CONTENTS Rapid Reference 🚀 Physiologic effects Specific agents Nitric Oxide (NO) Nitroglycerine Epoprostenol Milrinone Oxygen Contraindications & adverse effects Indications Overall concept – temporary bridge ARDS Pulmonary embolism Decompensated chronic pulmonary hypertension Right ventricular myocardial infarction Podcast Questions & discussion Pitfalls Inhaled pulmonary vasodilators yield three physiological advantages: #1) reduced pulmonary vascular resistance Pulmonary vasodilation […]
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Hypersensitivity pneumonitis (HP)
CONTENTS Basics Epidemiology Causative agents History Symptoms Laboratory evaluation Thoracic radiology Acute HP Nonfibrotic (subacute) HP Fibrotic HP Bronchoscopy Lung biopsy Differential diagnosis Diagnostic approach Treatment 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 […]
Hemophagocytic LymphoHistiocytosis (HLH)
CONTENTS Basics – what is HLH? Clinical features of HLH Laboratory findings Ferritin Lumbar puncture Pathology – Hemophagocytosis Causes of HLH Differential diagnosis – Closest mimics of HLH Approach to the diagnosis of HLH Treatment Treatment of the underlying cause (if possible) Steroid IL1 antagonism JAK inhibition Etoposide Podcast Questions & discussion Pitfalls what is […]
Nontuberculous mycobacteria (NTM)
CONTENTS Basics Epidemiology Clinical manifestations Fibrocavitary disease Nodular bronchiectatic disease (Lady Windermere syndrome) NTM in cystic fibrosis NTM in non-CF (cystic fibrosis) bronchiectasis Disseminated Mycobacterium avium complex (MAC) Hypersensitivity pneumonitis due to NTM Diagnosis Significance of positive culture Relative pathogenicity of different species Diagnostic criteria Decision to treat Treatment Treatment overview Antibiotic regimens for various […]
Brain Death
CONTENTS Brain death basics Clinical presentation of brain death Clinical context Clinical findings in brain death Spinal reflexes Diagnosis of brain death (1) Initial suspicion (2) Evaluate for confounders Excluding drug intoxication (3) Dedicated neurologic examination (4) Apnea test (5) Confirmatory test PRN If brain death is confirmed: Immediate next steps Supportive care prior to […]
Asbestosis, pneumoconiosis, and related disorders
CONTENTS Asbestos Asbestos interstitial lung disease (asbestosis) Benign asbestos pleural effusion (BAPE) ➡️ Pleural plaques Diffuse pleural thickening Mesothelioma Silicosis Coal workers pneumoconiosis Berylliosis Talcosis Intravenous talcosis Inhalational talcosis Silicone embolism syndrome Questions & discussion abbreviations used in the pulmonary section: 8 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute exacerbation of ILD 📖 AEP: Acute […]
Pulmonary embolism diagnosis & treatment of low-risk PE
CONTENTS Rapid reference 🚀 Risk factors and epidemiology Clinical presentation of PE Massive/submassive PE Large central PE Pulmonary infarction DVT Individual tests: D-dimer Arterial blood gas (ABG) DVT ultrasound to evaluate for PE Chest radiograph Radiology CT angiography in pulmonary embolism Causes of a filling defect on CT angiography CT angiography Causes of filling defect: […]
Histoplasmosis
CONTENTS Epidemiology Different forms of clinical disease: Acute (& subacute) pulmonary histoplasmosis Granulomatous mediastinitis Broncholithiasis Fibrosing mediastinitis Chronic cavitary pulmonary histoplasmosis (CCPH) Progressive disseminated histoplasmosis CNS histoplasmosis Diagnostic studies Histoplasma antigen test Histoplasma antibody (serology) Bronchoscopy Tissue biopsy (Fungal culture) Management Pathophysiology Questions & discussion abbreviations used in the pulmonary section: ABPA: Allergic bronchopulmonary aspergillosis […]
Large airway disorders (trachea and central bronchi)
CONTENTS Guide to the differential diagnosis: Bronchoscopic findings CT scan findings Flow-volume loops ➡️ Specific disorders Bilateral vocal fold paralysis Stenosis Laryngeal stenosis Tracheal stenosis Tracheobronchomalacia (TBM) Congenital tracheobronchomegaly (Mounier-Kuhn syndrome) Tracheobronchopathia osteochondroplastica (TPO) Tracheobronchial amyloidosis ➡️ Infectious: Respiratory papillomatosis Tracheobronchial aspergillosis ➡️ Broncholithiasis due to granulomatous mediastinitis ➡️ Inflammatory disorders: Sarcoidosis ➡️ GPA (granulomatosis […]
Viral pneumonia (non-COVID/influenza)
CONTENTS General properties of viral pneumonias Herpesviruses ⍺-herpesviruses HSV VZV β-herpesviruses CMV Paramyxoviruses RSV (respiratory syncytial virus) Parainfluenza Metapneumovirus Adenovirus Rhinovirus Hantavirus Questions & discussion abbreviations used in the pulmonary section: 2 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute exacerbation of ILD 📖 AEP: Acute eosinophilic pneumonia 📖 AFB: Acid Fast Bacilli AIP: Acute interstitial […]
Alcohol withdrawal
CONTENTS Rapid Reference 🚀 Preamble & disclaimer Diagnosis Alcohol withdrawal vs. hepatic encephalopathy Therapeutic target (CIWA vs RASS) Treatment: Phenobarbital monotherapy Phenobarbital pharmacology Advantages of phenobarbital over benzodiazepines Contraindications to phenobarbital ➡️ Phenobarbital guideline Checking phenobarbital levels? ➡️ Pitfalls of phenobarbital Alternative agents Benzodiazepines Valproic acid Antipsychotics & alpha-2 agonists (dexmedetomidine, clonidine, guanfacine) Ketamine Other […]
Lung cancer
CONTENTS Lung cancer screening Epidemiology Types of lung cancer NSCLC (non-small cell lung cancer) Adenocarcinoma Lepidic predominant adenocarcinoma Squamous cell carcinoma Large cell carcinoma Clinical presentation Management of NSCLC Staging Discussion of specific therapies: Radiotherapy Targeted therapy EGFR mutations ALK fusion gene Chemotherapy Integration of therapies to manage specific situations: Stage I-III: Surgery +/- adjuvant […]
Tuberculosis
CONTENTS Epidemiology & risk factors Clinicoradiologic forms Natural history of tuberculosis Primary pulmonary TB Tuberculous pleural effusion ➡️ Chronic tuberculous empyema ➡️ Healed tuberculosis (Ghon complex) Postprimary TB Miliary TB Acute miliary TB Subacute/chronic miliary TB Tracheobronchial involvement Laryngeal TB Diagnosis of active pulmonary TB: overview Red flags to consider the diagnosis of TB Initial […]
Pleural effusion
CONTENTS approach to pleural effusion of unclear etiology Initial trifecta: History CXR, POCUS, & review of prior radiology Blood tests More advanced testing: CT scan Thoracentesis differential diagnosis All causes of pleural effusion Transudates Exudates pleural radiology POCUS Chest radiograph Subpulmonic effusion Pseudotumor Specific radiologic findings: Chronic pleural effusion Rapidly growing effusion Pleural plus pericardial […]
Sleep-disordered breathing
CONTENTS Sleep-disordered breathing basics Obstructive sleep apnea (OSA) Epidemiology (including causes & consequences) Clinical features & assessment Diagnosis Treatment Obesity hypoventilation syndrome (OHS) Chronic OHS Epidemiology Signs & symptoms Evaluation & diagnosis Treatment Acute exacerbation of OHS (AEOHS) Definition Causes & patient evaluation Treatment Central sleep apnea (CSA) overview Hypercapnic CSA Nonhypercapnic CSA CSA due […]
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