The trigger is a dry cough, exertional dyspnoea and fever that do not settle after antibiotics. Open this first for the practical clues to cryptogenic organising pneumonia: peripheral or migrating opacities, high-resolution CT, and the need to exclude secondary causes before settling on the label.

Lung transplant medicine rewards thinking by timing. Early graft dysfunction, later rejection and shifting opportunistic infection risk require a structured differential, while tacrolimus interactions, new hypoxaemia and falling lung function should prompt early transplant-team involvement rather than routine ward management.

For acute dyspnoea, lung ultrasound often answers the first question faster than the inferior vena cava. Start with lung views for B-lines, sliding, and effusion, then use cardiac windows and EPSS to interpret ventricular function and avoid overcalling volume status from IVC size alone.

In the third trimester, malaise, abdominal pain and vomiting become high-risk when paired with jaundice, polyuria, confusion or coagulopathy. The practical lesson is not to wait for full Swansea criteria before escalating, because moderate transaminitis can still mask evolving acute liver failure.