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Principles of Pulmonary Medicine E-Book

Principles of Pulmonary Medicine E-Book

Steven E. Weinberger | Barbara A. Cockrill | Jess Mandel

(2017)

Additional Information

Book Details

Abstract

With an emphasis on the pathophysiologic basis of pulmonary disease, Principles of Pulmonary Medicine, 7th Edition, by Drs. Steven E Weinberger, Barbara A Cockrill, and Jess Mandel, provides a superbly illustrated introduction to this fast-changing field. This essential text employs a concise and understandable approach, integrating clinical topics with underlying physiologic, pathophysiologic, and basic science concepts critical for medical students, trainees, and those looking for a practical update on both acute and chronic pulmonary diseases


Table of Contents

Section Title Page Action Price
Front Cover cover
Inside Front Cover ifc1
Principles of Pulmonary Medicine i
Copyright Page iv
Dedication v
Introduction to the Seventh Edition vii
Table Of Contents ix
Online Contents xi
1 Pulmonary Anatomy and Physiology 1
Abstract 1.e1
Keywords 1.e1
Anatomy 1
Physiology 3
Mechanical Aspects of the Lungs and Chest Wall 3
Ventilation 5
Circulation 7
Diffusion 8
Oxygen Transport 8
Carbon Dioxide Transport 11
Ventilation-Perfusion Relationships 12
Abnormalities in Gas Exchange 15
Hypoxemia 15
Hypercapnia 17
References 18
2 Presentation of the Patient with Pulmonary Disease 19
Abstract 19.e1
Keywords 19.e1
Dyspnea 19
Cough 23
Evaluation and Management of Cough 25
Hemoptysis 26
Chest Pain 27
References 28
Dyspnea 28
Cough 28
Hemoptysis 28
Chest Pain 29
3 Evaluation of the Patient With Pulmonary Disease 30
Abstract 30.e1
Keywords 30.e1
Evaluation on a Macroscopic Level 30
Physical Examination 30
Chest Radiography 34
Computed Tomography 37
Magnetic Resonance Imaging 42
Radionuclide Lung Scanning 43
Perfusion and Ventilation Scanning 43
Positron Emission Tomography (Fluorodeoxyglucose Scanning) 45
Pulmonary Angiography 45
Ultrasonography 46
Bronchoscopy 46
Evaluation on a Microscopic Level 48
Obtaining Specimens 49
Processing Specimens 50
Assessment on a Functional Level 52
Pulmonary Function Tests 52
Lung Volumes 52
Flow Rates 53
Diffusing Capacity 54
Interpretation of Normality in Pulmonary Function Testing 55
Patterns of Pulmonary Function Impairment 55
Other Tests 57
Arterial Blood Gases 58
Pulse Oximetry 60
Exercise Testing 61
References 62
Physical Examination 62
Chest Roentgenography 62
Computed Tomography 62
Magnetic Resonance Imaging 62
Lung Scanning 62
Pulmonary Angiography 62
Ultrasound 63
Bronchoscopy 63
Obtaining and Processing Specimens 63
Assessment on a Functional Level 63
4 Anatomic and Physiologic Aspects of Airways 65
Abstract 65.e1
Keywords 65.e1
Structure 65
Neural Control of Airways 68
Function 70
Airway Resistance 70
Maximal Expiratory Effort 71
References 74
5 Asthma 75
Abstract 75.e1
Keywords 75.e1
Etiology and Pathogenesis 75
Predisposition to Asthma 76
Genetics 76
Acquired (Environmental) Factors 76
Airway Inflammation, Cytokine Mediators, and Bronchial Hyperresponsiveness 77
Asthma Phenotypes 79
Common Provocative Stimuli 79
Allergen Exposure 79
Histamine 80
Leukotrienes 80
Late-Phase Asthmatic Response 80
Inhaled Irritants 82
Respiratory Tract Infection 82
Exercise 82
Pathology 82
Pathophysiology 83
Clinical Features 84
Diagnostic Approach 85
Treatment 87
Bronchodilators 87
Antiinflammatory Drugs 89
Agents With Specific Targeted Action 89
Bronchial Thermoplasty 90
Management Strategy 90
References 91
Reviews 91
Etiology and Pathogenesis 91
Clinical Features and Diagnostic Approach 91
Treatment 92
6 Chronic Obstructive Pulmonary Disease 93
Abstract 93.e1
Keywords 93.e1
Etiology and Pathogenesis 94
Smoking 95
Environmental and Indoor Pollution 96
Infection 97
Genetic Factors 97
Pathology 98
Pathophysiology 98
Functional Abnormalities in Airways Disease 99
Functional Abnormalities in Emphysema 102
Mechanisms of Abnormal Gas Exchange 102
Pulmonary Hypertension 104
COPD Phenotypes 104
Clinical Features 105
Diagnostic Approach and Assessment 106
Treatment 107
References 110
Reviews 110
Etiology and Pathogenesis 110
Clinical Features 111
Treatment 111
7 Miscellaneous Airway Diseases 113
Abstract 113.e1
Keywords 113.e1
Bronchiectasis 113
Etiology and Pathogenesis 113
Pathology 114
Pathophysiology 115
Clinical Features 115
Diagnostic Approach 116
Treatment 116
Cystic Fibrosis 118
Etiology and Pathogenesis 118
Pathology 120
Pathophysiology 120
Clinical Features 120
Diagnostic Approach 121
Treatment 122
Upper Airway Disease 122
Etiology 123
Pathophysiology 123
Clinical Features 123
Diagnostic Approach 124
Treatment 124
References 124
Bronchiectasis 124
Cystic Fibrosis 125
Upper Airway Disease 125
8 Anatomic and Physiologic Aspects of the Pulmonary Parenchyma 126
Abstract 126.e1
Keywords 126.e1
Anatomy 126
Physiology 129
References 131
Anatomy 131
Physiology 131
9 Overview of Diffuse Parenchymal Lung Diseases 132
Abstract 132.e1
Keywords 132.e1
Pathology 134
Pathology of Idiopathic Interstitial Pneumonias 135
End-Stage Diffuse Parenchymal Lung Disease 138
Pathogenesis 138
Pathophysiology 140
Decreased Compliance 141
Decrease in Lung Volumes 141
Impairment of Diffusion 141
Abnormalities in Small Airways Function 142
Disturbances in Gas Exchange 142
Pulmonary Hypertension 142
Clinical Features 142
Diagnostic Approach 143
References 144
10 Diffuse Parenchymal Lung Diseases Associated With Known Etiologic Agents 145
Abstract 145.e1
Keywords 145.e1
Diseases Caused by Inhaled Inorganic Dusts 145
Silicosis 146
Coal Worker’s Pneumoconiosis 146
Asbestosis 148
Berylliosis 150
Hypersensitivity Pneumonitis 151
Drug-Induced Parenchymal Lung Disease 153
Radiation-Induced Lung Disease 155
References 156
Diseases Caused by Inhaled Inorganic Dusts 156
Hypersensitivity Pneumonitis 157
Drug-Induced Parenchymal Lung Disease 157
Radiation-Induced Lung Disease 157
11 Diffuse Parenchymal Lung Diseases of Unknown Etiology 158
Abstract 158.e1
Keywords 158.e1
Idiopathic Pulmonary Fibrosis 158
Other Idiopathic Interstitial Pneumonias 161
Pulmonary Parenchymal Involvement Complicating Connective Tissue Disease 163
Sarcoidosis 164
Miscellaneous Disorders Involving the Pulmonary Parenchyma 169
Pulmonary Langerhans Cell Histiocytosis 169
Lymphangioleiomyomatosis 170
Goodpasture Syndrome 171
Granulomatosis with Polyangiitis 172
Chronic Eosinophilic Pneumonia 173
Pulmonary Alveolar Proteinosis 174
References 174
Idiopathic Pulmonary Fibrosis 174
Other Idiopathic Interstitial Pneumonias 175
Pulmonary Parenchymal Involvement Complicating Connective Tissue Disease 175
Sarcoidosis 176
Miscellaneous Disorders Involving the Pulmonary Parenchyma 176
12 Anatomic and Physiologic Aspects of the Pulmonary Vasculature 177
Abstract 177.e1
Keywords 177.e1
Anatomy 177
Physiology 178
Pulmonary Vascular Resistance 178
Distribution of Pulmonary Blood Flow 180
Pulmonary Vascular Response to Hypoxia 181
Other Aspects of Pulmonary Vascular Physiology 182
References 183
13 Pulmonary Embolism 184
Abstract 184.e1
Keywords 184.e1
Etiology and Pathogenesis 184
Pathology 185
Pathophysiology 186
Clinical Features 187
Diagnostic Evaluation 188
Treatment 191
References 192
General Reviews 192
Specific Aspects 193
14 Pulmonary Hypertension 194
Abstract 194.e1
Keywords 194.e1
Pathogenesis 195
Pathology 197
Pathophysiology 197
Clinical Features 199
Diagnostic Features 199
Specific Disorders Associated With Pulmonary Hypertension 201
Idiopathic Pulmonary Arterial Hypertension and Related Disorders (Group 1 PAH) 201
Pulmonary Hypertension Owing to Left Heart Disease (Group 2 PH) 202
Pulmonary Hypertension Owing to Lung Disease and/or Hypoxia (Group 3 PH) 203
Chronic Thromboembolic Pulmonary Hypertension (Group 4 PH) 203
Pulmonary Hypertension With Unclear Multifactorial Mechanisms (Group 5 PH) 204
References 204
General Reviews 204
Pulmonary Arterial Hypertension and Related Disorders 204
Pulmonary Hypertension Related to Lung Disease 205
Chronic Thromboembolic Pulmonary Hypertension 205
Pulmonary Hypertension Associated With Left Heart Disease 205
Pulmonary Hypertension Associated With Multifactorial Mechanisms 205
15 Pleural Disease 206
Abstract 206.e1
Keywords 206.e1
Anatomy 206
Physiology 207
Pleural Effusion 209
Pathogenesis of Pleural Fluid Accumulation 209
Etiology of Pleural Effusion 210
Transudative Pleural Fluid 210
Exudative Pleural Fluid 211
Clinical Features 212
Diagnostic Approach 212
Treatment 214
Pneumothorax 215
Etiology and Pathogenesis 215
Pathophysiology 216
Clinical Features 217
Diagnostic Approach 217
Treatment 218
References 220
General Reviews 220
Pleural Effusion 220
Pneumothorax 220
16 Mediastinal Disease 221
Abstract 221.e1
Keywords 221.e1
Anatomic Features 221
Mediastinal Masses 223
Etiology 223
Anterior Mediastinal Masses 223
Middle Mediastinal Masses 224
Posterior Mediastinal Masses 224
Clinical Features 224
Diagnostic Approach 224
Treatment 225
Pneumomediastinum 226
Etiology and Pathogenesis 226
Pathophysiology 226
Clinical Features 226
Diagnostic Approach 227
Treatment 227
References 227
17 Anatomic and Physiologic Aspects of Neural, Muscular, and Chest Wall Interactions with the Lungs 229
Abstract 229.e1
Keywords 229.e1
Respiratory Control 229
Organization of Respiratory Control 230
The Respiratory Generator 230
Input from Other Regions of the Central Nervous System 231
Chemoreceptors 231
Input from Other Receptors 232
Ventilatory Response to Hypercapnia and Hypoxia 233
Ventilatory Response to Other Stimuli 235
Respiratory Muscles 235
References 237
Respiratory Control 237
Respiratory Muscles 238
18 Disorders of Ventilatory Control 239
Abstract 239.e1
Keywords 239.e1
Primary Neurologic Disease 239
Presentation with Hyperventilation 239
Presentation with Hypoventilation 240
Abnormal Patterns of Breathing 240
Cheyne-Stokes Breathing 240
Control Abnormalities Secondary to Lung Disease 242
Sleep Apnea Syndrome 243
Types 243
Clinical Features 243
Pathophysiology 244
Treatment 246
References 246
Primary Neurologic Disease 246
Cheyne-Stokes Breathing 246
Control Abnormalities Secondary to Lung Disease 247
Sleep Apnea Syndrome 247
19 Disorders of the Respiratory Pump 248
Abstract 248.e1
Keywords 248.e1
Neuromuscular Disease Affecting the Muscles of Respiration 248
Specific Diseases 248
Pathophysiology and Clinical Consequences 250
Diaphragmatic Disease 250
Diaphragmatic Fatigue 251
Unilateral Diaphragmatic Paralysis 252
Bilateral Diaphragmatic Paralysis 253
DISORDERS Affecting the Chest Wall 254
Kyphoscoliosis 254
Obesity 255
References 257
Neuromuscular Disease Affecting The Muscles Of Respiration 257
Diaphragmatic Disease 258
Diseases Affecting the Chest Wall 258
20 Lung Cancer 259
Abstract 259.e1
Key words 259.e1
Etiology and Pathogenesis 260
Smoking 260
Occupational Factors 261
Genetic Factors 261
Parenchymal Scarring 262
Miscellaneous Factors 262
Concepts of Lung Cancer Pathogenesis 263
Pathology 263
Squamous Cell Carcinoma 264
Small Cell Carcinoma 265
Adenocarcinoma 266
Large Cell Carcinoma 268
References 268
Etiology and Pathogenesis 268
Pathology 268
21 Lung Cancer 270
Abstract 270.e1
Keywords 270.e1
Clinical Features 270
Symptoms Relating to Primary Lung Lesion 271
Symptoms Relating to Nodal and Distant Metastasis 271
Paraneoplastic Syndromes 271
Diagnostic Approach 272
Macroscopic Evaluation 272
Staging of Lung Cancer 274
Microscopic and Molecular Evaluation 275
Functional Assessment 275
Screening for Lung Cancer 276
Principles of Therapy 276
Treatment of Non–Small Cell Lung Cancer 276
Treatment of Small Cell Lung Cancer 277
Restoration of Airway Patency 278
Bronchial Carcinoid Tumors 278
Malignant Mesothelioma 278
Solitary Pulmonary Nodule 281
References 282
Lung Cancer: General Reviews and Clinical Aspects 282
Lung Cancer: Diagnostic Approaches 283
Lung Cancer: Treatment 283
Bronchial Carcinoids 283
Malignant Mesothelioma 284
Solitary Pulmonary Nodule 284
22 Lung Defense Mechanisms 285
Abstract 285.e1
Keywords 285.e1
Physical or Anatomic Factors 286
Antimicrobial Peptides 287
Phagocytic and Inflammatory Cells 288
Pulmonary Alveolar Macrophages 288
Dendritic Cells 289
Polymorphonuclear Leukocytes 290
Natural Killer Cells 290
Adaptive Immune Responses 290
Humoral Immune Mechanisms 291
Cellular Immune Mechanisms 292
Failure of Respiratory Defense Mechanisms 292
Impairment of Physical Clearance 292
Impairment of Antimicrobial Peptides 293
Impairment of Phagocytic and Inflammatory Cells 293
Defects in the Adaptive Immune System 294
Augmentation of Respiratory Defense Mechanisms 295
References 295
Pulmonary Host Defenses 295
Augmentation of Respiratory Defense Mechanisms 296
23 Pneumonia 297
Abstract 297.e1
Keywords 297.e1
Etiology and Pathogenesis 298
Bacteria 299
Viruses 300
Mycoplasma 300
Pathology 301
Pathophysiology 301
Clinical Features 302
Diagnostic Approach 303
Therapeutic Approach: General Principles and Antibiotic Susceptibility 306
Initial Management Strategies Based on Clinical Setting of Pneumonia 307
Community-Acquired Pneumonia 307
Nosocomial (Hospital-Acquired) Pneumonia 309
Intrathoracic Complications of Pneumonia 310
Lung Abscess 310
Empyema 310
Respiratory Infections Associated With Bioterrorism 310
Anthrax 311
Plague 311
Tularemia 311
References 312
General Articles 312
Pneumonia Caused by Specific Organisms 312
Respiratory Infections Associated With Bioterrorism 313
24 Tuberculosis and Nontuberculous Mycobacteria 314
Abstract 314.e1
Keywords 314.e1
Etiology and Pathogenesis 315
Definitions 316
Pathology 317
Pathophysiology 317
Clinical Manifestations 318
Diagnostic Approach 318
Principles of Therapy 321
Nontuberculous Mycobacteria 322
References 323
General Reviews 323
Pathogenesis 323
Clinical Manifestations and Diagnostic Approach 324
Treatment 324
Nontuberculous Mycobacteria 324
25 Miscellaneous Infections Caused by Fungi and Pneumocystis 325
Abstract 325.e1
Keywords 325.e1
Fungal Infections 325
Histoplasmosis 325
Types of Infection 326
Coccidioidomycosis 327
Blastomycosis 328
Aspergillosis 329
Allergic Bronchopulmonary Aspergillosis 329
Aspergilloma 330
Invasive Aspergillosis 331
Chronic Necrotizing Pulmonary Aspergillosis 331
Cryptococcosis 331
Other Fungi 332
Pneumocystis Infection 332
References 334
Fungal Infections (General References) 334
Histoplasmosis 335
Coccidioidomycosis 335
Blastomycosis 335
Aspergillosis 335
Pneumocystis Infection 336
26 Pulmonary Complications in the Immunocompromised Host 337
Abstract 337.e1
Keywords 337.e1
Acquired Immunodeficiency Syndrome 338
Etiology and Pathogenesis 338
Infectious Complications of Acquired Immunodeficiency Syndrome 339
Pneumocystis jiroveci Pneumonia 339
Mycobacterial Infection 340
Other Bacterial Infection 341
Viral Infection 341
Fungal Infection 342
Noninfectious Complications of Acquired Immunodeficiency Syndrome 342
Neoplastic Disease 342
Inflammatory Disease 343
Pulmonary Vascular Disease 343
Diagnostic Evaluation of Pulmonary Infiltrates in Acquired Immunodeficiency Syndrome 344
Pulmonary Complications in Non–HIV Immunocompromised Patients 344
Organ Transplant Recipients 344
Solid Organ Transplantation 344
Hematopoietic Stem Cell Transplantation 345
Treatment of Inflammatory Conditions 345
Primary Immunodeficiencies 346
Diagnostic Evaluation of Pulmonary Infiltrates in Non–HIV Immunocompromised Patients 346
References 348
Infectious Pulmonary Complications of HIV Infection 348
Noninfectious Complications of HIV Infection 348
Pulmonary Disease Associated With Non-HIV Immunodeficiency 348
27 Classification and Pathophysiologic Aspects of Respiratory Failure 350
Abstract 350.e1
Keywords 350.e1
Definition of Respiratory Failure 351
Classification of Acute Respiratory Failure 351
Hypoxemic Type 351
Hypercapnic/Hypoxemic Type 352
Presentation of Gas Exchange Failure 352
Pathogenesis of Gas Exchange Abnormalities 353
Hypoxemic Respiratory Failure 353
Hypercapnic/Hypoxemic Respiratory Failure 353
Clinical and Therapeutic Aspects of Hypercapnic/Hypoxemic Respiratory Failure 354
References 355
General 355
Respiratory Failure in Obstructive Lung Disease 356
Respiratory Failure in Neuromuscular and Chest Wall Disease 356
28 Acute Respiratory Distress Syndrome 357
Abstract 357.e1
Keywords 357.e1
Physiology of Fluid Movement in Alveolar Interstitium 358
Two Mechanisms of Fluid Accumulation 359
Etiology 360
Inhaled Injurious Agents 360
Injury via Pulmonary Circulation 362
Pathogenesis 362
Pathology 363
Pathophysiology 364
Effects on Gas Exchange 364
Changes in Pulmonary Vasculature 365
Effects on Mechanical Properties of the Lungs 365
Clinical Features 365
Diagnostic Approach 366
Treatment 367
References 368
General Reviews 368
Pathogenesis 369
Treatment 369
29 Management of Respiratory Failure 370
Abstract 370.e1
Keywords 370.e1
Goals and Principles Underlying Supportive Therapy 371
Hypoxemic Respiratory Failure 371
Hypercapnic Respiratory Failure 372
Reducing Work of Breathing 373
Mechanical Ventilation 373
Pressure-Limited Ventilation 373
Volume-Cycled Ventilation 374
Positive End-Expiratory Pressure 376
Other Ventilatory Strategies 376
Discontinuation of Ventilatory Support 377
Noninvasive Ventilatory Support for Acute Respiratory Failure 377
Complications of Intubation and Mechanical Ventilation 377
Selected Aspects of Therapy for Chronic Respiratory Failure 380
Chronic Ventilatory Support 380
Lung Transplantation 380
References 381
Mechanical Ventilation 381
Chronic Ventilatory Support 382
Lung Transplantation 383
A Sample Problems Using Respiratory Equations 384
Answers 385
B Pulmonary Function Tests: Guidelines for Interpretation and Sample Problems 386
Analysis of Pulmonary Function Tests 386
Answers 389
C Arterial Blood Gases: Guidelines for Interpretation and Sample Problems 390
Analysis of Acid-Base Status 390
Analysis of Oxygenation 391
Sample Problems 392
Answers 392
Index 394
A 394
B 395
C 396
D 398
E 399
F 400
G 400
H 400
I 401
J 402
K 402
L 402
M 403
N 404
O 404
P 404
Q 407
R 407
S 407
T 408
U 409
V 409
W 410
X 410
Y 410
Z 410
Inside Back Cover ibc1