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.ATS GUIDELINES OF TB DEFAULT AND RELAPSE (1) 1.WHY FASCIAL PUFFINESS OCCURS FIRST IN RENAL EDEMA (1) Acute (2) ACUTE EXACERBATION OF COPD CRITERIA (1) Acute exacerbation of COPS (1) ACUTE EXACERBATION OF ILD CRITERIA (1) AE COPD (1) Air crescent sign and Monod sign (1) Alveolar arterial oxygen gradient (1) Amphoric breathing (1) Anuria and oliguria definition (1) apical cap (1) Apical impulse (1) Assessment of respiratory muscle strength (1) Asthma PEF variablity (1) Att in hepatotoxicity (1) ATT weight band recent (1) Austin flint murmur and Graham steel murmur (1) BEQ (1) BMI (1) Borg dyspnoea score (1) breathlessness-sherwood jones (1) Bronchiectasis- Definition (1) BRONCHOPULMONARY SEGMENTS (1) Causes of chest pain aggrevated by cough (1) Causes of localised bulging of chest wall (1) Causes of orthopnea (1) Causes of palpitation (1) Causes of Unilateral pedal edema (1) Cavity (1) check post (1) Chest physiotherapy (1) Chronic (2) Classification (1) Clubbing (1) clubbing -mechanism of (1) Clubbing Unilateral (1) CLUBBING-PATHOGENESIS PDGF (1) cobb's angle-In Kyphoscoliosis Cobb's angle above which can be operated (1) Cobbs angle (1) Complications of Tuberculosis (1) Cor pulmonale (1) Cough reflex (2) Cough- aggravating factors (1) Cultures- significant colony count (1) Cyst/Bulla/Bleb (1) Cystic Fibrosis- Female infertility (1) DD of Orthopnoea (1) definition (1) DNB question bank (1) Drugs causing breathlessness (1) dysphagia - approach (1) Dyspnea - Causes of acute dyspnea (1) ECG FEATURES OF DEXTROCARDIA (1) Emphysema (1) Emphysema and chronic bronchitis definition (1) Empyema necessitans (1) Exacerbation of ILD (1) Factitious asthma (1) Fever of unknown origin (1) fibrinolytics in plef (1) FORMOTEROL (1) Gastro Intestinal Tract and abdominal symptoms (1) Gram negative cocci & gram positive bacilli (1) HAM (1) Hemothorax (1) Hydropneumothorax- sound of Coin test (1) Hyperventilation syndrome (1) IDSA sinusitis management (1) ILD CLASSIFICATION (1) Impalpable apical impulse (2) Indications for steroids in Sarcoidosis (2) Krogg constant (1) Lung areas sensitive to pain (1) lung cancer- age group (1) Lung cancers-ALK inhibitors (1) MARKERS OF ILD (1) Massive hemoptysis (1) Massive hemoptysis criteria (1) Mines in Tamil Nadu (1) Muscles of respiration (2) Name reason for Potts spine (1) Nephrotic syndrome (1) NORMAL THYMUS IN CT (1) NYHA (1) Orthopnea (1) Orthostatic hypotension (1) Pain- CRPS (1) Paracetamol -MOA (1) Pathophysiology of breath sounds (1) Penetration and exposure in Chest Xray (1) Perception of Dyspnoea (1) Pleuroscopy guidelines (1) PND causes (1) Pneumatocele (1) pneumonia phases of (1) Positional variation in chest pain (1) Puddle sign (1) Pulmonary embolism (1) Pulsations in different areas- causes (1) Pulsus paradoxus (1) Pulsus paradoxus - Measuremen (2) RADS-Definition and Criteria (1) Respiratory system clinical examination (1) S3 (1) S4 HEART SOUNDS (1) Serum cortisol (1) Sherwood jones classification (1) Shivering (1) Silhouette sign (1) Six minute walk test (1) Skodaic resonance (1) Sleep study and polysomnography (1) Spinoscapular distance (1) Split pleura sign (1) Subacute (2) Subpulmonic effusion (1) Swellin (1) Terminal respiratory unit (1) Test (1) Tidal percussion (1) Tongue in HIV (1) Upper respiratory tract (1) Velcro crackles (1) Vesicular breath sounds - Physiology (1) weight loss (1)

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Friday, April 19, 2024

Breath sounds: Mechanism

 Normal breath sounds originate from the larynx. When the sound leaves the larynx it travels down the trachea and then divides when the airway divides. Eventually the sound travels along the airways of different lengths and therefore becomes out of phase. Next it arrives in the respiratory bronchioles and the alveoli and then get transmitted through the chest wall to your stethescope. The fat layer filters out much of the higher frequency (4 kHz). The resulting sounds are much softer (because the sounds has effectively been diluted throughout of the whole lungs). There is no gap between the inspiration and the expiration because the sound has become out of phase and therefore filled in the gap. Finally, the first third of expiration is now only part that is audible because the latter two thirds are much quieter. 

Reference: Chamberlain’s symptoms and signs in clinical medicine, 13th edition, page no:97

Wednesday, April 17, 2024

Cough- aggravating factors

 Pneumonic: PDFCE

P3

Pollen 

Pollution

Posture

D2

Drugs

Diurnal variation 

F

Food

C2

Common cold

Cold weather

E1

Exercise 

Exacerbation of ILD

 Acute exacerbation of ILD is defined as

 1) a previous or concurrent diagnosis of ILD 2) unexplained worsening of dyspnoea within the past 30 days

3) high-resolution computed tomography (HRCT) with new bilateral ground-glass opacity or consolidation; and 

4) exclusion of alternative causes, including pulmonary infection by endotracheal aspirate or bronchoalveolar lavage

Reference:journal for IPF