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Book Details
Abstract
Clinical Practice Manual for Pulmonary and Critical Care Medicine, by Judd W. Landsberg, MD, is a unique point-of-care manual that provides essential information on managing inpatients and outpatients with common, serious respiratory and internal medicine presentation and problems. Easy-to-follow diagnostic and therapeutic algorithms are accompanied by case-based illustrations encountered on a daily basis by attendings, fellows, residents, and students. The bulleted format, concise approach, and familiar examples provide a framework for effective teaching, learning, and patient care.
- Identifies common but important misconceptions that are regularly encountered in pulmonary and critical care training.
- Uses a concise, bulleted format throughout, helping you find key information quickly.
- Illustrates cases with primary data such as x-rays, monitor strips, ventilator wave forms, and other familiar documentation.
- Helps you develop your ability to effectively explain your thought process in the clinical setting to other practitioners at the bedside.
- Serves as a ‘teachers guide’ for clinician educators, organizing topics in an easy to teach fashion, amenable to ‘chalk talks’ and bedside didactics
- Provides focused discussions of basic physiology and pathophysiology related to pulmonary and critical care medicine.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Inside Front Cover | ES2 | ||
| Manual for Pulmonary and Critical Care Medicine | iii | ||
| Copyright | iv | ||
| Preface | v | ||
| Dedication | vii | ||
| Acknowledgments | ix | ||
| Contents | xi | ||
| Section I: Pulmonary | 1 | ||
| Chapter 1: Approach to oxygenation, hypoxemia, and hypoxemic respiratory failure | 1 | ||
| Common misconceptions and mistakes | 1 | ||
| Oxygenation | 1 | ||
| Acute hypoxemic respiratory failure | 4 | ||
| Chronic hypoxemic respiratory failure (physiology and underlying disease) | 5 | ||
| Clinical approach to acute hypoxemic respiratory failure | 5 | ||
| Co2 retention and high Fio2 | 7 | ||
| Common causes and initial treatment of acute hypoxemic respiratory failure | 9 | ||
| Common questions generated by this teaching | 10 | ||
| Chapter 2: Ventilation and hypercapnic respiratory failure | 11 | ||
| Common misconceptions and mistakes | 11 | ||
| Normal ventilation | 11 | ||
| Compensatory ventilatory responses to acidemia and alkalemia (A.K.A. ABG interpretation) | 12 | ||
| Acute hypercapnic respiratory failure | 14 | ||
| Overview common causes of acute of hypercapnic respiratory failure resulting in diaphragmatic fatigue | 17 | ||
| Acute hypercarbic respiratory failure from central hypoventilation | 18 | ||
| Acute on chronic hypercapnic respiratory failure and mixed acute hypercapnic failure | 18 | ||
| Chronic hypercapnic respiratory failure and ventilatory drive | 19 | ||
| Common questions generated by this teaching | 20 | ||
| Chapter 3: Pulmonary function testing | 22 | ||
| Common misconceptions and mistakes | 22 | ||
| Pulmonary function testing | 22 | ||
| Spirometry | 23 | ||
| Flow volume loop | 25 | ||
| Lung volumes | 27 | ||
| Diffusion capacity | 29 | ||
| Bronchodilator responsiveness | 29 | ||
| Respiratory muscle strength | 30 | ||
| Pulmonary function testing interpretation (Figs. 3.7, 3.8, and 3.9) | 30 | ||
| Common questions generated by this teaching | 35 | ||
| Chapter 4: The chest radiograph | 36 | ||
| Common misconceptions and mistakes | 36 | ||
| Approach to the chest radiograph | 36 | ||
| Common questions generated by this teaching | 47 | ||
| Chapter 5: Dyspnea and exercise limitation | 53 | ||
| Common misconceptions and mistakes | 53 | ||
| Major mechanisms of dyspnea (Fig. 5.1) | 53 | ||
| Physiology of exercise (Table 5.1) | 55 | ||
| Pathophysiology of cardiac mediated dyspnea on exertion and exercise limitation (see table 5.1) | 56 | ||
| Pathophysiology of pulmonary-mediated dyspnea on exertion and exercise limitation (see table 5.1) | 57 | ||
| Pathophysiology of acidosis and anemia-mediated dyspnea on exertion and exercise limitation (see table 5.1) | 58 | ||
| Primary activation of the aygdala-mediated dyspnea (dyspnea without an accompanying exercise limitation) | 58 | ||
| Evaluation of dyspnea and exercise limitation (Fig. 5.2) | 58 | ||
| Common questions generated by this teaching | 64 | ||
| Chapter 6: Heart failure for the pulmonary critical care physician | 65 | ||
| Common misconceptions and mistakes | 65 | ||
| Heart failure and the pulmonologist (A.K.A. Occult left heart failure) | 65 | ||
| The many faces of biventricular heart failure secondary to diastolic dysfunction (A.K.A. HFpEF) | 67 | ||
| How left-sided heart failure causes pulmonary hypertension and right-sided heart failure (the biventricular heart failure ... | 68 | ||
| The misleading nature of the transpulmonary gradient and \"passive,\" \"reactive,\" and \"out of proportion\" pulmonary hypertens ... | 70 | ||
| Individual variability in the biventricular heart failure reflex challenges the concept of out-of-proportion ph | 74 | ||
| Pathophysiology of biventricular heart failure (the numbers) | 74 | ||
| Pathophysiology of biventricular heart failure (the process) | 75 | ||
| Residual small vessel disease | 75 | ||
| Biventricular heart failure: reflex, not back pressure … so what? | 76 | ||
| Pitfalls in screening for HFPEF (A.K.A. biventricular heart failure from diastolic dysfunction) | 76 | ||
| Bilateral pleural effusions: the physiologic proof of biventricular heart failure | 78 | ||
| Management of biventricular heart failure from diastolic dysfunction (trial of euvolemia) | 81 | ||
| Fluid \"spaces\" and the anticipated sequence of fluid accumulation and mobilization in biventricular heart failure (HEPEF an ... | 81 | ||
| Separating decompensated heart failure from end stage heart failure | 82 | ||
| Effective diuresis (IE, achieving a significant net negative fluid balance) | 83 | ||
| Perceived (but not actual) stumbling blocks encountered while diuresing edematous left-sided heart failure patients t ... | 84 | ||
| Real problems encountered while diuresing the edematous patient | 87 | ||
| Heart failure—important review points | 87 | ||
| Common questions generated by this teaching | 91 | ||
| Chapter 7: Evaluation and treatment of pulmonary hypertension | 93 | ||
| Common misconceptions and mistakes | 93 | ||
| Pulmonary hypertension | 93 | ||
| Pathophysiology, evaluation, and treatment of pulmonary hypertension by group (Table 7.1): | 95 | ||
| Common questions generated by this teaching | 106 | ||
| Chapter 8: Exacerbation of obesity hypoventilation syndrome | 107 | ||
| Common misconceptions and mistakes | 107 | ||
| Obesity hypoventilation syndrome | 107 | ||
| Exacerbation of Obesity Hypoventilation Syndrome | 107 | ||
| Common questions generated by this teaching | 110 | ||
| Chapter 9: Lung cancer | 112 | ||
| Common misconceptions and mistakes | 112 | ||
| Lung cancer epidemiology | 112 | ||
| Concern for lung cancer | 113 | ||
| Evaluation and management of the worrisome parenchymal lesion(s) during a chest ct scan (number, size, appearance, and grow ... | 118 | ||
| Evaluation and management of mediastinal adenopathy and concern for N2 disease | 125 | ||
| Central mediastinal mass concerning for small cell lung cancer | 126 | ||
| Large necrotic parenchymal mass (often >5 cm) | 127 | ||
| Typical clinical radiographic and histopathologic features of lung cancer (and mesothelioma) by cell type | 127 | ||
| Lung cancer staging | 133 | ||
| Therapeutic approach to lung cancer | 134 | ||
| Stage iv disease and management of a proven malignant pleural effusion | 138 | ||
| Questions commonly generated by this teaching | 139 | ||
| Chapter 10: Aspergillus lung disease | 140 | ||
| Common misconceptions and mistakes | 140 | ||
| Aspergillus | 140 | ||
| Allergic aspergillus diseases | 141 | ||
| Aspergilloma | 144 | ||
| Chronic pulmonary aspergillosis | 145 | ||
| Invasive pulmonary aspergillosis | 149 | ||
| Tracheobronchial aspergillosis | 151 | ||
| Common questions generated by this teaching | 151 | ||
| Chapter 11: Oral anaerobic lung infection, aspiration pneumonia, lung abscess, and empyema | 152 | ||
| Common misconceptions and mistakes | 152 | ||
| Aspiration defined | 152 | ||
| Oral anaerobic lung infection | 154 | ||
| Infected bullae (A.K.A. “bullaetis”): a lung abscess mimic | 157 | ||
| Distinguishing a lung abscess (do not drain) from an empyema (must drain) | 158 | ||
| Lung Abscesses | 158 | ||
| Empyema and Complicated Parapneumonic Effusions | 162 | ||
| Common questions generated by this teaching | 165 | ||
| Chapter 12: Cough | 166 | ||
| Common misconceptions and mistakes | 166 | ||
| The cough reflex arc | 166 | ||
| Acute cough (<3 weeks) in individuals with no significant comorbidities (Fig. 12.1) | 166 | ||
| Acute cough (<3 weeks) in individuals with lung disease or immunosuppression (Fig. 12.2) | 167 | ||
| Subacute dry cough (lasting 3–8 weeks in the absence of radiographic abnormality) (Fig. 12.3) | 169 | ||
| Subacute purulent cough (lasting >3 weeks in the absence of radiographic abnormality) (Fig. 12.4) | 170 | ||
| Chronic cough (ie, nonproductive cough lasting more than 8 weeks in the absence of radiographic abnormality) (Fig. 12.5) | 171 | ||
| Common questions generated by this teaching | 174 | ||
| Chapter 13: Cough syncope | 175 | ||
| Common misconceptions and mistakes | 175 | ||
| Cough syncope | 175 | ||
| Pathophysiology of cough syncope | 175 | ||
| Conditions to be excluded when coughing is associated with syncope | 176 | ||
| Diagnosis of cough syncope | 176 | ||
| Treatment of cough syncope | 178 | ||
| Common question generated by this teaching | 178 | ||
| Chapter 14: Sarcoidosis | 179 | ||
| Common misconceptions and mistakes | 179 | ||
| Pathophysiology of sarcoidosis | 179 | ||
| Sarcoidosis clinical presentations (acute, stages 1–3, stage 4, and unique) | 180 | ||
| Evaluation and treatment after a diagnosis of sarcoid is made (Table 14.1) | 188 | ||
| Treatment | 191 | ||
| Questions commonly generated by this teaching | 191 | ||
| Chapter 15: Acute venous thromboembolic disease | 192 | ||
| Common misconceptions and mistakes | 192 | ||
| Overview of acute venous thromboembolic disease | 192 | ||
| Pathophysiology of pulmonary embolism | 193 | ||
| VTE diagnosis and risk stratification (Fig. 15.2) | 194 | ||
| Initial VTE management (Fig. 15.3) | 199 | ||
| Establishing the duration of anticoagulation and follow-up for a VTE (Fig. 15.4) | 202 | ||
| Upper extremity DVTS | 205 | ||
| Common questions generated by this teaching | 206 | ||
| Chapter 16: Pneumothorax and bronchopleural fistulas: air in the pleural space | 207 | ||
| Common misconceptions and mistakes | 207 | ||
| Approach to the pneumothorax | 207 | ||
| Pathophysiology of bronchopleural fistulas | 212 | ||
| Management of persistent bronchopleural fistulas: | 214 | ||
| Common questions generated by this teaching | 216 | ||
| Chapter 17: Diffuse parenchymal lung disease and its mimics | 217 | ||
| Common misconceptions and mistakes | 217 | ||
| Diffuse parenchymal lung disease | 217 | ||
| Asymptomatic diffuse parenchymal lung disease pattern incidentally found by chest CT imaging | 218 | ||
| Subacute dyspnea on exertion with a diffuse parentchymal lung disease pattern found on by chest CT imaging | 227 | ||
| Acute hypoxemic respiratory failure with a diffuse parenchymal lung disease pattern seen on chest CT imaging | 239 | ||
| Common questions generated by this teaching | 250 | ||
| Section II: Critical care | 251 | ||
| Chapter 18: Shock | 251 | ||
| Common misconceptions and mistakes | 251 | ||
| Shock | 251 | ||
| Initial evaluation | 254 | ||
| Differentiating the types of shock (Fig. 18.1) | 255 | ||
| Evaluation and management by type of shock | 257 | ||
| General principles of shock management | 267 | ||
| Special situations | 268 | ||
| Cirrhosis | 269 | ||
| Common questions generated by this teaching | 269 | ||
| Chapter 19: Invasive mechanical ventilation | 270 | ||
| Common misconceptions and mistakes | 270 | ||
| Invasive mechanical ventilation | 270 | ||
| Choosing a mode of ventilation (volume controlled vs pressure controlled) | 271 | ||
| Volume control: initial ventilator settings and adjustments for patients with normal to moderately abnormal mechanics (F ... | 273 | ||
| Pressure control: initial settings and adjustments for patients with severely abnormal lung mechanics | 275 | ||
| Improving oxygenation | 277 | ||
| Peep response in cardiogenic and noncardiogenic edema (avoiding alveolar derecruitment) | 278 | ||
| Troubleshooting a sudden change in respiratory mechanics (Fig. 19.5) | 279 | ||
| Special situations | 280 | ||
| Salvage therapies for acute respiratory distress syndrome | 281 | ||
| Common questions generated by this teaching | 282 | ||
| Chapter 19e: Liberation from mechanical ventilation | e1 | ||
| Common misconceptions and mistakes | e1 | ||
| Approach to extubation | e1 | ||
| Assessing readiness to extubate (Fig. 1) | e2 | ||
| Performing an SBT | e4 | ||
| Troubleshooting apparent sbt failure (Fig. 2) | e5 | ||
| Proceeding after a failed sbt: optimization and exercise (Fig. 3) | e8 | ||
| Spontaneous breathing trial versus exercise | e10 | ||
| Treatment of delirium in the intubated patient (haloperidol or dexmedetomidine) | e10 | ||
| Evaluation of upper airway narrowing and/or laryngeal edema | e11 | ||
| Common failure to wean situations (consults from surgery) | e12 | ||
| Common questions generated by this teaching | e13 | ||
| Chapter 20: Noninvasive ventilatory support with bilevel positive pressure ventilation | 283 | ||
| Common misconceptions and mistakes | 283 | ||
| Noninvasive ventilatory support | 283 | ||
| Initiation of bilevel positive airway pressure (Fig. 20.1) | 284 | ||
| Initial setup, settings, and adjustments (to be performed by the physician at the bedside) | 284 | ||
| Trialing patients off of bilevel positive airway pressure | 287 | ||
| Common questions generated by this teaching | 287 | ||
| Chapter 21: Hemoptysis | 288 | ||
| Common misconceptions and mistakes | 288 | ||
| Initial assessment/risk stratification | 288 | ||
| Pathophysiology and management of massive hemoptysis | 290 | ||
| Intubation in massive hemoptysis (when, why, and with what) | 291 | ||
| Interventional radiology vs cardiothoracic surgery | 293 | ||
| Nonmassive hemoptysis | 294 | ||
| Common questions generated by this teaching | 295 | ||
| Chapter 22: Salt and water: the physiology and regulation of volume and tonicity | 296 | ||
| Common misconceptions and mistakes | 296 | ||
| Volume status and tonicity | 296 | ||
| The normal homeostasis of volume status and sodium balance | 297 | ||
| The normal homeostasis of tonicity and water balance | 297 | ||
| The pathophysiology and evaluation of hyponatremia | 298 | ||
| Treatment of hyponatremia (Fig. 22.3) | 300 | ||
| The pathophysiology and evaluation of hypernatremia | 303 | ||
| Treatment of hypernatremia (Fig. 22.5) | 305 | ||
| Common questions generated by this teaching | 306 | ||
| Chapter 23: Diabetic emergencies | 308 | ||
| Common misconceptions and mistakes | 308 | ||
| Acute diabetic presentations | 308 | ||
| Ketoacidosis | 308 | ||
| Diabetic ketoacidosis classic presentation and pathophysiology | 310 | ||
| Hyperglycemic hyperosmolar nonketotic syndrome (HHNK): classic presentation and pathophysiology | 311 | ||
| Overlap syndromes | 312 | ||
| Typical derangements, causes, and initial treatments of diabetic emergencies | 312 | ||
| Alcoholic ketoacidosis: classic presentation and pathophysiology | 314 | ||
| Common questions generated by this teaching | 318 | ||
| Chapter 24: The obtunded inpatient with normal vital signs | 319 | ||
| Common misconceptions and mistakes | 319 | ||
| Obtundation with normal vital signs | 319 | ||
| God helps or dogs help | 319 | ||
| Common questions generated by this teaching | 322 | ||
| Chapter 25: Bedside presentations in the icu | 323 | ||
| Common misconceptions and mistakes | 323 | ||
| Goal of THE bedside presentation | 323 | ||
| New admission | 323 | ||
| Daily presentation | 327 | ||
| Common questions generated by this teaching | 328 | ||
| Chapter 26: Code status | 329 | ||
| Common misconceptions and mistakes | 329 | ||
| Approach to code status | 329 | ||
| Common questions generated by this teaching | 331 | ||
| Chapter 27: Advanced care planning and the family meeting | 332 | ||
| Common misconceptions and mistakes | 332 | ||
| Advanced care planning | 332 | ||
| Establishing a surrogate decision maker | 332 | ||
| The family meeting (helping loved ones accept futility) | 333 | ||
| Special situations | 334 | ||
| Common questions generated by this teaching | 334 | ||
| Chapter 28: Pulmonary and critical care pearls | 336 | ||
| Respiratory mechanics and sounds: (Fig. 28.1) | 336 | ||
| Smoking cessation | 336 | ||
| Bronchiectasis | 339 | ||
| Atypical and typical pneumonia (definitions and things to consider) | 341 | ||
| Troubleshooting poorly controlled obstructive lung disease (asthma and copd) | 342 | ||
| Tracheostomy | 343 | ||
| Evaluation of the presumed exudative effusion (Fig. 28.2) | 345 | ||
| Rounded atelectasis (Fig. 28.3) | 349 | ||
| Index | 353 | ||
| Inside Back Cover | ES3 |