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1. SOB
2. Chest pain
3. Cough
4. Cyanosis


== Tachypnea ==
{| class="wikitable"
! rowspan="3" |Organ system
! rowspan="3" |Diseases
! colspan="9" |Clinical manifestations
! colspan="5" rowspan="2" |Diagnosis
! rowspan="3" |Other features
|-
! colspan="4" |Symptoms
! colspan="5" |Physical exam
|-
!Chest pain
!Dyspnea
!Fever
!Palpitations
!Cyanosis
!Tachypnea
!JVD
!Peripheral edema
!Ascultation
!ABGs
!Lab findings
!Imaging
!PFT
!Gold standard
|-
! rowspan="8" |Pulmonary system
!Pneumothorax
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Pulmonary embolism
!
!
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!
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!
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!Pneumonia
!
!
!
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!
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!
!
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!
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!
!
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!Exacerbation of asthma/COPD
!
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!
!
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!Interstitial lung disease
!
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!
!
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!
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!Intrapulmonary shunt
!
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!Upper airway obstruction
!
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!High altitude sickness
!
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! rowspan="4" |Cardiovascular system
!Acute coronary syndrome
!
!
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!
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!
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!
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!
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!
|-
!Heart failure
!
!
!
!
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!Dysrhythmias
!
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!Shock
!
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! rowspan="3" |Metabolic/Systemic disorders
!Diabetic ketoacidosis
!
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!
!
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!
!
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!Hypocalcemia
!
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!
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!Hypoglycemia
!
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!
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! rowspan="2" |Endocrine system
!Hyperthyroidism
!
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!
!
!
!
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!Pheochromocytoma
!
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! rowspan="2" |CNS
!Central nervous system tumor
!
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!
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!Anxiety/panic attacks
!
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!
!
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! rowspan="3" |Others
!Pregnancy
!
!
!
!
!
!
!
!
!
!
!
!
!
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!Hepatic failure
!
!
!
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!
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!Sepsis
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|}
== Bradypnea ==
{| class="wikitable"
! rowspan="3" |Diseases
! colspan="10" |Clinical manifestations
! colspan="5" rowspan="2" |Diagnosis
! rowspan="3" |Associated features
|-
! colspan="6" |Symptoms
! colspan="4" |Physical exam
|-
!Chest pain
!Dyspnea
!Orthopnea
!Fever
!Palpitations
!Poor
quality sleep
!Cyanosis
!JVD
!Peripheral edema
!Auscultation
!ABGs
!Lab findings
!Imaging
!Spirometry
!Gold standard
|-
!Central hypoventilation syndrome CHS
!-
!+
!+
!-
!+/-
!+
!+
!+/-
!+/-
!
* Normal                   
!↓O2, ↑CO2
!
* PHOX2B                  screening testing            via fragment            analysis or              sequencing tests   
*  Polysomnography   
!
* Brain MRI              (exclude other      brainstem lesions)
!Normal
!
* Molecular testing      for PHOX2B            mutations               
!
* Hirschsprung          disease                 
* Neural crest            tumors                 
* Box-shaped face                 
* Meiosis                 
* Strabismus                 
|-
!Asphyxia
!-
!+
!+/-
!-
!+/-
!+
!+
!+/-
!+/-
!
* Systolic murmur
!↓O2, ↑CO2
!
* Abnormal renal      function tests                           
* Cardiac troponin          T and I levels are      elevated                           
!
* Chest X-ray            typically shows              cardiomegaly                 
* Echocardiography (to exclude other      structural heart                  diseases)                 
!Normal
!
* The fetal                  biophysical profile              score (BPS)            shows loss of        accelerations of      the fetal heart        rate, decreased      body movement,    breathing,              hypotonia and        decreased              amniotic fluid        volume                 
!
* Acute respiratory        distress                  syndrome (RDS)     
* Meconium            aspiration                syndrome (MAS) 
* Necrotizing            enterocolitis           
|-
!Chiari II malformation (Arnold-Chiari)
!-
!+
!+
!-
!+
!+
!-
!-
!-
!Stridor
!Normal
!_
!
* CT Scan of Brain  (hydrocephalus, herniated cerebellar tonsils, and a flattened spinal cord)
!_
!MRI Brain
!
* Myelomeningocele
* Hydrocephalus   
|-
!Spinal muscular atrophy
!-
!+
!+
!-
!+/-
!+
!+
!-
!-
! Stridor
!_
!
* Electromyography shows fibrillations and positive sharp waves
!_
!_
!Molecular genetic testing  by detection of homozygous deletions of exons 7 of the SMN1 gene
!
* Progressive            muscle weakness        and atrophy           
|-
!Guillain-Barré syndrome
!-
!+
!+/-
!-
!+
!+/-
!-
!-
!-
!
* Diminished breath sounds
* Absence of bowel sound
!↓O2, ↑CO2
!
* Albuminocytologic dissociation on CSF analysis
!
* MRI shows                        selective anterior        nerve root              enhancement           
!↓FEV1
↓FVC
↓TLC
!
* Nerve conduction studies (NCS) and needle electromyography (EMG)
!
* Preceded by mild respiratory or GIT infection
* Ascending fashion of weakness
|-
!Phrenic nerve injury
!+/-
!+
!+
!+/-
!-
!+/-
!-
!-
!-
!
* Normal                                       
!
* Normal                                       
!
* CBC (to rule out    anemia as the          cause of dyspnea)
* Thyroid function            tests                                           
!
* CXR shows            unilateral or            bilateral                    diaphragmatic        flattening                               
!↓Vt, ↑RV
(anatomical)
!
* Fluoroscopic            "sniff" test (              diaphragmatic              movement is            observed                  fluoroscopically      while the patient    sniffs forcefully)                                 
!
* Respiratory          insufficiency                   
|-
!Myasthenia gravis
!-
!+
!+/-
!-
!-
!+
!-
!-
!-
!
* Paradoxical          abdominal              breathing             
!
* ↓O2, ↑CO2         
!
* Anti-AChR ab       
* Anti–striated          muscle ab
* Anti-MuSK ab       
!
* CT may show        anterior                    mediastinal mass        (thymoma)           
!↓FEV1,↓FVC
↓TLC
!
* Anti–acetylcholine receptor antibody test
!
* Ptosis                   
* Diplopia               
* Fatigue               
|-
!Muscular dystrophy<ref name="pmid7699962">{{cite journal| author=Takasugi T, Ishihara T, Kawamura J, Sasaki K, Toyoda T, Oosumi M et al.| title=[Blood gas changes in Duchenne type muscular dystrophy]. | journal=Nihon Kyobu Shikkan Gakkai Zasshi | year= 1995 | volume= 33 | issue= 1 | pages= 17-22 | pmid=7699962 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7699962  }} </ref><ref name="pmid25755201">{{cite journal| author=Mayer OH, Finkel RS, Rummey C, Benton MJ, Glanzman AM, Flickinger J et al.| title=Characterization of pulmonary function in Duchenne Muscular Dystrophy. | journal=Pediatr Pulmonol | year= 2015 | volume= 50 | issue= 5 | pages= 487-94 | pmid=25755201 | doi=10.1002/ppul.23172 | pmc=4402127 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25755201  }} </ref>
!+/-
!+
!+/-
!-
!+/-
!+/-
!-
!+/-
!+/-
!
* Mid-systolic murmur             
!
* ↓O2, ↑CO2
!
* Elevated CPK          levels   
* ECG shows right    ventricular strain                   
!
* Ultrasonography      shows increased  echogenicity in      the affected              muscles               
!↓FVC, ↓PEF
!
* Genetic testing for mutation of the        dystrophin gene          (DMD)                     
!
* Waddling, wide-        based gait                
* Gower sign               
|-
!Pneumonia
!+
!+
!+/-
!+
!+/-
!+/-
!-
!-
!-
!Wheeze, Rhonchi, and Crackles
!Normal
!
* ↑WBC                        (neutrophilia)                     
!Lobar consolidation
!Normal
!Normal
!Productive cough
|-
!Aspiration
!+/-
!+
!+/-
!+
!+/-
!+/-
!+
!-
!-
!Diminished breath sounds
!Normal
!
* ↑WBC                                     
* Blood cultures           
!
* CXR shows            atelectasis           
!↓Vt, ↑RV
!Bronchoscopy
!
* Choking               
|-
!Obstructive sleep apnea
!+
!+
!+/-
!
!
!+
!
!
!
!
* Wheeze                 
* Systolic ejection      murmur                
!↓O2, ↑CO2
!
* Polysomnography
!
* MRI shows              enlarged                    adenoids, tonsils,    and soft palate     
!↑FRC,
!Polysomnography
!
* Depression           
* Hypertension       
* Coronary artery        disease                 
|-
!Lung hypoplasia
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Metabolic alkalosis
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Sepsis
!-
!+
!-
!+
!+/-
!+/-
!-
!-
!-
!Normal
!↓O2, ↑CO2
!
* CBC shows            ↑WBC                        (neutrophilia)         
!Normal
!Normal
!SIRS criteria
!
* Chills                   
* Confusion           
|-
!ROHHAD
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|}
== Obstructive lung Diseases ==
{| class="wikitable"
! rowspan="4" |Diseases
! colspan="10" |Clinical manifestations
! colspan="10" |Diagnosis
|-
! colspan="5" |Symptoms
! colspan="5" |Physical exam
! rowspan="3" |Lab findings
! colspan="4" |PFT
! colspan="3" rowspan="2" |Imaging
! rowspan="3" |Gold standard
! rowspan="3" |Other features
|-
! rowspan="2" |Cough
! rowspan="2" |Dyspnea
! rowspan="2" |Hemoptysis
! rowspan="2" |Fever
! rowspan="2" |Weight loss
! rowspan="2" |Cyanosis
! rowspan="2" |Clubbing
! rowspan="2" |JVD
! rowspan="2" |Peripheral edema
! rowspan="2" |Auscultation
! rowspan="2" |ABGs
! rowspan="2" |FEV1/FVC
! rowspan="2" |TLC
! rowspan="2" |DLCO
|-
!CXR
!CT scan
!Other
|-
!Asthma
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Chronic bronchitis
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Bronchiolitis
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Emphysema
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Bronchiectasis 
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Central airway obstruction
(Benign/Malignant lung mass)
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Heart failure
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Tuberculosis
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Lymphangioleiomyomatosis
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|}
== Restrictive lung Diseases ==
{| class="wikitable"
! rowspan="4" |Diseases
! colspan="10" |Clinical manifestations
! colspan="10" |Diagnosis
|-
! colspan="4" |Symptoms
! colspan="6" |Physical exam
! rowspan="3" |Lab findings
! colspan="4" |PFT
! colspan="3" rowspan="2" |Imaging
! rowspan="3" |Gold standard
! rowspan="3" |Other features
|-
! rowspan="2" |Cough
! rowspan="2" |Dyspnea
! rowspan="2" |Hemoptysis
! rowspan="2" |Fever
! rowspan="2" |Environmental/Occupational exposure
! rowspan="2" |Cyanosis
! rowspan="2" |Clubbing
! rowspan="2" |JVD
! rowspan="2" |Peripheral edema
! rowspan="2" |Auscultation
! rowspan="2" |ABGs
! rowspan="2" |FEV1/FVC
! rowspan="2" |TLC
! rowspan="2" |DLCO
|-
!CXR
!CT scan
!Other
|-
!Acute Respiratory Distress Syndrome
!-
!+
!-
!-
!'''Inciting event, such as [[Trauma]]'''
'''[[Sepsis]]'''
'''[[Drug overdose]]'''
'''[[Blood transfusion|Massive transfusion]]'''
'''[[Acute pancreatitis]] [[Aspiration]]'''
!+
!-
!-
!-
!
*
!
*
!
!
!
!
!
!
!
!
!
|-
!Asbestosis
!+
!+
!+/-
!-
!Ship yard workers
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Bronchitis
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Chronic Obstructive Pulmonary Disease (COPD)
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Coal Worker's Pneumoconiosis
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Emphysema
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Eosinophilic Pneumonia
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Hypersensitivity Pneumonitis
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Idiopathic Pulmonary Fibrosis
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Interstitial (Nonidiopathic) Pulmonary Fibrosis
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Lung Transplantation
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Lymphocytic Interstitial Pneumonia
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Obesity
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
!Pulmonary Eosinophilia
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|}
== Wheeze ==
<references />

Latest revision as of 15:53, 28 September 2018

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