RESPIRATORY CORE CONDITIONS SUMMARY
Condition Summary Epidemiology Pathophysiology Prognosis Aetiology Risk Factors S/S Investigations DDs Treatment Complications
SABA PRN;
Very good if well
Chronic, Trigger leads to the release of corticosteroids
controlled; may Genetic factors; Recent URTI; FEV1/FVC ratio; Exacerbation; airway
intermittent inflammatory mediators, causing CF; chronic rhinitis/ (beclometasone,
see a decline in environmental dyspnoea; cough; PEFR; CXR; FBC; remodelling; airway
Asthma inflammation of the Very common inflammation; products of the
lung function triggers (allergen,
FHx; allergy; atopy
expiratory wheeze; immunoassay for
sinusitis; COPD; PE; prednisolone);
candidiasis from
airway causing inflammatory response induce bronchiectasis; CCF leukotriene-receptor
with severe virus, chemicals) nasal polyposis allergen-specific IgE chronic ICS use
obstruction smooth muscle contraction antagonist
asthma (montelukast)
Chronic narrowing and BODE index
Chronic, Cough; SOB; barrel Cor pulmonale;
remodelling of the airways with for prognosis; Asthma; CCF; lung Smoking cessation;
COPD progressive airway enlargement of mucus-secreting key factors are Smoking; chest; hyper-resonance Spirometry; pulse cancer; chronic SABA PRN; Abx; recurrent pneumonia;
inflammation Adults Smoking; age; on percussion; poor air oximetry; ABGs; depression; anaemia;
(chronic obstructive M>F
glands causing increased airway smoking occupational
genetic factors flow on auscultation; CXR; FBC; ECG;
sinusitis; GORD; prednisolone; airway
pneumothorax;
resistance; expiratory flow cessation and exposure bronchiectasis; TB; clearance techniques;
pulmonary disease) (emphysema + limitation promotes hyperinflation need for
wheeze; asterixis; sputum culture bronchiolitis O2 therapy respiratory failure;
chronic bronchitis) cyanosis; clubbing polycythaemia
and subsequent hypoxia additional O2
Carcinoma of the Cough; dyspnoea;
Smoking; FHx; CXR; CT chest; SCLC; metastatic
Lung cancer lung, originating in
M>F Smoking-related endothelial environmental
haemoptysis; chest
sputum culture; cancer; pneumonia;
Post-operative
non-small cells Generally poor; Smoking; pain; weight loss; Chemotherapy; pneumonia; SVC
(non-small cell (adenocarcinoma
85% of lung injury, arising in the central lung related to stage radon exposure tobacco exposure fatigue; wheeze; rales; bronchoscopy; FBC; bronchitis; TB; radiotherapy; surgery syndrome; para-
cancer with mediastinal involvement COPD; age; radon thoracocentesis; sarcoidosis;
carcinoma) + SCC + large cell
exposure
quiet breath sounds;
lung function test lymphoma; RA
neoplastic syndrome
carcinoma) dullness on percussion
Cough; dyspnoea;
CXR; CT chest; NSCLC; metastatic Post-operative
haemoptysis; chest
Lung cancer Carcinoma of the M>F Smoking-related endothelial Generally poor; Smoking, sputum culture; cancer; pneumonia; pneumonia; SCV
Smoking; pain; weight loss; Chemotherapy;
lung, originating in 15% of lung injury, arising in the central lung 5y survival environmental bronchoscopy; FBC; bronchitis; TB; syndrome; para-
(small cell carcinoma) radon exposure fatigue; wheeze; rales; radiotherapy; surgery
small cells cancer with mediastinal involvement <25% tobacco exposure thoracocentesis; sarcoidosis; neoplastic syndrome;
quiet breath sounds;
lung function test lymphoma; RA haemoptysis
dullness on percussion
Embolic pulmonary vasculature Poor if not
Age; DVT; recent Pleuritic chest pain; Unstable angina; MI; Acute bleeding;
obstruction increases vascular treated quickly;
Embolism of a surgery or trauma; dyspnoea; tachypnoea; Well’s score; D- CAP; panic attack; Thrombolysis; anti- recurrent VTE;
resistance, increasing RV mortality is
PE thrombus from a hospitalisation; syncope; hypotension; dimer; CTPA; V/Q COPD exacerbation; coagulation; IV fluids; pulmonary infarction;
Elderly workload; compensatory dilation usually due to
deep vein, lodging Virchow’s triad previous VTE; active cough; tachycardia; scan; coagulation pericarditis; cardiac respiratory support; cardiac arrest;
(pulmonary embolism) M≳F of the RV leads to ↓RV output, cardiogenic
in the pleural cancer; pregnancy; pyrexia; unilateral calf studies; FBC; BNP; tamponade; embolectomy; IVC pulmonary HTN;
which decreases LV pre-load, shock,
vasculature recent long-haul swelling; haemoptysis; CXR; ECG; ABG pneumothorax; filter Heparin-associated
resulting in ↓LV filling, ↓CO, secondary to
travel elevated JVP costochondritis thrombocytopenia
hypotension and shock RV collapse
Exudative (local):
Imbalance between pulmonary
pneumonia, PE, RA, Dyspnoea; dullness on Light’s criteria for
fluid production and removal; Atelectasis; lobar
Accumulation of empyema, percussion; pleuritic exudative vs.
exudative fluid (high protein) from Poor prognosis CCF; pneumonia; Pleural thickening; Diuretic (furosemide); collapse; pleural
fluid in the pleural malignancy, SLE chest pain; reduced transudative; CXR;
Pleural effusion space (exudative Related to cause infection, infarction or tumour if malignancy-
Transudative
malignancy; recent breath sounds and pleural USS; pleural
pneumothorax; thoracocentesis; O2; fibrosis; re-expansion
and transudative fluid (low related CABG consolidation Abx; physiotherapy pulmonary oedema;
or transudative) (systemic): cirrhosis, tactile vocal fremitus; fluid sample; FBC;
protein) from heart failure, pneumothorax
ascites, sarcoidosis, cough CRP; CT chest
cirrhosis or nephrotic syndrome
CCF, renal disease
Strep. pneumoniae
Determined by CXR; FBC; U&Es;
Lung infection with Adults Invasion and overgrowth of a Age; COPD; Cough with increasing Acute bronchitis;
Pneumonia, consolidation that LRTIs are most pathogen in the lung parenchyma age,
+ H. influenzae, smoking; alcohol; sputum; fever; LFTs; CRP; ABGs; CCF; COPD Septic shock; ARDS;
comorbidities, procalcitonin; blood Abx; supportive care; Abx-associated C.
community-acquired is acquired outside deadly infectious that overwhelms host defences
and the setting
Staph. aureus, poor oral hygiene; confusion; dyspnoea;
glucose; blood/
exacerbation; lung
corticosteroids difficile colitis; heart
of healthcare disease and produces intra-alveolar Pseudomonas PPI use; DM; CKD; pleuritic pain; abnormal cancer/metastases;
(CAP) facilities M>F exudates where Abx are
aeruginosa, GAS, chronic liver disease ausculatory findings sputum cultures; empyema failure
given bronchoscopy
viruses
Pseudomonas Poor infection Productive cough with
Lung infection with Adults Aspiration of oropharyngeal ARDS; cardiogenic Empyema; lung
Pneumonia, hospital consolidation that M>F secretions (most commonly),
Mortality is high; aeruginosa, E. coli, control; intubation thick yellow/green CXR; FBC; O2
pulmonary oedema;
Before culture results:
abscess; SIRS; C.
many die from Klebsiella sp., and mechanical sputum; dyspnoea; saturations; sputum empirical Abx
acquired is acquired ≥48hrs haematogenous spread from an the underlying MRSA, MDRs ventilation; head of pleuritic pain; abnormal culture; ABGs; CRP; pleural effusion; PE;
After culture results: diff colitis; sepsis;
of admission to Extends admission infected IV catheter, translocation atelectasis; lung multi-organ failure;
(HAP) hospital by 7-11 days from the GIT, direct inoculation
cause (common in ICU), bed <30o; poor oral auscultatory findings; procalcitonin
cancer
directed Abx
PE; lung infarction
Strep. pneumoniae hygiene tachycardia; fever
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Condition Summary Epidemiology Pathophysiology Prognosis Aetiology Risk Factors S/S Investigations DDs Treatment Complications
SABA PRN;
Very good if well
Chronic, Trigger leads to the release of corticosteroids
controlled; may Genetic factors; Recent URTI; FEV1/FVC ratio; Exacerbation; airway
intermittent inflammatory mediators, causing CF; chronic rhinitis/ (beclometasone,
see a decline in environmental dyspnoea; cough; PEFR; CXR; FBC; remodelling; airway
Asthma inflammation of the Very common inflammation; products of the
lung function triggers (allergen,
FHx; allergy; atopy
expiratory wheeze; immunoassay for
sinusitis; COPD; PE; prednisolone);
candidiasis from
airway causing inflammatory response induce bronchiectasis; CCF leukotriene-receptor
with severe virus, chemicals) nasal polyposis allergen-specific IgE chronic ICS use
obstruction smooth muscle contraction antagonist
asthma (montelukast)
Chronic narrowing and BODE index
Chronic, Cough; SOB; barrel Cor pulmonale;
remodelling of the airways with for prognosis; Asthma; CCF; lung Smoking cessation;
COPD progressive airway enlargement of mucus-secreting key factors are Smoking; chest; hyper-resonance Spirometry; pulse cancer; chronic SABA PRN; Abx; recurrent pneumonia;
inflammation Adults Smoking; age; on percussion; poor air oximetry; ABGs; depression; anaemia;
(chronic obstructive M>F
glands causing increased airway smoking occupational
genetic factors flow on auscultation; CXR; FBC; ECG;
sinusitis; GORD; prednisolone; airway
pneumothorax;
resistance; expiratory flow cessation and exposure bronchiectasis; TB; clearance techniques;
pulmonary disease) (emphysema + limitation promotes hyperinflation need for
wheeze; asterixis; sputum culture bronchiolitis O2 therapy respiratory failure;
chronic bronchitis) cyanosis; clubbing polycythaemia
and subsequent hypoxia additional O2
Carcinoma of the Cough; dyspnoea;
Smoking; FHx; CXR; CT chest; SCLC; metastatic
Lung cancer lung, originating in
M>F Smoking-related endothelial environmental
haemoptysis; chest
sputum culture; cancer; pneumonia;
Post-operative
non-small cells Generally poor; Smoking; pain; weight loss; Chemotherapy; pneumonia; SVC
(non-small cell (adenocarcinoma
85% of lung injury, arising in the central lung related to stage radon exposure tobacco exposure fatigue; wheeze; rales; bronchoscopy; FBC; bronchitis; TB; radiotherapy; surgery syndrome; para-
cancer with mediastinal involvement COPD; age; radon thoracocentesis; sarcoidosis;
carcinoma) + SCC + large cell
exposure
quiet breath sounds;
lung function test lymphoma; RA
neoplastic syndrome
carcinoma) dullness on percussion
Cough; dyspnoea;
CXR; CT chest; NSCLC; metastatic Post-operative
haemoptysis; chest
Lung cancer Carcinoma of the M>F Smoking-related endothelial Generally poor; Smoking, sputum culture; cancer; pneumonia; pneumonia; SCV
Smoking; pain; weight loss; Chemotherapy;
lung, originating in 15% of lung injury, arising in the central lung 5y survival environmental bronchoscopy; FBC; bronchitis; TB; syndrome; para-
(small cell carcinoma) radon exposure fatigue; wheeze; rales; radiotherapy; surgery
small cells cancer with mediastinal involvement <25% tobacco exposure thoracocentesis; sarcoidosis; neoplastic syndrome;
quiet breath sounds;
lung function test lymphoma; RA haemoptysis
dullness on percussion
Embolic pulmonary vasculature Poor if not
Age; DVT; recent Pleuritic chest pain; Unstable angina; MI; Acute bleeding;
obstruction increases vascular treated quickly;
Embolism of a surgery or trauma; dyspnoea; tachypnoea; Well’s score; D- CAP; panic attack; Thrombolysis; anti- recurrent VTE;
resistance, increasing RV mortality is
PE thrombus from a hospitalisation; syncope; hypotension; dimer; CTPA; V/Q COPD exacerbation; coagulation; IV fluids; pulmonary infarction;
Elderly workload; compensatory dilation usually due to
deep vein, lodging Virchow’s triad previous VTE; active cough; tachycardia; scan; coagulation pericarditis; cardiac respiratory support; cardiac arrest;
(pulmonary embolism) M≳F of the RV leads to ↓RV output, cardiogenic
in the pleural cancer; pregnancy; pyrexia; unilateral calf studies; FBC; BNP; tamponade; embolectomy; IVC pulmonary HTN;
which decreases LV pre-load, shock,
vasculature recent long-haul swelling; haemoptysis; CXR; ECG; ABG pneumothorax; filter Heparin-associated
resulting in ↓LV filling, ↓CO, secondary to
travel elevated JVP costochondritis thrombocytopenia
hypotension and shock RV collapse
Exudative (local):
Imbalance between pulmonary
pneumonia, PE, RA, Dyspnoea; dullness on Light’s criteria for
fluid production and removal; Atelectasis; lobar
Accumulation of empyema, percussion; pleuritic exudative vs.
exudative fluid (high protein) from Poor prognosis CCF; pneumonia; Pleural thickening; Diuretic (furosemide); collapse; pleural
fluid in the pleural malignancy, SLE chest pain; reduced transudative; CXR;
Pleural effusion space (exudative Related to cause infection, infarction or tumour if malignancy-
Transudative
malignancy; recent breath sounds and pleural USS; pleural
pneumothorax; thoracocentesis; O2; fibrosis; re-expansion
and transudative fluid (low related CABG consolidation Abx; physiotherapy pulmonary oedema;
or transudative) (systemic): cirrhosis, tactile vocal fremitus; fluid sample; FBC;
protein) from heart failure, pneumothorax
ascites, sarcoidosis, cough CRP; CT chest
cirrhosis or nephrotic syndrome
CCF, renal disease
Strep. pneumoniae
Determined by CXR; FBC; U&Es;
Lung infection with Adults Invasion and overgrowth of a Age; COPD; Cough with increasing Acute bronchitis;
Pneumonia, consolidation that LRTIs are most pathogen in the lung parenchyma age,
+ H. influenzae, smoking; alcohol; sputum; fever; LFTs; CRP; ABGs; CCF; COPD Septic shock; ARDS;
comorbidities, procalcitonin; blood Abx; supportive care; Abx-associated C.
community-acquired is acquired outside deadly infectious that overwhelms host defences
and the setting
Staph. aureus, poor oral hygiene; confusion; dyspnoea;
glucose; blood/
exacerbation; lung
corticosteroids difficile colitis; heart
of healthcare disease and produces intra-alveolar Pseudomonas PPI use; DM; CKD; pleuritic pain; abnormal cancer/metastases;
(CAP) facilities M>F exudates where Abx are
aeruginosa, GAS, chronic liver disease ausculatory findings sputum cultures; empyema failure
given bronchoscopy
viruses
Pseudomonas Poor infection Productive cough with
Lung infection with Adults Aspiration of oropharyngeal ARDS; cardiogenic Empyema; lung
Pneumonia, hospital consolidation that M>F secretions (most commonly),
Mortality is high; aeruginosa, E. coli, control; intubation thick yellow/green CXR; FBC; O2
pulmonary oedema;
Before culture results:
abscess; SIRS; C.
many die from Klebsiella sp., and mechanical sputum; dyspnoea; saturations; sputum empirical Abx
acquired is acquired ≥48hrs haematogenous spread from an the underlying MRSA, MDRs ventilation; head of pleuritic pain; abnormal culture; ABGs; CRP; pleural effusion; PE;
After culture results: diff colitis; sepsis;
of admission to Extends admission infected IV catheter, translocation atelectasis; lung multi-organ failure;
(HAP) hospital by 7-11 days from the GIT, direct inoculation
cause (common in ICU), bed <30o; poor oral auscultatory findings; procalcitonin
cancer
directed Abx
PE; lung infarction
Strep. pneumoniae hygiene tachycardia; fever
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