Asthma, COPD, pneumonia, ILD, lung cancer, TB, and pleural disease with NICE-aligned investigation and management pathways.
Sustained worsening of COPD symptoms beyond normal day-to-day variation, requiring a change in treatment. Commonly triggered by viral/bacterial infection.
Non-cardiogenic pulmonary oedema characterised by acute hypoxaemic respiratory failure with bilateral infiltrates. Mortality 35-46% depending on severity by Berlin criteria.
Life-threatening medical emergency requiring immediate bronchodilator therapy, systemic corticosteroids, and oxygen. Characterised by severe airflow obstruction with PEF 33-50% best/predicted.
Hypersensitivity reaction to Aspergillus fumigatus colonising the airways, causing eosinophilic inflammation and bronchiectasis. Occurs almost exclusively in asthma and cystic fibrosis patients.
Autosomal codominant genetic condition causing deficiency of alpha-1 antitrypsin, leading to early-onset panacinar emphysema and liver disease. Most common genetic cause of liver disease in children.
Pulmonary infection resulting from inhalation of oropharyngeal or gastric contents into the lower airways. Commonly affects the right lower lobe due to anatomy of the right main bronchus.
Chronic inflammatory airway disease characterised by variable airflow obstruction, bronchial hyperresponsiveness, and reversible bronchoconstriction. Affects ~5.4 million people in the UK.
Pneumonia caused by organisms not detectable on Gram stain or standard culture, presenting with dry cough, systemic symptoms, and extrapulmonary features. Key organisms: Mycoplasma, Legionella, Chlamydophila.
Cough persisting >8 weeks in adults requiring systematic evaluation. Commonest causes are upper airway cough syndrome, asthma, and GORD, but must exclude serious pathology including malignancy and TB.
Eosinophilic granulomatosis with polyangiitis (EGPA) — small-vessel vasculitis characterised by asthma, eosinophilia, and multi-organ vasculitis. Cardiac involvement is the leading cause of mortality.
Pneumonia acquired outside of hospital or within 48 hours of admission. Most commonly caused by S. pneumoniae. Severity assessed using CURB-65 score.
Progressive, largely irreversible airflow obstruction associated with an abnormal inflammatory response to noxious particles, principally cigarette smoke. Third leading cause of death worldwide.
Autosomal recessive multisystem disease caused by CFTR gene mutations, leading to thick mucus secretions affecting lungs, pancreas, GI tract, and reproductive system. Most common lethal genetic disorder in Caucasians.
Coughing up blood originating from the lower respiratory tract. Ranges from mild blood-streaking to massive haemoptysis (>240 ml/24h). Always requires investigation to exclude malignancy and TB.
Pneumonia developing ≥48 hours after hospital admission, not incubating at time of admission. Associated with Gram-negative organisms and MRSA, with higher mortality than CAP.
Immune-mediated inflammatory lung disease caused by inhalation of organic antigens in sensitised individuals. Previously known as extrinsic allergic alveolitis. Classified as acute, subacute, or chronic (fibrotic vs non-fibrotic).
Progressive fibrosing interstitial pneumonia of unknown cause, with UIP pattern on HRCT/histology. Most common idiopathic interstitial pneumonia with median survival 3-5 years from diagnosis.
Heterogeneous group of disorders characterised by inflammation and/or fibrosis of the lung parenchyma, causing restrictive physiology and impaired gas exchange. Over 200 recognised subtypes.
Ventilatory support delivered via face mask or nasal interface without endotracheal intubation. BiPAP is first-line for acute hypercapnic respiratory failure in COPD exacerbations (pH 7.25-7.35).
Pulmonary and extrapulmonary infections caused by mycobacteria other than M. tuberculosis complex and M. leprae. Most commonly M. avium complex (MAC) and M. kansasii in the UK.
Combination of obesity (BMI ≥30 kg/m²) and chronic daytime hypercapnia (PaCO₂ >6.0 kPa) in the absence of other causes of hypoventilation. Often coexists with OSA (~90%).
Recurrent upper airway collapse during sleep causing apnoeas/hypopnoeas, oxygen desaturation, sleep fragmentation, and excessive daytime somnolence. Affects ~4% of middle-aged men and ~2% of women.
Spectrum of respiratory conditions caused or worsened by workplace exposures including dusts, chemicals, and biological agents. Includes asbestosis, silicosis, coal workers' pneumoconiosis, and occupational asthma.
Inflammatory lung disease characterised by granulation tissue plugs in distal airways and alveoli. Highly steroid-responsive but with significant relapse rates of 30-50% on tapering.
Therapeutic administration of supplemental oxygen to correct hypoxaemia. BTS guideline recommends target SpO₂ 94-98% for most patients and 88-92% for those at risk of hypercapnic respiratory failure.
Abnormal accumulation of fluid in the pleural space, classified as transudative (protein <25 g/L) or exudative (protein >35 g/L) using Light's criteria. Most commonly caused by heart failure, pneumonia, and malignancy.
Acute infection of the lung parenchyma causing consolidation and impaired gas exchange. Classified by setting of acquisition: community-acquired (CAP), hospital-acquired (HAP), or aspiration.
Accumulation of air in the pleural space causing partial or complete lung collapse. Classified as primary spontaneous (no underlying disease), secondary (underlying lung disease), or traumatic.
Occlusion of pulmonary arterial vasculature by thrombus, most commonly from deep vein thrombosis. Major cause of preventable hospital death with ~25,000 deaths per year in the UK.
Group of conditions characterised by eosinophilic infiltration of the lungs, presenting with cough, dyspnoea, and pulmonary infiltrates. Causes range from parasitic infections to drugs and vasculitis.
Elevated mean pulmonary artery pressure ≥20 mmHg at rest on right heart catheterisation. Classified into 5 WHO groups with distinct aetiologies and management strategies.
Group of conditions causing inflammation and necrosis of pulmonary blood vessels, presenting with haemoptysis, pulmonary infiltrates, and often renal involvement. Includes GPA, MPA, and EGPA.
Multisystem granulomatous disease of unknown cause, characterised by non-caseating epithelioid granulomas. Most commonly affects lungs and lymph nodes. Peak incidence in young adults, particularly Afro-Caribbean populations.
Structured interventions to help patients stop tobacco use. Smoking is the leading preventable cause of death in the UK, killing ~78,000 annually. Combination pharmacotherapy plus behavioural support is most effective.
Objective measurement of lung volumes and airflow for diagnosis and monitoring of respiratory disease. FEV₁/FVC ratio <0.70 defines airflow obstruction; reduced FVC with normal ratio suggests restriction.
Life-threatening emergency where a one-way valve mechanism causes progressive air accumulation in the pleural space, leading to mediastinal shift, impaired venous return, and cardiovascular collapse.
Chronic granulomatous infection caused by Mycobacterium tuberculosis, primarily affecting the lungs. UK incidence ~5,000 cases per year, concentrated in London, urban areas, and migrant populations.