Medical Concepts

 HOSPITAL ACQUIRED PNEUMONIA Definition: "HAP refers to a new episode of pneumonia occurring at least 2 days after the administration to hospital. It is the most common Hospital Acquired Infection (HAI) and leading cause of HAI-associated death". Predisposing factors: Aspiration of nasopharyngeal secretion Bacteria introduced into the lower GIT. Bacteriaemia Old age Mode of Spread:  Droplet infection Infecting agent: Bacteria: S.pneumonia , S.aureus , H.influenza Virus: Adenovirus, Corona virus, Herpes Simplex Clinical Features: Purulent sputum New radiological infiltrates Temperature > 38 degree Celsius Leukocytosis Investigations: Chest Pain:  to confirm the diagnosis and exclude complication. Pulse Oximetry : to monitor response to oxygen therapy, if SaO2 < 93% features of sever pneumonia, identify ventilatory failure or acidosis. Cell count:  ESR, Neutrophil leukocytosis Microbiological studies:  for severe CAP and those that do not respond to initial therapy (Gr

  CHRONIC ABSTRUCTIVE PULMONARY DISEASE (COPD) Definition: COPD is defined as "a disease state characterized by airflow limitation that is not fully reversible and this airflow limitation is progressive associated with abnormal inflammatory response to the noxious or gaseous particles. According to Davidson , COPD is defined as " COPD is preventable and treatable disease characterized by airflow limitation that is usually progressive and is associated with enhanced chronic inflammatory response in the airways and lungs to the noxious particles. According to National Institute for Health and Clinical Excellence (NICE) , COPD is defined as "Airflow obstruction with reduced FEV1/FEVc is less than 0.7, if FEV1 is greater than or equal to80%; so, diagnosis of COPD should be made on the presence of symptoms". Signs and Symptoms: Shortness of breathing Cough Pink puffers and Blue Blotters or Smokers Cough (classical signs of COPD). *Pink puffer is the major sign of emphyse

  ASTHMA Definition: According to WHO: "It is a disease characterized by recurring attacks of breathlessness and wheezing which vary in frequency according to the nature of allergen and these symptoms vary from hour to hour or day to day". According to Principle & Practice of Medicines by Davidson: "It is chronic inflammatory disorder of airways associated with airway hyper-responsiveness that leads to recurrent episodes of wheezing, breathlessness or coughing particularly at night or early in the morning". Etiology: Hyperresponsiveness -exaggerated response of airway to any non-specific stimulus which results in airway obstruction. Broncho-constriction- Breathlessness or spasm due to construction of bronchioles in airway stimulus. Allergens: Industrial chemicals such as paints, hairsprays or resins Drugs such as NSAIDs, Beta-blockers Food products such as dairy products, fish, etc. Environmental pollutants such as cigarette, smoke Industrial triggers such as w