Bob Dylan, Leonard Cohen, & the Cochrane review of videolaryngoscopy
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Acute colonic pseudo-obstruction (Oglivie’s syndrome)
CONTENTS Basics Clinical presentation Differential diagnosis Evaluation Causes Approach & management Podcast Questions & discussion Pitfalls definition Acute colonic pseudo-obstruction refers to a paralytic ileus of the colon which causes severe colonic dilation. In some cases the small bowel may also be involved. This is not due to anatomic obstruction, but rather due to hypomotility. […]
Large volume thoracentesis: How much can safely be removed?
0 Introduction 0 Completely draining a pleural effusion has many benefits including symptomatic improvement, avoiding multiple procedures, faster disposition home, and imaging the chest with the lung inflated. However, complete drainage is usually avoided to due to fear of re-expansion pulmonary edema. What is the evidence behind this? 0 Traditional model of reexpansion pulmonary edema (RPE) 0 […]
“The Case of the Uncertain Principle”
Atoms or elementary particles themselves are not real; they form a world of potentialities or possibilities rather than one of things or facts. -Werner Heisenberg The uncertainty principle states, there is a limit to the precision with which the position and momentum of any subatomic particle can be measured. Their location and velocity can only […]
Pleuroparenchymal fibroelastosis (PPFE)
CONTENTS Basics Epidemiology Clinical presentation Radiology Differential diagnosis Diagnostic approach Management Prognosis Questions & discussion abbreviations used in the pulmonary section: 1 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute exacerbation of ILD 📖 AEP: Acute eosinophilic pneumonia 📖 AFB: Acid Fast Bacillus AIP: Acute interstitial pneumonia (Hamman-Rich syndrome) 📖 ANA: Antinuclear antibody 📖 ANCA: Antineutrophil […]
Pulmonary alveolar proteinosis (PAP)
CONTENTS Basics Epidemiology Clinical presentation Radiology Bronchoscopy Laboratory studies Diagnosis Treatment Questions & discussion abbreviations used in the pulmonary section: 7 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute exacerbation of ILD 📖 AEP: Acute eosinophilic pneumonia 📖 AFB: Acid fast bacilli AIP: Acute interstitial pneumonia (Hamman-Rich syndrome) 📖 ANA: Antinuclear antibody 📖 ANCA: Antineutrophil cytoplasmic […]
Pulmonary Function Tests (PFTs)
CONTENTS Rapid reference: Approach to PFT interpretation 🚀 Approach to spirometry Approach to lung volumes About pulmonary function tests (PFTs) Contraindications to PFTs Brief discussion of commonly utilized tests Obstruction Large airway obstruction Restriction Nonspecific ventilatory limitation PRISM (preserved ratio impaired spirometry) DLCO Bronchial responsiveness: Bronchodilator response Methacholine bronchoprovocation Neuromuscular weakness & inspiratory pressures Changes […]
Pulmonary disorders of calcification & metastatic bone formation
CONTENTS Pulmonary alveolar microlithiasis (PAM) Metastatic pulmonary calcification (MPC) Differential diagnosis of pulmonary calcification & ossification Questions & discussion abbreviations used in the pulmonary section: 8 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute exacerbation of ILD 📖 AEP: Acute eosinophilic pneumonia 📖 AFB: Acid-fast bacilli AIP: Acute interstitial pneumonia (Hamman-Rich syndrome) 📖 ANA: Antinuclear antibody […]
PulmCrit- Nucleic acid microarrays streamline bacteremia management
Verigene is a nucleic acid micro-array which can be used to provide rapid information about positive blood cultures. The array detects genetic information which may reveal the genus/species of bacteria and the presence of various resistance genes.
Superior vena cava syndrome (SVCS)
CONTENTS Causes Signs & symptoms Diagnosis: CT scan findings Grading system to define severity Management: Range of treatment options Management of critical SVC syndrome Pathophysiology & anatomy Questions & discussion abbreviations used in the pulmonary section: 5 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute exacerbation of ILD 📖 AEP: Acute eosinophilic pneumonia 📖 AFB: Acid […]
Fluid selection using pH-guided resuscitation
0 PART 1: Fluid selection for resuscitation of hypovolemic, hyperkalemic renal failure 0 Introduction with a case 0 An elderly man on an ACE inhibitor and NSAIDs presents to the emergency department after a few days of severe norovirus gastroenteritis with a creatinine of 5 mg/dL, a bicarbonate of 15 mEq/L, and a potassium of […]
Pneumothorax and bronchopleural fistula (BPF)
CONTENTS Definitions & classifications Symptoms Signs Radiology: POCUS for diagnosis and monitoring Chest radiograph Signs of pneumothorax Size determination CT scan Causes of pneumothorax Management of various situations: Primary spontaneous pneumothorax Secondary spontaneous pneumothorax Indications for pleurodesis Management of persistent air leak Traumatic pneumothorax (including iatrogenic) Tension pneumothorax Oxygen to encourage nitrogen reabsorption? Pigtail versus […]
Idiopathic pulmonary fibrosis (IPF)
CONTENTS Basics Epidemiology Clinical presentation Laboratory studies Radiology IPF vs. NSIP (nonspecific interstitial pneumonia) ➡️ Bronchoscopy Biopsy (surgical vs. cryobiopsy) Differential diagnosis Approach to diagnosis Treatment Antifibrotic therapy Pirfenidone Nintedanib Management of pulmonary hypertension Transplantation ➡️ Prognosis Other related topics: Combined pulmonary fibrosis and emphysema (CPFE) Short telomere syndromes Progressive pulmonary fibrosis (PPF) Questions & […]
Avoiding over-diagnosis and over-treatment of MI in critically ill patients
Introduction 0 It’s common for critically ill patients to be screened for MI using troponin. Troponin levels are often positive. One thing leads to another, and before you know it the frail 99-year-old lady you admitted for a COPD exacerbation has an intracranial hemorrhage from the heparin drip she was put on because her troponin […]
Pulmonary amyloidosis
CONTENTS Amyloidosis basics Interstitial lung disease Tracheobronchial amyloidois Parenchymal nodular amyloidomas Other pulmonary manifestations Amyloid pleural effusion ➡️ Questions & discussion abbreviations used in the pulmonary section: 8 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute exacerbation of ILD 📖 AEP: Acute eosinophilic pneumonia 📖 AFB: Acid-fast bacilli AIP: Acute interstitial pneumonia (Hamman-Rich syndrome) 📖 ANA: […]
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