شيت بوص صهيب

#respirtory examination
Dr. Safa

د. الفنوب

Discussion 💬 💬 💬 💬 💬 💬 💬 💬

Respiratory

معظمم الكيس Lung fibrosis
بعد تخلصي بسألك اها ال DD شنو
اول شي تقولي ال TB
بعداك ترصي باقي الدفنرشيال
يلا بسألك أسماء ال Anti Tb
و بقول ليك قولي لي السايد افكت حق اي واحد




Pleural effusion
سألني من ال cause ممكن يكون شنو
الinvestigation
وبعداك سألني من الT. B الdiagnosis والmanagment والside effect بتاعت ال anti T. B

Lung Fibrosis


My diagnosis is right apical lung
fibrosis evidence by
By inspection the right side is moving less and depressed , trachea is divided to right side
Tactile Vocal fremitus + Vocal Resonance increase in right side and they are bronchial breathing at right side and they are fine crackles
Not change by cough

D/D
Upper lobe fibrosis

1. Post infection: like Tuberculosis which it is most common in our country

2. Connective tissue Disease
Like ankylosis Spondylitis
And sarcoidosis

3.Post Radiotherapy

4. Extrinsic allergic alveolitis

5. Post trauma



∆Investigation:

#Specific
1.Chest X Ray: looking for evidence of lung fibrosis like loss of lung volume
What else?
ground glass appearance/ Honey comp
More specific HRCT


2. Lung Function tests looking of Restrictive pattern 80% or higher than it

3. For sputum .... Acid fast bacilli

4. arterial blood gas


#General

1. Complete blood count
Looking For Wight blood cells count

2. Renal Function tests

3. Urinalysis


∆ Management

✓Pharmacological
Supportive treatment

Steroids if early stage
And antibiotics if they culture are postive



✓Non_Pharmological

1.Education
2. Consoling
3. Stop smoking
4 .vaccine

بسأل برضو
Example For anti Fibrotic Drug?
Nintedanib
Pirfenidone