The British Thoracic Society recommend adding a long-acting B2 agonist if there is an inadequate response to the addition of inhaled steroid. The inhaled steroid dose should be increased if there is an inadequate response to the long-acting B2 agonist. …
Computed tomographic pulmonary angiography (CTPA) is now used first-line to investigate the possiblity of pulmonary embolism. Patients with renal impairment however should be offered Ventilation-perfusion (V/Q) scans as the contrast media used during CTPAs is nephrotoxic. Pulmonary embolism: investigation 2012 …
These results show a restrictive picture, which may result from a number of conditions including kyphoscoliosis. The other answers cause an obstructive picture. Pulmonary function tests Pulmonary function tests can be used to determine whether a respiratory disease is obstructive …
Pulmonary embolism – CTPA is first-line investigation It is still common in UK hospitals, despite guidelines, for a ventilation-perfusion scan to be done first- line Pulmonary embolism: investigation 2012 NICE guidelines All patients with symptoms or signs suggestive of a …
Both the BNF and British Thoracic Society guidelines stress the need for good control of asthma during pregnancy. The BNF advises that ‘inhaled drugs, theophylline and prednisolone can be taken as normal during pregnancy and breast-feeding’. Asthma: stepwise management in …
Asthma diagnosis – if high probability of asthma – start treatment The new British Thoracic Society guidelines take a more practical approach to diagnosing asthma. If a patient has typical symptoms of asthma a trial of treatment is recommended. Normal …
Transfer factor raised: asthma, haemorrhage, left-to-right shunts, polycythaemia low: everything else Where alveolar haemorrhage occurs the TLCO tends to increase due to the enhanced uptake of carbon monoxide by intra-alveolar haemoglobin Transfer factor The transfer factor describes the rate at …
Asthma: stepwise management in adults The management of stable asthma is now well established with a step-wise approach: Step 1Â Â Â Inhaled short-acting B2 agonist as required Step 2 Add inhaled steroid at 200-800 mcg/day* 400 mcg is an appropriate …
Brain lesions The following neurological disorders/features may allow localisation of a brain lesion: Gross anatomy Parietal lobe lesions sensory inattention apraxias astereognosis (tactile agnosia) inferior homonymous quadrantanopia Gerstmann’s syndrome (lesion of dominant parietal): alexia, acalculia, finger agnosia and right-left disorientation …
Dystrophia myotonica – DM1 distal weakness initially autosomal dominant diabetes dysarthria Myotonic dystrophy Myotonic dystrophy (also called dystrophia myotonica) is an inherited myopathy with features developing at around 20-30 years old. It affects skeletal, cardiac and smooth muscle. There are …