Bronchiolitis Obliterans

Flu-like symptoms, non-productive cough, fever, malaise, dyspnea of 2 – 4 months duration. Resistant to antibiotics treatment. Inspiratory crackles and occasional wheezing can be found. Elevated WBC or ESR or both It is caused by excessive proliferation of granulation tissue within small airways and alveolar ducts, and chronic inflammation in the alveoli. Lung biopsy shows… Read more »

Idiopathic Pulmonary Arterial Hypertension

Idiopathic Pulmonary Arterial Hypertension (formerly primary pulmonary hypertension and also called: plexogenic pulmonary arteriopathy) is characterized by elevated pulmonary artery pressure with no apparent cause.  Drug- and toxin-induced pulmonary arterial hypertension has been most clearly linked to anorexigens, including aminorex, fenfluramine, and dexfenfluramine. Although these agents are no longer used, observational studies link amphetamines, methamphetamines, and… Read more »

Granulomatosis with polyangiitis

Granulomatosis with polyangiitis (GPA), formerly known as Wegener granulomatosis is a granulomatous vasculitis of upper and lower respiratory tract and glomerulonephritis (variable degrees of diffuse vasculitis also may be present). Upper respiratory symptoms (sinusitis), lower respiratory symptoms (multiple bilateral lung lesions – necrotizing granulomas), and glomerulonephritis are main symptoms. Cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA)can be detected… Read more »

Pulmonary Embolism

Pulmonary embolus (PE) refers to the obstruction of the pulmonary artery or one of its branches by a material (eg, thrombus, tumor, air, or fat) that originated elsewhere in the body. The incidence of pulmonary embolism has increased since the introduction of computed tomography. Before 1998, the 5 year incidence rate was 68 per 100,000 which… Read more »

Legionnaire’s Disease

Caused by Legionella pneumophila The Legionella bacteria (the cause for Legionnaires’s Disease) are found naturally in the environment, usually in water. The bacteria grow best in warm water, like the kind found in Hot tubs Cooling towers Hot water tanks Large plumbing systems Decorative fountains They do not seem to grow in car or window air-conditioners. The bacteria are not spread… Read more »

Primary Lung Malignancies

The primary lung malignancies are: Small Cell and Non-Small Cell. Lung cancer is the leading cause of cancer death in BOTH men and women. Risk factors include: ~Smoking ~Asbestos ~COPD ~Exposure to heavy metals & gases ~Secondary smoke Non-Small Cell Lung Cancer Non-small cell lung cancer accounts for 85% of all lung cancers. Non-small cell… Read more »

Upper Airway Cough Syndrome

Top Three Causes of a COUGH: Upper airway cough syndrome, previously referred to as postnasal drip syndrome Asthma Gastroesophageal reflux disease (GERD) “The pathogenic triad of chronic cough” Postnasal drip syndrome refers to secretions from the sinuses that drain into the pharynx causing frequent throat clearing.  20% of patients with Postnasal drip syndrome-induced cough are unaware… Read more »

Kartagener syndrome

This is a syndrome of immotile cilia associated with situs viscerum inversus. The classic combination is situs inversus, chronic sinusitis, and bronchiectasis There is also male infertility due to immotility of the sperms, recurrent or chronic sinusitis, and bronchiectasis.

Pulmonary Function Test Questions

  As we’ve stressed, out Hot Topics are HOT because we think there will be questions on these topics.  With Flow Volume Loops, we KNOW there will be questions on this!!  Just spend a little time on this and look for these questions.  First make sure you know the basic volumes shown above in the… Read more »

Pleural Effusions

Effusions can be either exudative or transudative. At least 150 mL of fluid is needed to be seen on upright PA films as blunting of costophrenic angle, and 25-50 mL on lateral films. Obtain decubitus films on all patients prior to thoracentesis to decipher loculations and evaluate underlying parynchema. >1cm of fluid on decub film… Read more »