Pulmonology

17. C O P D

21. What are the Risk Factors for Developing COPD?

28. Risk factors: Passive, or 2 nd -hand smoking (ETS)

31. MMP Serine proteinases MMP Cysteine proteinases Proteinase inhibitors ECM degradation: lung destruction Emphysema Repair Inflammatory cell recruitment

32. Transcription of cytokines Inactivation of antiproteinases Lipid peroxidation Depletion of antioxidant defenses Neutrophil sequestration OXIDATIVE STRESS I N F L A M M A T I O N I N J U R Y &

33. What are the Major Categories of COPD?

36. - What are the clinical manifestations of COPD? - What is the most common symptom which prompts patients to seek consultation?

39. What are the physiologic abnormalities in COPD?

42. Airway obstruction & low elastic recoil Expiratory flow limitation Hyperinflation at rest, worsened by exercise Limited inspiratory “space”/”depth of breath” Dyspnea

43. Hyperinflation

44. How do you stage the severity of COPD? What are the recommended therapies?

83. Exudate Further diagnostic procedure Approach to the Diagnosis of Pleural Effusions Pleural effusion Perform diagnostic thoracentesis Measure PF CHON & LDH Any of the ff met? PF/serum CHON >0.5 PF/serum:LDH >0.6 PF LDH > 2/3 upper normal serum limit Transudate Treat CHF, cirrhosis, nephrosis

84. Measure PF glucose, amylase Obtain PF cytology Differential cell count Culture, stain PF PF markers for TB Exudate Further diagnostic procedure

110. Disorders of the Mediastinum

117. Clinical Disorders Commonly Associated with ARDS Post-cardiopulmonary bypass Pancreatitis Toxic inhalation injury Drug overdose Near-drowning Multiple transfusions Pulmonary contusion Severe trauma Aspiration of gastric contents Sepsis Pneumonia Indirect Lung Injury Direct Lung Injury

118. Diagnostic Criteria for ALI & ARDS ARDS: PaO 2 /FIO 2 < 200 PCWP < 18 mmHg or no clinical evidence of left atrial HPN Bilateral alveolar or interstitial infiltrates Acute ALI: PaO 2 /FIO 2 < 300 Absence of Left Atrial HPN CXR Onset Oxygenation