-Asthma with Arrhythmia:
-Digoxin and amiodarone may be used.
-Aminophylline or theophylline should be avoided.
#Respiratory
-Digoxin and amiodarone may be used.
-Aminophylline or theophylline should be avoided.
#Respiratory
Drug of choice—calcium channel blocker or ARB (losartan, valsartan). ACE inhibitor is avoided as it may induce cough in Asthma.
#Respiratory
#Respiratory
Remember:
-Metformin should be avoided in uncontrolled asthma and contraindicated in acute severe asthma.
#Respiratory
-Metformin should be avoided in uncontrolled asthma and contraindicated in acute severe asthma.
#Respiratory
Cardiac asthma:
-It means left ventricular failure in which the patient usually presents with sudden severe dyspnea and cough with profuse mucoid expectoration.
-On examination, there are bilateral basal crepitations and no rhonchi or wheeze.
#Respiratory
-It means left ventricular failure in which the patient usually presents with sudden severe dyspnea and cough with profuse mucoid expectoration.
-On examination, there are bilateral basal crepitations and no rhonchi or wheeze.
#Respiratory
Gordon’s sign:
-Elicited by pinching the calcaneus tendon.
-If present, there is extensor plantar response.
#Neurology
-Elicited by pinching the calcaneus tendon.
-If present, there is extensor plantar response.
#Neurology
Oppenheim’s sign:
-Elicited by squeezing the calf or pressing heavily along the inner border of the tibia.
-If present, there is extensor plantar response.
#Neurology
-Elicited by squeezing the calf or pressing heavily along the inner border of the tibia.
-If present, there is extensor plantar response.
#Neurology
Hoffman’s sign:
-Elicited by briskly flicking down the patient’s tip of the middle finger with the examiner’s thumb and index. If there is flexion of thumb or all fingers, it is positive.
-It indicates extensive upper motor neuron lesion.
#Neurology
-Elicited by briskly flicking down the patient’s tip of the middle finger with the examiner’s thumb and index. If there is flexion of thumb or all fingers, it is positive.
-It indicates extensive upper motor neuron lesion.
#Neurology
•What are the causes of dyspnea on exertion?
-COPD
-Bronchial asthma
-DPLD (Interstitial lung disease)
-LVF
-Valvular diseases of the heart
-Anemia.
#Respiratory
-COPD
-Bronchial asthma
-DPLD (Interstitial lung disease)
-LVF
-Valvular diseases of the heart
-Anemia.
#Respiratory
•What is Macleod’s syndrome?
-It is a type of unilateral emphysema due to childhood bronchitis or bronchiolitis, resulting in subsequent impairment of alveolar growth.
-t is a rare disease (also called Swyer-James syndrome).
#Respiratory
-It is a type of unilateral emphysema due to childhood bronchitis or bronchiolitis, resulting in subsequent impairment of alveolar growth.
-t is a rare disease (also called Swyer-James syndrome).
#Respiratory
•Why lip pursing is present in emphysema?
-By this in expiration through partly closed lips, there is increased end-expiratory pressure that keeps airway open, helping to minimize air trapping.
#Respiratory
-By this in expiration through partly closed lips, there is increased end-expiratory pressure that keeps airway open, helping to minimize air trapping.
#Respiratory
•What are the types of emphysema?
-Four types:
1-Centriacinar:
-Involves the proximal part of acini, limited to respiratory bronchiole with relatively less change in acinus.As in COPD.
2-Panacinar:
-All the alveoli and alveolar ducts in acinus are involved, both central and peripheral portion. It occurs mostly in a1-antitrypsin deficiency.
3-Paraseptal:
-Along the septa, blood vessels and pleura.
4-Scar or irregular emphysema:
-Scarring and damage affecting the lung parenchyma without involving acinus structure.
#Respiratory
-Four types:
1-Centriacinar:
-Involves the proximal part of acini, limited to respiratory bronchiole with relatively less change in acinus.As in COPD.
2-Panacinar:
-All the alveoli and alveolar ducts in acinus are involved, both central and peripheral portion. It occurs mostly in a1-antitrypsin deficiency.
3-Paraseptal:
-Along the septa, blood vessels and pleura.
4-Scar or irregular emphysema:
-Scarring and damage affecting the lung parenchyma without involving acinus structure.
#Respiratory
•Why low concentration O2 given in COPD? Or what happens when high flow O2 given?
-In COPD, the patient is dependent on hypoxic drive for respiration.
-High flow oxygen blunts the chemoresponsiveness of the respiratory center in the medulla (part of the brainstem) and thus aggravates respiratory failure (RF2).
-To avoid this, low flow oxygen is given.
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-In COPD, the patient is dependent on hypoxic drive for respiration.
-High flow oxygen blunts the chemoresponsiveness of the respiratory center in the medulla (part of the brainstem) and thus aggravates respiratory failure (RF2).
-To avoid this, low flow oxygen is given.
#Respiratory
•Poor prognostic factors in COPD:
-Increasing age (inversely related)
-Fall of FEV1 over time
-Weight loss
-Pulmonary hypertension.
#Respiratory
-Increasing age (inversely related)
-Fall of FEV1 over time
-Weight loss
-Pulmonary hypertension.
#Respiratory
•What organisms are associated with acute exacerbation of COPD?
-Common organisms:
Haemophilus influenzae
Streptococcus pneumoniae.
-Less common organisms:
Moraxella catarrhalis
Chlamydia pneumoniae
Pseudomonas aeruginosa.
#Respiratory
-Common organisms:
Haemophilus influenzae
Streptococcus pneumoniae.
-Less common organisms:
Moraxella catarrhalis
Chlamydia pneumoniae
Pseudomonas aeruginosa.
#Respiratory
•What are the types of cor pulmonale?
1-Acute:
-It occurs following massive pulmonary embolism with acute pulmonary HTN causing right ventricular dilatation and failure (no RVH).
-May occur in ARDS.
2-Chronic:
-It's defined as “right ventricular hypertrophy or dilatation with or without right sided heart failure due to causes of lung parenchyma, pulmonary vasculature or chest wall.
#Respiratory
1-Acute:
-It occurs following massive pulmonary embolism with acute pulmonary HTN causing right ventricular dilatation and failure (no RVH).
-May occur in ARDS.
2-Chronic:
-It's defined as “right ventricular hypertrophy or dilatation with or without right sided heart failure due to causes of lung parenchyma, pulmonary vasculature or chest wall.
#Respiratory
Remember:
•Unilateral bronchiectasis in:
-Resolution stage of pneumonia
-Lung abscess
-Localized fibrosis of lung.
#Respiratory
•Unilateral bronchiectasis in:
-Resolution stage of pneumonia
-Lung abscess
-Localized fibrosis of lung.
#Respiratory
•What is post-tussive crepitation? What is its significance?
-Crepitation which appears after cough is called posttussive crepitation.
-It's usually at the apex, indicates TB.
#Respiratory
-Crepitation which appears after cough is called posttussive crepitation.
-It's usually at the apex, indicates TB.
#Respiratory
Remember:
•Causes of bilateral crepitation with clubbing:
-Bilateral bronchiectasis
-IPF (fibrosing alveolitis or ILD).
#Respiratory
•Causes of bilateral crepitation with clubbing:
-Bilateral bronchiectasis
-IPF (fibrosing alveolitis or ILD).
#Respiratory
•What is dry bronchiectasis (bronchiectasis sicca)?
-It is a type of bronchiectasis in which dry cough is associated with intermittent episodes of hemoptysis.
-It may be massive, even life-threatening as bleeding is from bronchial vessels with systemic pressure.
-Common in patient with granulomatous infection, especially TB and usually involves upper lobe.
#Respiratory
-It is a type of bronchiectasis in which dry cough is associated with intermittent episodes of hemoptysis.
-It may be massive, even life-threatening as bleeding is from bronchial vessels with systemic pressure.
-Common in patient with granulomatous infection, especially TB and usually involves upper lobe.
#Respiratory
Remember:
•Pleural fluid normally present: 5 to 15 mL.
•At least 500 mL of fluid is necessary to detect clinically.
•At least 300 mL of fluid is necessary to detect radiologically in PA view.
•At least 100 mL of fluid is necessary to detect radiologically in lateral decubitus position.
•Less than 100 mL or small amount of fluid is detected by ultrasonography (even 20 to 25 mL fluid can be detected).
#Respiratory
•Pleural fluid normally present: 5 to 15 mL.
•At least 500 mL of fluid is necessary to detect clinically.
•At least 300 mL of fluid is necessary to detect radiologically in PA view.
•At least 100 mL of fluid is necessary to detect radiologically in lateral decubitus position.
•Less than 100 mL or small amount of fluid is detected by ultrasonography (even 20 to 25 mL fluid can be detected).
#Respiratory