WEGENER GRANULOMATOSIS
Diffuse alveolar hemorrhage
sinusitis
Cavitary lung lesions
Glomerulonephritis
Arthritis and cutaneous leukocytoclastic vasculitis
Dx: c ANCA
Open lung biopsy or bp of nasal membrane
Tx: prednisone, cyclophosphamide
Diffuse alveolar hemorrhage
sinusitis
Cavitary lung lesions
Glomerulonephritis
Arthritis and cutaneous leukocytoclastic vasculitis
Dx: c ANCA
Open lung biopsy or bp of nasal membrane
Tx: prednisone, cyclophosphamide
GOODPASTURE SYNDROME
Pulmonary renal sd
Linear deposition of antiglomerular basement membrane antibodies in lungs and kidneys
60-80% are men in their 20s
Dx kidney or lung bp
Tx cyclophosphamide, prednisone
Can be done plasma exchange due to presence of antibodies
Pulmonary renal sd
Linear deposition of antiglomerular basement membrane antibodies in lungs and kidneys
60-80% are men in their 20s
Dx kidney or lung bp
Tx cyclophosphamide, prednisone
Can be done plasma exchange due to presence of antibodies
EOSINOPHILIC PNEUMONIAS
Loeffle sd
Eosinophils in blood and sputum
CXR migratory pulmonary infiltrates
Minimal respiratory symptoms
Generally self limited, corticosteroids can be given
R/o drugs and parasites (strongyloides)
Loeffle sd
Eosinophils in blood and sputum
CXR migratory pulmonary infiltrates
Minimal respiratory symptoms
Generally self limited, corticosteroids can be given
R/o drugs and parasites (strongyloides)
LYMPHANGIOMYOMATOSIS
Premenstrual women
CXR honeycomb, Chronic pneumothorax
Chylous pleural effusions
Premenstrual women
CXR honeycomb, Chronic pneumothorax
Chylous pleural effusions
MYCETOMA
CXR or CT: Crescent sign
Preexiting cavity and grows aspergillus
Tx: Broncheo artery embolization (stop circulation)
CXR or CT: Crescent sign
Preexiting cavity and grows aspergillus
Tx: Broncheo artery embolization (stop circulation)
* Malignant hyperthermia: inherited skeletal muscle disorder
. Increased intracellular calcium leads to sustained muscle contractions, with skeletal muscle rigidity and masseter muscle spasm, tachycardia, hypercarbia, hypertension, hyperthermia, tachypnea, and cardiac arrhythmias. Rhabdomyolysis and acute renal failure. Precipitated by exposure to
volatile inhalational anesthetics (halothane, isoflurane, enflurane,
desflurane, sevoflurane) and the depolarizing muscle relaxants
succinylcholine and decamethonium.
Important: suspected in patients with a family history of problems during anesthesia.
* Neuroleptic malignant syndrome: it is caused by an idiosyncratic reaction to neuroleptic tranquilizers (dopamine D2-receptor antagonists) and some antipsychotic drugs.
Example: Parkinson pt who d/c levodopa or anticholinergic therapy.
Symptoms: muscle rigidity, hyperthermia, cognitive changes, autonomic instability, diaphoresis, sialorrhea, seizures, arrhythmias, and rhabdomyolysis .
The most common offending neuroleptic agents are haloperidol and fluphenazine.
Important: suspected in patients with a family history of problems during anesthesia.
* Neuroleptic malignant syndrome: it is caused by an idiosyncratic reaction to neuroleptic tranquilizers (dopamine D2-receptor antagonists) and some antipsychotic drugs.
Example: Parkinson pt who d/c levodopa or anticholinergic therapy.
Symptoms: muscle rigidity, hyperthermia, cognitive changes, autonomic instability, diaphoresis, sialorrhea, seizures, arrhythmias, and rhabdomyolysis .
The most common offending neuroleptic agents are haloperidol and fluphenazine.