#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

🟨CURB-65 score

Patients are stratified for risk of death as follows:

0: low risk (less than 1% mortality risk)

1 or 2: intermediate risk (1-10% mortality risk)

3 or 4: high risk (more than 10% mortality risk). https://t.co/pZQ5BjtoIW

#Keypoints_Pneumonia 🩺📝

Symptoms of pneumonia + Rust-colored sputum+H/O herps libials =
❇️Sterptococcus pneumonia

Symptoms of pneumonia + yellow to green Sputum + H/O common cold (flu) =
❇️Staph.aureus

Symptoms of pneumonia + red currant jelly Sputum + Alcoholic or Diabetes patients + cavitary lesion in upper lobe =
❇️Klebsiella pneumonia

Symptoms of pneumonia + SIADH (⬇️Na) + H/O of using hot water tanks =
❇️Legionella pneumonia

Symptoms of pneumonia + Hemolytic anemia (positive cold agglutinins test) + GBS + Erythema multiform =
❇️Mycoplasma pneumonia

مهماااااات هلبا تبتوهم🙏💪

❇️Indication of steroids in sarcoidosis 📝

❇️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📝