Crepitation

Coarse crepitation
-เกิดจาก movement of fliud or secretion in airway
-ได้ยินทั้ง inspire and expire crep
-change with respiration
– พบใน Tracheobronchitis Bronchiectasis

Late crepitation
-Alveoli process

Early crepitation
-end before end inspiration
-indicate small airway

มันเลยเหมือนสาเหตุคนละตำแหน่งเ​ลยไม่มี Late coarse crepitation
มีแต่ Early coarse crepitaion (^^)

Bronchiectasis three layers phlegm

Bronchiectasis three layers phlegm

1.the upper for bubble-like, frothy, faomy (partly from saliva)
2.middle-level for thin sero-mucus liquid
3.the underlying base = pus ,necrotic tissue , cell debris

Fluoroquinolone

Gatiflox ถูกถอนเพราะ Dysglycemia
Levoflox Moxiflox cover Pseudo ได้ไม่ดี

Criteria diagnosis IPF without open lung biopsy

Criteria diagnosis IPF without open lung biopsy

Major Criteria (all 4 needed)
1.Exclusion of other known causes of ILD such as certain drug toxicities, environmental exposures, and connective tissue diseases
2.Abnormal pulmonary function studies that include evidence of restriction (reduced VC, often with an increased FEV1/FVC ratio) and impaired gas exchange [increased P(A–a)O2, decreased PaO2 with rest or exercise or decreased DLCO]
3.Bibasilar reticular abnormalities with minimal ground glass opacities on HRCT scans
4.Transbronchial lung biopsy or BAL showing no features to support an alternative diagnosis

Minor Criteria (3/4 needed)
1.Age >50 yr
2.Insidious onset of otherwise unexplained dyspnea on exertion
3.Duration of illness >3 mo
4.Bibasilar, inspiratory crackles (dry or “Velcro”-type in quality)

From ATS/ERS