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3-b
bronchial asthma treatment
bronchial asthma treatment
in-between attacks
tablets ketotifen
asthma protective side effect
100
mentality Egyptian
dilated spasm bronchi dilated overtime
salbutamol beta 2 stimulant long acting all the time
42 long acting salmetrol
iv or suppository aminophylin
theophyllin
corticosteroids
Grade 3
severe symptoms attack bronchial asthma
50- 800 % PEFR
high dose low dose
Grade 4
101
not responding to high dose very severe symptoms , attack daily bronchial asthma
inhaled steroids
50- 800 % PEFR
theophyillin , leukotriens high dose
Long acting Beta 2 stimulants mast cell stabilizer receptor blocker ,
Grade 5
cortisol oral stage
bronchial asthma
Bronchial asthma with daily attack … PERF 18-80 % mcq
Which of the following drug should be added
stage
severe stage 2 corticosterois
Status asthmaticus
status asthamticus ?
infection precipitating factor infection
bronchial asthma sudden withdrawal of corticosteroid
Clinical picture
coma convulsions irritable , anxious , confused CNS
brain
brain
patient cant finish a single sentence sympathetic tone cyanosis , sweaty Face
without single breath
102
08 respiratory rate 08 respiratory rate chest
08 respiratory failure
Heart
Tachycardia and arrthmia
sever pulses paradox
dysentery bronchial asthma and copd
=D
:D
investigation
investigations status asthmaticus
CO2 wash tachypnea CO2 ABG
late stage respiratory failure
pneuomothorax Xray
hypokalemia salbutamol Serum potassium
respiratory function
ventilator test
ventilator
workshop
alveoli pressure
status asthmaticus
chest xray investigations
respiratory function test
103
if the doctor is crazy enough to ask fro respiratory function test the patient will be intelligent enough to refuse
=D
immediately
Treatment
nasal cannula high flow oxygen ICU
salbutamol and cortisone 4
combivent combination ipratropium
aminophyillin iv salbutamol IV
mucus bronchoscope under general anaesthia MgSO4
bronchial lavage
Investigation , treatment , status asthamticus and differential diagnosis
atelectasis
By definition: reduction of lung volume due to absorbtion of alveolar air *
acquired
bronchus obstruct bronchial obstruction 5
alveoli blood vessels absorption alveoli
collapse alveoli blood vessels
bronchial obstruction absorption collapse
bronchial obstruction
wall lumen *
foreign body and secretions lumen
stricture or bronchogenic carcinoma wall
tumor or lymph node :
contraction collapse 0
contraction fibrous tissue alveoli fibrosis
contraction collapse collapse alveolus
patchy collapse 2
collapse collapse lung
ARDS surfactant
acquired
Congenital
surfactant hyaline disease congenital
baby during labour collapse premature babies diabetic mother
meconium aspiration birth canal
105
clinical picture
symptoms **
Dyspnea , dry cough , chest pain*
broncho disease haemoptysis and wheezes
Symptoms of cause and complications
signs **
palpation
shifted Trachea
absorbtion collapse bronchi TVF
TVF
dull Percussion *
bronchial absent breathing sound Auscultation
breathing
General examination
investigation
oxygen and co2 ABG blood lab Lab
sputum 4
raised copula homogenous opacity , collapsed lobe xray Radiological
secretions foreign body obstruction bronchscopy Instrumental
treatment
secondry infection antibiotic bronchodilator oxygen
106
physiotherapy foreign body bronchoscope cause
107
1
upper upper abdomen
movement of restriction bandage abdomen
respiratory muscles
pain pai n
support wound bandage
pain
collapse
functions 0 lung
alveoli ventilation
ventilation
perfusion alveoli
diffusion gas
functions testing
ventilation test 5
radioactive xenon **
lung lung alveoli alveoli
ventilation test ventilation defect
inhalation of radio active xenon
spirometer **
spirometer
018
spirometer
108
under basal condition lung
188 188 tidal volume
tidal volume 188
inspiratory
0 reserve
expiratory
reserve volume
residual volume
residual volume inspiratry and expiratry reserve tidal volume
0 inspiratory reserve 188 tidal
1- it’s the amount of air inspired and expired under resting condition
tidal volume
2- it’s the maximum volume of air inspired more than the tidal volume
inspiratory reserve
3- it’s the maximum volume of air that can be expired more than the tidal volume
expiratory reserve
4- it is the remaining volume in the lung after maximum expiration
residual volume
6- it is the total volume of air in the lung after max. inspiration
total lung capacity
7- it’s the max volume of air that can be expired after maximum inspiration
vital capacity
vital capacity
residual volume total lung capacity vital capacity
109
total lung capacity
capacities volumes
lung disease
MCQ
in a pation with Kyphoscoliosis the following respiratory func test is right
? expiration
during expiration
airway obstruction expiratory reserve volume
110
volumes and respiratory center suppression respiratory center
capacities
central
maximum breathing capacity volumes and capacity
2 51 as speed as you can
respiratory center suppression
test respiratory center suppression
respiratory center suppression
test
obstructive restrictive obstructive and restrictive diseases
respiratory functions test mcq expiratory
IV perfusion
gamma camera lung lung
3b
111
chest “
3-c
Dyspnea
definition of dyspnea *
uncomfortable awareness of respiration
mechanism of dyspnea
process of respiration dyspnea
respiratory center in medulla process of respiration
intercostals diaphragm nerves anterior horn of spinal cord respiratory center
negative pressure negative intrapleural pressure contraction muscles
gas exchange blood alveoli Trachea and bronchi
dyspnea
dyspnea opiates
Anemia *
112
Congenital : kyphoscoliosis
Traumatic : fracture , dislocation , disc prolapsed
, inflammatory : pots disease
menengioma meningies
, inflammatory , neoplastic and spinal cord
congenital
Congenital : syringomelia
transverse mylitis , inflammatory
glioma Neoplastic
myasthenia gravis 2
contract diaphragm diaphragm impulse nerves diaphragm
pregnancy abdominal mass ascitis
myopathy muscle 1
chest wall 0
Skin : obesity
Ribs : fracture rib
Pleura : pleurisy or PE
Trachea or bronchi: Foreign body , tumor , bronchitis , bronchiectasis
Alveoli : alveolar collapse , pneumonia , tb
Blood : pulmonary embolism or congestion
hysterical 5
113
More times 488 CO2 physiology diffusion and perfusion
which means diffusion surface area CO2 diffusible than O2
diffusion and perfusion Oxygen surface area
oxygen oxygen surface area
Respiratory failur
respiratory failure
respiratory failure
Definition
it is inability of the lung to perform its function leading to hypoxia
114
, lack of concentreation and defective apathy , mental dullness chronic hypoxia
memory ,
=D
type 2
larynx , trachea and bronchi , vertebrae , menengies , anterior horn cell , nerves Etiology
dyspnea
CO2 investigation
Treatment
type 2 type 1
oxygen apnea chronic acute
115
chronic acute chronic acute type 2
COPD
3c
116