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__NOTOC__ | __NOTOC__ | ||
{| class="wikitable" | {| class="wikitable" | ||
! rowspan="3" |Disease | ! colspan="2" rowspan="3" |Disease | ||
! colspan="11" |Clinical manifestations | ! colspan="11" |Clinical manifestations | ||
! colspan=" | ! colspan="4" |Diagnosis | ||
|- | |- | ||
! colspan="4" |Symptoms | ! colspan="4" |Symptoms | ||
! colspan="7" |Physical exam | ! colspan="7" |Physical exam | ||
! | ! rowspan="2" |Lab findings | ||
! colspan=" | ! colspan="2" |Imaging | ||
!Gold standard | !Gold standard | ||
|- | |- | ||
!Cough | !Cough | ||
Line 23: | Line 22: | ||
!Auscultation | !Auscultation | ||
!Other prominent findings | !Other prominent findings | ||
!CXR | !CXR | ||
!CT | !CT | ||
! | ! | ||
|- | |- | ||
|Acute Respiratory Distress Syndrome (ARDS) | | colspan="2" |Acute Respiratory Distress Syndrome (ARDS) | ||
| - | | - | ||
| + | | + | ||
Line 50: | Line 45: | ||
* Rhonchi [[crackles]] | * Rhonchi [[crackles]] | ||
* Decreased [[breath sounds]] | * Decreased [[breath sounds]] | ||
| | | | ||
* Initially respiratory alkalosis transforming to respiratory acidosis | * Initially respiratory alkalosis transforming to respiratory acidosis | ||
| | | | ||
* BNP level of less than 100 pg/mL | * BNP level of less than 100 pg/mL | ||
Line 63: | Line 54: | ||
** Leukocytosis | ** Leukocytosis | ||
** Thrombocytopenia | ** Thrombocytopenia | ||
| | | | ||
* Bilateral pulmonary infiltrates | * Bilateral pulmonary infiltrates | ||
Line 73: | Line 62: | ||
| | | | ||
* Bronchial dilatation within areas of ground-glass opacification | * Bronchial dilatation within areas of ground-glass opacification | ||
| | | | ||
|- | |- | ||
|Acute | | rowspan="2" |Bronchitis | ||
|Acute | |||
|<nowiki>+</nowiki> | |<nowiki>+</nowiki> | ||
|<nowiki>-</nowiki> | |<nowiki>-</nowiki> | ||
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* [[Rales]] | * [[Rales]] | ||
| | | | ||
* [[Hoarseness]] | |||
| | | | ||
* N/A | * N/A | ||
| | |||
* Normal | |||
| | | | ||
* N/A | * N/A | ||
| | | | ||
* | * Clinical diagnosis | ||
|- | |||
|Chronic | |||
| + | |||
| + | |||
| - | |||
| - | |||
| | |||
* A positive history of chronic productive [[cough]] | |||
* Shortness of breath | |||
| + | |||
| - | |||
| + | |||
| + | |||
| | |||
* Prolonged expiration; [[wheezing]] | |||
* Diffusely decreased breath sound | |||
* Coarse [[crackles]] with inspiration | |||
* Coarse [[rhonchi]] | |||
| | | | ||
| | | | ||
* Chronic [[hypoxemia]] may lead to [[polycythemia]] | |||
* Increase in [[Neutrophil|Neutrophils]] count | |||
* Chronic [[respiratory acidosis]]. To compensate for this, the body may develop [[metabolic alkalosis]] | |||
| | | | ||
* | * Radiolucency | ||
* Diaphragmatic flattening due to hyperinflation | |||
* Increased retrosternal airspace on the lateral radiograph | |||
|N/A | |||
| | | | ||
|- | |- | ||
|Hypersensitivity Pneumonitis | | colspan="2" |Hypersensitivity Pneumonitis | ||
|<nowiki>+</nowiki> | |<nowiki>+</nowiki> | ||
|<nowiki>+</nowiki> | |<nowiki>+</nowiki> | ||
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** Anorexia | ** Anorexia | ||
** Muscle weakness | ** Muscle weakness | ||
| | | | ||
* Neutrophilia | * Neutrophilia | ||
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* Mild fibrotic changes | * Mild fibrotic changes | ||
| | | | ||
|- | |||
| rowspan="4" |Pneumoconiosis | |||
|SIlicosis | |||
| rowspan="4" | + | |||
| rowspan="4" | + | |||
| rowspan="4" | +/- | |||
| rowspan="4" | - | |||
| | | | ||
* History of substantial exposure to silica dusts | |||
* Occupational history | |||
** Sandblasting | |||
** Bystanders | |||
** Quartzite miller | |||
** Tunnel workers | |||
** Silica flour workers | |||
** Workers in the scouring powder industry | |||
| rowspan="4" | + | |||
| rowspan="4" | + | |||
| rowspan="4" | + | |||
| - | |||
| rowspan="4" | | |||
**Lungs are hyperresonant | |||
**Fine[[crackles]] upon auscultation of the lung bases or apices, unilaterally or bilaterally | |||
**Rhonchi | |||
**Bronchial breath sounds | |||
**Expiratory wheezing with normal or delayed expiratory phase | |||
**[[Wheezing]] may be present | |||
**[[Egophony]] present | |||
**[[Bronchophony]] present | |||
**Increased [[tactile fremitus]]. | |||
| | |||
* Increased susceptiblity to tuberculosis. | |||
| rowspan="4" | | |||
*Abnormal ABG | |||
<ref name="pmid16545629">{{cite journal |vauthors=du Bois RM |title=Evolving concepts in the early and accurate diagnosis of idiopathic pulmonary fibrosis |journal=Clin. Chest Med. |volume=27 |issue=1 Suppl 1 |pages=S17–25, v–vi |year=2006 |pmid=16545629 |doi=10.1016/j.ccm.2005.08.001 |url=}}</ref><ref name="pmid9563720">{{cite journal |vauthors=Gay SE, Kazerooni EA, Toews GB, Lynch JP, Gross BH, Cascade PN, Spizarny DL, Flint A, Schork MA, Whyte RI, Popovich J, Hyzy R, Martinez FJ |title=Idiopathic pulmonary fibrosis: predicting response to therapy and survival |journal=Am. J. Respir. Crit. Care Med. |volume=157 |issue=4 Pt 1 |pages=1063–72 |year=1998 |pmid=9563720 |doi=10.1164/ajrccm.157.4.9703022 |url=}}</ref><ref name="pmid21996929">{{cite journal |vauthors=Neghab M, Mohraz MH, Hassanzadeh J |title=Symptoms of respiratory disease and lung functional impairment associated with occupational inhalation exposure to carbon black dust |journal=J Occup Health |volume=53 |issue=6 |pages=432–8 |year=2011 |pmid=21996929 |doi= |url=}}</ref> | |||
**May indicate hypoxia, hypercapnia and respiratory acidosis | |||
*Abnormal sputum analysis | |||
**May contain bacteria, such as mycobacterium tuberculosis or inorganic particles, such as asbestos bodies or organic particles | |||
*Peak flow assessment | |||
**May be below normal range which is 100 liters/minute for men, and 80 liters/minute for women | |||
*Spirometry | |||
**May indicate an obstructive or restrictive pulmonary disease | |||
**A FEV1/FVC ratio < 80% indicates and obstructive disease,such as asthma, whilst a FEV1/FVC ratio higher than restrictive pulmonary disease indicates a restrictive disease, such as pulmonary fibrosis | |||
*CBC | |||
**May indicate anemia, neutrophilia, elevated ESR, elevated CRP, and elevated immunoglobulin | |||
*Bronchoscopy and bronchoalveolar lavage | |||
**May reveal mineral dust | |||
*Tuberculin skin test | |||
**To test for tuberculosis, and induration > 5mm is positive | |||
*Stool examination for occult blood | |||
**May indicate colorectal carcinoma | |||
| | |||
* Small round opacities | |||
** Symmetrically distributed | |||
** Upper-zone predominance | |||
* Diffuse interstitial pattern of fibrosis without the typical nodular opacities in chronic case | |||
| | | | ||
* Nodular changes in lung parenchyma | |||
* Progressive massive fibrosis | |||
* Bullae, emphysema | |||
* Pleural, mediastinal, and hilar changes | |||
| | |||
* Clinical history | |||
* Radiological findings | |||
|- | |- | ||
| | |Asbestosis | ||
| | | | ||
| | | | ||
| | | | ||
* Lung cancer | |||
* Mesothelioma | |||
| | | | ||
* Predilection to lower lobes | |||
* Fine and coarse linear, peripheral, reticular opacities | |||
| | | | ||
| | | | ||
|- | |||
|Berylliosis | |||
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* Multiple, rounded opacities with or without calcification | |||
* Architectural distortion | |||
* Loss of lung tissue volume | |||
* Shadows | |||
* Upper lobe predominance | |||
* Chronic berylliosis shows emphysema with bulla formation | |||
| | | | ||
| | | | ||
|- | |||
|Byssinosis | |||
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|- | |- | ||
|Eosinophilic Pneumonia | | rowspan="3" |Eosinophilic Pneumonia | ||
|Acute | |||
|<nowiki>+</nowiki> | |<nowiki>+</nowiki> | ||
|<nowiki>+</nowiki> | |<nowiki>+</nowiki> | ||
|<nowiki>-</nowiki> | |<nowiki>-</nowiki> | ||
|<nowiki>+</nowiki> | |<nowiki>+</nowiki> | ||
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|Loffler syndrome | |||
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|Chronic | |||
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|- | |||
| colspan="2" |Sarcodiosis | |||
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|- | |- | ||
| colspan="2" |Pleural Effusion | |||
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| colspan="2" |Myasthenia gravis | |||
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|- | |||
| rowspan="2" |Neuromuscular disease | |||
|Muscular dystrophy | |||
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|- | |||
|ALS | |||
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Revision as of 17:44, 15 February 2018
Disease | Clinical manifestations | Diagnosis | ||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Symptoms | Physical exam | Lab findings | Imaging | Gold standard | ||||||||||||
Cough | Dyspnea | Hemoptysis | Fever | History/Exposure | Cyanosis | Clubbing | JVD | Peripheral edema | Auscultation | Other prominent findings | CXR | CT | ||||
Acute Respiratory Distress Syndrome (ARDS) | - | + | - | - | Inciting event, such as: | + | - | - | - |
|
|
|
|
|
||
Bronchitis | Acute | + | - | +/- | + | - | - | - | - | - |
|
|
|
| ||
Chronic | + | + | - | - |
|
+ | - | + | + |
|
|
N/A | ||||
Hypersensitivity Pneumonitis | + | + | - | + |
|
- | + | - | - |
|
|
|
|
|
||
Pneumoconiosis | SIlicosis | + | + | +/- | - |
|
+ | + | + | - |
|
|
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|
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|
Asbestosis |
|
|
||||||||||||||
Berylliosis |
|
|||||||||||||||
Byssinosis | ||||||||||||||||
Eosinophilic Pneumonia | Acute | + | + | - | + | |||||||||||
Loffler syndrome | ||||||||||||||||
Chronic | ||||||||||||||||
Sarcodiosis | ||||||||||||||||
Pleural Effusion | ||||||||||||||||
Myasthenia gravis | ||||||||||||||||
Neuromuscular disease | Muscular dystrophy | |||||||||||||||
ALS |
- ↑ du Bois RM (2006). "Evolving concepts in the early and accurate diagnosis of idiopathic pulmonary fibrosis". Clin. Chest Med. 27 (1 Suppl 1): S17–25, v–vi. doi:10.1016/j.ccm.2005.08.001. PMID 16545629.
- ↑ Gay SE, Kazerooni EA, Toews GB, Lynch JP, Gross BH, Cascade PN, Spizarny DL, Flint A, Schork MA, Whyte RI, Popovich J, Hyzy R, Martinez FJ (1998). "Idiopathic pulmonary fibrosis: predicting response to therapy and survival". Am. J. Respir. Crit. Care Med. 157 (4 Pt 1): 1063–72. doi:10.1164/ajrccm.157.4.9703022. PMID 9563720.
- ↑ Neghab M, Mohraz MH, Hassanzadeh J (2011). "Symptoms of respiratory disease and lung functional impairment associated with occupational inhalation exposure to carbon black dust". J Occup Health. 53 (6): 432–8. PMID 21996929.