#Bedside_Notes
◻Respiratory (د.خليفة دعيب)

Q1_ What is the DD of large amount of sputum?
👇
1_ Bronchiactesis
2_ Alveolar cell carcinoma

Q2_ لو المريض قالك البلغم متعي تغيير فجاءة من Small amout الي large amount ، شن ممكن يكون صايرله ؟
👇
1_ Ruptured abscess
2_ Empyema

Q3_ Why an ECG is recommended in pt with respiratory diseases?
👇
1_ Drugs S/E..(Sulbutamol / Sinus Tachycardia )
2_ Chest infections exacerbates arrhythmia
( خاصة البيشنت اللي عنده AF تنوض عليه لما يصيرله pneumonia )
3_ pts with chronic respiratory diseases are risky for Core pulmonale .

#Bedside_Notes
◻Respiratory ( د.نعيمة التركي)

Q1_ What are the drugs which exacerbates the br.asthma ?
👇
1_ B,Blockers
2_ NSAID / Aspirin, Voltarin , Ipopruphen
3_ ACEIs

Q2_ امتى نسمع Course crepitation
في مريض ال Br. Asthma ?
👇
1_ If associated with Superimposed Infection
2_ If associated with Bronchiactasis

#Bedside_notes 📝
#Respiratory 🫁(د.عبد الفتاح الرياني)

🔴~ Drugs which can cause lung fibrosis~
( BBC every MANS go )💭
B- Bleomycin
B- Busalfan
C- Cyclophosphamide / Cephalosporin
M- Methotrexate
A- Amiodarone
N- Nitrofuranton
S- Sulfasalazine

بالإضافة إلي GP😁 اللي هما ال Gold وال pencillamine D و هادو أدوية قديمة كانت زمان تستخدم لعلاج ال Rheumatoid arthritis .

#Respiratory

🟨Type 1 respiratory failure (T1RF): is characterised by
hypoxaemia (PaO2 < 8 kPa)
normal or low CO2.

🟨Type 2 respiratory failure (T2RF): is characterised by
hypoxaemia (PaO2 < 8 kPa) hypercapnia (PaCO2 > 6.5 kPa).

#Respiratory

✳️Respiratory Conditions: Choice of investigations📝
__

✅Extrinsic upper airway obstruction assessment➝ Flow-volume loop

✅Expiratory obstruction (e.g. Asthma, COPD)➝ FEV1

✅Respiratory muscle strength assessment (e.g. GBS, Myasthenia gravis)➝ FVC

✅Assessment whether obstructive or restrictive lung disease➝ FEV1/FVC ratio
◾If ratio <0.7 indicates obstructive
◾If ratio is >0.7 indicates restrictive

✅Monitoring of Asthma➝ PEFR

#Respiratory

#Signs_of_Acute_severe_asthma📝
Any one of the followings:

*Peak flow 33% to 50% best
*Predicted Respiratory rate ≥25 per minute
*Heart rate ≥110 beats per minute
*Inability to complete sentences in one breath.🩺

#Respiratory

🟨The most common infective causes of COPD exacerbations are:

📝bacteria:
-Haemophilus influenzae (most common cause)
-Streptococcus pneumoniae
Moraxella catarrhalis

📝Respiratory viruses:
-account for around 30% of exacerbations
-human rhinovirus is the most important pathogen🩺

🟨Severity of COPD categorised by using

➡️FEV 1

🟨Factors which improve survival in COPD

Smoking cessation
LTOT (Long Term Oxygen Therapy)
Lung volume reduction surgery

❇️The mainstay of ttt in bronchiectasis is ➡️

📝Antibiotics + Chest physiotherapy .

🟨fibrosis predominantly effecting the lower zones of lung 🫁

📝Asbestosis
📝Idiopathic pulmonary fibrosis
📝Connective tissue diseases (Except Ankylosing spondylitis)
📝Drug induced ➡️ e.g Amiodarone, Nitrofuranton, Bleomycin , Methotrexate

و اي حاجة تانية غيرهم بتاتر على ال upper zones.

❇️Hypercalcemia and respiratory diseases

Sarcoidosis ➡️presence of 1α-hydroxylase enzyme in macrophages and giant cells that form part of the granuloma.

Squamous cell carcinoma of lung ➡️
parathyroid hormone-related peptide (PTHrP), a protein that has similar action to parathyroid hormone (PTH) .

ركزوا عليهم مهمات في ال MCQ📝

🟨CXR in patient with PE is usually

➡️Normal