Pulmonology Flashcards
What is a MONOD sign?
Aspergilloma secondary to a previous TB infection. Angola is an area with a high prevalence of TB and the chest x-ray findings are typical of aspergilloma - a mass within a cavity with a ‘Monod sign’ (the crescent of the surrounding air)
What is the diagnostic test for suspected aspergilloma??
Aspergillus precipitins
(May have a previous history of TB)
If eosinophil count/FeNO do not confirm suspected asthma, and spirometry is not available then??
Measure peak expiratory flow (PEF) twice daily for 2 weeks
Diagnose asthma if:
PEF variability (expressed as amplitude percentage mean) is ≥ 20%
If asthma is not confirmed by eosinophil count, FeNO, BDR or PEF variability but still suspected on clinical grounds??
Refer for consideration of a bronchial challenge test
Diagnose asthma if bronchial hyper-responsiveness is present
If asthma is not confirmed by the eosinophil count or FeNO??
Measure bronchodilator reversibility (BDR) with spirometry
Diagnose asthma if:
the FEV1 increase is ≥ 12% and 200 ml or more from the pre-bronchodilator measurement, or
the FEV1 increase is ≥ 10% of the predicted normal FEV1
What are the 5 main classes of pulmonary HTN??
Group 1:
Idiopathic/Familial PAH
Associated conditions: collagen vascular disease, congenital heart disease with systemic to pulmonary shunts, HIV, drugs and toxins, sickle cell disease
Persistent pulmonary hypertension of the newborn
Group 2:
{Pulmonary hypertension with left heart disease}
- left-sided atrial, ventricular or valvular disease such as left ventricular systolic and diastolic dysfunction, mitral stenosis and mitral regurgitation
Group 3:
{Pulmonary hypertension secondary to lung disease/hypoxia}
- COPD
- interstitial lung disease
- sleep apnea
- high altitude
Group 4:
{Pulmonary hypertension due to thromboembolic disease}
Group 5: Miscellaneous conditions
- lymphangiomatosis e.g. secondary to carcinomatosis or sarcoidosis
