Respiratory
Airways disease, infection, pulmonary vascular disease and pleural problems.
- Asthma Confirming the diagnosis objectively with FeNO and spirometry, the move to anti-inflammatory reliever and MART therapy, and grading the acute attack.
- Chronic Obstructive Pulmonary Disease Confirming fixed obstruction with post-bronchodilator spirometry, choosing inhalers by steroid responsiveness, and the controlled oxygen and NIV decisions in an exacerbation.
- Asthma-COPD Overlap Fixed obstruction with asthmatic features: why NICE asks about steroid responsiveness instead, and why an inhaled corticosteroid is never optional in these patients.
- Pneumonia Scoring severity with CURB-65, recognising the organism from the clinical clues, choosing antibiotics by severity, and the effusion you must always sample.
- Acute Bronchitis The features that separate a self-limiting viral cough from pneumonia, how CRP guides prescribing, and the red flags that mean this is something else entirely.
- Bronchiectasis The vicious cycle that destroys the airway wall, the treatable causes worth hunting for, the CT signs, and why physiotherapy matters more than antibiotics.
- Cystic Fibrosis How one defective chloride channel produces lung, pancreatic and reproductive disease, the sweat test and newborn screening, and how modulators changed the outlook.
- Pulmonary Embolism Working the Wells score through to D-dimer or CTPA, recognising the unstable patient who needs thrombolysis, and choosing the anticoagulant and how long to give it.
- Pneumothorax The BTS 2023 shift from measuring size to assessing high-risk characteristics, when conservative care is enough, and spotting tension before the film is taken.
- Pleural Effusion Separating transudate from exudate with Light's criteria, reading the pH, glucose and cytology, and working up an effusion that stays undiagnosed.
- Empyema The pneumonia that will not settle: why the pleural pH decides the drain, and the role of intrapleural tPA with DNase and of surgical decortication.
- Lung Abscess Why aspiration explains the site, what else cavitates on a chest film, and why the antibiotic course runs for weeks rather than days.
- Interstitial Lung Disease Separating upper from lower zone fibrosis, recognising a UIP pattern on HRCT, the antifibrotics, and why steroids increase mortality in IPF.
- Occupational Lung Disease Taking the exposure history properly, the asbestos-related diseases and mesothelioma, the pneumoconioses, and the reporting and compensation duties that follow.
- Sarcoidosis Bilateral hilar lymphadenopathy and Scadding staging, the extrapulmonary features that force treatment, and the large majority who simply need observing.
- Lung Cancer Who to refer and how fast, separating small cell from non-small cell disease, the paraneoplastic syndromes that give it away, and treatment by stage and molecular subtype.
- Obstructive Sleep Apnoea Scoring sleepiness with Epworth, reading the apnoea-hypopnoea index, getting patients to tolerate CPAP, and the DVLA duty that follows the diagnosis.
- Respiratory Failure The five mechanisms of hypoxaemia, using bicarbonate to separate acute from chronic type 2 failure, and choosing between oxygen, CPAP, NIV and intubation.
- Acute Respiratory Distress Syndrome The Berlin definition and PaO2/FiO2 severity bands, separating it from cardiogenic oedema, and why 6 ml/kg tidal volumes and proning save lives.
- Oxygen Therapy and Non-Invasive Ventilation Prescribing oxygen to a target range, choosing the delivery device, the Venturi colours, and knowing when a patient needs CPAP, NIV or intubation.
- Arterial Blood Gas Interpretation A fixed five-step sequence for every gas, the anion gap and the causes behind each disorder, expected compensation, and eight worked examples.
- Chest X-ray Interpretation Checking quality with RIPE then working through ABCDE, using the silhouette sign to localise disease, and the review areas where missed findings hide.
- Spirometry and Lung Function Tests Separating obstruction from restriction, testing reversibility, using TLCO and KCO to locate the problem, and the flow-volume loops that change the diagnosis.