Chest notes 2

• Restrictive lung disorders are characterised by reduced FEV1 & FVC, FEV1/FVC >70%, reduced TLC & RV and reduced TLCO.

Causes of restrictive lung defect are: - neurogenic or psychogenic causes - abnormalities of the thoracic wall - stiff parenchyma (pulmonary fibrosis) - loss of lung tissue, e.g. pneumonectomy - displacement

• Obstructive lung disorders are characterised by reduced FEV1 & FVC, FEV1/FVC < 70%, raised TLC & RV (gas trapping) and reduced TLCO (emphysema) or normal or raised TLCO (asthmatics).PEFR decrease

• Environmental tobacco smoke (‘passive smoking’) has been shown to cause more frequent and more severe attacks of asthma in children and possibly increases the number of cases of asthma. It is also associated with a small but definite increase in lung cancer

• Drugs for stop smoking: Nicotine replacement therapy (better) and bupropion only for 2 weeks beyond the target stop date. Varenicline is an oral partial agonist on nicotinic acetylcholine receptor, SE is nausea and sever depression

• Influenza Neuraminidase inhibitors 48 hour before the symptoms >> shorten the duration of influenza, But zanamivir and oseltamivir are currently recommended for patients with suspected influenza over the age of 65 and ‘at-risk’ adults. Vaccin CI for patients allergic to egg proteins

• Allergic nasal polyp responds to oral steroid for 2 ws and recurrence can prevented by local steroid