Textbook of Pulmonary Medicine Jyotsna M Joshi
INDEX
A
Abdominal tuberculosis 143
clinical presentation 144
diagnosis 144
pathogenesis 143
treatment 144
types 143
intestinal tuberculosis 143
TB peritonitis 143
tuberculous lymphadenopathy 143
Acid-base disturbances 65
metabolic acidosis 67
approach 67
causes 67
metabolic alkalosis 68
approach 68
causes 68
respiratory acidosis 66
approach 66
causes 66
respiratory alkalosis 66
approach 67
causes 66
respiratory and metabolic disorder 65
Air pollution and related disorders 299
Air pollution in India 302
Airway disorders 197
chronic airway disease 198
large airways disorders 197
small airways disorders 197
Allen's test 61
Allergic bronchopulmonary aspergillosis 273
acute stage 273
exacerbation stage 273
remission stage 273
steroid dependent stage 274
Anticholinergics 208
Anti-tuberculosis therapy 111
basis of anti-tuberculosis chemotherapy 113
careful use of fixed dose combinations 114
importance of dosage adjustment 114
role of individual drugs in chemotherapy 113
specific empiric anti-tuberculosis therapy 114
Aortic aneurysms 336
Arterial blood gas analysis 60, 282
acid-base analysis 60
acute onset of dyspnea 60
alveolar arterial oxygen gradient 64
anion gap 61
blood sample from an arterial puncture 61
blood sample from an indwelling arterial cannula 62
checking the compatibility of ABG report 63
consideration in the assessment of oxygen status 63
indications 60
interpretation 62
modified Allen's test 61
noninvasive methods 62
pathophysiology of hypoxemia 63
pulmonary shunting of blood flow 64
Arterial blood gas analysis exercises 70
Asthma in pregnancy 224
Asthma variants 221
aspirin induced asthma 221
cough variant asthma 221
exercise induced asthma 223
nocturnal asthma 223
B
Beta -2(β2) agonists 208
long acting β2 agonists 208
short acting β2 agonists 208
Benign self-limiting pleural effusions 186
asbestos related PE 186
clinical presentation 187
diagnosis 187
etiology 186
treatment 187
atelectasis 186
clinical presentation 186
diagnosis 186
etiology 186
treatment 186
benign postpartum pleural effusion 188
clinical presentation 188
diagnosis 188
etiology 188
treatment 188
PE associated with diabetes mellitus 187
clinical presentation 188
diagnosis 188
etiology 187
treatment 188
postcardiac injury syndrome 187
clinical presentation 187
diagnosis 187
etiology 187
treatment 187
viral infection 186
clinical presentation 186
diagnosis 186
etiology 186
treatment 186
Brock's syndrome 175
Bronchial asthma 71, 214
acute exacerbation 219
diagnostic evaluation 216
pulmonary function tests 216
epidemiology 214
pathogenesis 214
environment factors 214
genetic predisposition and atopy 214
pharmacotherapy 218
prevention 217
treatment 217
Bronchiectasis 239
causes 240
clinical presentation 243
history 243
physical findings 243
demographic characteristics 239
etiology 240
investigations 244
biochemical investigations 244
hematological investigations 244
imaging studies 244
management 247
pathophysiology 239
prevalence 239
prognosis 248
Bronchopleural fistula 193
Bronchoscopy 76
bronchoscope cleaning and disinfection 79
bronchoscopy in ICU 79
complications 81
diagnostic indications 79
endotracheal intubation 80
hemoptysis 80
infection 80
interstitial lung disease 80
lobar collapse 80
localization of fistulae 80
localized wheeze 80
malignancy 79
pleural effusions 81
thermal and chemical inhalation injury 80
trauma 80
unexplained cough 80
flexible fiberoptic bronchoscopy (FOB) 77
instruments 77
balloon catheters 78
biopsy forceps 78
bronchoscope through bronchoscope 78
cytology brushes 78
endobronchial suture 78
flexible biopsy scraper 78
flexible cryoprobes 78
flexible scissors 78
foreign body extractors 78
polypectomy snare 78
protected bronchoalveolar lavage catheter 78
protected specimen brush 78
transbronchial aspiration needle 78
preprocedure requisites 78
procedure 79
rigid bronchoscopy 77
routes 77
therapeutic indications 81
balloon dilatation 81
brachytherapy 81
bronchoalveolar lavage 81
cryosurgery 81
electrosurgery and argon plasma coagulation 81
foreign body removal 81
laser photoresection 81
photodynamic therapy 81
pulmonary toilet and drainage of lung abscesses 81
stent placement 81
Building related illness 302
C
Capnography 69
Cardiopulmonary exercise testing 58
glossary of terms 59
indications 58
methods 58
objective 58
preoperative evaluation 59
Case illustrations 391
Central nervous system TB 140
clinical presentation 140
diagnosis 140
pathogenesis 140
treatment 141
Chest radiographs and their explanation 404
Childhood tuberculosis 130
congenital TB 136
diagnosis 132
bacteriological diagnosis 133
pitfalls of radiology in TB 133
radiological diagnosis 133
rapid direct tests 133
serology and antigen testing 133
drug resistant TB in children 136
epidemiology 130
forms of childhood TB 131
gastrointestinal TB 132
lymph node TB 132
miliary TB 131
skeletal TB 132
histopathology 134
infectivity 130
interpretation 134
Mantoux test (MT) 134
pathogenesis 130
symptomatology 132
treatment 134
tuberculin test 134
Chronic bronchitis 236
acute exacerbation 236
Chronic obstructive pulmonary disease 228
clinical features 230
epidemiology 229
investigations 230
imaging studies 230
pulmonary function tests 231
pathogenesis 229
risk factors 229
treatment 231
nonpharmacological 232
pharmacological 232
Chronic obstructive pulmonary disease 373
Churg Strauss syndrome 275
clinical features 275
radiographic features 275
treatment 275
Collagen vascular disease 250
Community acquired pneumonia 90
clinical presentation 90
diagnostic studies in patients 90
chest radiograph 90
hematological investigations 90
sputum examination 90
duration of treatment 91
risk factors 90
treatment guidelines 91
Complications of pneumonia 94
Computed tomography 26
indications 26
techniques 26
contrast enhanced CT 26
HRCT 27
plain CT only 27
reconstructions 27
spiral CT 27
Congenital cysts of mediastinum 337
bronchogenic cysts 337
esophageal cysts 338
neuroenteric cysts 338
pericardial cysts 338
Control of indoor air pollution 302
Control of outdoor air pollution 303
COPD and air travel 236
COPD and nutrition 235
COPD and psychiatric problems 235
Cromones 207
Cryptogenic adult obliterative bronchiolitis 251
D
Deep vein thrombosis 372
Difficult asthma 219
management 219
Diffusion capacity of lung for carbon monoxide (DLCO) 56
calculating 56
factors affecting DLCO 56
indications 57
measurement 56
measuring diffusing capacity 56
preoperative evaluation for lung resection 57
results of DLCO test 57
Diseases of mediastinum 327
clinical features 327
investigations 328
Diseases of mediastinum 327
clinical features 327
investigations 328
Drug-induced respiratory diseases 358
clinical features 358
diagnosis 361
laboratory diagnostic clues 362
mechanism 361
pathogenesis 358
Dry powder inhalers 212
E
Empyema 188
etiology 188
management 189
stages 188
exudates stage 188
fibrinopurulent stage 189
stage of organization 189
Encountered pleural effusions 184
exudates 184
empyema like fluid 184
malignant effusions 184
pancreatitis associated pleural effusions 185
problems 184
TB pleural effusion 184
transudates 185
cirrhosis of liver—hepatic hydrothorax 185
congestive cardiac failure 185
nephrotic syndrome 186
peritoneal dialysis 185
urinothorax 186
Extrapulmonary tuberculosis 137
diagnosis 138
pathogenesis 138
G
Gastroesophageal reflux and asthma 222
Genitourinary tuberculosis 144
clinical presentation 144
diagnosis 145
management 145
pathogenesis 144
Ghon's complex 103
H
Health effects of air pollution 301
Hemithoracic shrinkage 171
Hospital acquired pneumonia 94
antibiotic treatment 96
causes of apparent failure 96
diagnostic tests 96
diagnostic work-up 95
normal pattern of response 96
organisms implicated 95
pathogenesis 95
prevention 97
risk factors 95
Hudson's chamber 213
Hypereosinophilic syndrome 275
clinical features 276
pathogenesis 276
treatment 276
I
Idiopathic pulmonary fibrosis 283
Inhalation therapy in airway disorders 211
effect of ventilatory pattern 211
importance of good inhaler technique 212
methods of aerosol delivery 211
Inhaled corticosteroids 205
comparison of inhaled steroids 205
inhaled corticosteroids in asthma 207
inhaled steroid in COPD 207
mechanism of action of glucocorticoids 205
safety of inhaled steroids 206
starting dose of inhaled steroid 206
steroid resistance 206
Interstitial lung diseases 278
causes 278
clinical features 280
investigation 280
laboratory tests 280
chest X-ray 281
HRCT 282
pathogenesis 279
treatment 283
K
Kaposi's sarcoma 159
Kartagener's syndrome 407, 423
L
Leukotriene receptor antagonists 209
Löfgren's syndrome 292
Luftsichel sign 423
Lung abscess 97
clinical features 98
investigations 98
pathogenesis 97
etiological agents 97
treatment 98
Lung cancer 254
clinical presentation 255
etiology 254
investigations 256
paraneoplastic syndromes 256
pathology 255
nonsmall cell lung cancer 255
small cell lung cancer 255
risk factors 254
symptoms 255
treatment 261
Lymph node tuberculosis 138
clinical presentation 138
diagnosis 138
management of complication 139
pathogenesis 138
treatment 139
M
Magnetic resonance (MR) 27
indications 27
techniques 27
Mantoux test 282
Marfan's syndrome 424
McLeod's syndrome 36, 250
MDI with spacer and spacer with mask 212
beta agonists inhalers 212
spacers 212
advantages 212
precautions 212
steroid inhalers 212
Mediastinal goiter 333
Mediastinal lymphadenopathy 334
Mediastinal masses 330
germ cell tumors 332
mediastinal seminoma 333
nonseminomatous germ cell tumors 333
teratoma 333
thymic tumors 330
thymic carcinoid 332
thymic carcinoma 331
thymic cysts 332
thymolipoma 332
thymoma 330
Mediastinal parathyroid adenoma 334
Mediastinitis 340
acute mediastinitis 340
chronic mediastinitis 340
Metered dose inhalers 212
Methylxanthines 209
Miliary tuberculosis 142
clinical presentation 142
diagnosis 143
pathogenesis 142
treatment 143
types 142
classical 142
cryptic 142
non-reactive 142
Mixed acid-base disorders 68
respiratory acidosis and metabolic acidosis 68
respiratory acidosis and metabolic alkalosis 68
respiratory alkalosis and metabolic acidosis 68
respiratory alkalosis and metabolic alkalosis 69
Multidrug resistant TB 148
diagnosis 148
clinical situations 148
confirmation 149
laboratory situations 149
management 148
pitfalls in diagnosis 150
pitfalls in treatment 151
prevalence 148
treatment 149
types of resistance 148
Munier-Kuhn syndrome 420
N
Nebulisers 213
jet nebuliser 213
ultrasonic nebuliser 213
Negatives pressure ventilation 375
Neurogenic tumors 339
Non-infections pulmonary complications of HIV 163
bronchiolitis obliterans with organizing pneumonia 165
diffuse alveolar damage 165
evaluation of HIV infection 165
interstitial fibrosis 165
interstitial pneumonitis 164
Kaposi's sarcoma 163
lymphocytic interstitial pneumonitis 164
non-Hodgkin's lymphoma 163
nonspecific interstitial pneumonitis 164
obstructive lung diseases 164
pleural disorders 164
pleural effusions 164
pneumothorax 164
pulmonary alveolar proteinosis 165
pulmonary hypertension 164
sarcoidosis 165
Non-Hodgkin's lymphoma 158
Noninvasive positive pressure ventilation 376
equipments 377
initiating 379
interface 376
modes 378
monitoring 379
role of NPPV in various diseases 380
Noninvasive ventilation 375
location 375
techniques 375
Non-respiratory sleep disorders 344
O
Obesity hypoventilation syndrome 353
Obliterative bronchiolitis 249
Oral corticosteroids 207
indications 207
bronchial asthma 207
COPD 207
Organ transplantation and obliterative bronchiolitis 251
Overlap syndrome 234
P
Pathologic processes of respiratory system 27
mediastinal and hilar 41
bony cage 43
infection and neoplasm 43
masses 41
non-mass lesions 43
recognizing bone lesions 43
trauma 43
parenchymal 27
abscess 30
bulla, bleb, pneumatocele 32
cavity 29
collapse 29
consolidation 27
emphysema 32
fibrosis 31
infiltrate 30
interstitial lung diseases 32
masses and malignant neoplasms 33
nodules 31
pleural 38
bronchopleural fistula 40
effusion, empyema 38
fibrothorax 40
hydropneumothorax 40
masses 41
pneumothorax 40
tracheobronchial 34
bronchiectasis 34
foreign bodies and other obstructions 37
masses 38
obliterative/constrictive bronchiolitis 36
tracheal diseases 37
vascular abnormalities 43
Pediatric SAS 355
Pericardial tuberculosis 145
clinical presentation 145
diagnosis 146
pathogenesis 145
treatment 146
Peripheral nerve tumor 339
malignant tumor of nerve sheath origin 340
neurofibroma 339
Schwannoma 339
Peripheral nerve tumor 339
malignant tumor of nerve sheath origin 340
neurofibroma 339
Schwannoma 339
Pharmacotherapy for asthma 210
preventer medications 210
reliever medications 210
role of combination therapy 210
symptom controllers 210
Pharmacotherapy for COPD 210
role of combination therapy 210
Pharmacotherapy for small airway disease 211
Pleural effusion 181
concepts in management 183
diagnosis 183
etiology 181
treatment 183
Pleuropulmonary complications of amoebiasis 367
clinical features 368
diagnosis 368
treatment 369
Pneumomediastinum 341
Pneumonias 87
classification 88
anatomical/radiological classification 88
classification based on clinical setting 88
classification based on host status 88
etiological classification 88
Pneumothorax 192
drainage systems 195
pleurodesis 195
removal of the ICD 195
suction 195
intercostals tube drainage 195
treatment 194
types 192
chronic pneumothorax 193
close, open and valular pneumothorax 193
complicated pneumothorax 193
spontaneous 192
tension pneumothorax 193
traumatic 192
Polysomnography 72
cardiorespiratory variables 74
indications 75
narcolepsy 75
neurological variables 72
Preoperative evaluation in COPD 236
Preoperative pulmonary evaluation 370
lung resection 370
surgery other than lung surgery 371
upper gastrointestinal and thoracic surgery 371
Prevention of CAP 94
Primary mediastinal lymphomas 335
Hodgkin's lymphoma 335
non-Hodgkin's lymphoma 336
Primary snoring 352
Principles of lung injury 300
Problems in management of tuberculosis 123
complications 126
diagnostic techniques 123
diagnostic test based on immunology 124
antigen-antibody based test 124
bacteriology 124
culture and sensitivity 124
histopathology 124
specific empiric anti-tuberculosis therapy 125
tuberculin test 124
evaluating effective chemotherapy and follow-up
non-application of diagnosis and treatment guidelines 125
prevention of transmission of infection 123
problems in initial chemotherapy 125
principles of TB chemotherapy 125
relapse 126
sequelae 126
side effects 126
treatment of TB in special situations 127
diabetes mellitus 127
pregnancy 127
renal failure 127
Pulmonary collapse 170
adhesive collapse 178
central obstructive collapse 173
compressive collapse 177
fibrotic collapse 177
mechanisms 170
other types of collapse 178
plate or disk atelectasis 178
round atelectasis 178
pathophysiology 171
peripheral obstructive collapse 175
radiological signs 171
types 170
adhesive collapse 170
fibrotic collapse 170
relaxation or compressive collapse 170
resorption collapse 170
Pulmonary complications of HIV 160
fungi 162
Cryptococcus neoformans 163
parasites 163
Pneumocystis carinii 162
viruses 163
mycobacteria 160
M. kansasii 162
Mycobacterium avium intracellulare complex 161
Pulmonary defence mechanisms 10
aerodynamic filtration 10
antioxidants and antiproteases 11
cough reflex 10
immunological defense 11
mucociliary transport system 10
phagocytic cells 11
Pulmonary diseases in HIV infected individuals 157
clinical assessment 157
history 158
imaging studies 160
laboratory evaluation 159
pathogenesis 157
physical examination 159
Pulmonary eosinophilia 269
Pulmonary fibrosis 178, 274
diagnosis 274
treatment 275
Pulmonary function tests 282
Pulmonary hydatidosis 364
diagnosis 364
pathogenesis 364
treatment 366
Pulmonary hypertension 317
clinical features 320
diagnostic evaluation 321
etiology 319
management 322
primary pulmonary hypertension 324
secondary pulmonary hypertension 322
pathology 318
risk factors 320
signs 320
symptoms 320
Pulmonary interstitium 278
Pulmonary rehabilitation 384
assessment 384
medical care 385
noninvasive ventilation 385
oxygen therapy 385
nutritional assessment and intervention 388
physical rehabilitation 389
exercise training 389
physical rehabilitation 389
chest physical therapy 389
exercise training 389
prevention of infections 386
influenza vaccine 386
pneumococcal vaccine 386
preventive therapy 385
nicotine replacement therapy 386
smoking cessation 385
psychosocial and behavioral intervention 388
treatment 386
Pulmonary thromboembolic disease 309
clinical features 310
acute pulmonary embolism 310
chronic pulmonary embolism 311
diagnosis 311
investigations 311
leg imaging 313
ascending contrast venography 313
impedance plethysmography 313
radiolabelled antibody imaging 314
real time (Doppler) ultrasonography 314
management 314
anticoagulation 314
heparin 314
low molecular weight heparin 315
prognosis 316
prophylaxis for DVT and PTE 314
surgical embolectomy 316
thrombolytic therapy 315
vena caval filters 315
warfarin 314
newer diagnostic methods 313
computerized tomography scans 313
D dimmer measurement 313
echocardiography 313
magnetic resonance imaging 313
pathophysiological consequences 310
cardiovascular effects 310
respiratory effects 310
prevalence 309
risk factors 309
Pulmonary thromboembolism 372
Pulmonary vasculitides 304
large vessel vasculitides 304
Takayasu's arteritis 305
temporal arteritis 304
medium vessel vasculitis 305
Kawasaki syndrome 306
polyarteritis nodosa 305
other small vessel vasculitis 307
hypersensitivity vasculitis 307
small vessel vasculitis 306
Churg Strauss syndrome 307
microscopic polyangiitis 307
polyangiitis overlap syndrome 307
Wegener's granulomatosis 306
Q
Quantitative ventilation-perfusion 263
R
Radiology of chest 25
indications 25
normal anatomy 25
techniques 25
digital radiography 25
high KV technique 25
standard method 25
views 25
Recent advances in asthma 225
anticytokine therapies 226
anti-IgE therapy 226
asthma prevention 225
asthma therapy 225
gene therapy for asthma 226
novel steroids 226
Recent advances in COPD 237
Recurrent pneumonia 94
Rehabilitation 234
Residual volume 55
Respiratory sleep disorders 344
Respiratory system 1
applied anatomy 1
lungs 1
thoracic cage and pleura 1
applied physiology 7
arterial blood gases 8
control of respiration 7
respiratory function 7
case illustrations 17
clinical assessment 12
clinical examination 12
Revised national tuberculosis control program 117
components 117
DOTS strategy 117
DOTS therapy 118
good quality diagnosis 118
good quality drugs 118
right treatment 118
systematic monitoring and accountability 118
key features 118
steps 118
treatment outcome 119
S
Sarcoidosis 289
clinical manifestations 292
acute sarcoidosis 292
extrapulmonary sarcoidosis 292
pulmonary sarcoidosis 292
diagnostic approach 295
diagnostic modalities 292
epidemiology 289
etiology 290
immunopathogenesis 290
natural history 296
pathology 291
recent advances 297
treatment 296
Severe nosocomial pneumonia 96
Simmond's focus 103
Simple pulmonary eosinophilia 269
drug-induced pulmonary eosinophilia 270
clinical features 271
pathogenesis 271
helminthic pulmonary eosinophilia 269
clinical features 270
etiology 270
pathogenesis 270
radiographic features 270
treatment 270
idiopathic pulmonary eosinophilia 271
acute eosinophilic pneumonia 271
chronic eosinophilic pneumonia 271
tropical eosinophilia 272
clinical features 272
radiographic features 272
treatment 273
Skin tuberculosis 146
diagnosis 146
treatment 146
Sleep apnea syndromes 344
clinical features 347
consequences 346
diagnosis 348
epidemiology 345
pathophysiology 345
physical findings 347
risk factors 346
treatment 350
medical therapy 350
surgical therapy 352
Small airway obstruction 249
anatomy 249
diagnosis 251
infection 249
management 252
prognosis and sequelae 253
Small cell lung cancer 265
management 265
management 266
prevention 267
Spirometry 46
indications 48
interpretation of spirometric data 48
interpretation of spirometry and fallacies 48
obstructive and restrictive abnormalities 48
recommendations 47
spirometric equipment 47
spirometric measurements 47
Spirometry exercises 51
Static lung volumes and capacities 54
body plethysmography 55
going towards the extremes 54
helium dilution 55
methods of measurement 54
single breath nitrogen 55
spirometry 55
steady state volumes 54
transient volumes 54
Superior vena caval syndrome 341
Surgery and asthma 225
Surgical management of pulmonary tuberculosis 152
collapse therapy 154
complications of surgery 155
indication for surgery in complication 152
bronchial stenosis 153
bronchiectasis 153
bronchopleural fistula 153
empyema 153
hemoptysis 152
localized pulmonary disease 153
multidrug resistance tuberculosis 153
indication for surgery in tuberculosis 152
surgery in diagnosis 152
therapeutic surgery 152
resectional surgery 154
operational management 155
preoperative evaluation 154
thoracoplasty 154
indications 154
types 154
types of thoracic surgery in pulmonary TB 153
Sympathetic ganglia tumors 340
ganglioneuroblastoma 340
ganglioneuroma 340
neuroblastoma 340
T
TB in India 100
epidemiological dimensions 100
TB pleural effusion (PE) 139
clinical presentation 139
diagnosis 139
management 140
pathogenesis 139
Thoracoscopy 82
clinical applications 84
diffuse pulmonary disease 84
mediastinal staging of lung cancer 84
miscellaneous 84
spontaneous pneumothorax 84
undiagnosed pleural effusions 84
complications 85
technique 83
Tissue oxygenation 640
Toxic fume obliterative bronchiolitis 251
Tuberculosis 100
epidemiology 100
global picture 100
natural history 102
Tuberculosis of spine 141
clinical presentation 141
diagnosis 142
pathogenesis 141
treatment 142
Tuberculosis prevention 104
administrative control 106
chemoprophylaxis 109
primary 109
secondary 109
control in community 110
BCG vaccination 110
contraindications 111
environmental control 106
high efficient particle air filtration 108
ultraviolet germicidal irradiation 107
epidemiology 104
pathogenesis 104
risk of infection 104
personal respiratory protection 108
preventive measures in laboratories 109
respirators 108
surgical masks 108
reducing risk of infection 105
infection control strategies 105
tansmission of disease 104
Types of pollutants 299
U
Ultrasound 25
indications 25
techniques 26
Upper airway obstruction 49, 199
causes 199
flow volume loop 199
interpretation 200
illustrative cases 200
bilateral vocal cord adductor palsy 203
goiter with fixed UAO 201
goiter with positional UAO 201
left mainstem bronchus obstruction 200
nasopharyngeal carcinoma 202
obstructive sleep apnea with UAO 202
tracheal tumor 201
mechanism for abnormal flow volume loop in UAO 203
Upper airway obstruction 49
Upper airway resistance syndrome 352
Upper respiratory tract infections 86
acute epiglottitis 87
acute laryngotracheo-bronchitis 87
acute pharyngitis 86
common cold 86
influenza 87
laryngitis 86
tonsillitis 86
V
Vaculitis in connective tissue disorders 308
Ventilatory status 65
Viral capacity 55
Virchow's triad 309
W
Wegener's granulomas 407
Weigart's focus 103
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