#NEETPG #INICET #FMG #MCISCREENING #MARWAHMEDICINE #PREPLADDERMEDICINE 2 min read Telegram link: https://t.me/realmarwahmedicine  Mnemonic to remember the key features of Allergic Bronchopulmonary Aspergillosis (ABPA): “SPADE.” S: Serum Ig E elevation > 1000 IU/ml  is a  hallmark feature of ABPA due to allergic sensitization to Aspergillus. Alternatively Skin test reactivity can be used for diagnosis confirmation. P: Pulmonary findings like infiltrates on CXR and CT scan shows Central Bronchiectasis and Positive Precipitins to aspergillus A: Asthma association though in some cases patient may has cystic fibrosis. Aspergillus colonization of airways is responsible for this presentation. D: Dyspnea: Dyspnea, or shortness of breath, is a common symptom of ABPA, often accompanied by coughing, wheezing, and sputum production. E: Eosinophilia For management of ABPA, itraconazole and systemic steroids are used. Alternatively, Omalizumab is used. The rationale for using itraconazole is to reduce antigenic stimulation.   Comparison of ABPA versus Acute eosinophilic pneumonia   ABPA Allergic interstitial pneumonitis Etiology Allergic reaction to the fungus Aspergillus Unknown, smoking initiation, Vaping Clinical Presentation Brown sputum plugs in an asthmatic or cystic fibrosis Acute respiratory distress, fever, cough, and shortness of breath. The onset is rapid, often within a few days. Chest X-rays may show diffuse infiltrates.   Labs Elevated serum IgE levels, eosinophilia, and positive Aspergillus-specific IgE and IgG antibodies Eosinophilia and BAL showing eosinophils Treatment Steroids plus antifungals Steroids  

#NEETPG #INICET #FMG #MCISCREENING #MARWAHMEDICINE #PREPLADDERMEDICINE Churg-Strauss syndrome, also known as eosinophilic granulomatosis with polyangiitis (EGPA), has peripheral eosinophilia and pulmonary eosinophilia with infiltrates on CXR. The characteristic feature of this disease is Eosinophilic vasculitis which is not seen in other diseases of lungs which have eosinophilia. A mnemonic to remember Churg-Strauss syndrome is: “CHARM”: C –Cardiac manifestation of myocarditis H –High eosinophil count with as much 75% of TLC being eosinophils A – Asthma and Allergic rhinitis history R – Renal involvement with Glomerulonephritis and Rashes with Purpura M – Mononeuritis multiplex (peripheral neuropathy) Usually, the patient will start having features of asthma and allergic rhinitis by 20-30 years of age. Lateral Peripheral eosinophilia is seen with as much as 75% of TLC being eosinophils. Eosinophils then infiltrate tissues producing neuropathy, myocarditis, eosinophilic gastroenteritis. In late forties or fifties these patients will develop fever, weight loss and malaise with myalgia.   Laboratory Findings Eosinophilia: Elevated eosinophil count in peripheral blood. Elevated Acute Phase Reactants: Such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Positive ANCA (Antineutrophil Cytoplasmic Antibodies): Although not always present, ANCA positivity, particularly perinuclear ANCA (p-ANCA), can be seen in a subset of patients. Chest X-ray: May reveal pulmonary infiltrates, nodules, or cavities CT Scan: High-resolution CT may show ground-glass opacities, interstitial fibrosis, or other pulmonary abnormalities. Biopsy Findings: Histopathological examination of affected tissues may reveal eosinophilic infiltration, vasculitis, and granulomatous inflammation. Telegram link: https://t.me/realmarwahmedicine

#NEETPG #INICET #FMG #MCISCREENING #MARWAHMEDICINE #PREPLADDERMEDICINE Here is a Quick mnemonic to remember the features of Hypersensitivity pneumonitis is: FARMER’S LUNG 4 F – Fever and Breathing problems A – Acute onset on exposure to grain, Moldy hay and Silage which harbor Thermophilic Actinomycetes R – Respiratory symptoms (cough, dyspnea and Clubbing is seen too M – Malaise starting within 4 to 8 hours of antigenic exposure E – Elevated erythrocyte sedimentation rate and BAL shows lymphocytosis R – Radiographic findings (ground-glass opacities, reticulonodular infiltrates) S – Symptoms improve with removal from exposure L – Lymphocytic alveolitis U – Uncommon but can progress to chronic disease N – Noncaseating granulomas G – Granulomatous inflammation and Diagnosis is based on Clinical prediction rule 4- Type 4 hypersensitivity reaction This mnemonic can help you recall the key features associated with Hypersensitivity pneumonitis.