By Robert Kalimi MD, L. Penfield Faber MD
This particular case-based assessment of thoracic surgical procedure deals first-class guidance for oral board examinations, which emphasize either common wisdom and case administration. Written by means of well-known specialists, the booklet provides a number of circumstances protecting the complete spectrum of thoracic surgical ailments. every one case starts with the scientific presentation and proceeds to X-ray document, differential prognosis, CT experiment document, analysis and suggestion, surgical strategy, final result, and dialogue. X-rays, CT scans, bronchoscopic pictures, and different proper illustrations accompany the textual content. a few circumstances contain postoperative issues and dialogue of the reasons, evaluate, and administration of those problems.
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Additional resources for Clinical Scenarios in Thoracic Surgery: A Case Study Approach (Clinical Scenarios in Surgery Series)
Options for treating severe asthma are discussed in E Chapter 4. Chapter 3 Recurrent or persistent ‘chest infection’ History 8 Examination 8 Investigation and diagnosis 9 Middle lobe syndrome 2 17 18 Chapter 3 Recurrent or persistent ‘chest infection’ History One of the most common presentations to a respiratory clinic is the child who has recurrent chestiness or (as it is often reported) chest infection. A good history is essential, in order to understand the problem. • What do the parents mean by chestiness or chest infection?
Recurrent or persistent infection, with or without CXR changes. Consider: • middle lobe syndrome (MLS); • immune deficiency; • structural airway disease; • cardiac disease, usually left-to-right shunting; • aspiration lung disease; 19 20 Chapter 3 Recurrent or persistent ‘chest infection’ poor cough clearance, possibly reflecting bulbar dysfunction or muscular weakness; • TB. • Uncommon and rare conditions Most respiratory specialists will have one or two children with these conditions under their care.
Upper airway noises. Consider: • inspiratory stridor—possibly laryngomalacia, but other conditions may need excluding; • biphasic stridor—always needs further investigation with laryngobronchoscopy; • a rattle (ruttle) transiently cleared by swallowing—usually no further investigation needed. • Chronic productive cough. Consider: • chronic endobronchial infection; • PCD; • CF; • immune deficiency; • aspiration lung disease. • Recurrent cough and wheeze. Consider: • wheeze associated with viral illnesses; • atopic asthma; • aspiration lung disease.