,Contents
List of Abbreviations ix
An Explanation of the Text xiii
PART I RESPIRATORY MEDICINE 1
1 Clinical Assessment 3
1.1 History 3
1.2 Examination 7
1.3 Investigations in Respiratory Medicine 11
2 Respiratory Infection 20
2.1 Upper Respiratory Tract Infections (URTIs) 20
2.2 Influenza 21
2.3 Acute Bronchitis 25
2.4 Community-Acquired Pneumonia (CAP) 27
2.5 Hospital-Acquired Pneumonia (HAP) 33
2.6 Empyema (Pyothorax) 36
2.7 COVID-19 40
3 Asthma 47
3.1 Acute Exacerbations of Asthma 57
4 Chronic Obstructive Pulmonary Disease 60
4.1 Acute Exacerbations of COPD 70
5 Lung Malignancy 73
5.1 Primary Lung Malignancy 73
5.2 Mesothelioma 93
5.3 Secondary Spread of Systemic Malignancy to Lung
and Pleura 96
5.4 Mediastinal Masses 97
6 Pleural Disease 99
6.1 Pneumothorax 99
6.2 Pleural Effusion 108
7 Pulmonary Embolism 120
7.1 Clinical Management of PE 122
8 Tuberculosis 130
8.1 Pulmonary Tuberculosis 130
8.2 Extra-Pulmonary Tuberculosis 136
8.3 Tuberculosis Treatment 140
8.4 Tuberculosis Worldwide 144
,vi Contents
9 Bronchiectasis and Cystic Fibrosis 147
9.1 Development of Bronchiectasis 147
9.2 Clinical Management 150
9.3 Cystic Fibrosis 154
10 Sarcoidosis 163
11 Interstitial Lung Disease and Vasculitis 170
11.1 Classification of Interstitial Lung Diseases 170
11.2 Idiopathic Pulmonary Fibrosis (IPF) 171
11.3 Other Idiopathic Interstitial Pneumonias 176
11.4 Hypersensitivity Pneumonitis (HSP) 179
11.5 ILD Associated with Non-Pulmonary Conditions 182
11.6 Vasculitis and the Lung 183
11.7 Eosinophilic Granulomatosis with Polyangiitis (EGPA) 184
11.8 Granulomatosis with Polyangiitis (GPA) 185
11.9 Microscopic Polyangiitis (MPA) 186
11.10 Goodpasture’s Syndrome 186
11.11 Connective Tissue Disease and Lung Vasculitis 187
11.12 Presentation, Investigation and Management of Vasculitis 187
12 Pulmonary Hypertension 191
12.1 Pulmonary Hypertension 191
12.2 Idiopathic Pulmonary Arterial Hypertension (IPAH) 193
12.3 Pulmonary Hypertension due to Other Causes 199
13 Fungal Diseases of the Lung 201
13.1 Allergic Bronchopulmonary Aspergillosis (ABPA) 201
13.2 Aspergilloma 206
13.3 Chronic Cavitary Pulmonary Aspergillosis (CCPA) 207
13.4 Subacute Invasive Aspergillosis (SAIA) 208
13.5 Invasive Aspergillosis 209
13.6 Pneumocystis Pneumonia (PCP/PJP) 213
14 Sleep Disordered Breathing 218
14.1 Obstructive Sleep Apnoea/Hypopnoea Syndrome (OSAHS) 218
14.2 Central Sleep Apnoea 222
14.3 Sleep-Related Hypoventilation 223
14.4 Other Causes of Poor Sleep/Daytime Somnolence 223
15 Occupational Lung Disease 224
15.1 Work-Related Asthma 224
15.2 Asbestosis 228
15.3 Asbestos-Related Pleural Diseases 231
15.4 Coal Workers Pneumoconiosis 232
15.5 Silicosis 234
, Contents vii
16 Respiratory Emergencies 237
16.1 Respiratory Failure 237
16.2 Acute Asthma 239
16.3 COPD Exacerbation 240
16.4 Anaphylaxis 242
16.5 Tension Pneumothorax 244
16.6 Massive Pulmonary Embolus (PE) 245
16.7 Massive Haemoptysis 248
16.8 Superior Vena Cava Obstruction (SVCO) 249
17 Smoking and the Lung 252
PART II QUESTIONS AND ANSWERS 259
18 Questions and Answers 261
Questions261
Answers286
Index307
List of Abbreviations ix
An Explanation of the Text xiii
PART I RESPIRATORY MEDICINE 1
1 Clinical Assessment 3
1.1 History 3
1.2 Examination 7
1.3 Investigations in Respiratory Medicine 11
2 Respiratory Infection 20
2.1 Upper Respiratory Tract Infections (URTIs) 20
2.2 Influenza 21
2.3 Acute Bronchitis 25
2.4 Community-Acquired Pneumonia (CAP) 27
2.5 Hospital-Acquired Pneumonia (HAP) 33
2.6 Empyema (Pyothorax) 36
2.7 COVID-19 40
3 Asthma 47
3.1 Acute Exacerbations of Asthma 57
4 Chronic Obstructive Pulmonary Disease 60
4.1 Acute Exacerbations of COPD 70
5 Lung Malignancy 73
5.1 Primary Lung Malignancy 73
5.2 Mesothelioma 93
5.3 Secondary Spread of Systemic Malignancy to Lung
and Pleura 96
5.4 Mediastinal Masses 97
6 Pleural Disease 99
6.1 Pneumothorax 99
6.2 Pleural Effusion 108
7 Pulmonary Embolism 120
7.1 Clinical Management of PE 122
8 Tuberculosis 130
8.1 Pulmonary Tuberculosis 130
8.2 Extra-Pulmonary Tuberculosis 136
8.3 Tuberculosis Treatment 140
8.4 Tuberculosis Worldwide 144
,vi Contents
9 Bronchiectasis and Cystic Fibrosis 147
9.1 Development of Bronchiectasis 147
9.2 Clinical Management 150
9.3 Cystic Fibrosis 154
10 Sarcoidosis 163
11 Interstitial Lung Disease and Vasculitis 170
11.1 Classification of Interstitial Lung Diseases 170
11.2 Idiopathic Pulmonary Fibrosis (IPF) 171
11.3 Other Idiopathic Interstitial Pneumonias 176
11.4 Hypersensitivity Pneumonitis (HSP) 179
11.5 ILD Associated with Non-Pulmonary Conditions 182
11.6 Vasculitis and the Lung 183
11.7 Eosinophilic Granulomatosis with Polyangiitis (EGPA) 184
11.8 Granulomatosis with Polyangiitis (GPA) 185
11.9 Microscopic Polyangiitis (MPA) 186
11.10 Goodpasture’s Syndrome 186
11.11 Connective Tissue Disease and Lung Vasculitis 187
11.12 Presentation, Investigation and Management of Vasculitis 187
12 Pulmonary Hypertension 191
12.1 Pulmonary Hypertension 191
12.2 Idiopathic Pulmonary Arterial Hypertension (IPAH) 193
12.3 Pulmonary Hypertension due to Other Causes 199
13 Fungal Diseases of the Lung 201
13.1 Allergic Bronchopulmonary Aspergillosis (ABPA) 201
13.2 Aspergilloma 206
13.3 Chronic Cavitary Pulmonary Aspergillosis (CCPA) 207
13.4 Subacute Invasive Aspergillosis (SAIA) 208
13.5 Invasive Aspergillosis 209
13.6 Pneumocystis Pneumonia (PCP/PJP) 213
14 Sleep Disordered Breathing 218
14.1 Obstructive Sleep Apnoea/Hypopnoea Syndrome (OSAHS) 218
14.2 Central Sleep Apnoea 222
14.3 Sleep-Related Hypoventilation 223
14.4 Other Causes of Poor Sleep/Daytime Somnolence 223
15 Occupational Lung Disease 224
15.1 Work-Related Asthma 224
15.2 Asbestosis 228
15.3 Asbestos-Related Pleural Diseases 231
15.4 Coal Workers Pneumoconiosis 232
15.5 Silicosis 234
, Contents vii
16 Respiratory Emergencies 237
16.1 Respiratory Failure 237
16.2 Acute Asthma 239
16.3 COPD Exacerbation 240
16.4 Anaphylaxis 242
16.5 Tension Pneumothorax 244
16.6 Massive Pulmonary Embolus (PE) 245
16.7 Massive Haemoptysis 248
16.8 Superior Vena Cava Obstruction (SVCO) 249
17 Smoking and the Lung 252
PART II QUESTIONS AND ANSWERS 259
18 Questions and Answers 261
Questions261
Answers286
Index307
