•How to confirm if there is small effusion?
-(if not detected by chest X-ray PA view.)
By doing:
1-X-ray in lateral decubitus position
2-Ultrasonogram (USG) of lower part of the chest
3-Occasionally, CT scan of chest may be needed.
#Respiratory
-(if not detected by chest X-ray PA view.)
By doing:
1-X-ray in lateral decubitus position
2-Ultrasonogram (USG) of lower part of the chest
3-Occasionally, CT scan of chest may be needed.
#Respiratory
•What are the definitive signs of pleural effusion?
-Stony dullness on percussion and reduced or absent breath sound (confirmed by aspiration).
#Respiratory
-Stony dullness on percussion and reduced or absent breath sound (confirmed by aspiration).
#Respiratory
•Causes of right-sided pleural effusion
1-Liver abscess
2-Meig’s syndrome
3-Dengue hemorrhagic fever.
#Respiratory
1-Liver abscess
2-Meig’s syndrome
3-Dengue hemorrhagic fever.
#Respiratory
•Causes of left-sided pleural effusion
1-Acute pancreatitis
2-Rheumatoid arthritis
3-Dressler’s syndrome
4-Esophageal rupture (Boerhaave’s syndrome)
5-Dissecting aneurysm.
#Respiratory
1-Acute pancreatitis
2-Rheumatoid arthritis
3-Dressler’s syndrome
4-Esophageal rupture (Boerhaave’s syndrome)
5-Dissecting aneurysm.
#Respiratory
•What is yellow nail syndrome?
-It is a congenital disorder characterized by:
•Nails—yellow, thick, onycholysis
•Lymphedema of legs
•Pleural effusion or bronchiectasis.
#Respiratory
-It is a congenital disorder characterized by:
•Nails—yellow, thick, onycholysis
•Lymphedema of legs
•Pleural effusion or bronchiectasis.
#Respiratory
Remember:
-Pleural fluid cholesterol level < 60 mg dl indicates transudate.
-In all malignant effusion, pleural fluid cholesterol > 60 mg/dL. So, this test is useful to separate these two types of effusion.
-High pleural fluid ADA indicates tubercular pleural effusion.
#Respiratory
-Pleural fluid cholesterol level < 60 mg dl indicates transudate.
-In all malignant effusion, pleural fluid cholesterol > 60 mg/dL. So, this test is useful to separate these two types of effusion.
-High pleural fluid ADA indicates tubercular pleural effusion.
#Respiratory
•Why lung abscess is more common on the right side?
-It's due to less obliquity of the right major bronchus.
#Respiratory
-It's due to less obliquity of the right major bronchus.
#Respiratory
•What are the pathological stages of Pneumonia?
1-Stage of congestion—persists for 1 to 2 days
2-Stage of red hepatization(red and solid like liver)—persists for 2 to 4 days
3-Stage of grey hepatization—persists for 4 to 8 days
4-Stage of resolution—8 to 9 days or more.
#Respiratory
1-Stage of congestion—persists for 1 to 2 days
2-Stage of red hepatization(red and solid like liver)—persists for 2 to 4 days
3-Stage of grey hepatization—persists for 4 to 8 days
4-Stage of resolution—8 to 9 days or more.
#Respiratory
•What is atypical pneumonia?
-When pneumonia is caused by mycoplasma, legionella, coxiella, chlamydia.
-In these cases, constitutional symptoms are more than respiratory symptoms.
-Features are:
Gradual onset
Dry cough
Low grade fever
Constitutional symptoms are more than respiratory symptoms (headache, myalgia, fatigue, nausea, vomiting)
Less physical finding in the chest.
#Respiratory
-When pneumonia is caused by mycoplasma, legionella, coxiella, chlamydia.
-In these cases, constitutional symptoms are more than respiratory symptoms.
-Features are:
Gradual onset
Dry cough
Low grade fever
Constitutional symptoms are more than respiratory symptoms (headache, myalgia, fatigue, nausea, vomiting)
Less physical finding in the chest.
#Respiratory
•What is typical pneumonia?
-Typical pneumonia is characterized by high temperature with cough, pleuritic chest pain, features of consolidation, caused by Streptococcus pneumoniae, Staphylococcus aureus, etc.
-Respiratory symptoms are more with constitutional symptoms.
#Respiratory
-Typical pneumonia is characterized by high temperature with cough, pleuritic chest pain, features of consolidation, caused by Streptococcus pneumoniae, Staphylococcus aureus, etc.
-Respiratory symptoms are more with constitutional symptoms.
#Respiratory
•What is the usual presentation of pneumothorax?
-The patient usually presents with sudden onset of unilateral pleuritic chest pain and breathlessness.
•What are the definitive signs of pneumothorax?
-Hyper-resonance on percussion and diminished or absent breath sound.
#Respiratory
-The patient usually presents with sudden onset of unilateral pleuritic chest pain and breathlessness.
•What are the definitive signs of pneumothorax?
-Hyper-resonance on percussion and diminished or absent breath sound.
#Respiratory
•What is Hamman-Rich syndrome?
-It is a type of acute form of IPF, occurs in a small proportion of cases.
#Respiratory
-It is a type of acute form of IPF, occurs in a small proportion of cases.
#Respiratory
-Cardinal features of tension pneumothorax are progressively increasing dyspnea and features of shock.
#Respiratory
#Respiratory
In esophageal Cancer:
-Adenocarcinoma: most common type of esophageal cancer in the US.
Mostly in lower third.
-Squamous cell carcinoma(SCC): most common type of esophageal cancer worldwide.
Mostly middle&upper third.
#Esophagus
-Adenocarcinoma: most common type of esophageal cancer in the US.
Mostly in lower third.
-Squamous cell carcinoma(SCC): most common type of esophageal cancer worldwide.
Mostly middle&upper third.
#Esophagus
Note
Hyponatremia occurs in those with hyperglycemia, for every 100 mg/dL increment in plasma Glucose there is about 1.4 mEq/L drop in serum sodium level.
#Metabolic
Hyponatremia occurs in those with hyperglycemia, for every 100 mg/dL increment in plasma Glucose there is about 1.4 mEq/L drop in serum sodium level.
#Metabolic
•What is erythema nodosum?
-It is an inflammatory disorder characterized by non-suppurative, painful, palpable, tender, erythematous nodular lesion in the skin, common in shin below the knee.
#Infections
-It is an inflammatory disorder characterized by non-suppurative, painful, palpable, tender, erythematous nodular lesion in the skin, common in shin below the knee.
#Infections
•Causes of Erythema nodosum:
-Acute sarcoidosis
-S.β-hemolyticus (in throat)
-Primary pulmonary T.B.
-Drugs (sulfonamide, penicillin, estrogen-containing OCP, salicylates, barbiturates, sulfonylureas, bromides and iodides)
-IBD (Crohn’s disease, UC)
-Fungal infections (histoplasmosis, coccidioidomycosis and blastomycosis)
-Protozoal (toxoplasmosis)
-Leprosy (erythema nodosum leprosum (ENL)
-Idiopathic (up to 50% cases)
-Physiological: Pregnancy (often unilateral).
-Others: Salmonella, Shigella, Yersinia, brucellosis, Chlamydia, rickettsial and mycoplasma infection, viral infection, lymphoma, cat-scratch disease, Behçet’s syndrome and SLE.
#Infections
-Acute sarcoidosis
-S.β-hemolyticus (in throat)
-Primary pulmonary T.B.
-Drugs (sulfonamide, penicillin, estrogen-containing OCP, salicylates, barbiturates, sulfonylureas, bromides and iodides)
-IBD (Crohn’s disease, UC)
-Fungal infections (histoplasmosis, coccidioidomycosis and blastomycosis)
-Protozoal (toxoplasmosis)
-Leprosy (erythema nodosum leprosum (ENL)
-Idiopathic (up to 50% cases)
-Physiological: Pregnancy (often unilateral).
-Others: Salmonella, Shigella, Yersinia, brucellosis, Chlamydia, rickettsial and mycoplasma infection, viral infection, lymphoma, cat-scratch disease, Behçet’s syndrome and SLE.
#Infections
Causes of postural hypotension:
-Drop of systolic blood pressure 20 mmHg &drop of diastolic blood pressure 10 mmHg on standing.
1. Hypovolemia-dehydration, bleeding, hypopituitarism
2. Addisons
3. Neuropathy-autonomic as in DM, Amyloidosis, Shy-drager syndrome
4. Drugs-nitrates, antihypertensive, TCA, antipsychotic, diuretics
5. Idiopathic orthostatic hypotension-progressive degeneration of the autonomic nervous system usually in elderly.
#Cardiology
-Drop of systolic blood pressure 20 mmHg &drop of diastolic blood pressure 10 mmHg on standing.
1. Hypovolemia-dehydration, bleeding, hypopituitarism
2. Addisons
3. Neuropathy-autonomic as in DM, Amyloidosis, Shy-drager syndrome
4. Drugs-nitrates, antihypertensive, TCA, antipsychotic, diuretics
5. Idiopathic orthostatic hypotension-progressive degeneration of the autonomic nervous system usually in elderly.
#Cardiology
Liver cirrhosis
-In the micronodular form, the nodules are less than 3 mm across with uniform liver involvement - seen in alcohol or biliary disease.
-In the macronodular form there are larger nodules, classically seen in chronic viral hepatitis.
#Liver
-In the micronodular form, the nodules are less than 3 mm across with uniform liver involvement - seen in alcohol or biliary disease.
-In the macronodular form there are larger nodules, classically seen in chronic viral hepatitis.
#Liver