - HLG,Cn, ionoghama;biachimie, PCR. a Grpneumonie: Leu> 15 x10°/y L (neutrofilie 9072) PCR> 100 VSH>I90 . deu-N —* dact ephey aneme> Coombs din 0 3 ‘ mB ogl. 1a HEC elegroneua limPopenie x lelicacdtoyS marcata T ASAT, ALAT hiapadlo Gayom etna anterials se face doth aac la 44 Coltuna spite: Hepat Sata, e iub < 9% Ia tots cu PC merterat ww. em -» mOrtalitate ‘mai mare @ la Sho. Rem > er mal sevend€RB-65 = O obmicliy ‘Kanoliyex CA maxici lind Sarma x ¢ Sou Claritramiciaa Soa mg PET) Doxieialind 100 mg lyt (doya ae iudincatte 200 mg) (decd e alergie'la peniciling) enc-65- 4 / mortalitate 3 —#esteidoar dac’ susp. ‘focar epid. fepidem ie. - ee an Hycoplasma Ag preumonoeie (rn Cayce: sp) I 'Serologiel PER Ta cay de epid Amanielling Soy Di | Atricx 1 Seo-logn mg X Bly i - ce Lar ltramicin’ Sama xl! | Claritramie uk moriaitate 97 So mgxalyi au se paste oral) | olergie la penietting | Doxic voling toa eng Lyi Levotovasin Stamg x 2dyi Hoxif loxaciads boamg yi 8 =6 3 401. £3 5) 4-5 > ATh | — Ihe mocuH uti, 5pute, ay; preumoescie, F cayonena, Pek seloye Co-amoxiclav Lux dg at v +Claritro S00 mig x 214i Iv. (Aqgionelia >'Fiaragutna lore’ olergie fa pens 9 ) ) _CeFal departnd (Cette, 2g hy) + Claritro 500 x2/¥i Benullpeniciling lag Wai iw [sou lah + Levoflox, (Noxificx, eed doa dberes eaTeelrorculsge patagen ininacelubt aehob UUQIG boct la mf.alveolane.—> > @ inflam.consec yg! lane. ingenate @ infla => necroya tis. Ganvlcame. yond eentrala scayeum = —-(elrepili yond coyenass se calcific (vindlecare complet) noduli Calcif cane contin mycobactek Ca cake narminia stake dohmanda muiti ant “ + Rx: Mic nodul Fonanul Ghon be pat Genrgiongr 5 ia extratoracicl > intrator,med. adenop.cervicals /supraclaviculars = cons. f erm, nedurerca: ~ yonacentralg * va licheria > devine Fluctuant.ck e pehifortic. - fenumentel dle deasupna: indurat: / traciect fistubs cu scurgere. purulent XKenitem =p abces « rece.” probele se obfin: puuctie arpa oc fin, Afidots ecaghatic/ ope 1 peac / hey plete pl g intratoracic: >» GUS PUTT TTT ney ifyCol. cu cuttamiaa = hodamin6 T® cons, la mets > 6 lune T® SNC > mra.td luac SNC [Pericard: adjyuant CS (cami pe fermen lng) rayinamida Etambut TS purmenary 1 &xtrapulm. | Q lun Ripe TH miliard ( X SNC) TS SNC. 1; RIPE : + » — ha t 7 | Dex gametqyans 0,5°Q4 mg/Ra/yr = 4 (cu sewwta a Fragnes tmpde B- R spt) = = = Tolatent® | © luni: Ri : 3) set Le luais iyoniayidd § Cigontayidg poli neuxopatie. sec. deF.de OG => suphmentém cu Piridoxind losing lye: rash eutanat, feb d hepatits (<17-) >) = inductokal eny. hep “5 ~¢ned.concomitent inebure heeval: ahticlepr; antiepil, caloheng’ secr.org mr r0g4/FO alageny, STUN trombocitopenie.WUUTTU COUT vila) tox hep. A ~2. [rosh 2 | prurit artraigit V 8erecr, nenafd a 0.uric. * poate reguia Neuritd opticd hetrobulbart fe de tS eee te | WAV dep dle doy’ (15 mg/g, AX 2g) carcinom eu cel mict rag din cetule netehaenclar. (PUD) ~ sectetd des f, polipept. Yse dey. CENTRAL META PRECOCE ce cu ee! stuUOManse. cc. eu cel make - meta PRECOCE carci nom NOM Mickoeelulah t adk, tenapie pertsonaliyata : - mutatile de activane duu cada! EG FRY — netuUstor? — FD — amatict = pneyenta onc enet ole fuxiune a ALK — MF uatilocd / fost? ~pactinentmetastayanea {a di stan te vad. Frecvent > gql. mediastinal? cervical axilaré 7 intraabdominale dunene 0s09sa ie = Fracturt patolagice— implicanea Col vel ¥ ee > muse de compiene [1S cane = pondenalis > tHae unigen{alt durenea ta HD inod. de-a lungul abd. = invayid, copwilt 2D eer 4 iy ~ Poy cu ef de mast : ~gemne de Pic TT supranenal® inf. supr xemeningita cc. 7. mai puting Tn.gen ascnpiomatice wat Ou.c o aes / frecuent 3 = conf ye Sad 4 dg, spiculate RAR > ley.viibile >4cm, bey € Sa ararnerede ICT —>ggl.it 7A Cay. de suspiciuue a Comprere: HS cenebral > pt meta celtebrale 5. Scanarie osoast > pt meta woase A AB PP sm ot om et ot mt me MAMMA AA AARI r . - Lat “ny ubiiow -suad/| 04819 yosugnay } 103neid ‘DU 011014309 G0) UL" PU (7 eons NS ® 15 vyaw Dubus O e anenes a7 in vy Srojsopa}y } pouyorgns 165 Soe MOM iB ys qoisdiysorpeny 166 yoIi50! 1oSv0Jg Had 1 : 5 “en” a : ey FN oypjuny bo oy mbyuoyau - —— wnderpmogorsiniang : ; De sjouowny apo) 104/a40d 0 opus B wall, 7 5 gun) 1y"Gou auds DY Axo -ofq’Daw sunduans : : |. wa ssoo SaaaeReResh p:oqo] ‘oa wl FIRD;DOID' SkOWSD- — >pyowWNoIT Ta) KOAUI B a . (pIDsssIA TINE! PONV! ~ gardoosyuoug ‘pints x + SARI rpuldt> 210}29j0 BRS Q|OISDSIA S968 ce : : ganaw- — /wynd8—j ap Tou, | CA resi iYHIS — yi Std W - v1, VN, Da- vv, oe te f 2 1 i: (es IE” Saxo — Tig Noi He 2 (7 GHD - Ta No Mo 7 TS - MyYd No' Mo Ez ~ Ty No Ho e TS — ei Pyya,Tab! UNA Mo 7 WS No Mo = SHAUNA - Ti Taga iN Ho = Ws NW Ho e v GW Noy Ho e TS - Timamb Ns Mo 2 To = Awe = Yo- 2. ss = _ se , Ae = Cav. pt histofogie ¥ cilologies as & e fibrobnonhoscopia 5 # ecagna fie endo-brongica 5 « puttetie ~biopsie transgfiaat’ CT / ece: pulm S : M / meta hep/ ex, * @ tonacocenteya ghidlatS ecagrafic. eed J w) « toracascopia medical 8 /video-asistaty e mediastinoscopia laa Rael 21intentre qurativd indicat i > radio chimio pt 4 sta.» Faciliteaya rey dacs lata chir, se dem, implicarea gf > china adjuvant’ Felepimonartiadeauats _, (Tindeve mart SS 7 continua sou NSCLC To #0. incipient ier thigerFraehionata conti a eral de electie. cdnd intehv.chir. nu e posibild foomord CV (itespiratorlt’ _.,. ser stereatactid de ablone PABIa}ia prin RF may. cay, urilor 10-167. > han pod blunt pot limitata doar la yona de iractiehe nu e€ limitate nol mamelionanea : durekilar asoase ¢ de P2"-OF | Hes ound Pay obstr. brongice, fa RT pe oosth. VCS, Tenmen scunt Aemoptinia Ja 2 Se 8 2 2 a “Forele Sudcarinala a [ so Unherioara) [ipartaesoragian l — mediast aul Ng pulmonar ingerior— . 3 muboontic ona fantenopost : Caontici) paTa=aortic * gg) N4 FAAAARAAAAAAAARAARRR AAA AAA AARTy] cc. Stomac gaucneas Sdn tipic.,tumona primard: Q aase, @ inch, © prostata ® san © coluienm 6 atract GiS > li mFangita caremno mataasd t Re t ti my Rx:3)-li mfadenop. bilaterala = opocit-liniane boxale., cane se extind la ambete ari, pulen.