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  <head>
    <title>015-01 Foundations</title>
    <ownerName>Integrated Medical Foundations</ownerName>
  </head>
  <body>
    <outline text="Obstructive, restrictive, vascular, infectious, and neoplastic lung disease">
      <outline text="Orientation">
        <outline text="Airways, alveoli, interstitium, vessels, pleura"/>
        <outline text="Respiratory muscles and breathing control"/>
        <outline text="Similar symptoms from different compartments"/>
        <outline text="Exposure, tempo, physiology, imaging, pathology"/>
        <outline text="Remove cause, treat disease, prevent, rehabilitate"/>
      </outline>
      <outline text="Asthma">
        <outline text="Variable obstruction with hyperresponsiveness and inflammation"/>
        <outline text="Triggers: allergen, virus, exercise, cold, smoke"/>
        <outline text="Mast cells, eosinophils, mucus, oedema, constriction"/>
        <outline text="Normal interval tests do not exclude asthma">
          <outline text="Bronchodilator response and peak-flow variability"/>
          <outline text="Challenge testing or anti-inflammatory response"/>
        </outline>
        <outline text="Inhaled corticosteroid treats inflammation, reduces exacerbations"/>
        <outline text="Long-acting beta agonist always with corticosteroid"/>
        <outline text="Severe attack: effort, tachypnoea, silent chest">
          <outline text="Normal or rising carbon dioxide suggests fatigue"/>
        </outline>
      </outline>
      <outline text="Chronic obstructive pulmonary disease">
        <outline text="Persistent limitation with remodelling, mucus, emphysema"/>
        <outline text="Tobacco, biomass, occupation, alpha one antitrypsin"/>
        <outline text="Chronic bronchitis is a mucus-hypersecretion phenotype"/>
        <outline text="Emphysema destroys distal to terminal bronchioles"/>
        <outline text="Recoil loss, expiratory collapse, mucus trap air"/>
        <outline text="Ventilation-perfusion mismatch causes hypoxaemia">
          <outline text="Later hypercapnia, pulmonary hypertension, right-heart failure"/>
        </outline>
        <outline text="Diagnosis needs post-bronchodilator obstruction"/>
        <outline text="Long-term oxygen for severe resting hypoxaemia"/>
      </outline>
      <outline text="Bronchiectasis and cystic fibrosis">
        <outline text="Irreversible dilation from a self-sustaining cycle">
          <outline text="Impaired clearance, infection, inflammation, wall damage"/>
        </outline>
        <outline text="Productive cough, recurrent infection, haemoptysis, crackles"/>
        <outline text="Clearance, sampling, targeted antibiotics, cause treatment"/>
        <outline text="Cystic fibrosis: chloride transport, dehydrated secretions">
          <outline text="Modulator therapy for eligible variants"/>
        </outline>
      </outline>
      <outline text="Pneumonia and tuberculosis">
        <outline text="Infection of the lung parenchyma"/>
        <outline text="Pathogens vary with exposure, immunity, age, geography"/>
        <outline text="Subtle signs in older or immunocompromised patients"/>
        <outline text="Complications: sepsis, abscess, necrosis, effusion">
          <outline text="Empyema needs drainage as well as antibiotics"/>
        </outline>
        <outline text="Tuberculosis: airborne spread, latent or active">
          <outline text="Immune tests show infection, not active disease"/>
        </outline>
      </outline>
      <outline text="Consolidation and its limits">
        <outline text="Inflammatory cells and fluid replace alveolar gas"/>
        <outline text="A structural pattern, not a pathogen name"/>
        <outline text="Tissue and fluid attenuate X-rays more than air"/>
        <outline text="Absent crackles do not exclude the process"/>
        <outline text="Opacity alone does not establish infection">
          <outline text="Oedema, haemorrhage, collapse also raise density"/>
        </outline>
        <outline text="Ask compartment, process, and severity separately"/>
      </outline>
      <outline text="Interstitial and occupational disease">
        <outline text="Inflammation, fibrosis, or both in alveolar walls"/>
        <outline text="Exertional dyspnoea, dry cough, fine crackles"/>
        <outline text="Low volumes, impaired diffusion, exertional desaturation"/>
        <outline text="High-resolution computed tomography narrows the differential"/>
        <outline text="Ask about birds, mould, dust, silica, asbestos"/>
        <outline text="Remove exposure, antifibrotic in progressive fibrosis"/>
      </outline>
      <outline text="Pulmonary vascular disease">
        <outline text="Embolism raises dead space and right-ventricular afterload"/>
        <outline text="Silent clot to pleuritic pain, syncope, shock"/>
        <outline text="Clinical probability guides D-dimer and imaging"/>
        <outline text="Anticoagulation, reperfusion for haemodynamic compromise"/>
        <outline text="Echocardiography estimates, catheterisation defines haemodynamics"/>
        <outline text="Vasodilators helping one group may harm another"/>
      </outline>
      <outline text="Pleura, pneumothorax, and lung cancer">
        <outline text="Effusion from pressure, inflammation, infection, malignancy"/>
        <outline text="Thoracentesis separates transudate from exudate"/>
        <outline text="Pneumothorax: spontaneous, traumatic, or iatrogenic"/>
        <outline text="Tension decompressed on instability, not imaging"/>
        <outline text="Small-cell and non-small-cell, with molecular subtypes"/>
        <outline text="Radon, occupation, pollution beyond tobacco"/>
        <outline text="Imaging, tissue, histology, molecular testing, staging"/>
      </outline>
      <outline text="Acute lung injury, aspiration, immune compromise">
        <outline text="Permeability injury, bilateral opacities, low compliance"/>
        <outline text="Hypoxaemia not fully explained by cardiac failure"/>
        <outline text="Lung-protective ventilation, prone position when severe"/>
        <outline text="Aspiration: chemical pneumonitis to bacterial pneumonia">
          <outline text="Antibiotics only for established or suspected infection"/>
        </outline>
        <outline text="Pneumocystis causes diffuse hypoxaemic pneumonia"/>
      </outline>
    </outline>
  </body>
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