Lung cancer

Type 1.Adenocarcinoma Site- Peripheral Gene- Ras 2.Squamous cell carcinoma Site- Central Characteristic- Central necrosis, cavitation, keratinization, stratification, intercellular bridge formation, Pancoast tumor 3.Large cell undifferentiated carcinoma Site- Peripheral Pathology- Anaplastic pleomorphic cells 4.Small lung cell cancer Site- Central Paraneoplastic syndrome 1.Adenocarcinoma- Hypertrophic pulmonary osteoarthropathy(HPO), migrating thrombophlebitis, NBTE 2.Squamous- HyperCa, Horner syndrome3.Small- SIADH, Cushing syndrome, Eaton […]

Pleural effusion

Light Criteria(exudates if meet>= 1criteria)- Pleural protein/serum protein>0.5, Pleural LDH/serum LDH>0.6, Pleural LDH>200 Protein-TB(>4.0),  Waldenström’s macroglobulinemia and multiple myeloma(7.0~8.0) LDH >1000- Empyema, rheumatoid pleurisy, and pleural paragonimiasis, Pleural/Serum>1.0 & pleural/serum protein<0.5(PJP, malignancy) TG- Chylothorax(>110) Glucose <60 or pleural/serum<0.5→ Rheumatoid, TB, empyema, malignancy, Lupus pleuritis, esophageal rupture PH- <7.30→ empyema, malignancy, rheumatoid pleurisy, and tuberculous pleurisy, […]

Acute respiratory distress syndrome (ARDS)

Berlin definition 1.Acute onset(< 24hrs) 2. Bilateral opacities 3. No cardiac failure, PAWP<18 mmHg 4. 300 mmHg ≥PaO2/FiO2 >200 mmHg(mild),  200 mmHg ≥PaO2/FiO2 >100 mmHg(moderate),  PaO2/FiO2 ≤100 mmHg(severe), all with PEEP ≥5 cm H2O. Etiology Stage ARDS vs Heart failure pulmonary edema Ventilation strategy

Aspergillosis

Toxin- Aflatoxin, orchratoxin, fumagillin, gliotoxin Type 1.Aspergilloma(Most common) Foreword– Lung cavitation already present X-ray- Monod sign(Radiopaque lesion surrounded by radiolucency) Treatment- Amphotericin B, voriconazole 2.Allergic bronchopulmonary aspergillosis(ABPA) Foreword- Accompanied with asthma, Th2↑ Diagnostic criteria(Major criteria) CT- Central bronchiectasis Treatment- Steroid, Itraconazole 3.Invasive aspergillosis Forewaord- Immunocompromised patient CT- Halo sign, ground glass, Air crescent Treatment- Hematopoietic […]

Bronchiectasis

Etiology- Cystic fibrosis, Alpha-1 antitrypsin deficiency, selective Ig A deficiency, ABPA, Sjogren syndrome, Kartagener’s syndrome(sinusitis, bronchiectasis, situs inversus, hypomotile cilia), Obstruction(carcinoid tumor), Bacteria(SP, HI, KP, SA, pertussis, TB), Virus(Measles, Influenza, VZV, adenovirus) Presentation- Cough with sputum Pathogen- H.influenza, Pseudomonas, Streptococcus Image- Signet ring sign, dot ring sign, tram tracks, ring shadow Complication- Lung, brain abscess