Pneumothorax differential diagnosis: Difference between revisions

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{{Pneumothorax}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Pneumothorax]]
{{CMG}}
{{CMG}}; {{AE}} {{HQ}}
 
==Overview==
==Overview==
==Differentiating Pneumothorax from other Diseases==
Pneumothorax must be differentiated from other diseases that cause shortness of breath, difficulty breathing, and chest pain, such as [differential dx1], [differential dx2], and [differential dx3].
*[[Myocardial infarction|Acute Myocardial Infarction]]: presents with shortness of breath and chest pain, though MI chest pain is characteristically crushing, central and radiating to the jaw, left arm or stomach.  While not a lung condition, patients having an MI often happen to also have lung disease.
<small><small>
*[[Emphysema]]: here, delicate functional lung tissue is lost and replaced with air spaces, giving shortness of breath, and decreased air entry and increased resonance on examination.   However, it is usually a chronic condition, and signs are diffuse (not localised as in pneumothorax). 
{|
 
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
A careful history, physical examination and a chest x-ray will allow the conditions to be differentiated.
! colspan="3" rowspan="3" |Organ system
! rowspan="3" |Diseases
! colspan="11" |Clinical manifestations
! colspan="5" rowspan="2" |Diagnosis
! rowspan="3" |Other features
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! colspan="6" |Symptoms
! colspan="5" |Physical exam
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
!Loss of consciousness
!Agitation
!Weight loss
!Fever
!Chest pain
!Cough
!Cyanosis
!Clubbing
!JVD
!Peripheral edema
!Auscultation
!CBC
!ABG
!Imaging
!Spirometry
!Gold standard
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
! rowspan="17" |Acute Dyspnea
! rowspan="10" |[[Respiratory system]]
![[Head]] and [[Neck]],
Upper [[airway]]
![[Aspiration]]<ref name="pmid25581840">{{cite journal| author=O'Horo JC, Rogus-Pulia N, Garcia-Arguello L, Robbins J, Safdar N| title=Bedside diagnosis of dysphagia: a systematic review. | journal=J Hosp Med | year= 2015 | volume= 10 | issue= 4 | pages= 256-65 | pmid=25581840 | doi=10.1002/jhm.2313 | pmc=4607509 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25581840  }}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |Diminished [[breath sounds]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |[[Atelectasis]]
! style="background: #F5F5F5; padding: 5px;" |↓[[Tidal volume|Vt]], ↑[[Residual volume|RV]]
! style="background: #F5F5F5; padding: 5px;" |[[Bronchoscopy]]
! style="background: #F5F5F5; padding: 5px;" |[[Choking]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
! rowspan="9" |[[Chest]] and [[Pleurae|Pleura]],
Lower [[airway]]
![[Pneumothorax]]<ref name="pmid17621614">{{cite journal| author=Currie GP, Alluri R, Christie GL, Legge JS| title=Pneumothorax: an update. | journal=Postgrad Med J | year= 2007 | volume= 83 | issue= 981 | pages= 461-5 | pmid=17621614 | doi=10.1136/pgmj.2007.056978 | pmc=2600088 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17621614  }}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |Diminished [[breath sounds]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
! style="background: #F5F5F5; padding: 5px;" |Radiolucency without [[lung]] marking
! style="background: #F5F5F5; padding: 5px;" |↓[[Tidal volume|Vt]]
! style="background: #F5F5F5; padding: 5px;" |CXR and [[Computed tomography|Chest CT scan]]
! style="background: #F5F5F5; padding: 5px;" |[[Tracheal deviation]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[Asthma attack]]<ref name="pmid19858243">{{cite journal| author=Hodder R, Lougheed MD, Rowe BH, FitzGerald JM, Kaplan AG, McIvor RA| title=Management of acute asthma in adults in the emergency department: nonventilatory management. | journal=CMAJ | year= 2010 | volume= 182 | issue= 2 | pages= E55-67 | pmid=19858243 | doi=10.1503/cmaj.080072 | pmc=2817338 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19858243  }}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |[[Wheeze]]
! style="background: #F5F5F5; padding: 5px;" |↑ [[Eosinophil]]
! style="background: #F5F5F5; padding: 5px;" |[[Respiratory alkalosis]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |↓ [[FEV1]], [[Peak expiratory flow|PEF]]
! style="background: #F5F5F5; padding: 5px;" |[[Physical examination|Physical exam]] and
[[Spirometry]]
! style="background: #F5F5F5; padding: 5px;" |[[Chest pain]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[Bronchitis]]<ref name="CantinBankier2009">{{cite journal|last1=Cantin|first1=Luce|last2=Bankier|first2=Alexander A.|last3=Eisenberg|first3=Ronald L.|title=Bronchiectasis|journal=American Journal of Roentgenology|volume=193|issue=3|year=2009|pages=W158–W171|issn=0361-803X|doi=10.2214/AJR.09.3053}}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |[[Rhonchi]] 
! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |[[Physical examination|Physical exam]]
! style="background: #F5F5F5; padding: 5px;" |[[Rhonchi]] relieved by [[Dextromethorphan|cough]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[Bronchospasm]]<ref name="pmid23015953">{{cite journal| author=Molis MA, Molis WE| title=Exercise-induced bronchospasm. | journal=Sports Health | year= 2010 | volume= 2 | issue= 4 | pages= 311-7 | pmid=23015953 | doi=10.1177/1941738110373735 | pmc=3445098 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23015953  }}</ref>
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |[[Wheeze]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |↓[[Tidal volume|Vt]], ↑[[Residual volume|RV]]
! style="background: #F5F5F5; padding: 5px;" |[[Physical examination|Physical exam]]
! style="background: #F5F5F5; padding: 5px;" |[[Allergic reaction]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[Bronchiolitis]]<ref name="pmid23562737">{{cite journal |vauthors=Holbro A, Lehmann T, Girsberger S, Stern M, Gambazzi F, Lardinois D, Heim D, Passweg JR, Tichelli A, Bubendorf L, Savic S, Hostettler K, Grendelmeier P, Halter JP, Tamm M |title=Lung histology predicts outcome of bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation |journal=Biol. Blood Marrow Transplant. |volume=19 |issue=6 |pages=973–80 |year=2013 |pmid=23562737 |doi=10.1016/j.bbmt.2013.03.017 |url=}}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |[[Wheeze]] and [[Crackles]]
! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |Bronchovascular markings
! style="background: #F5F5F5; padding: 5px;" |↓[[Tidal volume|Vt]]
! style="background: #F5F5F5; padding: 5px;" |[[Clinical]] assessment
! style="background: #F5F5F5; padding: 5px;" |[[Respiratory syncytial virus|Respiratory syncytial virus (RSV)]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[COPD exacerbation resident survival guide|COPD exacerbation]]<ref name="pmid25177479">{{cite journal| author=Qureshi H, Sharafkhaneh A, Hanania NA| title=Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications. | journal=Ther Adv Chronic Dis | year= 2014 | volume= 5 | issue= 5 | pages= 212-27 | pmid=25177479 | doi=10.1177/2040622314532862 | pmc=4131503 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25177479  }}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |+/-
! style="background: #F5F5F5; padding: 5px;" |[[Wheeze]], [[Rhonchi]], and [[Crackles]]
! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]], ↑[[RBC]]
! style="background: #F5F5F5; padding: 5px;" |[[Respiratory alkalosis]]
! style="background: #F5F5F5; padding: 5px;" |Hyperexpansion
! style="background: #F5F5F5; padding: 5px;" |↓ [[FEV1]]/[[FVC]]
! style="background: #F5F5F5; padding: 5px;" |[[Clinical]] assessment
! style="background: #F5F5F5; padding: 5px;" |[[Chronic bronchitis|Acute '''exacerbations''' of chronic bronchitis (AECB)]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[Pneumonia]]<ref name="pmid25165554">{{cite journal| author=Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà J| title=Management of community-acquired pneumonia in older adults. | journal=Ther Adv Infect Dis | year= 2014 | volume= 2 | issue= 1 | pages= 3-16 | pmid=25165554 | doi=10.1177/2049936113518041 | pmc=4072047 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25165554  }}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |[[Wheeze]], [[Rhonchi]], and [[Crackles]]
! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]], [[neutrophilia]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |[[Consolidation (medicine)|Lobar consolidation]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |[[Chest X-ray]] and CT Scan
! style="background: #F5F5F5; padding: 5px;" |[[productive cough]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[Pulmonary embolism]]<ref name="pmid23940438">{{cite journal| author=Bĕlohlávek J, Dytrych V, Linhart A| title=Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism. | journal=Exp Clin Cardiol | year= 2013 | volume= 18 | issue= 2 | pages= 129-38 | pmid=23940438 | doi= | pmc=3718593 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23940438  }}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |[[Respiratory alkalosis]]
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |[[Lung|Pulmonary]] [[CT angiography]]
! style="background: #F5F5F5; padding: 5px;" |[[Pleuritic chest pain]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[Rib fractures]] ([[flail chest]])<ref name="pmid27984449">{{cite journal |vauthors=Swart E, Laratta J, Slobogean G, Mehta S |title=Operative Treatment of Rib Fractures in Flail Chest Injuries: A Meta-analysis and Cost-Effectiveness Analysis |journal=J Orthop Trauma |volume=31 |issue=2 |pages=64–70 |date=February 2017 |pmid=27984449 |doi=10.1097/BOT.0000000000000750 |url= |author=}}</ref>
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |+
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |-
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |[[Respiratory acidosis]]
! style="background: #F5F5F5; padding: 5px;" |Fracture marks
! style="background: #F5F5F5; padding: 5px;" |Normal
! style="background: #F5F5F5; padding: 5px;" |[[Chest X-ray]]
! style="background: #F5F5F5; padding: 5px;" |[[Pneumothorax]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
|}
</small></small>
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Chest trauma]]
[[Category:Diseases involving the fasciae]]
[[Category:Pulmonology]]
[[Category:Pulmonology]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]

Latest revision as of 19:33, 19 February 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]

Overview

Pneumothorax must be differentiated from other diseases that cause shortness of breath, difficulty breathing, and chest pain, such as [differential dx1], [differential dx2], and [differential dx3].

Organ system Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam
Loss of consciousness Agitation Weight loss Fever Chest pain Cough Cyanosis Clubbing JVD Peripheral edema Auscultation CBC ABG Imaging Spirometry Gold standard
Acute Dyspnea Respiratory system Head and Neck,

Upper airway

Aspiration[1] - + - - +/- + + - - - Diminished breath sounds Normal Normal Atelectasis ↓Vt, ↑RV Bronchoscopy Choking
Chest and Pleura,

Lower airway

Pneumothorax[2] - - - - + - - - +/- - Diminished breath sounds Normal ↓O2, ↑CO2 Radiolucency without lung marking ↓Vt CXR and Chest CT scan Tracheal deviation
Asthma attack[3] - + - - +/- + + - - - Wheeze ↑ Eosinophil Respiratory alkalosis Normal ↓ FEV1, PEF Physical exam and

Spirometry

Chest pain
Bronchitis[4] - - - + + + - - - - Rhonchi  ↑WBC Normal Normal Normal Physical exam Rhonchi relieved by cough
Bronchospasm[5] +/- + - - + +/- + - - - Wheeze Normal ↓O2, ↑CO2 Normal ↓Vt, ↑RV Physical exam Allergic reaction
Bronchiolitis[6] - - - + +/- + - - - - Wheeze and Crackles ↑WBC Normal Bronchovascular markings ↓Vt Clinical assessment Respiratory syncytial virus (RSV)
COPD exacerbation[7] - + - + + + + +/- +/- +/- Wheeze, Rhonchi, and Crackles ↑WBC, ↑RBC Respiratory alkalosis Hyperexpansion ↓ FEV1/FVC Clinical assessment Acute exacerbations of chronic bronchitis (AECB)
Pneumonia[8] - - - + + + - - - - Wheeze, Rhonchi, and Crackles ↑WBC, neutrophilia Normal Lobar consolidation Normal Chest X-ray and CT Scan productive cough
Pulmonary embolism[9] - - - - + - - - - - Normal Normal Respiratory alkalosis Normal Normal Pulmonary CT angiography Pleuritic chest pain
Rib fractures (flail chest)[10] - + - - + - - - - - Normal Normal Respiratory acidosis Fracture marks Normal Chest X-ray Pneumothorax

References

  1. ↑ O'Horo JC, Rogus-Pulia N, Garcia-Arguello L, Robbins J, Safdar N (2015). "Bedside diagnosis of dysphagia: a systematic review". J Hosp Med. 10 (4): 256–65. doi:10.1002/jhm.2313. PMC 4607509. PMID 25581840.
  2. ↑ Currie GP, Alluri R, Christie GL, Legge JS (2007). "Pneumothorax: an update". Postgrad Med J. 83 (981): 461–5. doi:10.1136/pgmj.2007.056978. PMC 2600088. PMID 17621614.
  3. ↑ Hodder R, Lougheed MD, Rowe BH, FitzGerald JM, Kaplan AG, McIvor RA (2010). "Management of acute asthma in adults in the emergency department: nonventilatory management". CMAJ. 182 (2): E55–67. doi:10.1503/cmaj.080072. PMC 2817338. PMID 19858243.
  4. ↑ Cantin, Luce; Bankier, Alexander A.; Eisenberg, Ronald L. (2009). "Bronchiectasis". American Journal of Roentgenology. 193 (3): W158–W171. doi:10.2214/AJR.09.3053. ISSN 0361-803X.
  5. ↑ Molis MA, Molis WE (2010). "Exercise-induced bronchospasm". Sports Health. 2 (4): 311–7. doi:10.1177/1941738110373735. PMC 3445098. PMID 23015953.
  6. ↑ Holbro A, Lehmann T, Girsberger S, Stern M, Gambazzi F, Lardinois D, Heim D, Passweg JR, Tichelli A, Bubendorf L, Savic S, Hostettler K, Grendelmeier P, Halter JP, Tamm M (2013). "Lung histology predicts outcome of bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation". Biol. Blood Marrow Transplant. 19 (6): 973–80. doi:10.1016/j.bbmt.2013.03.017. PMID 23562737.
  7. ↑ Qureshi H, Sharafkhaneh A, Hanania NA (2014). "Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications". Ther Adv Chronic Dis. 5 (5): 212–27. doi:10.1177/2040622314532862. PMC 4131503. PMID 25177479.
  8. ↑ Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà J (2014). "Management of community-acquired pneumonia in older adults". Ther Adv Infect Dis. 2 (1): 3–16. doi:10.1177/2049936113518041. PMC 4072047. PMID 25165554.
  9. ↑ Bĕlohlávek J, Dytrych V, Linhart A (2013). "Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism". Exp Clin Cardiol. 18 (2): 129–38. PMC 3718593. PMID 23940438.
  10. ↑ Swart E, Laratta J, Slobogean G, Mehta S (February 2017). "Operative Treatment of Rib Fractures in Flail Chest Injuries: A Meta-analysis and Cost-Effectiveness Analysis". J Orthop Trauma. 31 (2): 64–70. doi:10.1097/BOT.0000000000000750. PMID 27984449.

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