Category Archives: Respiratory

Pulmonary fibrosis

Causes include: chemical or dust inflammation idiopathic (idiopathic pulmonary fibrosis or cryptogenic fibrosing alveolitis) local fibrosis from infection or infarction various congenital syndromes – neurofibromatosis, Gaucher’s disease, Niemann-Pick disease, tuberous sclerosis. various acquired inflammatory conditions – RA, AS, Sjogren’s, systemic … Continue reading

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Exercise-induced bronchoconstriction in adults

This is transient constriction of the lower airways induced by vigorous exercise, and may or may not be associated by asthma. It is no longer referred to as ‘exercise-induced asthma’. It is caused by dehydration of the respiratory mucosa, due … Continue reading

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Chronic refractory cough

Known by other names (chronic idiopathic cough, unexplained chronic cough), it is defined as: A cough that persists despite specialist guideline treatment. This of course means it is a diagnosis of exclusion. It is either one form of cough hypersensitivity … Continue reading

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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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