Oxford Handbook of Respiratory Medicine

Front matter
- Quick Reference Material
- Preface
- Acknowledgements
- Abbreviations

Part 1 Clinical presentations—approaches to problems
- Chapter 1 Breathlessness
  - Chapter 1 Breathlessness
  - Clinical assessment and causes
  - Specific situations
- Chapter 2 Chest pain
  - Chapter 2 Chest pain
  - Acute pleuritic chest pain
  - Chronic chest pain
- Chapter 3 Chronic cough and normal CXR
  - Chapter 3 Chronic cough and normal CXR
  - Aetiology and clinical assessment
  - Treatment
  - Causes of cough (with or without CXR abnormality)
  - Causes of chronic cough: asthma, GORD
  - Causes of chronic cough: rhinitis, post-infectious, ACE inhibitors, idiopathic
- Chapter 4 Critically ill patient with respiratory disease
  - Chapter 4 Critically ill patient with respiratory disease
- Chapter 5 Diffuse alveolar haemorrhage
  - Chapter 5 Diffuse alveolar haemorrhage
  - Diffuse alveolar haemorrhage
- Chapter 6 Diffuse lung disease
  - Chapter 6 Diffuse lung disease
  - Causes
  - Clinical assessment and imaging
  - HRCT diagnosis
  - Further investigations
- Chapter 7 Haemoptysis
  - Chapter 7 Haemoptysis
  - Clinical assessment and causes
  - Investigations
- Chapter 8 Pleural effusion
  - Chapter 8 Pleural effusion
  - Clinical assessment
  - Diagnostic algorithm for the patient with a pleural effusion
  - Transudative pleural effusions
  - Exudative pleural effusions
  - Pleural fluid analysis 1
  - Pleural fluid analysis 2
- Chapter 9 Post-operative breathlessness
  - Chapter 9 Post-operative breathlessness
- Chapter 10 Pregnancy and breathlessness
  - Chapter 10 Pregnancy and breathlessness
  - Causes
  - Investigations
- Chapter 11 Pre-operative assessment
  - Chapter 11 Pre-operative assessment
- Chapter 12 Pulmonary disease in the immunocompromised (non-HIV)
  - Chapter 12 Pulmonary disease in the immunocompromised (non-HIV)
  - Clinical assessment
  - Further investigations
  - Causes
  - Differential diagnosis of pulmonary complications based on time course after transplantation
  - Treatment
- Chapter 13 Pulmonary disease in the immunocompromised (HIV)
  - Chapter 13 Pulmonary disease in the immunocompromised (HIV)
  - Clinical assessment
  - Further investigations and treatment
  - Causes of respiratory disease in HIV infection
- Chapter 14 Sleep and ventilation
  - Chapter 14 Sleep and ventilation
  - History
  - Examination and investigations
- Chapter 15 Unexplained ventilatory failure
  - Chapter 15 Unexplained ventilatory failure
  - Causes
  - Clinical assessment and management

Part 2 Clinical conditions
- Chapter 16 Acute respiratory distress syndrome
  - Chapter 16 Acute respiratory distress syndrome
  - Pathophysiology and diagnosis
  - Management and complications
- Chapter 17 Asbestos and the lung
  - Chapter 17 Asbestos and the lung
  - Asbestos
  - Benign asbestos-related pleural disease
  - Asbestosis
  - Mesothelioma: diagnosis
  - Mesothelioma: treatment and outcome
  - Compensation for asbestos-related diseases
- Chapter 18 Asthma
  - Chapter 18 Asthma
  - Definition, epidemiology, pathophysiology, aetiology
  - Clinical features
  - Investigations
  - Acute severe asthma
  - Chronic asthma: management
  - Chronic asthma: additional treatment options
  - Non-pharmacological management
  - Difficult/refractory asthma
  - Asthma in pregnancy
  - Occupational asthma
  - Management of occupational asthma
  - Vocal cord dysfunction
  - Allergic rhinitis (hay fever)
- Chapter 19 Bronchiectasis
  - Chapter 19 Bronchiectasis
  - Epidemiology, pathophysiology, and causes
  - Clinical features and diagnosis
  - General management
  - Further management
- Chapter 20 Bronchiolitis
  - Chapter 20 Bronchiolitis
  - Pathophysiology and causes
  - Management
- Chapter 21 Chronic obstructive pulmonary disease (COPD)
  - Chapter 21 Chronic obstructive pulmonary disease (COPD)
  - Definition, aetiology, pathology, and clinical features
  - Investigations
  - Non-pharmacological management of stable COPD
  - Pharmacological management of stable COPD
  - COPD exacerbations
  - Management of exacerbations
  - Surgical treatment
  - α₁-antitrypsin (α₁-AT) deficiency
- Chapter 22 Connective tissue disease and the lung
  - Chapter 22 Connective tissue disease and the lung
  - Differential diagnosis and standard tests
  - Rheumatoid arthritis (RA)
  - Systemic lupus erythematosus (SLE)
  - Polymyositis and dermatomyositis
  - Systemic sclerosis
  - Sjögren’s syndrome
  - Ankylosing spondylitis
  - Behçet’s syndrome
- Chapter 23 Cor pulmonale
  - Chapter 23 Cor pulmonale
- Chapter 24 Cystic fibrosis
  - Chapter 24 Cystic fibrosis
  - General principles
  - CF pulmonary sepsis: aetiology
  - CF pulmonary sepsis antibiotics: 1
  - CF pulmonary sepsis antibiotics: 2
  - IV antibiotic administration
  - Management of an exacerbation
  - Other pulmonary interventions
  - Other pulmonary disease
  - Non-pulmonary disease
  - Other issues
  - Seeing the patient with CF in clinic
- Chapter 25 Eosinophilic lung disease
  - Chapter 25 Eosinophilic lung disease
  - Eosinophilic lung disease
  - Causes of eosinophilic lung disease 1
  - Causes of eosinophilic lung disease 2
- Chapter 26 Extreme environments: flying, altitude, diving
  - Chapter 26 Extreme environments: flying, altitude, diving
  - Lung disease and flying
  - Altitude sickness
  - Diving
- Chapter 27 Gastrointestinal disease and the lung
  - Chapter 27 Gastrointestinal disease and the lung
  - Hepatic hydrothorax and hepatopulmonary syndrome
  - Portopulmonary hypertension
  - Inflammatory bowel disease, coeliac disease, and pancreatitis
- Chapter 28 Hypersensitivity pneumonitis
  - Chapter 28 Hypersensitivity pneumonitis
  - Causes
  - Diagnosis
  - Management
- Chapter 29 Hyperventilation syndrome
  - Chapter 29 Hyperventilation syndrome
- Chapter 30 Idiopathic interstitial pneumonias
  - Chapter 30 Idiopathic interstitial pneumonias
  - Overview
  - Idiopathic pulmonary fibrosis (IPF): diagnosis
  - IPF: management 1
  - IPF: management 2
  - Non-specific interstitial pneumonia (NSIP)
  - Cryptogenic organizing pneumonia (COP)
  - Acute interstitial pneumonia (AIP)
  - Respiratory bronchiolitis-associated interstitial lung disease (RB-ILD)
  - Desquamative interstitial pneumonia (DIP)
  - Lymphoid interstitial pneumonia (LIP)
- Chapter 31 Lung cancer
  - Chapter 31 Lung cancer
  - Epidemiology and types
  - Clinical features
  - Investigations
  - Diagnostic procedures
  - Staging
  - Non-small cell lung cancer (NSCLC): surgery
  - NSCLC: chemotherapy
  - NSCLC: radiotherapy
  - Small cell lung cancer: treatment
  - Lung cancer: emerging areas
  - Superior vena caval obstruction (SVCO): aetiology and clinical assessment
  - Hypercalcaemia
  - Syndrome of inappropriate secretion of ADH (SIADH)
  - Spinal cord compression
  - Pulmonary carcinoid tumours
  - Pulmonary nodules 1
  - Pulmonary nodules 2
  - Lung cancer screening
- Chapter 32 Lung transplantation
  - Chapter 32 Lung transplantation
  - Patient selection
  - Specific conditions
  - Investigations and surgical approaches
  - Follow-up
  - Complications 1
  - Complications 2
- Chapter 33 Mediastinal abnormalities
  - Chapter 33 Mediastinal abnormalities
  - Anatomy
  - Mediastinal abnormalities 1
  - Mediastinal abnormalities 2
- Chapter 34 Paediatric lung disorders pertinent to adult patients
  - Chapter 34 Paediatric lung disorders pertinent to adult patients
  - Chronic lung disease of prematurity
  - Viral wheeze and asthma
  - Congenital abnormalities
- Chapter 35 Pleural effusion
  - Chapter 35 Pleural effusion
  - Clinical features and imaging
  - Malignant pleural effusion: causes and investigations
  - Malignant pleural effusion: management
  - Parapneumonic effusion and empyema: definition and clinical features
  - Parapneumonic effusion and empyema: bacteriology and investigations
  - Parapneumonic effusion and empyema: management and outcome
  - Tuberculous pleural effusion
  - Other causes
- Chapter 36 Pneumoconioses
  - Chapter 36 Pneumoconioses
  - Overview and causative mineral dusts
  - Coal-worker’s pneumoconiosis
  - Silicosis
  - Berylliosis
- Chapter 37 Pneumothorax
  - Chapter 37 Pneumothorax
  - Clinical features and investigations
  - Initial management
  - Further management
  - Treatment algorithm for primary pneumothorax
  - Treatment algorithm for secondary pneumothorax
  - Specific situations
- Chapter 38 Pulmonary hypertension
  - Chapter 38 Pulmonary hypertension
  - Classification
  - Idiopathic pulmonary arterial hypertension (IPAH)
  - IPAH: clinical features
  - IPAH: general management
  - IPAH: disease-targeted therapy
  - IPAH: surgical treatments, end of life care, and future developments
  - Non-idiopathic pulmonary hypertension: causes
  - Non-idiopathic pulmonary hypertension: management
- Chapter 39 Pulmonary thromboembolic disease
  - Chapter 39 Pulmonary thromboembolic disease
  - Epidemiology and pathophysiology
  - Aetiology
  - Clinical features
  - Diagnosis of acute PE
  - Investigations
  - Special circumstances
  - Rare causes
- Chapter 40 Respiratory infection: bacterial
  - Chapter 40 Respiratory infection: bacterial
  - Community-acquired pneumonia (CAP)
  - CAP: clinical features
  - CAP: severity assessment
  - CAP: investigations
  - CAP: management
  - CAP: antibiotics
  - CAP: treatment failure
  - CAP: follow-up
  - Hospital-acquired pneumonia: clinical features
  - Hospital-acquired pneumonia: management
  - Ventilator-acquired pneumonia (VAP)
  - Aspiration pneumonia
  - Aspiration pneumonia: clinical features
  - Lung abscess: clinical features
  - Lung abscess: diagnosis
  - Lung abscess: management
  - Nocardiosis
  - Actinomycosis
  - Anthrax
  - Tularaemia
  - Melioidosis
  - Leptospirosis
- Chapter 41 Respiratory infection: fungal
  - Chapter 41 Respiratory infection: fungal
  - Aspergillus lung disease: classification
  - Atopic allergy to fungal spores
  - Asthma and positive IgG precipitins to Aspergillus
  - Bronchopulmonary aspergillosis
  - Invasive aspergillosis
  - Semi-invasive aspergillosis
  - Aspergilloma/mycetoma
  - Pneumocystis pneumonia (PCP): diagnosis
  - PCP: treatment
  - Endemic mycoses
  - Histoplasmosis
  - Blastomycosis
  - Coccidioidomycosis
  - Paracoccidioidomycosis
  - Other fungi: cryptococcosis
  - Candidal pneumonia
- Chapter 42 Respiratory infection: mycobacterial
  - Chapter 42 Respiratory infection: mycobacterial
  - Tuberculosis: epidemiology and pathophysiology
  - TB: pulmonary disease
  - TB: extrapulmonary disease
  - TB: investigations
  - TB: management 1
  - TB: management 2
  - First-line antituberculosis drugs
  - TB: in-patient admission
  - TB in pregnancy
  - TB chemotherapy with comorbid disease
  - TB: adverse drug reactions
  - Multiple drug resistant TB (MDR-TB)
  - Latent TB infection
  - TB and anti-TNFα treatment
  - TB: screening and contact tracing
  - Disseminated BCG infection (BCGosis)
  - Non-tuberculous mycobacteria (NTM)
  - NTM: management
- Chapter 43 Respiratory infection: parasitic
  - Chapter 43 Respiratory infection: parasitic
  - Pulmonary hydatid disease
  - Amoebic pulmonary disease
  - Pulmonary ascariasis
  - Strongyloidiasis
  - Toxocariasis
  - Dirofilariasis
  - Schistosomiasis
  - Paragonimiasis
  - Tropical pulmonary eosinophilia
- Chapter 44 Respiratory infection: viral
  - Chapter 44 Respiratory infection: viral
  - Viral pneumonia: overview
  - Influenza: diagnosis
  - Influenza: management
  - Cytomegalovirus pneumonia
  - Varicella pneumonia
  - Respiratory syncytial virus
  - Measles
  - Hantavirus pulmonary syndrome
  - Severe acute respiratory syndrome (SARS): epidemiology and pathophysiology
  - SARS: clinical features and management
- Chapter 45 Sarcoidosis
  - Chapter 45 Sarcoidosis
  - Aetiology and pathology
  - Chest disease: clinical features
  - Chest disease: management
  - General management
  - Extra-thoracic disease 1
  - Extra-thoracic disease 2
- Chapter 46 Sickle cell disease: pulmonary complications
  - Chapter 46 Sickle cell disease: pulmonary complications
  - Overview
  - Acute chest syndrome
  - Sickle cell chronic lung disease
- Chapter 47 Sleep apnoea and hypoventilation
  - Chapter 47 Sleep apnoea and hypoventilation
  - Obstructive sleep apnoea (OSA)
  - OSA: clinical features
  - OSA: types of sleep study
  - OSA: nasal CPAP
  - OSA: driving advice to patients
  - OSA in children
  - OSA: future developments
  - Central sleep apnoea (CSA) and nocturnal hypoventilation
  - Causes and clinical features of CSA/hypoventilation 1
  - Causes and clinical features of CSA/hypoventilation 2
  - CSA/hypoventilation: investigations
  - Obesity-related respiratory problems
- Chapter 48 Toxic agents
  - Chapter 48 Toxic agents
  - Drug-induced lung disease: clinical presentations
  - Drug-induced lung disease: examples 1
  - Drug-induced lung disease: examples 2
  - Paraquat poisoning
  - Radiation-induced pulmonary disease
  - Inhalational lung injury 1
  - Inhalational lung injury 2
  - Carbon monoxide poisoning
- Chapter 49 Unusual conditions (BOLD)
  - Chapter 49 Unusual conditions (BOLD)
  - British Orphan Lung Disease (BOLD) project
  - Alveolar microlithiasis
  - Amyloidosis: pathophysiology and classification
  - Amyloidosis: lung involvement 1
  - Amyloidosis: lung involvement 2
  - Hereditary haemorrhagic telangiectasia
  - Idiopathic pulmonary haemosiderosis
  - Langerhans’ cell histiocytosis
  - Lymphangioleiomyomatosis (LAM): clinical features
  - LAM: diagnosis and management
  - Primary ciliary dyskinesia (PCD)
  - Pulmonary alveolar proteinosis (PAP): pathophysiology and clinical features
  - PAP: diagnosis and treatment
  - Pulmonary arteriovenous malformations (PAVMs): aetiology and diagnosis
  - PAVMs: management and complications
  - Recurrent respiratory papillomatosis
- Chapter 50 Upper airway diseases
  - Chapter 50 Upper airway diseases
  - Acute upper airway obstruction
  - Anaphylaxis
  - Upper respiratory tract infections 1
  - Upper respiratory tract infections 2
- Chapter 51 Vasculitis and the lung
  - Chapter 51 Vasculitis and the lung
  - Classification
  - Wegener’s granulomatosis: presentation and diagnosis
  - Wegener’s granulomatosis: management
  - Microscopic polyangiitis
  - Goodpasture’s disease
  - Churg–Strauss syndrome
  - Rare pulmonary vasculitides

Part 3 Supportive care
- Chapter 52 Ethical issues
  - Chapter 52 Ethical issues
  - Background
  - COPD
  - Lung cancer and neurological disease
- Chapter 53 Financial entitlements
  - Chapter 53 Financial entitlements
  - Patient financial entitlements
- Chapter 54 Immunosuppressive drugs
  - Chapter 54 Immunosuppressive drugs
  - Patient advice and monitoring
  - Corticosteroids and azathioprine
  - Methotrexate and cyclophosphamide
- Chapter 55 Inhalers and nebulizers
  - Chapter 55 Inhalers and nebulizers
  - Background
  - Different inhaler types and instructions for their use
- Chapter 56 Intensive therapy unit (ITU): when to involve
  - Chapter 56 Intensive therapy unit (ITU): when to involve
  - PAR (patient at risk) scoring system
- Chapter 57 Non-invasive ventilation
  - Chapter 57 Non-invasive ventilation
  - Terminology
  - Indications
  - Contraindications
  - NIV in acute respiratory failure: practical use
  - NIV in chronic respiratory failure
- Chapter 58 Oxygen therapy
  - Chapter 58 Oxygen therapy
  - Acute oxygen therapy
  - Home oxygen therapy
  - Practical issues
- Chapter 59 Palliative care
  - Chapter 59 Palliative care
  - Lung cancer and mesothelioma
  - Other symptoms
  - Non-malignant respiratory disease (COPD, CF, fibrotic lung disease)
- Chapter 60 Pulmonary rehabilitation
  - Chapter 60 Pulmonary rehabilitation
  - Aims and patient selection
  - Programme
- Chapter 61 Smoking cessation
  - Chapter 61 Smoking cessation
  - Aims and nicotine replacement therapy
  - Non-nicotine replacement therapy
- Chapter 62 Tracheostomy
  - Chapter 62 Tracheostomy

Part 4 Practical procedures
- Chapter 63 Airway management
  - Chapter 63 Airway management
  - Simple airway
- Chapter 64 Bronchoscopy
  - Chapter 64 Bronchoscopy
  - Indications and risks
  - Patient preparation and procedure
  - Sampling techniques
  - Central airway obstruction
  - Interventional bronchoscopy
- Chapter 65 Chest drains
  - Chapter 65 Chest drains
  - Indications, drain types, complications
  - Insertion technique
  - Drain management
- Chapter 66 Cricothyroidotomy
  - Chapter 66 Cricothyroidotomy
- Chapter 67 Miscellaneous diagnostic tests
  - Chapter 67 Miscellaneous diagnostic tests
  - Skin prick tests
  - Technique of induced sputum
  - Methacholine challenge testing
- Chapter 68 Pleural biopsy
  - Chapter 68 Pleural biopsy
- Chapter 69 Pleurodesis
  - Chapter 69 Pleurodesis
  - Chemical pleurodesis
- Chapter 70 Pneumothorax aspiration
  - Chapter 70 Pneumothorax aspiration
- Chapter 71 Thoracentesis
  - Chapter 71 Thoracentesis
  - Diagnostic thoracentesis
  - Therapeutic thoracentesis
- Chapter 72 Thoracoscopy (medical)
  - Chapter 72 Thoracoscopy (medical)

Appendices
- Appendix 1 Blood gases and acid–base balance
- Appendix 2 BMI calculator; height and weight converter
- Appendix 3 CT anatomy of the thorax
- Appendix 4 CT patterns of lung disease
- Appendix 5 Lung function testing
- Appendix 6 Plain radiograph and lobar collapses
- Appendix 7 Radiological investigations and radiation exposure
- Appendix 8 Useful websites

Index
- Index

2nd edition

Respiratory ailments are the most common reason for emergency admission to hospital, the most common reason to visit the GP, and cost the NHS more than any other disease area. This invaluable reference offers instant access to a wealth of information needed in the day-to-day practice of respiratory medicine.

About the Authors

Stephen Chapman Clinical Lecturer in Respiratory Medicine, University of Oxford, UK

Grace Robinson Consultant, Respiratory Medicine, Royal Berkshire NHS Foundation Trust, UK

John Stradling Professor of Respiratory Medicine, University of Oxford, UK

Sophie West Consultant, Respiratory Medicine, Churchill Hospital, Oxford, UK

Disclaimer: Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work.

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