• Archive for May, 2013

    Extrinsic Allergic Alveolitis (EAA) / Hypersensitivity pneumonitis

    by  • 27/05/2013 • Respiratory

    Extrinsic Allergic Alveolitis (EAA) / Hypersensitivity pneumonitis Definition  Widespread diffuse inflammatory reaction in small airways of lung and alveoli in response to ORGANIC dusts.  A restrictive lung disease  P/c: fever, malaise, cough, SOB, tachypnoea, course end-inspiratory crackles, wheeze (due to allergic component of reaction).   Diagnostic/Investigation  Chest xray o Fluffy...

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    Upper GI Cancer

    by  • 27/05/2013 • Oncology

    Oesophageal carcinoma:  Incidence increasing – UK 5-10/100,000  Declining squamous cell carcinomas (due to reduced smoking), but increasing adenocarcinoma of distal oesophagus/gastric cardia (linked to Barretts)?  Pathophysiology: – 2 types of oesophageal cancer o Squamous carcinoma: affects middle third of oes. Associated to cigarette smoking. o Adenocarcinoma: affects lower third, and merges...

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    Sarcoidosis

    by  • 27/05/2013 • Respiratory

    Sarcoidosis: Definition  Systemic (multi-system) granulomatous inflammatory disease characterized by non-caseating granulomas (small inflammatory nodules) on lung…  Granulomas most often appear in the lungs or the lymph nodes, but virtually any organ can be affected. Normally the onset is gradual/insidious.  Sarcoidosis may be asymptomatic or chronic and may cause death.   Epidemiology...

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    Colorectal Cancer

    by  • 27/05/2013 • Oncology

       PH issue in MEDCs  Incidence: 20,000 deaths/yr/UK – and increasing!  Conditions which predispose to CRC: o Adenomatous polyps of the colon  Usually tubulovillous adenomas  These polyps have potential to become malignant  Larger polyps = more risk of cancer forming at site (<1cm polyps = 1-10% risk, >2cm...

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    Radiotherapy

    by  • 27/05/2013 • Oncology

       Uses ionizing radiation to produce free radicals which damage DNA  Normal cells are better at repairing this damage than cancer cells – so are able to recover before next dose (or fraction) of treatment.  Approaches: o Radical treatment: given with curative intent, total doses range from 40-70Gy in 15-35 daily...

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    Chemotherapy

    by  • 27/05/2013 • Oncology

    Chemotherapy:  Should be given by specialist only  Modes of administration: o ‘Neoadjuvant’: to shrink tumour before surgical intervention o ‘Adjuvant’: to control ‘micro-mets’ after post-operatively o Sole ‘primary therapy’ in some cancers (=haematological) o Palliative therapy: to provide relief from symptomatic metastatic disease. May prolong survival  Important classes of CT (class,...

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    Asbestosis

    by  • 26/05/2013 • Respiratory

    Asbestosis  Asbestos = mixture of silicates of iron, magnesium, nickel, cadmium and aluminium.  Uncommon RLD  Asbestos bodies on CXR is a ‘warning sign’ and shows exposure – not diagnostic of disease.  Mesothelioma = cancer of mesothelium (protective lining that covers lung) – commonly occurs at pleura as a result of...

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    Berylliosis

    by  • 26/05/2013 • Respiratory

    Berylliosis  Incredibly rare – occupational hazard of fluorescent light bulb manufacturing or beryllium mining.  Used in aerospace industry.  P/c: cough, SOB, chest pain, arthralgia, weight loss, fever.  CXR = nodular granulomatous change, 

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    Coal-worker’s Pneumoconiosis

    by  • 25/05/2013 • Respiratory

    Coal-worker’s Pneumoconiosis Pneumoconiosis = accumulation of (‘inorganic’) dust in the lungs and the reaction of the tissue to its presence. Simple pneumoconiosis:  Reflects the deposition of coal dust in the lung.  CXR = micronodular shadowing   Categories of simple pneumoconiosis: 1. Small round opacities definitely present but few in number 2. Small...

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    Chronic Bronchitis

    by  • 24/05/2013 • Respiratory

    Chronic Bronchitis (‘blue bloater’):  p/c: obese, chronic mucus production and cough (=impaired mucociliary), course rhonci and wheezing, RHF (=oedema/cyanosis), reduced PEFR.  Pathology: o Arteriovenous anastomoses (‘shunts’) hypoxaemia pulmonary vasoconstriction (to reduce deoxygenated blood flow in lungs) PAH CP RVH RHF systemic symptoms (oedema/cyanosis) = blue bloater. o Pt may be hypercapnic =...

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