Category Archives: Respiratory

Wheezing in pre-school children

I never quite understood why wheezing in pre-school children is not meant to be called asthma when it looks like asthma, sounds like asthma and behaves like asthma, but apparently the reason is the absence of eosinophilic airways inflammation. Some … Continue reading

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Prescribing tips

I was taught that prednisolone courses for COPD exacerbations should be two weeks plus a wean-off, but have noticed that most people seem to use five days. The controversy is now resolved – the REDUCE trial, an RCT in Switzerland, … Continue reading

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Spirometry

Good link for normal values here. Remember: FEV1/FVC ratio is 70% or higher in restrictive disease and <70% in obstructive. Restrictive disease will show reduction in both FEV1 and FVC, proportionately (FEV1 <80% but FEV1/FVC ratio 70% or higher) Reversibility … Continue reading

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Chronic cough in children

❤ weeks counts as acute, >8 weeks as chronic. 3 – 8 weeks is called ‘subacute’ and may be pertussis, but may also be post-viral. Post-viral cough presents as a persistent dry cough and, if history and examination do not … Continue reading

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Community acquired pneumonia in children

Definitions of tachypnoea in children: <2 months: >60/min 2 – 12 months: >50/min >12 months: >40/min. Triad of symptoms suggesting CAP in children: Tachypnoea Chest recession Persistent fever >38.5 No definitive scoring systems for CAP severity exist. However, the following … Continue reading

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BMJ 2011:343:1119 – 1176 (3rd December)

A meta-analysis has confirmed that intensive glycaemic control does not reduce the risk of mortality in Type 2 diabetes, and doesn’t seem to reduce the risk of microvascular or macrovascular disease.  It does, however, increase the risk of severe hypoglycaemia … Continue reading

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BMJ 2011: 342: 1035 – 1092 (14th May)

It’s official – we can give beta-blockers to COPD patients with CCF.  The benefits outweigh the risks, though we’re meant to give a supervised first dose to minimise risk in those rare patients who do have severe bronchospasm. The main … Continue reading

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