Pneumatocele

 Are thin walled, air filled structures that often develop early in the course of staphylococcal pneumonia, particularly in infants and young children, and usually disappear over the course of a few months. These cystic spaces are believed to be the consequence of check valve opening between a peribronchial abcess and an adjacent bronchus. 

Minimal fluid to visualise pleural effusion

  Effusions first become apparent on lateral upright radiographs with blunting of the posterior costophrenic angle. An accumulation of 200 ml of fluid is necessary for the effusion tp affect the lateral angles of frontal standing radiographs. Lateral decubitus radiograph with the affected side down is the more sensible view to identify an effusion of 5 to 15 ml. 

Causes of impalpable Apical impulse

  -overweight

-hyperinflated lungs

-behind the rib

-pericardial effusion 

-dextrocardia

Definition of PUO

 PUO is defined as a temperature persistently above 38 degree celcius for more than 3 weeks, without diagnosis, despite initial investigations during 3 days of inpatient care or after more than 2 outpatient visits.

Conversion of C to F

 Conversion from farenheit to celsius = (F-32)*5/9

Conversion from celsius to farenheit = (C*9/5)+32

Acute,Subacute,Chronic

  Acute <3 weeks Harrison's principles of internal medicine, 21st edition

Subacute 3-8 weeks

Chronic > 8 weeks

Reference: Harrison's principles of internal medicine, 21st edition

Cor pulmonale

Clinical/pathological definition:-

Right ventricular hypertrophy and/or dilation occuring as a result of an abnormality of lung structure or function.

Radiological definition:-

The combination of pulmonary artery hypertension and chronic lung disease with /without evidence of enlargement of right heart chambers.

Reference from Fraser.

Indications for steroids in Sarcoidosis

  1.Threatened Organ failure -severe ocular/neurologic/cardiac  disease 

2.Progressive or persistent pulmonary disease 

3.Uveitis unresponsive to topical corticosteroids 

4.Persistent Hypercalcemia/ renal or hepatic dysfunction 

5.Palpable splenomegaly or hypersplenism

6.Severe myopathy 

7.Disfiguring skin disease 

8.Painful lymphadenopathy 

9.Severe fatigue and weight loss

Pleuroscopy guidelines

 Pleuroscopy guidelines- click on the link

TIDAL PERCUSSION

 REFERENCE : MANUAL OF CLINICAL METHODS BY P.S.SHANKAR