Wrreraeeesreeeaeaeaeeee
~wRRAR!
Amrraree
@ obstr difuyS a Giilor geriene.
. hiperreoctiv. bronsic®
@ iaflam bronsics ©
ones es oe
x ning wend
PALI
Ae J
‘se asociaya Clie extravoyare plas pals
extem
fupertrohe cel.
mus netede,
depen de
corggen (ony.
Oe ematical’
| dkpuri de mucus
injure epitetiald
obstr br i revensibildf = Key.
| 2 + t
agree Fam. eo avn init nemodel® ai calor aetiene
—Aesitut. prich® |. hrimale nsecte| — enitom tray cin aekmul de Lunges
aGleenicom| | 2 tn duet)
~acami-dengen |. eFiyice. Cera
specie sa = (cas virale.
Sene'biliyand ir ocupationali > pau fa 197ain cayurile deal
Wheering-ul ineusae fort > apane in mad caractenistic
uPA efont
Mon geneticeale eny.amiox dante > se asxiaya cu form a,
< may seyehe de atm
@mteuraned PEF
~ latreyire, y
~ Tnargie de culcane. - } 4 mas,
= clupt admin.uuu GS + Maintea admin.
yan. imine > ind. bunal activ. avtiuler;
allele ATA MM A A WWHWHAWHHHHRHW ane ]
Spirometrie. eau
lestu/de prov.br.cu H/S/metacoli ng
@Jratamentu! ce prob cucs
Prednison dong anal yi -2 Set
SE cominud Tu cay de Tap. fav. cu CS inhalatar’
® Oxiaul nitric ain acu! expiraé
(MOS. iWFLAN. COilor QEWenNe
eval. hdsp le CS
© Teste eg. vi din sputt! > Eo sputer-ane perfdg. mai make
@ Rx torazic. > fiperinFl ia ep tamute /fonm&ecr. were
@ Teste cutanate. = se Fac in TOATE cayurrile.
@ Teste de provcare alergenica
nececohe 7m susp.ae atm aupafional,
Puatyrvedt
Cruaoterapia aubbingvall cu acatiens die proful de cost
— & exacenba nile fa cop
— x lo colulte
igti ai © P2-adrenergici
selectivitate pt trhesp.
~ neloxeays Amuse netede, bronyice
XK ef.ps inflam, wibiacenti
ecu cunatd scurta de achune > Sal buts mol 400 ig
x Tendutaling 280 Jug
ax put Ia nevoie “G
+ cu durafe dung’ de acliune -» Salmeteral
au Formarerd: J
oluuxald cle acl. de pana fe 2h > 1/2 «140
se osataya cu CS inh. > combin doye fixe TU
ac. dispay. inkalatoh ‘ ‘iprapional de. béclomefayona -> cel mai utili yat
Budesanid ., 59, (00,200,259 jug [pu
Propionatul de fluifcayona d
turoatul de fluticayond
‘Furaatul de mamefayons
Triamernolonul
hadv: candidoya ohale 1 _,
disfonia Ske
cajanacte caps.- rake ,gpare la vonst nici
5 clateasti gua ctups
ovteopahaya ~ doar Ia obye. de @d0/ btesoniad = saglee ‘
Tmanyiehea Mpa tenmen scynt ( >400 Me I> molt finale
b> dloon ta copii nu a foxt chert.
CS onali' #1 a9. imunosup! alternatvi
mec. Tex exacerbOhi acute,
esec al altar reg fekop
rus ovkmul corticadlep x Maidan: Hetatrexat < terap. bralogics
Giefasporin evar. mencel nal
[cAniag. @ pt Gucoiriene | = pe ® cdeinil (74
Hontelvkost heart
Praniukast oral, 50 face probs 4 Spt
@afirlukast
— axtm necontrofat cu cs inh wa clove mici-maolunat®
— sntolenanJe Ja aspiring
= pac cu avtmn 4 reinits
— copii cu art # wheenoy, pov-aral
Pranhodilatataare anticalinegice]
Ty Ipatroplom. > drat sii, netulryane
Thotropium. b dutalts aug
Aclidiaium
> in exacenby ti acule were,
> X fa pre lo care odiuul aw econtrolet eu keropie tandary
III J
MaLalleallallelladlldblilb AAA A DSS Med. anti-iaflamatarii
Cromaglicatul ofisoolia ~~» au previn aetivanea LF
Nedbétomilu! sadic.
. ve (] <>bloch. influx.fe Ca => previr activahen
loch un canal de Ci =7lach. influx. ofe Ca => preven re tee
Tn forme yscane,olar nu 7a med obigauit
\
Omatizumad ~ leagts al delg€ libere V ar. yy Cetv x bayofilelor
morstocit lor
6,0, lq 24 Siplimdne ~7n for_ole niv ole (9E w Bch)
Mepottyumab
Resiiyumah > ach. Fmpatniva i-6 f@ ec
Denraliyumad ef. 7a astmul eoyinorilic,
Fenmoplastia bren sii > ovkm pensident modlenat- suet
Exacenbinite astmatice.
> @ inwiee precace a ut trot cu CSoal’ >}ednison 2o-comg
PEF > ISoL/min > torep onus uebuliyohe Astpt
X inteknate
Ecancenbaren severis
PEF
ambuianta
4 Salbutamol Smg /Teitbutalin& Ao ma>nebultyohe.
09%} 2. Wigrocortiyon: iv. 200 mg
3: Oxygen 407601.
4. Phednison 60 mg oral pp)
fa spital: heevaluake.
4. OXIQeN LO-G07
Q. mByunTm PEF % sat O2
3 Salbutamal Sq [Teroutaliny Ao ma > 0 clade , duepd tot
¢ 1a Hohe,
°b. ,
SUN VUE EEUU |
4. Bromur’ide iprotromium 45mg ( 5. Hidrecortiyan 200 mg.iv.
6. Pregnison 4O-¢ min.5 yile
+ Facor > 60mm Ha => venti], mec
8. Rx pulm ;
9. Xameliotahe=> MgSO, ae
v. Tr 20 minute.
noornnopanwan ma
hmm mm t@nanhoditatatearne
# Ag. Paddrenergici ~ Sal butamo! ae.
ea 4-6
ameli Oneaee dispneeo,
© med.anti coli nergice.
ww cduratt longi ae act > T fed. puims cal.
(Viortrapi Viehis Wdispreea |
NU Previne Aeclinul VENS
e TEOFling ~benef.y
Tinh de Tostadiestenayack:
Rotlueni |ast — Prep.antiintiam.
adjuvant
\a gac VENS < 607. din\al p. si bronntd or
i VEMS < 0%. olin Val. p-
bs. ap orer)
biopsia endlabronsic®
predominant eeucofic > cicatniyahen sp, fibrora
in ! SN smal =
macrofageloi ilar aetucne Mic
disthugehea per alvedlori => emfiyem,
t = dlistensia anohmal’ % pekmanenta a spt. _
aehiene atuate distal de. bnohhiola tenminala
dtstraigenea per. acestor sai
hidla. An
fet erimimal® ee CeNTNE -acinah
= distemsa 4 divtkugekeo }. pulmonar
Mgurul bhonhiblatenminale.
duct atv. — cea mai frecuent® fonme
‘sac all.
enuf e Sechestratia plamani, dec:
pate oa limitane expiratone.
“ e 5
epan-acinar i enekeguiat
def.de o t-antitripsing
ak 0 Forepele cove
itinanul devine &
5 Prmcatecyee de oule.
obstr. sevend
de.seen ventilate!
pertuyie,
feta dite b
nenehmutul &
pancelars
Wb 50mLfan a VENS Tu OPAC VS V2OmL/an la
SSB low e& sistemice
( H ipertensiune,
Cnsut.cara.de.
Gerdere mast pond.& muse.
Qcteoporoyt
Deoresic
Aistenie fiyict
Semne
forme uscaKe -> semne absente /ralurt sibilante.
forme seuehe'-> palipnee
expir prelungit
* m.acesorii
+irg) intercostal ‘aspir
expit cu buye pensate.
stant crio-stennala
excursii costale Y
matitate 9 ¥ © -aosente,
tack ntfsp. 1a Cz @ conservat = alispnee. .
} fahcanoya
dacd devin rnsenwibili la cee —> edeme +cianoya
hah dispnee
Hippie > vd perif + puls amplu
asterixis
sSomnolentS pr
See ea Fem SEVERE
donme auansate: ¢ iRegtcard pulmonar + Hip
> cel mai 7 CLINIC.
RAR AA AR AAR AD Aw AHA
ye WWWUUUUUEUUWTUD UPN |
( “ee »
OULU Sy —-we
i Va Al/ RY
, fobare -
< bronbopnevmoniee Ss
y
“tuse, el == €URB-65 a am
+ hem e
+ dispnee ontuyie: preyent’i(sconul testutur mental a.<8/t0)
+ febr?
1 REE ross BRMMBLAELY mmol/L)
+fr.ple
* manif. EF ata Peselt.: SBOnese/ min
«arte Clood encecires TASEBamm Hy TABSEommHg
~ Pe ES varstar secant «aif manken’
~ cefal Rxth
= S60 ipa => amoutatsr en
— mea hence
- host alte comorbiditak.
x Febra lo varsinici
tobi pacientii rntennal 7 spital thebuie 83 et: Rx
analiyesc
teste mnobiofagice.
Rx th has ad
normal Ia prey? se Repel dup’ 2-3 yile, 7n susp.clinrc 2 PO
se repela la 6 capt pia exclude uu cc xsbiacent bronbic
Analiye sange HLG,Cn, ionoghama,biachimia, PCR, x i
dg 5
Grpmeumonie: Leu> 45 x10°/uL (neutrofilie doy.
PCR 100 neutro ilie doy)
VSH 100. .
deu-N * dach epkey aneme> Coombs din
mE.0,
- 11a Hee
legionella: ir Popenie \x leuicadtays marcate
TASAT, ALAT
hiopaAlo
Gayomethia anteriala®
se face doah act
uiei 9, saNest
Sato e wb mortglitate ‘mai mare
@laioin bem i mai sevens TTT TT
|
)
( ? aaN N
CULM yg
f, lobar zs
ara NG
< bronkopneumonie. @
+ hemoptiyie, 7
* dispnee
+ febr& dactt e asiilanta, ae, gandim la ua empiem
« durere toracicl oe noturd euritice®
fr. pleuralé (7 faya vaifrala @ 60!)
+ manif. EP
+ paakipesmcgy morgan 56 a [HuebgiaSma
= pericarait&, miocardita Mycoplasma
= cefolee JLegicnella ()
= durere aba; aianee, vars (9)
patita -» Legronella
= meaciivarea HSV labial. pneumacoc,. {relat ?)
~ hosh-uri eutanate: eritem paltmonf ,nodos (SS)
Hycoplasma G nave
tofi pactentin intennali 7: gpital thebuie a et: Rx th
a a
4 gut a ied 7
aah la pr ey? se nepett aupa 2-3 yile, 7n susp.c (inva ole PO
se hepeta (a 6 capt pla exclude uu cc swabiacent bronprc
Anoliye sange - HLG,Cn, ionoghama;biachimie, PCR.
a
Grpneumonie: Leu> 15 x10°/y L (neutrofilie 9072)
PCR> 100
VSH>I90 .
deu-N —* dact ephey aneme> Coombs din 0
3 ‘ mB ogl. 1a HEC
elegroneua limPopenie x lelicacdtoyS marcata
T ASAT, ALAT
hiapadlo
Gayom etna anterials
se face doth aac
la 44
Coltuna spite: Hepat
Sata, e iub < 9%
Ia tots cu PC merterat ww.
em -» mOrtalitate ‘mai mare
@ la Sho. Rem > er mal sevend €RB-65 = O
obmicliy
‘Kanoliyex
CA maxici lind Sarma x ¢
Sou
Claritramiciaa Soa mg PET)
Doxieialind 100 mg lyt (doya ae iudincatte 200 mg)
(decd e alergie'la peniciling)
enc-65- 4 /
mortalitate 3
—#esteidoar dac’ susp.
‘focar epid. fepidem ie. - ee
an Hycoplasma Ag preumonoeie (rn Cayce: sp)
I 'Serologiel PER Ta cay de epid
Amanielling Soy Di | Atricx 1 Seo-logn mg X Bly i
-
ce Lar ltramicin’ Sama xl! | Claritramie
uk
moriaitate 97
So mgxalyi
au se paste oral)
| olergie la penietting
| Doxic voling toa eng Lyi
Levotovasin Stamg x 2dyi
Hoxif loxaciads boamg yi
8 =6 3 401. £3 5) 4-5 > ATh |
— Ihe mocuH uti, 5pute, ay; preumoescie,
F cayonena, Pek seloye
Co-amoxiclav Lux dg at v +Claritro S00 mig x 214i Iv.
(Aqgionelia >'Fiaragutna lore’
olergie fa pens 9 ) )
_CeFal departnd (Cette, 2g hy) + Claritro 500 x2/¥i
Benullpeniciling lag Wai iw [sou lah
+ Levoflox, (Noxificx,
eed doa dberes
ea Teelrorculsge
patagen ininacelubt aehob
UUQIG
boct la mf.alveolane.—> > @ inflam.consec
yg! lane. ingenate @ infla
=> necroya tis.
Ganvlcame.
yond eentrala scayeum
=
—-(elrepili
yond coyenass se calcific (vindlecare complet)
noduli Calcif cane contin mycobactek
Ca cake narminia stake dohmanda
muiti ant “
+ Rx: Mic nodul
Fonanul Ghon be pat
Genrgiongr 5 ia
extratoracicl > intrator,med.
adenop.cervicals /supraclaviculars
= cons. f erm, nedurerca:
~ yonacentralg * va licheria > devine Fluctuant.ck e pehifortic.
- fenumentel dle deasupna: indurat: / traciect fistubs cu scurgere.
purulent
XKenitem =p abces « rece.”
probele se obfin: puuctie arpa oc fin, Afidots ecaghatic/
ope 1 peac /
hey plete
pl g intratoracic: >» GUS
PUTT TTT ney
ify Col. cu cuttamiaa = hodamin6
T® cons, la mets > 6 lune
T® SNC > mra.td luac
SNC [Pericard: adjyuant CS
(cami pe fermen lng)
rayinamida
Etambut
TS purmenary
1 &xtrapulm. | Q lun Ripe
TH miliard
( X SNC)
TS SNC. 1; RIPE :
+ » — ha t 7
| Dex gametqyans 0,5°Q4 mg/Ra/yr =
4 (cu sewwta a Fragnes tmpde B- R spt) =
=
=
Tolatent® | © luni: Ri : 3) set
Le luais iyoniayidd
§ Cigontayidg poli neuxopatie. sec. deF.de OG
=> suphmentém cu Piridoxind losing lye:
rash eutanat, feb d
hepatits (<17-)
>) = inductokal eny. hep
“5 ~¢ned.concomitent inebure heeval: ahticlepr; antiepil,
caloheng’ secr.org mr r0g4/FO alageny, STUN
trombocitopenie. WUUTTU COUT
vila) tox hep.
A ~2. [rosh
2 | prurit
artraigit
V 8erecr, nenafd a 0.uric. * poate reguia
Neuritd opticd hetrobulbart
fe de
tS eee te
| WAV
dep dle doy’ (15 mg/g, AX 2g)
carcinom eu cel mict rag din cetule netehaenclar. (PUD)
~ sectetd des f, polipept.
Yse dey. CENTRAL
META PRECOCE
ce cu ee! stuUOManse.
cc. eu cel make
- meta PRECOCE
carci nom NOM Mickoeelulah t adk,
tenapie pertsonaliyata :
- mutatile de activane duu cada! EG FRY
— netuUstor?
— FD
— amatict
= pneyenta onc enet ole fuxiune a ALK
— MF uatilocd / fost?
~pactinent metastayanea {a di
stan te
vad. Frecvent > gql. mediastinal?
cervical
axilaré 7
intraabdominale
dunene 0s09sa
ie = Fracturt patolagice—
implicanea Col vel ¥
ee > muse de compiene [1S
cane
= pondenalis > tHae unigen{alt
durenea ta HD
inod. de-a lungul abd.
= invayid, copwilt 2D
eer 4
iy ~ Poy cu ef de mast
: ~gemne de Pic TT
supranenal®
inf. supr xemeningita cc. 7. mai puting
Tn.gen ascnpiomatice wat Ou.c
o aes / frecuent 3
= conf ye
Sad 4 dg, spiculate
RAR > ley.viibile >4cm, bey € Sa ararnerede
ICT —>ggl.it 7A Cay. de suspiciuue a Comprere: HS
cenebral > pt meta celtebrale
5. Scanarie osoast > pt meta woase
A
AB PP sm ot om et ot mt me
MAMMA AA AAR I r . - Lat “ny
ubiiow -suad/| 04819
yosugnay } 103neid ‘DU
011014309 G0) UL" PU
(7
eons NS ®
15 vyaw Dubus O e anenes
a7 in vy Srojsopa}y
} pouyorgns 165 Soe MOM iB ys
qoisdiysorpeny 166 yoIi50! 1oSv0Jg Had 1
: 5 “en”
a : ey FN oypjuny bo
oy mbyuoyau - —— wnderpmogorsiniang :
; De sjouowny apo) 104/a40d 0 opus B
wall, 7 5 gun) 1y"Gou auds DY Axo -ofq’Daw sunduans
: : |. wa ssoo SaaaeReResh p:oqo] ‘oa
wl FIRD;DOID' SkOWSD- — >pyowWNoIT Ta) KOAUI B
a . (pIDsssIA TINE! PONV! ~ gardoosyuoug ‘pints x
+ SARI rpuldt> 210}29j0 BRS Q|OISDSIA S968 ce
: : ganaw- — /wynd8—j ap Tou,
| CA resi iY HIS — yi
Std W - v1, VN,
Da- vv, oe
te f
2 1 i:
(es
IE” Saxo — Tig Noi He 2
(7 GHD - Ta No Mo 7
TS - MyYd No' Mo Ez
~ Ty No Ho e
TS — ei Pyya,Tab! UNA Mo 7
WS No Mo =
SHAUNA - Ti Taga iN Ho =
Ws NW Ho e
v GW Noy Ho e
TS - Timamb Ns Mo 2
To =
Awe =
Yo- 2. ss =
_ se
, Ae =
Cav. pt histofogie ¥ cilologies as &
e fibrobnonhoscopia 5
# ecagna fie endo-brongica 5
« puttetie ~biopsie transgfiaat’ CT / ece: pulm S
: M / meta hep/ ex,
* @ tonacocenteya ghidlatS ecagrafic. eed
J w)
« toracascopia medical 8 /video-asistaty
e mediastinoscopia
laa Rael 21 intentre
qurativd
indicat
i > radio chimio pt 4 sta.» Faciliteaya rey
dacs lata chir, se dem, implicarea gf > china adjuvant’
Felepimonartiadeauats _, (Tindeve mart
SS 7
continua
sou
NSCLC To #0. incipient ier thigerFraehionata conti a
eral
de electie. cdnd intehv.chir. nu e posibild
foomord CV (itespiratorlt’ _.,. ser stereatactid de ablone
PABIa}ia prin RF
may. cay, urilor
10-167.
> han pod
blunt pot
limitata doar la
yona de iractiehe
nu e€ limitate
nol mamelionanea : durekilar asoase ¢ de P2"-OF | Hes ound Pay
obstr. brongice, fa RT pe
oosth. VCS, Tenmen scunt
Aemoptinia J a
2
Se
8
2
2
a
“Forele Sudcarinala a [
so Unherioara) [ipartaesoragian
l
— mediast aul Ng pulmonar
ingerior—
. 3 muboontic
ona fantenopost :
Caontici) paTa=aortic
* gg) N4
FAAAARAAAAAAAARAARRR AAA AAA AAR Ty]
cc. Stomac
gaucneas
Sdn
tipic.,tumona primard: Q aase,
@ inch,
© prostata
® san
© coluienm
6 atract GiS
> li mFangita caremno mataasd
t
Re t ti my
Rx:3)-li mfadenop. bilaterala
= opocit-liniane boxale., cane
se extind la ambete ari, pulen.