Pulmonology : Chest Medicine and Respiratory Medicine

SARS is caused by a single-stranded RNA coronavirus that infects respiratory tract cells via the angiotensin converting enzyme, with possible systemic spread and respiratory distress syndrome, and no proven therapy.

Explore the pneumonia severity index, also known as gerb 65, which uses confusion, urea, blood pressure, and age to assign 0–1, 2, or 3–5 points for severity.

Identify allergic bronchopulmonary aspergillosis as a hypersensitivity reaction to aspergillus fumigatus in patients with asthma or cystic fibrosis, causing mucus plugs and central bronchiectasis.

Learn how the DLCO diffusion test measures carbon monoxide transfer from alveoli to blood, and how factors like membrane area, thickness, diffusion coefficient, RBC volume, and hemoglobin influence diffusion.

Pulmonary hemosiderosis causes repeated intrapulmonary bleeding with iron accumulation in alveolar macrophages and iron-deficiency anemia, with variants including Good Posture Syndrome and hyena's syndrome (cow's milk hypersensitivity) and pulmonary hemorrhage.

Central cyanosis arises from decreased arterial oxygen, affecting mucous membranes and the skin. Peripheral cyanosis results from redistribution or obstruction of blood flow.

Define respiratory failure as a condition where arterial oxygen falls and lung function cannot meet metabolic demands, with type i perfusion or diffusion defects and type ii ventilation failure.

Differentiate static and dynamic lung compliance: static is elasticity, unaffected by resistance; dynamic includes resistance. Static reduces in rigid lungs, dynamic in obstruction; emphysema shows static decline with dynamic rise.

Identify atypical pneumonia as an interstitial, non-consolidative infection caused by intracellular organisms and viruses, including mycoplasma, chlamydia, Coxiella, Pneumocystis, and influenza, with mild white blood cell elevation.

Explore allergic asthma with family history and elevated IgE, and idiosyncratic asthma with no history or negative tests, then classify severity as mild, moderate, or severe.

Bronchiectasis is a structural abnormality defined by dilation and distortion of the bronchial tree, causing chronic obstructive lung disease and cough with sputum, evaluated by CT imaging and laboratory tests.

Adenocarcinoma is the most common lung cancer. Small cell carcinoma metastasizes to the opposite lung and causes Cushing's syndrome; squamous cell shows cavitation and calcifications and has the best prognosis.

Identify pulmonary embolism risk factors such as immobility, age, obesity, pregnancy, estrogen therapy, trauma or surgery, heart failure, and leg paralysis; screen with d-dimer and CT angiography.

Explore how the tuberculin test uses cell-mediated immunity and delayed-type hypersensitivity to detect Mycobacterium tuberculosis infection, via intradermal purified protein derivatives that provoke induration and redness within 48–72 hours.

Define a lung cavity as a gas-filled space within consolidation or a mass, from necrosis or infection; include bacterial and fungal etiologies, tumors, and autoimmune associations.

Asthma is a chronic inflammatory airway disease causing wheeze, breathlessness, and nocturnal cough due to bronchoconstriction and increased airway responsiveness, with mucus plugs and remodeling.

Explore how chronic obstructive pulmonary disease is graded from mild to very severe using FEV1 percent predicted, and identify related symptoms like chronic cough and sputum production alongside spirometry values.

Kartagener syndrome, an autosomal recessive manifestation of primary Silveri dyskinesia, results from damaged cilia binding arms, causing bronchiectasis, sinusitis, infertility, and situs inversus.

Explore bronchiolitis obliterans, detailing proliferative and obstructive forms driven by chronic inflammation, fibroblast and immune cell infiltration, leading to airway obstruction with minimal radiographic changes and variable corticosteroid responsiveness.

Clubbing is the bulging of the fingers; it signals various diseases, including respiratory and cardiovascular conditions such as endocarditis, lung abscess, bronchiectasis, cystic fibrosis, malignancy, and idiopathic pulmonary fibrosis.

Explore tropical eosinophilic pneumonia, featuring nocturnal cough and wheezing, male predominance, eosinophilia, and restrictive lung function, with risks of chronic fibrosis and lymphadenopathy and hepatic involvement.

Explain how inhaled bacilli seed primary TB in high-flow lung zones, survive in macrophages, and form granulomas and Ghon complexes, then reactivate as secondary TB with necrosis and cavitation.

acute respiratory distress syndrome is an acute diffuse alveolar injury causing respiratory failure, triggered by pneumonia, aspiration, inhalation injury, sepsis, trauma, pancreatitis, and cardiopulmonary bypass.