Đánh dấu gia tăng các triệu chứng, chẳng hạn như phát triển đột ngột của nền nghỉ ngơi khó thở nặng COPD Khởi đầu của các các dấu hiệu vật lý mới (tím tái, phù nề ngoại vi) Thất bại của đợt để đáp ứng comorbidities quản lý y tế | OBSTRUCTIVE RESTRICTIVE LUNG DISEASE 421 TAB LE 17-22 INDICATIONS FOR HOSPITALIZATION OF COPD Marked increase in symptoms such as sudden development of resting dyspnea Severe background COPD Onset of new physical signs cyanosis peripheral edema Failure of exacerbation to respond to medical management Significant comorbidities New arrhythmia Diagnostic uncertainty Older age Insufficient home support Adapted by the author from the Global Strategy for the Diagnosis Management and Prevention of Chronic Obstructive Pulmonary Disease 2005 update http . TABLE 17-23 CLINICAL SIGNS OF CYSTIC FIBROSIS Respiratory Chronic productive cough Recurrent pneumonia Persistent chest radiograph abnormalities Airway obstruction Clubbing Sinusitis Nasal polyps GI Meconium ileus Distal intestinal obstruction Rectal prolapse Pancreatic insufficiency Pancreatitis Biliary cirrhosis Failure to thrive Other Male infertility Osteoporosis Adapted with permission from Ratjen 2003. 422 CHAPTER 17 THORACIC-RESPIRATORY DISORDERS PHYSICAL AND CHEMICAL IRRITANTS Pneumoconiosis Definition Pneumoconiosis is a general term for fibrotic lung disease caused by dust inhalation. Specific inhalants include asbestosis silicosis and coal worker s pneumoconiosis. Etiology Exposure to inert dusts such as coal asbestos talc aluminum powder or silica causes pulmonary fibrosis. Clinical Presentation Patients with exposure are often asymptomatic for decades despite CXR findings. When the disease is advanced patients experience dyspnea consistent with restrictive lung disease and have fine crackles on examination. Patients with asbestos exposure are at higher risk of lung cancer especially if they smoke. Diagnosis CXR shows diffuse nodular infiltrates. Pleural thickening and plaques are common in asbestosis. Treatment There is no specific treatment for pneumoconiosis. Patients should receive influenza and pneumococcal vaccines be encouraged to stop smoking and have supplemental oxygen if they have .
