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Essential Respiratory Medicine
von: Shanthi Paramothayan
Wiley-Blackwell, 2018
ISBN: 9781118618325 , 424 Seiten
Format: PDF, Online Lesen
Kopierschutz: DRM
Preis: 40,99 EUR
eBook anfordern 
Title Page
5
Copyright Page
6
Contents
9
About the author
11
Acknowledgements
13
About the companion website
15
Chapter 1 Introduction to respiratory medicine
17
About the book
18
Chapter 2 Embryology, anatomy, and physiology of the lung??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
21
Introduction
22
Development of the respiratory system
22
Development of the lungs
22
The respiratory tract
24
Muscles of respiration and mechanical ventilation
27
Structure of the lungs
30
Blood supply of the lungs
32
Nervous supply of the lungs
33
Lymphatics of the lungs
33
Control of breathing
34
Central control
34
Lung receptors and reflexes
34
Chemoreceptors
35
Transport of oxygen
36
Transport of carbon dioxide
37
The acid?base balance
39
Ventilation?perfusion mismatch
39
Lung defence
39
Multiple choice questions
41
Further Reading
44
Chapter 3 Pharmacology of the lung????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
45
Drugs and the lung
46
Principles of drug deposition in lungs
46
Inhaler devices
47
Oxygen
51
Inhaled drugs
52
Drugs prescribed for smoking cessation
60
Drugs that damage the lungs
61
Multiple choice questions
63
Further Reading??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
66
Chapter 4 Common respiratory investigations??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
67
Laboratory tests
68
Imaging of the lung
71
Lung function tests
81
Exercise testing
90
Sleep studies
91
Cardiology investigations
91
Invasive investigations
91
Miscellaneous investigations
93
Multiple choice questions
94
Further Reading??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
96
Chapter 5 Common presentations of respiratory disease??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
99
Respiratory history
100
Breathlessness
101
Management of severe breathlessness
104
Cough
104
Haemoptysis
105
Management of life?threatening haemoptysis
105
Chest pain
106
Wheeze
108
Hoarse voice
108
Snoring
108
Examination of the respiratory system
108
Examination of the chest
110
Pre?operative respiratory assessment
115
Post?operative respiratory problems
115
Respiratory assessment of an acutely ill patient
117
Multiple choice questions
118
Further Reading??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
120
Chapter 6 Obstructive airways disease??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
121
Introduction
122
Asthma
123
Definition
123
Epidemiology
123
Pathophysiology of asthma
124
Clinical presentation
125
Chronic obstructive pulmonary disease (COPD)
133
??1 Antitrypsin Deficiency
141
Allergic bronchopulmonary aspergillosis (ABPA)
142
Vocal cord dysfunction
143
Hyperventilation syndrome (HV)
144
Multiple choice questions
146
Appendix 6.A Diagnosis of asthma
148
Appendix 6.B Management of asthma
149
Appendix 6.C Management of COPD
150
Further Reading??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
151
Chapter 7 Diffuse parenchymal lung disease????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
153
Introduction
154
Diagnosis of DPLD
154
Investigations in a patient suspected of a DPLD
155
Idiopathic interstitial pneumonias (IIP)
156
Pathophysiology
156
Idiopathic pulmonary fibrosis (IPF)
157
Clinical presentation of IPF
158
Investigations in IPF
158
Management and prognosis in IPF
159
Non?specific interstitial pneumonia (NSIP)
160
Clinical presentation of NSIP
161
Investigations in NSIP
161
Management of NSIP
162
Prognosis in NSIP
162
Cryptogenic organising pneumonia (COP)
162
Desquamative interstitial pneumonia (DIP)
163
Respiratory bronchiolitis interstitial lung disease (RB?ILD)
164
Lymphoid interstitial pneumonia (LIP)
164
Acute interstitial pneumonia (AIP)
165
Eosinophilic lung disease
165
Sarcoidosis
166
Clinical presentation of sarcoidosis
170
Acute sarcoidosis (Löfgren’s syndrome)
170
Chronic sarcoidosis
170
Multisystem sarcoidosis
171
Investigations
171
Radiology
171
Blood tests
174
Lung function test
174
Histological diagnosis of sarcoidosis
174
Other investigations
174
Management and prognosis of sarcoidosis
175
Hypersensitivity pneumonitis (HP)
176
Acute hypersensitivity pneumonitis
176
Sub?acute hypersensitivity pneumonitis
177
Chronic hypersensitivity pneumonitis
178
Management of HP
178
Prognosis of HP
179
Lymphangioleiomyomatosis (LAM)
179
Pulmonary Langerhans cell histiocytosis (PLCH)
180
Pulmonary alveolar proteinosis (PAP)
181
Pulmonary amyloidosis
182
Multiple choice questions
184
Appendix 7.A Drugs that cause peripheral eosinophilia
186
Further Reading??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
186
Chapter 8 Respiratory infections????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
189
Introduction
190
Respiratory tract infections
190
Pneumonia
191
Viral pneumonia
191
Bacterial pneumonia
192
Community acquired pneumonia (CAP)
192
Pathophysiology
192
Diagnosis of CAP
197
Microbiological diagnosis of CAP
197
Radiological diagnosis of CAP
198
Management of CAP
199
Prognosis with CAP
200
Hospital acquired pneumonia (HAP)
201
Ventilator?associated pneumonia
201
Aspiration pneumonia
202
Lipoid pneumonia
202
Pulmonary infections in the immunocompromised
202
Mycobacterium tuberculosis
204
Epidemiology
204
Pathogenesis of primary pulmonary tuberculosis
204
Post?primary tuberculosis
205
Immunology
205
Diagnosis
205
Radiological diagnosis
206
Microbiological and histological diagnosis
206
Immunological diagnosis
207
Management of MTB
208
HIV and MTB
211
Information to patients with TB
211
Infectivity of tuberculosis
211
Contact tracing
211
Screening of immigrants
212
Latent tuberculosis
212
Prevention of Mycobacterium tuberculosis (MTB)
212
Treatment of multi?drug?resistant tuberculosis (MDRTB)
212
Pulmonary complications of mycobacterium tuberculosis
213
Extra?pulmonary tuberculosis
213
Opportunistic (atypical) mycobacterium
215
Multiple choice questions
217
Further Reading??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
220
Chapter 9 Lung cancer??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
221
Introduction
222
Epidemiology of lung cancer
222
Aetiology of lung cancer
224
Pathophysiology of lung cancer
225
Clinical presentation of lung cancer
225
Clinical signs of lung cancer
226
Ectopic secretion of hormones in lung cancer
226
Management of superior vena cava obstruction (SVCO)
228
Management of a patient suspected of having a lung malignancy
228
Clinical assessment of patient with suspected lung cancer
228
Investigations for patients suspected of having lung cancer
228
Histological diagnosis
230
Classification of lung cancer
232
Staging of NSCLC
233
Staging of SCLC
233
Management of lung cancer
233
Surgery
233
Essential investigations prior to surgery
236
Fitness for surgery
236
Post?operative complications
236
Follow?up post?surgery
237
Radiotherapy
237
Radical radiotherapy
237
Palliative radiotherapy
238
Chemotherapy
238
Assessing fitness for chemotherapy
238
Chemotherapy for NSCLC
238
Chemotherapy for SCLC
239
Palliative chemotherapy
239
Side effects of chemotherapy
239
Treatment response
239
Targeted molecular therapy
239
Palliative treatment
240
Palliative procedures
240
Communicating the diagnosis of lung cancer
240
The lung multidisciplinary meeting
240
Tracheal and laryngeal tumours
241
Benign lung masses and solitary pulmonary nodules (SPN)
241
Common causes of SPN and benign lung mass
242
Cavitating lung lesions
242
Carcinoid tumour
242
Future developments
245
Multiple choice questions
246
Further Reading??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
249
Chapter 10 Pleural disease????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
251
Normal pleura and pleural fluid
252
Pleural effusion
252
Definition
252
Aetiology of pleural effusion
252
Clinical assessment of a patient presenting with a pleural effusion
252
Diagnostic pathway for management of a unilateral pleural effusion
252
Pleural Aspiration (Thoracocentesis)
253
Pleural biopsy
255
Differential diagnosis of a transudate
257
Management of a transudate
258
Differential diagnosis of an exudate
258
Management of malignant pleural effusion
258
Pleural infection and empyema
259
Definitions
259
Aetiology of pleural infection
259
Pathophysiology of pleural infection
260
Pneumothorax
264
Definition
264
Primary spontaneous pneumothorax (PSP)
264
Secondary pneumothorax (SP)
264
Clinical presentation of pneumothorax
265
Investigations for a pneumothorax
266
Classification of pneumothorax
266
Management of pneumothorax
266
Management of primary spontaneous pneumothorax (PSP)
266
Intercostal chest drain insertion for pneumothorax
267
Management of secondary pneumothorax (SP)
267
Management of patients with a chest drain for pneumothorax
268
Complications of chest drain for pneumothorax
268
Surgery for persistent pneumothorax
268
Traumatic pneumothorax
269
Tension pneumothorax
269
Management of tension pneumothorax
269
Recurrent pneumothorax
269
Asbestos?related pleural disease
270
Benign pleural plaque
270
Diffuse pleural thickening
271
Benign asbestos?related pleural effusion
272
Mesothelioma
272
Aetiology of mesothelioma
273
Pathophysiology of mesothelioma
273
Investigations in the diagnosis of malignant mesothelioma
273
Pleural biopsy
274
Pathological types of malignant mesothelioma
275
Management of malignant mesothelioma
275
Palliative care
275
Chemotherapy
275
Surgery
276
Compensation
276
Multiple choice questions
277
Appendix 10.A Analysis of pleural fluid
279
Biochemistry
279
Microbiology
279
Cytology
280
pH
280
Haematocrit
280
Appendix 10.B Compensation for asbestos?related disease
280
Further Reading??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
281
Chapter 11 Pulmonary embolus, pulmonary hypertension, and vasculitides????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
283
Introduction
284
Pulmonary embolism
284
Acute pulmonary embolus
286
Diagnosis of pulmonary embolus
286
Investigations in the diagnosis of pulmonary embolus
287
Imaging to confirm a diagnosis of PE
288
Management of acute pulmonary embolus
291
Anticoagulation
291
Oral anticoagulation
292
Duration of anticoagulation
292
Inferior vena cava filter
292
Management of massive life?threatening pulmonary embolus
293
Prognosis after acute PE
293
Recurrent pulmonary emboli
293
Chronic pulmonary emboli
293
Pulmonary hypertension
294
Classification of pulmonary hypertension
295
Group 1: Pulmonary Arterial Hypertension
295
Group 2: Pulmonary hypertension secondary to left heart disease
298
Group 3: Pulmonary hypertension secondary to lung disease
298
Group 4: Pulmonary hypertension secondary to chronic thromboembolic disease (CTEPH)
298
Group 5: Multifactorial pulmonary hypertension
298
Management of pulmonary hypertension
299
Surgical treatment of pulmonary hypertension
299
Pulmonary haemorrhagic syndromes
299
Granulomatosis with polyangiitis (GPA)
300
Other vasculitides
300
Anti?glomerular basement membrane antibody (Goodpasture’s) syndrome
300
Eosinophilic granulomatosis with polyangiitis (Churg?Strauss syndrome)
301
Hereditary haemorrhagic telangiectasia (HHT)
302
Multiple Choice Questions
303
Further Reading??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
306
Chapter 12 Suppurative lung disease??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
309
Introduction
310
Bronchiectasis
310
Pathogenesis of bronchiectasis
311
Aetiology of bronchiectasis
312
Diagnosis of bronchiectasis
314
Differential diagnoses of bronchiectasis
315
Management of bronchiectasis
316
Infective exacerbations of bronchiectasis
318
Prevention of exacerbations
318
Cystic fibrosis
320
Clinical presentation of CF
321
Diagnosis of CF
321
Management of CF
321
Prognosis of CF
324
Future therapy for CF
324
Primary ciliary dyskinesia
324
Diagnosis of PCD
324
Lung abscess
325
Causative organisms in lung abscess
326
Management of lung abscess
326
Multiple choice questions
328
Further Reading??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
330
Chapter 13 Respiratory failure????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
333
Respiratory failure
334
The regulation of breathing
334
Mechanisms of respiratory failure
335
Type 1 respiratory failure
335
Clinical presentation of type 1 respiratory failure
336
Investigations in type 1 respiratory failure
336
Alveolar?arterial oxygen gradient
336
Management of type 1 respiratory failure
336
Oxygen therapy and monitoring in type 1 respiratory failure
337
Devices for giving oxygen
337
Chronic type 1 respiratory failure
338
Type 2 respiratory failure
338
Clinical presentation of acute type 2 respiratory failure
339
Investigations for acute type 2 respiratory failure
339
Immediate management of acute type 2 respiratory failure
340
Controlled oxygen therapy and monitoring in type 2 respiratory failure
340
Type 2 respiratory failure: to treat or not to treat?
340
Non?invasive ventilation (NIV)
341
BiPAP
342
Monitoring on NIV
343
Weaning off NIV
344
Respiratory stimulants
344
Prognosis and outcome
344
Management of chronic type 2 respiratory failure
344
Multiple choice questions
345
Appendix 13.A Calculation of the alveolar?arterial oxygen gradient
348
Further Reading??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
348
Chapter 14 Sleep-related disorders????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
349
Introduction
350
Sleep physiology
350
Non?REM sleep
350
REM sleep
351
Snoring
352
Simple snoring
352
Upper airways resistance syndrome (UARS)
352
Management of UARS
352
Obstructive sleep apnoea/hypopnoea syndrome (OSAHS)
353
Epidemiology of OSAHS
354
Pathophysiology of OSAHS
355
Investigations for possible OSAHS
357
Diagnosis of OSA
358
Consequences of OSA
358
OSAHS and driving
359
Management of OSA
360
Lifestyle changes
360
Surgery
360
Intra?oral devices
360
Mandibular advancement device (MAD)
360
Continuous positive airway pressure (CPAP)
360
Narcolepsy
362
Pathophysiology
362
Clinical features
362
Investigations
362
Management
362
Periodic limb movement disorder (PLMD)
363
Restless leg syndrome (RLS)
363
REM behaviour disorder (RBD)/parasomnia
363
Idiopathic hypersomnia (IH)
363
Insomnia
364
Chronic sleep insufficiency
364
Central sleep apnoea (CSA)
364
Nocturnal hypoventilation
364
Multiple choice questions
365
Appendix 14.A Epworth Sleepiness Scale (ESS)
367
Further Reading??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
368
Chapter 15 Occupational, environmental, and recreational lung disease??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
369
Occupational, environmental, and recreational lung diseases
370
Occupational lung disease
370
Occupational asthma
370
Pneumoconiosis
371
Asbestosis
372
Coal worker’s pneumoconiosis
374
Silicosis
375
Siderosis
376
Byssinosis
376
Berylliosis
376
Hypersensitivity pneumonitis
376
Recreational drugs and the lungs
376
Smoking
377
Cocaine
378
Cannabis
378
The environment and the lungs
379
Pollution
379
Toxic substances
379
Inhaled allergens and irritants
379
Weather
379
Multiple choice questions
381
Further Reading??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
383
Chapter 16 Disorders of the mediastinum??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
385
Anatomy of the mediastinum
386
Diagnosis of a mediastinal mass
386
History and examination
386
Chest X?ray: PA and lateral
387
Anterior mediastinal mass
387
Middle mediastinal mass
390
Posterior mediastinal mass
392
Other mediastinal conditions
393
Multiple choice questions
395
Further Reading??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
397
Chapter 17 Acute lung injury and acute respiratory distress syndrome????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
399
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS)
400
Diagnosis of ALI and ARDS
400
Incidence and mortality of ALI and ARDS
401
Pathogenesis of ALI and ARDS
401
Investigations in patients suspected of ALI and ARDS
402
Management of ALI and ARDS
402
Principles of mechanical ventilation in ARDS
403
Other therapies for ARDS
403
Morbidity and mortality in ARDS
403
Transfusion?Related Acute Lung Injury (TRALI)
403
Acute chest syndrome with sickle cell disease
404
Smoke inhalation
404
Carbon monoxide poisoning
405
Airway trauma
405
Near?drowning
405
Deep sea diving
405
Acute altitude sickness
406
Multiple choice questions
407
Further Reading??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
409
Index
411
EULA
425