Respiratory Medicine

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  Investigating recurrent RTIs
This BMJ paper, part of the rational investigations series, looked at what GPs should do if a young and otherwise well adult presents with recurrent respiratory tract infections.
  Pneumonia
This BMJ Clinical Review summarised papers published in the last 2 years relating to community-acquired pneumonia in adults (from now on I am going to refer to it just as pneumonia).
  Bronchiectasis
  Tuberculosis
TB is not something we are going to be managing ourselves in primary care, but we need to be alert to the possibility of the diagnosis and be aware of the relevant tests and treatment regimens.
  Sarcoidosis
Sarcoidosis has always been one of those diseases I have never felt I fully understood, and therefore always worried that I might miss it.
  Chronic cough including whooping cough
This review comes from the Lancet. It gives us a good overview of the many causes of chronic cough and an approach to take if a clear cause can't be identified.
  Pulmonary embolus
I've summarised this review of pulmonary emboli (PE) from the BMJ 'Easily missed' series.
  Acute bronchitis and cough
This section refers only to adults without pre-existing co-morbidity (e.g. COPD).
  Asthma
  COPD
'Have you got an inhaler on you so I can check your inhaler technique?' Fred, who had had moderate COPD for some years now, rooted round in his pockets and produced 5 different inhalers. Slightly surprised, I changed tack.
  In an emergency, should we give oxygen?
The BTS produced guidance on the use of oxygen in emergency situations in 2008. However, it doesn't seem to have percolated down to primary care. Because it challenges many assumptions we have summarised it here. Take note if you carry an oxygen cylinder in your emergency bag!
  Pneumonia and CRB-65
CRB-65 is a simple tool, championed by the British Thoracic Society, developed to stratify the severity of pneumonia
  Drug reminders: beclometasone and prednisolone
  Lung cancer
In April 2011 NICE produced guidance on the diagnosis and treatment of lung cancer. A large part of this was dedicated to hospital investigation and treatment. Here I will focus on the aspects around diagnosis related to primary care. First though, a reminder of how reassuring a negative chest X-ray should (or shouldn't!) be!