Category Archives: Respiratory

COPD: NICE guidance

Another from the archives; notes on this BMJ article. Quite a bit has changed since I last updated my COPD knowledge. These days, there are considered to be five fundamentals of COPD (the ones highlighted in red are the three … Continue reading

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Palliative care in end-stage chronic respiratory disease

(COPD, interstitial lung disease, CF, etc.) 1st-line: Small hand-held fan to blow air on face. (Not much evidence that it works in the palliative care setting, but has the benefit of being cheap and simple, so worth a try.) 2nd-line: … Continue reading

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Flozins and COPD inhalers

That’s two separate subjects, not one, whose link here is that they were both the topics of useful papers in this week’s BMJ. The first was on possible adverse effects of flozins (sodium-glucose cotransporter-2 inhibitors). The paper was a very … Continue reading

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Idiopathic pulmonary fibrosis

Quick refresher in May’s BJGP: Interstitial lung disease, characterised by progressive scarring of the lungs Typically presents in 6th or 7th decade Presents with persistent progressive breathlessness, with or without cough Signs include finger clubbing and velcro crackles – not … Continue reading

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Community-acquired pneumonia; a couple of points

So, I was reading an article on CRP in the March 2018 BJGP, and a couple of interesting things came up. The most important one is that I’m out of date on my CRP thresholds. I was still using the … Continue reading

Posted in Credits 2018, Infectious Diseases, Respiratory | Leave a comment

Noisy breathing in newborns

Periodic increases/decreases in breathing sounds are normal in babies. Wheeze: Can be infection (mild or serious) or heart failure. Check for signs of heart problems; murmur, absent femorals, etc. Check sats. Normal sats and normal feeding are reassuring. If any … Continue reading

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COPD algorithm

This is our practice algorithm for COPD treatment: Treat intermittent symptoms with a SABA. If more severe, differentiate between low-risk and high-risk patients. Low-risk patients are those with: FEV1 >50% <2 exacerbations/yr For low-risk patients: First-line treatment: LAMA If symptoms … Continue reading

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