Feb 252019
 

Respiratory Medicine is the study of that deals with the causes, diagnosis, prevention and treatment of diseases affecting the lungs. Medicos Library has provided high standard Respiratory Medicine Notes by Dr. Yousif Abdallah Hamad.

Summary of Notes:

Lung development

  • Complete development of the alveoli and the pores of Kohn only occurs around the age of 7 years.
  • Distension in the fluid-filled lungs, tonic negative pressure of diaphragmatic tone and fetal breathing all cause lung growth.
  • Absence of liquor, which is produced by the fetal kidneys, causes poor lung growth and a low phospholipid content. Renal agenesis is therefore a cause of hypoplastic lungs.
  • Lamellar bodies in type II pneumocytes that produce surfactant are seen by 22 weeks’ gestation.

Phrenic nerve

  • The diaphragm is innervated by the phrenic nerve (C3,4,5).
  • Diagnosis is suspected when on the chest radiograph the diaphragmatic leaflet is elevated and is confirmed fluoroscopically by observing paradoxical diaphragmatic motion on sniff and cough.
  • In patients with normal lungs unilateral paralysis is usually asymptomatic and rarely requires treatment.
  • The diagnosis of unilateral paralysis, suggested by asymmetric elevation of the affected hemidiaphragm on X-ray, can be confirmed by fluoroscopy.
  • During a forced inspiratory manoeuvre (the ‘sniff test), the unaffected hemidiaphragm descends forcefully, increasing intra-abdominal pressure and pushing the paralysed hemidiaphragm cephalad (paradoxical motion).
  • Fluoroscopy is inaccurate for the diagnosis of bilateral paralysis.
  • While MRI may demonstrate a structural defect, it isn’t a dynamic investigation.

Advice form Dr. Yousif Abdallah Hamad

How to use the notes to study for MRCP:

  • Initially, you need to skim through the notes at least twice to build up an idea about the syllabus of MRCP. Highlight any portion that is difficult so that you can concentrate on that during your revision.
  • Next proceed to the question banks. You can choose to do Passmedicine, onexamination or Pastest. I usually recommend students to do Passmedicine and the Pastest.
  • As you go through the questions make a super-revised notes of your own. Write down in one sentence what you learned from the question you just attempted.
  • If you get any question wrong or you get confused then return to the notes and re-read one more time before attempting the question again. And write down the point in red in you revision notes so that you can skim through it easily during your revision.
  • I have highlighted some points in yellow and green to help you concentrate on those points. As you go through passmedicine and pastest, you can highlight the points further to help in your revision.
  • During your revision before the main exam, only read the highlighted portions including those that you highlighted when practicing the question bank. And also read your super-revised notes that you made from the question banks.

I believe these method has worked for many students and will help you in your journey to be successful in MRCP part 1 and as well as build your basics for Part 2.


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