Table of Contents

Cover

Title Page

Copyright

Dedication

Preface

About the Companion Website

Part 1: Structure and function

Chapter 1: Anatomy and physiology of the lungs

A brief revision of clinically relevant anatomy

Physiology

Further Reading

Multiple choice questions

Multiple choice answers

Part 2: History taking, examination and investigations

Chapter 2: History taking and examination

History taking

Symptoms

History

Examination

Signs

Further Reading

Multiple choice questions

Multiple choice answers

Chapter 3: Pulmonary function tests

Normal values

Simple tests of ventilatory function

Transfer factor for carbon monoxide

Arterial blood gases

Further Reading

Multiple choice questions

Multiple choice answers

Chapter 4: Radiology of the chest

Chest X-ray

Abnormal features

Ultrasonography

Computed tomography

Positron emission tomography

Further reading

Multiple choice questions

Multiple choice answers

Part 3: Respiratory diseases

Chapter 5: Upper respiratory tract infections and influenza

Introduction

Common cold

Pharyngitis

Sinusitis

Acute laryngitis

Croup

Pertussis

Acute epiglottitis

Influenza

Further Reading

Multiple choice questions

Multiple choice answers

Chapter 6: Pneumonia

Lower respiratory tract infections

Pneumonia

Specific pathogens

Immunocompromised patients

Pulmonary complications of HIV infection

Further Reading

Multiple choice questions

Multiple choice answers

Chapter 7: Tuberculosis

Epidemiology

Clinical course

Diagnosis

Treatment

Latent tuberculosis

Tuberculin testing

Control

Nontuberculous mycobacteria (atypical opportunist mycobacteria)

Further Reading

Multiple choice questions

Multiple choice answers

Chapter 8: Bronchiectasis and lung abscess

Bronchiectasis

Lung abscess

Necrobacillosis

Bronchopulmonary sequestration

Further Reading

Multiple choice questions

Multiple choice answers

Chapter 9: Cystic fibrosis

Introduction

The basic defect

Clinical features

Diagnosis

Treatment

Prognosis

Prospective treatments

Further Reading

Multiple choice questions

Multiple choice answers

Chapter 10: Asthma

Definition

Prevalence

Aetiology

Pathogenesis and pathology

Clinical features

Diagnosis

Investigations

Management

Acute severe asthma

Further Reading

Multiple choice questions and answers

Multiple choice answers

Chapter 11: Chronic obstructive pulmonary disease

Introduction

Definitions

Aetiology

Clinical features and progression

Investigations

Management

Emergency treatment

Admission avoidance and early supported discharge for COPD

Further Reading

Multiple choice questions

Multiple choice answers

Chapter 12: Carcinoma of the lung

Introduction

Aetiology

Pathology

Diagnosis

Communicating the diagnosis

Treatment

Other thoracic neoplasms

Further Reading

Multiple choice questions

Multiple choice answers

Chapter 13: Interstitial lung disease

Introduction

Idiopathic pulmonary fibrosis

Idiopathic interstitial pneumonias

Connective tissue diseases

Hypersensitivity pneumonitis

Sarcoidosis

Further Reading

Multiple choice questions

Multiple choice answers

Chapter 14: Occupational lung disease

Introduction

Work-related asthma

Berylliosis

Popcorn worker's lung

Pneumoconiosis

Silicosis

Siderosis

Asbestos-related lung disease

Further Reading

Multiple choice questions

Multiple choice answers

Chapter 15: Pulmonary vascular disease

Pulmonary embolism

Pulmonary hypertension

Pulmonary vasculitis

Further Reading

Multiple choice questions

Multiple choice answers

Chapter 16: Pneumothorax and pleural effusion

Pneumothorax

Pleural effusion

Oesophageal rupture

Further Reading

Multiple choice questions

Multiple choice answers

Chapter 17: Acute respiratory distress syndrome

Introduction

Pathogenesis

Clinical features

Recognition of critically ill patients

Treatment

Prognosis

Further Reading

Multiple choice questions

Multiple choice answers

Chapter 18: Ventilatory failure and sleep-related breathing disorders

Introduction

Sleep physiology

Ventilatory failure

Ventilatory failure and sleep

Obstructive sleep apnoea

Central sleep apnoea

Further Reading

Multiple choice questions

Multiple choice answers

Chapter 19: Lung transplantation

Introduction

Types of operation

Indications for transplantation

Post-transplantation complications and treatment

Prognosis

Future prospects

Further Reading

Multiple choice questions

Multiple choice answers

Index

End User License Agreement

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Guide

Cover

Table of Contents

Preface

Part 1: Structure and Function

Begin Reading

List of Illustrations

Chapter 1: Anatomy and physiology of the lungs

Figure 1.1 Diagram of bronchopulmonary segments. LING, lingula; LL, lower lobe; ML, middle lobe; UL, upper lobe.

Figure 1.2 Surface anatomy. (a) Anterior view of the lungs. (b) Lateral view of the right side of the chest at resting end-expiratory position. LLL, left lower lobe; LUL, left upper lobe; RLL, right lower lobe; RML, right middle lobe; RUL, right upper lobe.

Figure 1.3 Structure of the alveolar wall as revealed by electron microscopy. Ia, type I pneumocyte; Ib, flattened extension of type I pneumocyte covering most of the internal surface of the alveolus; II, type II pneumocyte with lamellar inclusion bodies, which are probably the site of surfactant formation; IS, interstitial space; RBC, red blood corpuscle. Pneumocytes and endothelial cells rest upon thin continuous basement membranes, which are not shown.

Figure 1.4 Effect of diaphragmatic contraction. Diagram of the ribcage, abdominal cavity and diaphragm showing the position at the end of resting expiration (a). As the diaphragm contracts, it pushes the abdominal contents down (the abdominal wall moves outwards) and reduces pressure within the thorax, which ‘sucks’ air in through the mouth (inspiration). (b) As the diaphragm shortens and descends, it also stiffens. The diaphragm meets a variable degree of resistance to downward discursion, which forces the lower ribs to move up and outward to accommodate its new position.

Figure 1.5 Graph of (static) lung volume against oesophageal pressure (a surrogate for intrapleural pressure). In both subjects A and B, we see that lung compliance – the change in lung volume per unit change in intrapleural pressure (or slope of the curve) is reduced at higher lung volumes. A: normal individual. B: individual with reduced lung compliance, such as lung fibrosis.

Figure 1.6 Diagrammatic representation of the increase in total cross-sectional area of the airways at successive divisions.

Figure 1.7 Model of the lung, demonstrating the flow-limiting mechanism (see text). The chest is represented as a bellows. The airways of the lungs are represented collectively as having a distal resistive segment (Res) and a more proximal collapsible or ‘floppy’ segment. The walls of the floppy segment are kept apart by the retractile force of lung recoil (Rec). EXP, expiration; INSP inspiration.

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