❇️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📝

مهماااااات جداً📝

✳️Most common type of lung cancer worldwide is
➡️ lung adenocarcinoma 📝

مهمة و لازم يجي منها سؤال سواء Case او MCQ📝

#light's_criteria

#Indications_of_Steroids_in_TB:📝

📝Pericarditis +/- Myocarditis
📝Meningitis
📝Adrenalitis
📝Uveitis
📝Paradoxical response
📝Endobronchial LN compression/impending rupture

#Manegment of Pneumothorax 📝

🟨DD of yellow nail

1_Onychomycosis
2_ Chronic paronychia
3_ Pseudonymous infection
4_ Yellow nail syndrome
5_Drugs ( Topical 5`flurouracil , tetracycline)💊

📝Restrictive/obstructive lung disaeses

🟪Restrictive_lung_disease
👉FEV1 - reduced
👉FVC - significantly reduced
👉FEV1% (FEV1/FVC) - normal or increased

◾️Main causes
*Pulmonary fibrosis
*Asbestosis
*Extrinsic hypersensitivity pneumonitis
*Sarcoidosis
*Acute respiratory distress syndrome
*Infant respiratory distress syndrome
*Kyphoscoliosis
*Neuromuscular disorders

🟪Obstructive_lung_disease
👉FEV1 - significantly reduced
👉FVC - reduced or normal
👉FEV1% (FEV1/FVC) - reduced

◾️Main causes
*Asthma
*COPD
*Bronchiectasis
*Bronchiolitis obliterans

#COPD_long_term_oxygen_therapy

✴Patients who receive LTOT should breathe supplementary oxygen for at least 15 hours
a day.

#Assess patients if any of the following:
💥very severe airflow obstruction (FEV1 < 30% predicted).
💥Assessment should be 'considered' for patients with severe airflow obstruction (FEV1 30-49% predicted)
💥cyanosis
💥polycythaemia
💥peripheral oedema
💥raised jugular venous pressure
💥oxygen saturations less than or equal to 92% on room air

#Assessment is done by measuring arterial blood gases on 2 occasions at least 3 weeks apart in patients with stable COPD on optimal management.

📝Offer LTOT to patients with

1_ pO2 of < 7.3 kPa (<55 %)
2_to those with a pO2 of 7.3 - 8 kPa and one of the following:
✔secondary polycythaemia
✔nocturnal hypoxaemia
✔peripheral oedema , raised JVP
✔pulmonary hypertension

🟨Complcations of COPD

◾️2ry Polycythemia
◾️Cor-Pulmonale
◾️Recurrent infections
(Bronchiectasis)
◾️Rupture bullae
◾️Pneumothorax
◾️Type II Respiratory failure

📝Causes of pulmonary edema
🟥Cardiogenic
Acute HF

🟥Noncardiogenic
🔵 Drowning
🔵 Acute glomerulonephritis
🔵 Fluid overload
🔵 Aspiration
🔵 Inhalation injury
🔵 Opioid overdose
🔵 Salicylate toxicity
🔵 Neurogenic pulmonary edema
🔵 Allergic reaction
🔵 Adult respiratory distress syndrome

📝Pneumonia

There are 2 types of pneumonia:
👉community-acquired pneumonia 👉 hospital acquired (nosocomial) pneumonia.

Community-acquired pneumonia are either typical or atypical, and occurs in community or within the first 72 hours of hospitalization.

Typical community-acquired pneumonia presents with acute onset of shaking chills then fever, productive cough with thick purulent sputum, pleuritic chest pain, and dyspnea. Signs are tachypnea, tachycardia, and pleural friction rub (if pleural effusion). Chest X rays shows lobar or multilobar consolidation.

Atypical community-acquired pneumonia presents with insidious onset of headache, sore throat, fatigue, myalgia, fever (chills are uncommon), and dry cough (no sputum production). Signs include fever with relative bradycardia. Chest X ray shows diffuse reticulonodular infiltrates with absent or minimal consolidation.

Nosocomial pneumonia occurs during hospitalization after the first 73 hours.

The most common pathogens of typical community-acquired pneumonia are strept. pneumoniae, hemophilus influenza, klebsiella and other enterobacteriaceae, and staph. aureus.

The most common pathogens of atypical community-acquired pneumonia are mycoplasma, chlamydia, coxiella, legionella, and viral pneumonia.

The most common bacterial pathogens of nosocomial pneumonia are escherichia coli, pseudomonas, and staph. aureus.

Studies have shown that if vital signs are entirely normal, the probability of pneumonia in outpatients is less than 1%.

Atypical pneumonia refers to organisms not visible on Gram stain and not culturable on standard blood agar.

Upper respiratory infection is more likely than lower respiratory infection if nasal discharge, sore throat, or ear pain predominates.

After treatment, changes evident on CXR usually lag behind the clinical response (up to 6 weeks).

False-negative chest radiographs occur with neutropenia, dehydration, infection with pneumocystis carinii, and early disease (less than 24 hours).

Legionella pneumonia is common in organ transplant recipients, patients with renal failure, patients with chronic lung disease, and smokers; presents with GI symptoms and hyponatremia. Urinary antigen assay for legionella is very sensitive, and the antigen persists in urine for weeks even after starting the treatment.