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| 1. SOB
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| 2. Chest pain
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| 3. Cough
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| 4. Cyanosis
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|
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|
| == Tachypnea ==
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|
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| == Bradypnea ==
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| {| class="wikitable"
| |
| ! rowspan="3" |Diseases
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| ! colspan="10" |Clinical manifestations
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| ! colspan="5" rowspan="2" |Diagnosis
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| ! rowspan="3" |Associated features
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| |-
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| ! colspan="6" |Symptoms
| |
| ! colspan="4" |Physical exam
| |
| |-
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| !Chest pain
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| !Dyspnea
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| !Orthopnea
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| !Fever
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| !Palpitations
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| !Poor
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| quality sleep
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| !Cyanosis
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| !JVD
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| !Peripheral edema
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| !Auscultation
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| !ABGs
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| !Lab findings
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| !Imaging
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| !Spirometry
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| !Gold standard
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| |-
| |
| ![[Congenital central hypoventilation syndrome|Central hypoventilation syndrome CHS]]
| |
| !-
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| !+
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| !+
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| !-
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| !+/-
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| !+
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| !+
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| !+/-
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| !+/-
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| !
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| * Normal
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| !↓[[Oxygen|O2]], ↑[[CO2]]
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| !
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| * [[PHOX2B]] [[Screening test|screening testing]] via fragment analysis or sequencing tests
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| * [[Polysomnography]]
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| !
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| * [[Brain imaging|Brain MRI]] (exclude other [[Brainstem|brainstem lesions]])
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| !Normal
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| !
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| * [[PHOX2B|Molecular testing for PHOX2B mutations]]
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| !
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| * Hirschsprung disease
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| * Neural crest tumors
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| * Box-shaped face
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| * Meiosis
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| * Strabismus
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| |-
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| ![[Asphyxia]]
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| !-
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| !+
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| !+/-
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| !-
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| !+/-
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| !+
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| !+
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| !+/-
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| !+/-
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| !
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| * [[Systolic murmurs|Systolic murmur]]
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| !↓[[Oxygen|O2]], ↑[[CO2]]
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| !
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| * Abnormal [[renal function tests]]
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|
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| * [[Cardiac troponin I (cTnI) and T (cTnT)|Cardiac troponin T and I ↑]]
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| !
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| * [[Chest X-ray|CXR]] typically shows [[cardiomegaly]]
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| * [[Echocardiography]] (to exclude other [[Structural heart diseases|structural heart diseases]])
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| !Normal
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| !
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| * 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
| |
| !
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| * Acute respiratory distress syndrome (RDS)
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| * Meconium aspiration syndrome (MAS)
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| * Necrotizing enterocolitis
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| |-
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| ![[Arnold-Chiari malformation|Chiari II malformation (Arnold-Chiari)]]
| |
| !-
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| !+
| |
| !+
| |
| !-
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| !+
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| !+
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| !-
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| !-
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| !-
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| !
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| * [[Stridor]]
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| !Normal
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| !_
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| !
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| * [[Ct scan|CT Scan of Brain]] ([[hydrocephalus]], [[Cerebellar tonsill herniation|herniated cerebellar tonsils]], and a [[Spinal cord|flattened spinal cord]])
| |
| !_
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| ![[MRI|MRI Brain]]
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| !
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| * Myelomeningocele
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| * Hydrocephalus
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| |-
| |
| ![[Spinal muscular atrophy]]
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| !-
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| !+
| |
| !+
| |
| !-
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| !+/-
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| !+
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| !+
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| !-
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| !-
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| !
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| * [[Stridor]]
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| !_
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| !
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| * [[Electromyography]] shows [[Fibrillation|fibrillations]] and positive sharp waves
| |
| !_
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| !_
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| ![[Genetic testing|Molecular genetic testing]] by detection of [[homozygous]] [[Deletion (genetics)|deletions]] of [[exons]] 7 of the [[SMN1|SMN1 gene]]
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| !
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| * Progressive muscle weakness and atrophy
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| |-
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| ![[Guillain-Barré syndrome]]
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| !-
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| !+
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| !+/-
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| !-
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| !+
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| !+/-
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| !-
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| !-
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| !-
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| !
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| * [[Decreased breath sounds|Diminished breath sounds]]
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| * [[Diminished bowel sounds|Absence of bowel sound]]
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| !↓[[Oxygen|O2]], ↑[[Carbon dioxide|CO2]]
| |
| !
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| * Albuminocytologic [[Dissociation (chemistry)|dissociation]] on [[CSF analysis]]
| |
| !
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| * [[MRI]] shows [[Anterior nerve roots|selective anterior nerve root enhancement]]
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| !↓[[FEV1]]
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|
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| ↓[[FVC]]
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|
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| ↓[[Total lung capacity|TLC]]
| |
| !
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| * [[Nerve conduction studies|Nerve conduction studies (NCS)]] and [[EMG|needle electromyography (EMG)]]
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| !
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| * Preceded by mild respiratory or GIT infection
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| * Ascending fashion of weakness
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| |-
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| ![[Phrenic nerve paralysis|Phrenic nerve injury]]
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| !+/-
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| !+
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| !+
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| !+/-
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| !-
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| !+/-
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| !-
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| !-
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| !-
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| !
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| * Normal
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| !Normal
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| !
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| * [[Complete blood count|CBC]] (to rule out [[anemia]] as the cause of [[dyspnea]])
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| * [[Thyroid function tests|Thyroid function tests]]
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| !
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| * [[Chest X-ray|CXR]] shows unilateral or bilateral [[Diaphragmatic dysfunction|diaphragmatic flattening]]
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| !↓[[Tidal volume|Vt]], ↑[[RV]]
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|
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| [[Anatomical|(anatomical)]]
| |
| !
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| * Fluoroscopic "sniff" test ([[Thoracic diaphragm|diaphragmatic]] movement is observed fluoroscopically while the patient sniffs forcefully)
| |
| !
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| * Respiratory insufficiency
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| |-
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| ![[Myasthenia gravis]]
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| !-
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| !+
| |
| !+/-
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| !-
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| !-
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| !+
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| !-
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| !-
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| !-
| |
| !
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| * [[Abdominal breathing|Paradoxical abdominal breathing]]
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| !↓[[Oxygen|O2]], ↑[[Carbon dioxide|CO2]]
| |
| !
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| * Anti-AChR ab
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| * Anti–striated muscle ab
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| * Anti-MuSK ab
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| !
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| * [[CT-scans|CT]] may show [[Anterior mediastinum|anterior mediastinal mass]] ([[thymoma]])
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| !↓[[FEV1]],↓[[FVC]]
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|
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| ↓[[Total lung capacity|TLC]]
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| !
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| * Anti–[[acetylcholine receptor]] [[antibody test]]
| |
| !
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| * Ptosis
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| * Diplopia
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| * Fatigue
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| |-
| |
| ![[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>
| |
| !+/-
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| !+
| |
| !+/-
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| !-
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| !+/-
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| !+/-
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| !-
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| !+/-
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| !+/-
| |
| !
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| * [[Midsystolic murmur|Mid-systolic murmur]]
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| !↓[[Oxygen|O2]], ↑[[Carbon dioxide|CO2]]
| |
| !
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| * [[CPK elevation|Elevated CPK levels]]
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| * [[ECG]] shows [[right ventricular strain]]
| |
| !
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| * [[Ultrasonography]] shows [[Echogenicity|increased echogenicity]] in the affected [[Muscle|muscles]]
| |
| !↓[[FVC]], ↓[[Peak expiratory flow|PEF]]
| |
| !
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| * [[Genetic testing]] for [[Dystrophin|mutation of the dystrophin gene (DMD)]]
| |
| !
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| * Waddling, wide- based gait
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| * Gower sign
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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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| !-
| |
| !-
| |
| !-
| |
| !
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| * [[Wheeze]], [[Rhonchi]] and [[Crackles]]
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| !Normal
| |
| !
| |
| * [[Neutrophilia|↑WBC (neutrophilia)]]
| |
| ![[Lobar pneumonia|Lobar consolidation]]
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| !Normal
| |
| !Normal
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| !Productive cough
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| |-
| |
| ![[Aspiration pneumonia|Aspiration]]
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| !+/-
| |
| !+
| |
| !+/-
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| !+
| |
| !+/-
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| !+/-
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| !+
| |
| !-
| |
| !-
| |
| !
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| * [[Decreased breath sounds|Diminished breath sounds]]
| |
| !Normal
| |
| !
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| * [[WBC|↑WBC]]
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| * [[Blood cultures]]
| |
| !
| |
| * [[Chest X-ray|CXR]] shows [[atelectasis]]
| |
| !↓[[Tidal volume|Vt]], ↑[[Residual volume|RV]]
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| ![[Bronchoscopy]]
| |
| !
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| * Choking
| |
| |-
| |
| ![[Obstructive sleep apnea]]<ref name="pmid26209328">{{cite journal| author=Abdeyrim A, Zhang Y, Li N, Zhao M, Wang Y, Yao X et al.| title=Impact of obstructive sleep apnea on lung volumes and mechanical properties of the respiratory system in overweight and obese individuals. | journal=BMC Pulm Med | year= 2015 | volume= 15 | issue= | pages= 76 | pmid=26209328 | doi=10.1186/s12890-015-0063-6 | pmc=4513967 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26209328 }} </ref>
| |
| !+
| |
| !+
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| !+/-
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| !-
| |
| !+/-
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| !+
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| !+/-
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| !+/-
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| !+/-
| |
| !
| |
| * [[Wheeze]]
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| * [[Systolic ejection murmur|Systolic ejection murmur]]
| |
| !↓[[Oxygen|O2]], ↑[[Carbon dioxide|CO2]]
| |
| !
| |
| * [[Polysomnography]]
| |
| !
| |
| * [[MRI]] shows [[enlarged adenoids]], [[tonsils]] and [[soft palate]]
| |
| !↑FRC
| |
| ![[Polysomnography]]
| |
| !
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| * Loud snoring
| |
|
| |
| * Depression
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| * Hypertension
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| * Coronary artery disease
| |
| |-
| |
| !Pulmonary hypoplasia
| |
| !-
| |
| !+
| |
| !+/-
| |
| !-
| |
| !+/-
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| !+/-
| |
| !+
| |
| !-
| |
| !-
| |
| !
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| * [[Diminished bowel sounds|Breath sounds may be decreased or absent]] on the side of [[hypoplasia]]
| |
| !↓[[Oxygen|O2]], ↑[[Carbon dioxide|CO2]]
| |
| !
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| * [[Basic metabolic panel|Abnormal BMP]]
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| * [[Echocardiography]] is done to rule out [[cardiac]] [[complications]]
| |
| !
| |
| * [[Chest X-ray|CXR]] shows crowded [[ribs]] and low thoracic-to- abdominal ratio
| |
| * [[CT scan]] of [[chest]]
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| !↑[[Residual volume|RV]]
| |
| !_
| |
| !
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| * Myopathic facies
| |
| |-
| |
| ![[Metabolic alkalosis]]
| |
| !-
| |
| !+
| |
| !+/-
| |
| !-
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| !+/-
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| !+/-
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| !-
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| !+/-
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| !+/-
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| !_
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| !↓[[Oxygen|O2]], ↑[[Carbon dioxide|CO2]]
| |
| !
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| * [[Anion gap|Serum Anion Gap]] is elevated
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| * [[Electrolyte disturbance|Abnormal Urine Sodium Ion Concentration]]
| |
| !_
| |
| !_
| |
| !_
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| !
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| * Hypokalemia
| |
| |-
| |
| ![[Sepsis]]
| |
| !-
| |
| !+
| |
| !-
| |
| !+
| |
| !+/-
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| !+/-
| |
| !-
| |
| !-
| |
| !-
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| !Normal
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| !↓[[Oxygen|O2]], ↑[[Carbon dioxide|CO2]]
| |
| !
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| * [[Neutrophilia|CBC shows ↑WBC (neutrophilia)]]
| |
| !Normal
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| !Normal
| |
| ![[SIRS|SIRS criteria]]
| |
| !
| |
| * Chills
| |
| * Confusion
| |
| |-
| |
| !ROHHAD<ref name="pmid3991276">{{cite journal| author=duRivage SK, Winter RJ, Brouillette RT, Hunt CE, Noah Z| title=Idiopathic hypothalamic dysfunction and impaired control of breathing. | journal=Pediatrics | year= 1985 | volume= 75 | issue= 5 | pages= 896-8 | pmid=3991276 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3991276 }} </ref><ref name="pmid14320765">{{cite journal| author=FISHMAN LS, SAMSON JH, SPERLING DR| title=PRIMARY ALVEOLAR HYPOVENTILATION SYNDROME (ONDINE'S CURSE). | journal=Am J Dis Child | year= 1965 | volume= 110 | issue= | pages= 155-61 | pmid=14320765 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14320765 }} </ref><ref name="pmid20727534">{{cite journal| author=Paz-Priel I, Cooke DW, Chen AR| title=Cyclophosphamide for rapid-onset obesity, hypothalamic dysfunction, hypoventilation, and autonomic dysregulation syndrome. | journal=J Pediatr | year= 2011 | volume= 158 | issue= 2 | pages= 337-9 | pmid=20727534 | doi=10.1016/j.jpeds.2010.07.006 | pmc=3976575 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20727534 }} </ref>
| |
| !-
| |
| !+
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| !+/-
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| !-
| |
| !+/-
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| !+
| |
| !+/-
| |
| !-
| |
| !-
| |
| !
| |
| * [[Displaced point of maximal impulse|Displaced cardiac impulse]]
| |
|
| |
| * [[P2|Loud pulmonic second heart sound]]
| |
| !↓[[Oxygen|O2]], ↑[[Carbon dioxide|CO2]]
| |
| !
| |
| * [[Serum bicarbonate|Abnormal Serum bicarbonate levels]]
| |
| * [[Polysomnography|Attended laboratory nocturnal polysomnography]]
| |
| !
| |
| * [[Lateral]] [[neck]] [[Radiography|radiographs]] shows [[Airway constriction|airway narrowing]]
| |
| * [[Chest X-ray|CXR]] shows [[Chest wall deformities|chest wall deformity]]
| |
| !↓[[Tidal volume|Vt]]
| |
| !_
| |
| !
| |
| * Hypothalamic endocrine manifestations
| |
| * Tumors of neural crest origin
| |
| |}
| |
|
| |
| == Obstructive lung Diseases ==
| |
| {| class="wikitable"
| |
| ! rowspan="4" |Diseases
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| ! colspan="10" |Clinical manifestations
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| ! colspan="10" |Diagnosis
| |
| |-
| |
| ! colspan="5" |Symptoms
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| ! colspan="5" |Physical exam
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| ! rowspan="3" |Lab findings
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| ! colspan="4" |PFT
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| ! colspan="3" rowspan="2" |Imaging
| |
| ! rowspan="3" |Gold standard
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| ! rowspan="3" |Other features
| |
| |-
| |
| ! rowspan="2" |Cough
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| ! rowspan="2" |Dyspnea
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| ! rowspan="2" |Hemoptysis
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| ! rowspan="2" |Fever
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| ! rowspan="2" |Weight loss
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| ! rowspan="2" |Cyanosis
| |
| ! rowspan="2" |Clubbing
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| ! 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
| |
| !
| |
| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| |-
| |
| !Chronic bronchitis
| |
| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| |-
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| !Bronchiolitis
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| |-
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| !Emphysema
| |
| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| |-
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| !Bronchiectasis
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| |-
| |
| !Central airway obstruction
| |
| (Benign/Malignant lung mass)
| |
| !
| |
| !
| |
| !
| |
| !
| |
| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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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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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
| |
| |-
| |
| !Tuberculosis
| |
| !
| |
| !
| |
| !
| |
| !
| |
| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
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| !
| |
| |-
| |
| !Lymphangioleiomyomatosis
| |
| !
| |
| !
| |
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| |}
| |
|
| |
| == Restrictive lung Diseases ==
| |
|
| |
| == Wheeze ==
| |
| <references />
| |