Lecturio: Study for Medical School, USMLE, MCAT & MBBS

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Obstructive sleep apnea (OSA) is a disorder characterized by recurrent obstruction of the upper airway during sleep, causing hypoxia and fragmented sleep. Obstructive sleep apnea is due to a partial or complete collapse of the upper airway and is associated with snoring, restlessness, sleep interruption, and daytime somnolence. The diagnosis relies on medical history, and polysomnography can confirm the diagnosis. Management includes lifestyle changes, methods of positive airway pressure, and surgical intervention.

Cystic Fibrosis

Cystic fibrosis is an autosomal recessive disorder caused by mutations in the gene CFTR. The mutations lead to dysfunction of chloride channels, which results in hyperviscous mucus and the accumulation of secretions. Common presentations include chronic respiratory infections, failure to thrive, and pancreatic insufficiency. The gold standard for diagnosis is the sweat chloride test, which can be complemented by genetic testing. Cystic fibrosis ultimately leads to chronic inflammation and multisystem organ failure. Management includes CFTR modulator therapy and system-specific strategies for supportive care. Prognosis varies depending on treatment and complications. With optimal medical care, patients can live into their mid-40s.

Pneumonia

Pneumonia or pulmonary inflammation is an acute or chronic inflammation of lung tissue. Causes include infection with bacteria, viruses, or fungi. In more rare cases, pneumonia can also be caused through toxic triggers through inhalation of toxic substances, immunological processes, or in the course of radiotherapy.

Interstitial Lung Diseases

Interstitial lung diseases are a heterogeneous group of disorders characterized by the inflammation and fibrosis of lung parenchyma, especially the pulmonary connective tissue in the alveolar walls. It may be idiopathic (e.g., idiopathic pulmonary fibrosis) or secondary to connective tissue diseases, medications, malignancies, occupational exposure, or allergens. Interstitial lung diseases commonly present with progressive exertional dyspnea and dry cough. Pulmonary function testing shows a restrictive lung disease pattern. Lung high-resolution computed tomography and biopsy usually establish the diagnosis. Treatment includes steroids and immunosuppressives.

COVID-19 (Coronavirus disease 2019)

COVID-19, also known as Coronavirus disease, is a respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2). Transmission mainly occurs via direct contact or aerosol droplets. The disease may present asymptomatically or with fever and dry cough.

Lung Cancer: Invasion and Metastasis, Paraneoplastic Syndromes and Treatment of Mesothelioma, Small-cell Lung Carcinoma (SCLC) and Non-small Cell Lung Cancer (NSCLC)

Lung cancer is notoriously one of the most common lethal tumors in the medical world. It is essential to be accustomed with the basic details about this disease. In this article, you will gain all exam-relevant information about the epidemiology, pathogenesis and clinical recognition of lung cancer.

Empyema and Pleural Thickening — Symptoms and Treatment

Pleural thickening, diffuse pleural thickening (DPT), is a result of a severe inflammation of the pleural sheets, a thin membrane that covers the lungs, leading to the consolidation of the tissue due to a specific scaring. One of the causes for the condition is empyema that develops when pus builds-up in the space between the lung tissue and pleural space (the inner surface of the chest wall). With the advance of the scaring, the lungs may be encapsulated with the thick tissue, with the further disappearance of the natural space between the pleural cover and the lungs. The after-effect of this condition is a reduction of total lung capacity (TLC), thus, the deterioration of respiratory function and hemodynamic disorders due to growing hypoxemia.

Diseases of the Chest Wall and Respiratory Muscles Disorders — Diagnosis and Management

The alteration of the lung volume, in the form of reduction of total lung capacity (TLC), is regarded to restrictive lung diseases; as a rule the diseases of the chest wall and muscles, neuromuscular apparatus stipulate it; also, there are parenchymal ailments that may adjust the respiratory function of the lungs. The former ones lead to the decrease of TLC and refer to extrapulmonary diseases, and vice versa, the latter ones cause elevated TLC, like in COPD and asthma.

Common Lung Diseases — Overview and Investigations

This article should provide an overview of the main type of diseases that affect the lung. You will find a description of the important diagnostic tests used for investigating respiratory diseases, like general principles, emphasis on lung function testing role and interpretation and examples of diagnostic testing approach for some common presentations.

Thoracic Trauma: Management of Tension Pneumothorax, Rib Fracture, Pulmonary Contusion

Thoracic traumatic injuries can be generally classified according to the mechanism of injury as blunt or penetrating chest injuries. Chest injuries can be also classified according to the site of injury as chest wall, lung, heart, major blood vessel, and esophageal injuries. The extent and specific type of thoracic traumatic injury can be identified by a proper history and physical examination that is supported by adequate imaging studies. The treatment includes fluid therapy and oxygen supplementation in addition to specific treatments depending on the specific type of injury.

Upper Respiratory Tract Infection (URI, URTI) — Symptoms and Treatment

Upper respiratory tract infections (URIs) include a group of illnesses that can be mild to life-threatening where the upper respiratory tract is the main affected part. The infecting organism can affect the sinuses, the nasal passages, the pharynx or the larynx. Several diseases can be put under the umbrella of URIs which include rhinitis, pharyngitis, sinusitis, epiglottitis, laryngitis and tracheitis.

Pneumoconiosis — Symptoms and Treatment

Pneumoconiosis is an occupational lung disease that is related to coal dust exposure. Macrophages and fibroblasts become activated and focal lung fibrosis occurs. If left untreated, patients can progress to massive lung fibrosis which carries high mortality. History taking and chest x-rays are the mainstay diagnostic tests to confirm and stage pneumoconiosis. Current treatment of pneumoconiosis is mainly symptomatic. Lung transplantation might be an option for patients with advanced pneumoconiosis.

Hemoptysis — Etiology and Diagnostic Approach

Hemoptysis can be defined as the expectoration of blood during coughing that originates from the lower respiratory tract. Per this definition, coughing of blood from an upper respiratory tract illness can be excluded. While coughing blood can be alarming to the patient, it is usually a self-limiting symptom. In clinical practice, only 5% of the patients who present with hemoptysis are found to have a serious medical condition that needs further treatment.

Obesity Hypoventilation Syndrome (Pickwickian Syndrome) — Definition and Pathophysiology

The problem of obesity has already affected almost all corners of the world, thus causing emergence of syndromes and symptoms in all known diseases creating new comorbidities as well as separate ailments. Therefore, innovations and alterations in medical management of various illnesses are required. In 2015, approximately 1 in 3 adults on the planet were predicted to suffer from excess body mass (BMI>25kg/m2) and 10% of the world population was diagnosed as having obesity (BMI>30kg/m2). One of the syndromes that come with being obese is obesity hypoventilation syndrome (OHS) stipulated by a quotidian alveolar hypoventilation (PCO2 >45mm Hg), while other conventional reasons for the condition are absent. OHS is the causative factor of intensive usage of hospital beds nowadays. In addition, it is a leading factor in the development of cardiorespiratory diseases.

Lung Cancer (Bronchial Carcinoma) — Classification, Staging and Treatment

The lung is the major organ of the respiratory system and used to inhale oxygen and remove the metabolic waste in the form of CO2 from the body. Malfunctioning of the lungs can lead to serious complications and disturbs the normal living conditions. Lung cancer is one of the severe conditions which have a relatively high mortality risk. Previously, it was the leading cause of death among men in more than 25 developed countries. Now it has become a worldwide cause of death among men. Most common cause of lung cancer is smoking, especially in men. Prognosis of this condition is still poor for malignant tumors. Read everything important about it here.

Acid Base Balance and its Disturbances: Acidosis and Alkalosis

Acid base balance in the body is mandatory for the proper functioning of body organs. Even a slight alteration in the level of acid or base may severely impact many organs. Balance between acid and base is controlled by different mechanisms occurring in lungs, kidneys and buffer systems. Acid base disturbances are classified into metabolic acidosis, metabolic alkalosis, respiratory acidosis and respiratory alkalosis based on the variations of blood pH and carbon dioxide exhalations respectively. They are diagnosed through blood test and lung function test after evaluation of respective symptoms and etiology behind.

Asthma (Bronchial Asthma) — Classification, Diagnosis and Treatment

It is the chameleon of pulmonology: With as many different clinical phenotypes, making a diagnosis isn’t always easy, and pathogenesis is complex. In the following article, you will find all the important information about one of the most common chronic diseases in human beings: bronchial asthma.

Tuberculosis (TB, Consumption) — Diagnosis and Treatment

Mycobacterium tuberculosis: Ca. 30 % of humankind are infected with this pathogen, 10 % sicken from manifested tuberculosis. The special feature of these bacteria is that they are very acid-fast, they grow very slowly, and can survive in macrophages. This way, they are a great challenge in terms of therapy and prevention for physicians and scientists. The following article distinctly presents you all the relevant facts for exams concerning tuberculosis which are needed for the second state examination and clinical practice.

Chronic Obstructive Pulmonary Disease (COPD) — Classification, Symptoms and Diagnosis

Chronic obstructive pulmonary disease (COPD) is the most common chronic disease of the airways that is caused in 90 % of cases by smoking. COPD is a preventable and treatable disease. However, many patients do not know that they suffer from the disease, so the number of unreported cases of patients is very high. In this article, you will find important information on the epidemiology, etiology, pathophysiology and diagnosis, as well as the differential diagnosis and treatment of COPD.

Bronchiectasis — Diagnosis and Treatment

Bronchiectasis can develop from chronic lung diseases or pulmonary infectious diseases. Since it is irreversible, it is most important to diagnose it timely. Only then, it is possible to prevent it from progressing by implementing appropriate measures. This article will introduce you to the pathophysiological and etiological basics of bronchiectasis, and will prepare you for the treatment of affected patients.

Usual Interstitial Pneumonia (UIP) and Idiopathic Pulmonary Fibrosis (IPF) — Symptoms and Treatments

Idiopathic pulmonary fibrosis (IPF) belongs to a group of diseases whose specific cause is not well known, which keeps clinicians and researchers worried: the often rapid progression of IPF is very distressing. Also the underlying causes are mostly unknown, pathophysiologic explanations and findings are still unsatisfying. With only a 5-year survival rate of 20–40 %, only quick decisions such as initiating a lung transplantation, might help prolong a patient’s life.

Acute Respiratory Distress Syndrome (ARDS) — Phases and Treatment

Acute Respiratory Distress Syndrome (ARDS) is a severe inflammatory reaction of the lung that is characterized by presence of pulmonary infiltrates due to alveolar fluid accumulation, without evidence suggestive of a cardiogenic etiology. SIRS and sepsis are the major causes of ARDS. The main finding of ARD is respiratory failure. Chest x-ray usually shows diffuse bilateral lung infiltrates described as " (“butterfly opacity”). Management depends mainly on treating the underlying etiology, and maintaining adequate oxygenation, which may requires intubation and mechanical ventilation.

Hypersensitivity Pneumonitis & Eosinophilic Pneumonia

Hypersensitivity pneumonitis (HP), also called "extrinsic allergic alveolitis," is an immunologically-induced inflammatory disease affecting the alveoli and terminal airways (bronchioles), caused by repeated inhalation of a variety of inciting agents in a susceptible host. A wide range of organic antigens have been identified from different occupations. The clinical presentations of hypersensitivity pneumonitis vary depending upon the frequency, length, and intensity of exposure to the inciting agent. Surprisingly, cigarette smoking reduces the risk of developing the disease due to decreased antibody reaction to the antigen.

Chronic Bronchitis — Symptoms and Treatment

Chronic bronchitis is characterized by expectoration for a period of more than three months, in more than two consecutive years. Chronic irritation caused by smoking promotes hyperplasia of mucus glands and increases the production of mucus. Central and peripheral airways are involved in the pathophysiology of the disease and it includes inflammation, oxidative stress, inhibited repair processes, and an imbalance of proteinases/anti- proteinases. This article will prepare you perfectly well for your next exam!

Pulmonary Hypertension (PH) — Categories, Causes and Treatment

Pulmonary hypertension (PH) is a clinical condition that is characterized by elevated pulmonary arterial pressure. It can lead to serious clinical consequences, thus early detection and treatment is important before it becomes advanced and less responsive to therapy. PH is a feature of advanced underlying disease that are usually caused by cardiac, pulmonary, or intrinsic vascular diseases. Therefore, suspected cases will undergo diagnostic testing to confirm the condition and identify the underlying cause. The definition, epidemiology, classification and etiologies, pathophysiology, clinical features, diagnostic evaluation and treatment all will be discussed in this article.

Respiratory Failure: Hypoxemia, Hypercapnia and Hypoxia

The inspiration of oxygen and expiration of carbon dioxide are vital functions of the human body. A decrease in PO2 and increase in PCO2 can alter many normal physiologic processes, and may eventually be fatal. The human body has various reflex mechanisms to manage such changes. Understanding of these reflexes and identification and management of any impairment in them is essential in the management of many respiratory and renal diseases.

Asbestosis and Silicosis — Causes and Treatments

Occupational lung disease covers a specific area of knowledge in respiratory medicine. In these cases, information on the patients's history play an important role in the detection of these disorders, guiding investigations and management. Awareness of this topic is essential.

Pulmonary Embolism (PE) — Symptoms and Treatment

Pulmonary embolism (PE) is a fatal clinical condition that occurs as a result of mechanical obstruction of the pulmonary artery or its branches by any material (such as thrombus, air or fat) from anywhere in the body. Pulmonary embolism can be an acute condition, in which the signs and symptoms develop immediately after the event (i.e., the obstruction of the pulmonary vessels), or it can be chronic, in which the signs and symptoms develop progressively for years. In this article, you will be able to understand the definition, incidence, pathophysiology, risk factors, symptoms and signs and the prognosis of pulmonary embolism.

Infections of the Respiratory Tract 01:36 h / 20 videos 7 free

Infections of the Respiratory Tract 5 articles 5 free

Infections of the Respiratory Tract 110 quiz questions 27 free
Airway Diseases 02:07 h / 22 videos 4 free

Airway Diseases 7 articles 7 free

Airway Diseases 94 quiz questions 20 free
Interstitial Lung Disease (ILD) 00:43 h / 11 videos 3 free

Interstitial Lung Disease (ILD) 4 articles 4 free

Interstitial Lung Disease (ILD) 46 quiz questions 7 free
Lung Cancer 00:54 h / 15 videos 3 free

Lung Cancer 2 articles 2 free

Lung Cancer 38 quiz questions 3 free
Pulmonary Vascular Disease 00:36 h / 9 videos 2 free

Pulmonary Vascular Disease 3 articles 3 free

Pulmonary Vascular Disease 27 quiz questions 4 free
Pleural Disease 00:41 h / 10 videos 2 free

Pleural Disease 3 articles 3 free

Pleural Disease 34 quiz questions 8 free
Other Respiratory Disorders 00:31 h / 7 videos 2 free

Other Respiratory Disorders 8 articles 8 free

Other Respiratory Disorders 24 quiz questions 6 free

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Pulmonary System – Clinical Medicine (PA)

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Your Educators of course Pulmonary System – Clinical Medicine (PA)

Jeremy Brown, PhD

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