Wheeze differential diagnosis: Difference between revisions

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* Clear chest
* Clear chest
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* Sinus [[Computed tomography|CT]]
* Sinus [[Computed tomography|CT]] mat be helpful
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* Clinical diagnosis
* Clinical diagnosis
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* Cartilaginous calcification, bronchial wall thickness, and tracheal narrowing is observed on CT 
* Cartilaginous calcification, bronchial wall thickness, and tracheal narrowing is observed on CT 
* MRI can distinguish fibrosis from inflammation 
* MRI can distinguish [[fibrosis]] from inflammation 
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* Cartilaginous calicification, [[Bronchial|bronchial wall]] thickness and tracheal narrowing observed in  [[Computed tomography|CT]] <ref name="pmid11756115">{{cite journal |vauthors=Behar JV, Choi YW, Hartman TA, Allen NB, McAdams HP |title=Relapsing polychondritis affecting the lower respiratory tract |journal=AJR Am J Roentgenol |volume=178 |issue=1 |pages=173–7 |date=January 2002 |pmid=11756115 |doi=10.2214/ajr.178.1.1780173 |url= |author=}}</ref>
* Cartilaginous calicification, [[Bronchial|bronchial wall]] thickness and tracheal narrowing observed in  [[Computed tomography|CT]] <ref name="pmid11756115">{{cite journal |vauthors=Behar JV, Choi YW, Hartman TA, Allen NB, McAdams HP |title=Relapsing polychondritis affecting the lower respiratory tract |journal=AJR Am J Roentgenol |volume=178 |issue=1 |pages=173–7 |date=January 2002 |pmid=11756115 |doi=10.2214/ajr.178.1.1780173 |url= |author=}}</ref>
* [[Magnetic resonance imaging|MRI]] can distinguish fibrosis from inflammation 
* [[Magnetic resonance imaging|MRI]] can distinguish [[fibrosis]] from inflammation 
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Mc Adam criteria: <ref name="pmid775252">{{cite journal |vauthors=McAdam LP, O'Hanlan MA, Bluestone R, Pearson CM |title=Relapsing polychondritis: prospective study of 23 patients and a review of the literature |journal=Medicine (Baltimore) |volume=55 |issue=3 |pages=193–215 |date=May 1976 |pmid=775252 |doi= |url= |author=}}</ref>
Mc Adam criteria:<ref name="pmid775252">{{cite journal |vauthors=McAdam LP, O'Hanlan MA, Bluestone R, Pearson CM |title=Relapsing polychondritis: prospective study of 23 patients and a review of the literature |journal=Medicine (Baltimore) |volume=55 |issue=3 |pages=193–215 |date=May 1976 |pmid=775252 |doi= |url= |author=}}</ref>
*  [[Ear]] bilateral [[chondritis]]   
*  [[Ear]] bilateral [[chondritis]]   
*  Seronegative inflammatory [[polyarthritis]]
*  Seronegative inflammatory [[polyarthritis]]
*  [[Respiratory tract]] chondritirs
*  [[Respiratory tract]] chondritis
* Coclear or [[Vestibular system|vestibular]] dysfunction
* Coclear or [[Vestibular system|vestibular]] dysfunction
* [[Ocular]] [[inflamation]]
* [[Ocular]] [[inflamation]]
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* Involment of cartilage, ears, ribs. nose and eyes
* Involvement of cartilage of ears, ribs, nose, and eyes
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|Retropharyngeal abscess
|Retropharyngeal abscess
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* [[Tachypnea]]
* [[Tachypnea]]
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* Increased of [[white blood cell count]]
* [[Leukocytosis]]
* [[Aerobic bacteria|Aerobic]] and [[Anaerobic bacteria|anaerobic]] [[Blood culture|blood cultures]]<ref name="pmid28722903">{{cite journal |vauthors=Knorr TL, Sinha V |title= |journal= |volume= |issue= |pages= |date= |pmid=28722903 |doi= |url= |author=}}</ref>  
* [[Aerobic bacteria|Aerobic]] and [[Anaerobic bacteria|anaerobic]] [[Blood culture|blood cultures]] may be helpful<ref name="pmid28722903">{{cite journal |vauthors=Knorr TL, Sinha V |title= |journal= |volume= |issue= |pages= |date= |pmid=28722903 |doi= |url= |author=}}</ref>  
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* Normal function
* Normal function
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* Not required
* Not required
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* Direct visualization of enlarged tonsils in [[oropharyngeal]] exam <ref name="pmid22973368">{{cite journal |vauthors=Jazi SM, Barati B, Kheradmand A |title=Treatment of adenotonsillar hypertrophy: A prospective randomized trial comparing azithromycin vs. fluticasone |journal=J Res Med Sci |volume=16 |issue=12 |pages=1590–7 |date=December 2011 |pmid=22973368 |pmc=3434901 |doi= |url=}}</ref>
* Direct visualization of enlarged [[tonsils]] in [[oropharyngeal]] exam<ref name="pmid22973368">{{cite journal |vauthors=Jazi SM, Barati B, Kheradmand A |title=Treatment of adenotonsillar hypertrophy: A prospective randomized trial comparing azithromycin vs. fluticasone |journal=J Res Med Sci |volume=16 |issue=12 |pages=1590–7 |date=December 2011 |pmid=22973368 |pmc=3434901 |doi= |url=}}</ref>
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* More in children and adolescents
* More in children and adolescents
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* Flow loop shows inspiratory slowing
* Flow loop shows inspiratory slowing
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* Not requered
* Not required
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* [[Computed tomography|CT]] provide information of the grade of invation
* [[Computed tomography|CT]] provide information about the grade of invasion
* [[Magnetic resonance imaging|MRI]] can make a difference between tumors in the mucos or bone marrow <ref name="urlCDC - Head and Neck Cancers">{{cite web |url=https://www.cdc.gov/cancer/headneck/index.htm |title=CDC - Head and Neck Cancers |format= |work= |accessdate=}}</ref>
* [[Magnetic resonance imaging|MRI]] can make a difference between tumors in the mucosa or bone marrow<ref name="urlCDC - Head and Neck Cancers">{{cite web |url=https://www.cdc.gov/cancer/headneck/index.htm |title=CDC - Head and Neck Cancers |format= |work= |accessdate=}}</ref>
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* Fine needle aspiration [[biopsy]]
* Fine needle aspiration [[biopsy]]
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* Anti-acetylcholine receptor antibodies present in [[thymic]] [[Tumor|tumors]]   
* Anti-acetylcholine receptor antibodies present in [[thymic]] [[Tumor|tumors]]   
* High levels of [[Alpha-fetoprotein|AFP]] and [[Human chorionic gonadotropin|beta-hCG]] present in [[Germ cell tumor|germ cell tumors]]
* High levels of [[Alpha-fetoprotein|AFP]] and [[Human chorionic gonadotropin|beta-hCG]] present in [[Germ cell tumor|germ cell tumors]]
* Increased [[lactate dehydrogenase]] in [[Seminoma|Seminomas]]  
* Increased [[lactate dehydrogenase]] in [[Seminoma|seminomas]]  
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* [[Lung volumes|Expiratory flow rate]] decreased <ref name="pmid7652680">{{cite journal |vauthors=Shamberger RC, Holzman RS, Griscom NT, Tarbell NJ, Weinstein HJ, Wohl ME |title=Prospective evaluation by computed tomography and pulmonary function tests of children with mediastinal masses |journal=Surgery |volume=118 |issue=3 |pages=468–71 |date=September 1995 |pmid=7652680 |doi= |url=}}</ref>  
* [[Lung volumes|Expiratory flow rate]] decreased<ref name="pmid7652680">{{cite journal |vauthors=Shamberger RC, Holzman RS, Griscom NT, Tarbell NJ, Weinstein HJ, Wohl ME |title=Prospective evaluation by computed tomography and pulmonary function tests of children with mediastinal masses |journal=Surgery |volume=118 |issue=3 |pages=468–71 |date=September 1995 |pmid=7652680 |doi= |url=}}</ref>  
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* Size, location and density of the mass can be observed
* Size, location, and density of the mass can be observed
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* In [[Computed tomography|chest CT]] is observed  location, size, tissue characteristic and relationship with other structures of the mass
* In [[Computed tomography|chest CT]] . location, size, tissue characteristic, and relationship with other structures of the mass is observed
* Information of posterior mediastinal mass can be provided in chest or [[spine]] [[Magnetic resonance imaging|MRI]] <ref name="pmid23225215">{{cite journal |vauthors=Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L |title=A diagnostic approach to the mediastinal masses |journal=Insights Imaging |volume=4 |issue=1 |pages=29–52 |date=February 2013 |pmid=23225215 |pmc=3579993 |doi=10.1007/s13244-012-0201-0 |url=}}</ref>
* Information of posterior mediastinal mass can be provided in chest or [[spine]] [[Magnetic resonance imaging|MRI]] <ref name="pmid23225215">{{cite journal |vauthors=Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L |title=A diagnostic approach to the mediastinal masses |journal=Insights Imaging |volume=4 |issue=1 |pages=29–52 |date=February 2013 |pmid=23225215 |pmc=3579993 |doi=10.1007/s13244-012-0201-0 |url=}}</ref>
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* Solid or cavitated [[Pulmonary nodule|pulmonary nodules]]  
* Solid or cavitated [[Pulmonary nodule|pulmonary nodules]]  
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* [[Nodules]] which involves mucosal surface observed in [[Computed tomography|CT]] <ref name="urlLaryngotracheobronchial papillomatosis: findings on computed tomography scans of the chest">{{cite web |url=http://www.scielo.br/scielo.php?pid=s1806-37132008001200016&script=sci_arttext&tlng=en |title=Laryngotracheobronchial papillomatosis: findings on computed tomography scans of the chest |format= |work= |accessdate=}}</ref>
* [[Nodules]] which involves mucosal surface observed in [[Computed tomography|CT]]<ref name="urlLaryngotracheobronchial papillomatosis: findings on computed tomography scans of the chest">{{cite web |url=http://www.scielo.br/scielo.php?pid=s1806-37132008001200016&script=sci_arttext&tlng=en |title=Laryngotracheobronchial papillomatosis: findings on computed tomography scans of the chest |format= |work= |accessdate=}}</ref>
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* [[Polypoidy|Polypoid lesions]] observed in [[bronchoscopy]]  
* [[Polypoidy|Polypoid lesions]] observed on [[bronchoscopy]]  
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* Etiology: [[Human papillomavirus|HPV 6 and 11]]
* Etiology: [[Human papillomavirus|HPV 6 and 11]]
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* Airway compression from  other structures  
* Airway compression from  other structures  
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* Airway colalpsed observed in Images at the end of [[inspiration]] in dynamic [[Computed tomography|CT]]<ref name="pmid11351189">{{cite journal |vauthors=Aquino SL, Shepard JA, Ginns LC, Moore RH, Halpern E, Grillo HC, McLoud TC |title=Acquired tracheomalacia: detection by expiratory CT scan |journal=J Comput Assist Tomogr |volume=25 |issue=3 |pages=394–9 |date= 2001 |pmid=11351189 |doi= |url=}}</ref>  
* Airway collpse observed in images at the end of [[inspiration]] in dynamic [[Computed tomography|CT]]<ref name="pmid11351189">{{cite journal |vauthors=Aquino SL, Shepard JA, Ginns LC, Moore RH, Halpern E, Grillo HC, McLoud TC |title=Acquired tracheomalacia: detection by expiratory CT scan |journal=J Comput Assist Tomogr |volume=25 |issue=3 |pages=394–9 |date= 2001 |pmid=11351189 |doi= |url=}}</ref>  
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* Airway collapsed observed in [[bronchoscopy]] <ref name="pmid24960030">{{cite journal |vauthors=Majid A, Gaurav K, Sanchez JM, Berger RL, Folch E, Fernandez-Bussy S, Ernst A, Gangadharan SP |title=Evaluation of tracheobronchomalacia by dynamic flexible bronchoscopy. A pilot study |journal=Ann Am Thorac Soc |volume=11 |issue=6 |pages=951–5 |date=July 2014 |pmid=24960030 |doi=10.1513/AnnalsATS.201312-435BC |url=}}</ref>
* Airway collapse observed on [[bronchoscopy]]<ref name="pmid24960030">{{cite journal |vauthors=Majid A, Gaurav K, Sanchez JM, Berger RL, Folch E, Fernandez-Bussy S, Ernst A, Gangadharan SP |title=Evaluation of tracheobronchomalacia by dynamic flexible bronchoscopy. A pilot study |journal=Ann Am Thorac Soc |volume=11 |issue=6 |pages=951–5 |date=July 2014 |pmid=24960030 |doi=10.1513/AnnalsATS.201312-435BC |url=}}</ref>
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* [[Sputum]] retention
* [[Sputum]] retention
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* Extension of the narrowing observed in [[Computed tomography|CT]] or [[Magnetic resonance imaging|MRI]]
* Extension of the narrowing observed in [[Computed tomography|CT]] or [[Magnetic resonance imaging|MRI]]
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* Narrowing of the [[trachea]] observed in [[bronchoscopy]] <ref name="pmid9720679">{{cite journal |vauthors=Altman KW, Wetmore RF, Mahboubi S |title=Comparison of endoscopy and radiographic fluoroscopy in the evaluation of pediatric congenital airway abnormalities |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=44 |issue=1 |pages=43–6 |date=June 1998 |pmid=9720679 |doi= |url=}}</ref>  
* Narrowing of the [[trachea]] observed in [[bronchoscopy]]<ref name="pmid9720679">{{cite journal |vauthors=Altman KW, Wetmore RF, Mahboubi S |title=Comparison of endoscopy and radiographic fluoroscopy in the evaluation of pediatric congenital airway abnormalities |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=44 |issue=1 |pages=43–6 |date=June 1998 |pmid=9720679 |doi= |url=}}</ref>  
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* Long segment stenosis incompatible with survival <ref name="pmid16481247">{{cite journal |vauthors=Chiu PP, Rusan M, Williams WG, Caldarone CA, Kim PC |title=Long-term outcomes of clinically significant vascular rings associated with congenital tracheal stenosis |journal=J. Pediatr. Surg. |volume=41 |issue=2 |pages=335–41 |date=February 2006 |pmid=16481247 |doi=10.1016/j.jpedsurg.2005.11.034 |url=}}</ref>
* Long segment stenosis incompatible with survival<ref name="pmid16481247">{{cite journal |vauthors=Chiu PP, Rusan M, Williams WG, Caldarone CA, Kim PC |title=Long-term outcomes of clinically significant vascular rings associated with congenital tracheal stenosis |journal=J. Pediatr. Surg. |volume=41 |issue=2 |pages=335–41 |date=February 2006 |pmid=16481247 |doi=10.1016/j.jpedsurg.2005.11.034 |url=}}</ref>
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|Tracheal and bronchial tumors
|Tracheal and bronchial tumors
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* Narrowing of the [[trachea]]  
* Narrowing of the [[trachea]]  
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* Foca lesionsl, [[Polypoid cervical growth|polypoid]] and narrowing   observed in [[Computed tomography|CT]] <ref name="pmid28066620" />
* Foca lesionsl, [[Polypoid cervical growth|polypoid]] ,and narrowing observed in [[Computed tomography|CT]]<ref name="pmid28066620" />
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* [[Biopsy]] obtained by [[bronchoscopy]] <ref name="pmid28066620">{{cite journal |vauthors=Stevic R, Milenkovic B |title=Tracheobronchial tumors |journal=J Thorac Dis |volume=8 |issue=11 |pages=3401–3413 |date=November 2016 |pmid=28066620 |pmc=5179373 |doi=10.21037/jtd.2016.11.24 |url=}}</ref>
* [[Biopsy]] obtained by [[bronchoscopy]]<ref name="pmid28066620">{{cite journal |vauthors=Stevic R, Milenkovic B |title=Tracheobronchial tumors |journal=J Thorac Dis |volume=8 |issue=11 |pages=3401–3413 |date=November 2016 |pmid=28066620 |pmc=5179373 |doi=10.21037/jtd.2016.11.24 |url=}}</ref>
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* [[Squamous cell carcinoma]]
* [[Squamous cell carcinoma]]
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* [[ECG]] to rule out [[myocardial infarction]]
* [[ECG]] to rule out [[myocardial infarction]]
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* [[Computed tomography|CT]] or [[Angiography|angiography MR]] to determine the aortic diameter or any change
* [[Computed tomography|CT]] or [[Angiography|angiography MR]] to determine the aortic diameter or any change
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* Usually [[asymptomatic]]
* Usually [[asymptomatic]]
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* [[Neutrophilia]]  
* [[Neutrophilia]]  
* Levels of [[Immunoglobulin M|IgM]], [[Immunoglobulin G|IgG]] and [[Immunoglobulin A|IgA]]  
* Levels of [[Immunoglobulin M|IgM]], [[Immunoglobulin G|IgG]] and [[Immunoglobulin A|IgA]]  
* [[Sputum culture]] for [[fungi]], [[bacteria]] and [[mycobacteria]] <ref name="pmid28889110">{{cite journal |vauthors=Polverino E, Goeminne PC, McDonnell MJ, Aliberti S, Marshall SE, Loebinger MR, Murris M, Cantón R, Torres A, Dimakou K, De Soyza A, Hill AT, Haworth CS, Vendrell M, Ringshausen FC, Subotic D, Wilson R, Vilaró J, Stallberg B, Welte T, Rohde G, Blasi F, Elborn S, Almagro M, Timothy A, Ruddy T, Tonia T, Rigau D, Chalmers JD |title=European Respiratory Society guidelines for the management of adult bronchiectasis |journal=Eur. Respir. J. |volume=50 |issue=3 |pages= |date=September 2017 |pmid=28889110 |doi=10.1183/13993003.00629-2017 |url=}}</ref>
* [[Sputum culture]] for [[fungi]], [[bacteria]] and [[mycobacteria]]<ref name="pmid28889110">{{cite journal |vauthors=Polverino E, Goeminne PC, McDonnell MJ, Aliberti S, Marshall SE, Loebinger MR, Murris M, Cantón R, Torres A, Dimakou K, De Soyza A, Hill AT, Haworth CS, Vendrell M, Ringshausen FC, Subotic D, Wilson R, Vilaró J, Stallberg B, Welte T, Rohde G, Blasi F, Elborn S, Almagro M, Timothy A, Ruddy T, Tonia T, Rigau D, Chalmers JD |title=European Respiratory Society guidelines for the management of adult bronchiectasis |journal=Eur. Respir. J. |volume=50 |issue=3 |pages= |date=September 2017 |pmid=28889110 |doi=10.1183/13993003.00629-2017 |url=}}</ref>
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** [[FEV1/FVC ratio|FEV1/FVC]] <70%
** [[FEV1/FVC ratio|FEV1/FVC]] <70%
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* Hyperinflation
* Hyperinflation
* Mosaic attenuation
* Mosaic attenuation
* Increased bronchial wall <ref name="pmid20371529">{{cite journal |vauthors=Devakonda A, Raoof S, Sung A, Travis WD, Naidich D |title=Bronchiolar disorders: a clinical-radiological diagnostic algorithm |journal=Chest |volume=137 |issue=4 |pages=938–51 |date=April 2010 |pmid=20371529 |doi=10.1378/chest.09-0800 |url=}}</ref>
* Increased bronchial wall<ref name="pmid20371529">{{cite journal |vauthors=Devakonda A, Raoof S, Sung A, Travis WD, Naidich D |title=Bronchiolar disorders: a clinical-radiological diagnostic algorithm |journal=Chest |volume=137 |issue=4 |pages=938–51 |date=April 2010 |pmid=20371529 |doi=10.1378/chest.09-0800 |url=}}</ref>
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* Bronchoscopy to rule out other diseases
* Bronchoscopy to rule out other diseases
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* Clinical diagnosis
* Clinical diagnosis
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* Etiology: Respiratory ''[[Human respiratory syncytial virus|syncytial virus]], [[Rhinovirus]]''  
* Etiology: [[Respiratory syncytial virus]]'', [[Rhinovirus]]''  
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|Carcinoid syndrome
|Carcinoid syndrome
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* [[Shortness of breath]]
* [[Shortness of breath]]
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* Twenty.four hour urine for [[5-Hydroxyindoleacetic acid|5-HIAA]]
* Twenty four hour urine for [[5-Hydroxyindoleacetic acid|5-HIAA]]
* Urinary excretion of [[serotonin]]
* Urinary excretion of [[serotonin]]
* High levels of [[Chromogranin|chromogranin concentration]] <ref name="pmid27594907">{{cite journal |vauthors=Mota JM, Sousa LG, Riechelmann RP |title=Complications from carcinoid syndrome: review of the current evidence |journal=Ecancermedicalscience |volume=10 |issue= |pages=662 |date= 2016 |pmid=27594907 |pmc=4990058 |doi=10.3332/ecancer.2016.662 |url=}}</ref>
* High levels of [[Chromogranin|chromogranin concentration]] <ref name="pmid27594907">{{cite journal |vauthors=Mota JM, Sousa LG, Riechelmann RP |title=Complications from carcinoid syndrome: review of the current evidence |journal=Ecancermedicalscience |volume=10 |issue= |pages=662 |date= 2016 |pmid=27594907 |pmc=4990058 |doi=10.3332/ecancer.2016.662 |url=}}</ref>
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* Enlargement of the heart <ref name="pmid275949073">{{cite journal |vauthors=Mota JM, Sousa LG, Riechelmann RP |title=Complications from carcinoid syndrome: review of the current evidence |journal=Ecancermedicalscience |volume=10 |issue= |pages=662 |date= 2016 |pmid=27594907 |pmc=4990058 |doi=10.3332/ecancer.2016.662 |url=}}</ref>  
* Enlargement of the heart <ref name="pmid275949073">{{cite journal |vauthors=Mota JM, Sousa LG, Riechelmann RP |title=Complications from carcinoid syndrome: review of the current evidence |journal=Ecancermedicalscience |volume=10 |issue= |pages=662 |date= 2016 |pmid=27594907 |pmc=4990058 |doi=10.3332/ecancer.2016.662 |url=}}</ref>  
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* Carcinoid tumors of [[jejunum]], [[Appendix cancer|appendice]] and [[colon]] are oberved in abdominal [[Computed tomography|CT]]  
* Carcinoid tumors of [[jejunum]], [[appendix]] and [[colon]] are oberved in abdominal [[Computed tomography|CT]]  


* Liver metastases are visualized in [[MRI]]  
* Liver metastases are visualized in [[MRI]]  
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* Abdominal and pelvic [[Computed tomography|CT]] <ref name="pmid27594907" />
* Abdominal and pelvic [[Computed tomography|CT]]<ref name="pmid27594907" />
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* [[Flushing]]
* [[Flushing]]
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* [[Leg edema]]
* [[Leg edema]]
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* [[Blood urea nitrogen|BUN]] and [[Serum creatinine|serum creatinin]] concentration to evaluate renal function  
* [[Blood urea nitrogen|BUN]] and [[Serum creatinine|serum creatinin]] concentration to evaluate [[renal function]]
* [[Liver function tests]]
* [[Liver function tests]]
* Fasting [[lipid profile]] <ref name="pmid23741057">{{cite journal |vauthors=Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL |title=2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines |journal=Circulation |volume=128 |issue=16 |pages=1810–52 |date=October 2013 |pmid=23741057 |doi=10.1161/CIR.0b013e31829e8807 |url=}}</ref>
* Fasting [[lipid profile]]<ref name="pmid23741057">{{cite journal |vauthors=Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL |title=2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines |journal=Circulation |volume=128 |issue=16 |pages=1810–52 |date=October 2013 |pmid=23741057 |doi=10.1161/CIR.0b013e31829e8807 |url=}}</ref>
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* Not required
* Not required
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** [[ST]] and [[T wave|T waves]] abnormalities in [[ECG]]
** [[ST]] and [[T wave|T waves]] abnormalities in [[ECG]]
** [[Oxygen saturation|SaO2]] <90% <ref name="pmid20937981">{{cite journal |vauthors=Weintraub NL, Collins SP, Pang PS, Levy PD, Anderson AS, Arslanian-Engoren C, Gibler WB, McCord JK, Parshall MB, Francis GS, Gheorghiade M |title=Acute heart failure syndromes: emergency department presentation, treatment, and disposition: current approaches and future aims: a scientific statement from the American Heart Association |journal=Circulation |volume=122 |issue=19 |pages=1975–96 |date=November 2010 |pmid=20937981 |doi=10.1161/CIR.0b013e3181f9a223 |url=}}</ref>
** [[Oxygen saturation|SaO2]] <90%<ref name="pmid20937981">{{cite journal |vauthors=Weintraub NL, Collins SP, Pang PS, Levy PD, Anderson AS, Arslanian-Engoren C, Gibler WB, McCord JK, Parshall MB, Francis GS, Gheorghiade M |title=Acute heart failure syndromes: emergency department presentation, treatment, and disposition: current approaches and future aims: a scientific statement from the American Heart Association |journal=Circulation |volume=122 |issue=19 |pages=1975–96 |date=November 2010 |pmid=20937981 |doi=10.1161/CIR.0b013e3181f9a223 |url=}}</ref>
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* Clinical diagnosis (test are supportive)
* Clinical diagnosis (test are supportive)
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* Hyperplasia showed in  [[biopsy]]  
* Hyperplasia showed in  [[biopsy]]  
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* Single neuroendocrine cell and/ or linear proliferation of the cells that involves bronchiolar epitelium
* Single [[neuroendocrine cell]] and/ or linear proliferation of the cells that involves bronchial epithelium
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|Noncardiogenic pulmonary edema
|Noncardiogenic pulmonary edema
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* [[PaO2]]/[[FiO2]] <300 mmHg
* [[PaO2]]/[[FiO2]] <300 mmHg
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* Bilatera alveolar linfiltration
* Bilateral alveolar infiltration
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* Bilateral opacities in [[Computed tomography|CT]]
* Bilateral opacities in [[Computed tomography|CT]]
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According to Berlin definition:<ref name="pmid22797452">{{cite journal |vauthors=Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, Camporota L, Slutsky AS |title=Acute respiratory distress syndrome: the Berlin Definition |journal=JAMA |volume=307 |issue=23 |pages=2526–33 |date=June 2012 |pmid=22797452 |doi=10.1001/jama.2012.5669 |url=}}</ref>
According to Berlin definition:<ref name="pmid22797452">{{cite journal |vauthors=Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, Camporota L, Slutsky AS |title=Acute respiratory distress syndrome: the Berlin Definition |journal=JAMA |volume=307 |issue=23 |pages=2526–33 |date=June 2012 |pmid=22797452 |doi=10.1001/jama.2012.5669 |url=}}</ref>
* One week of new or worse respiratory symptoms or clinical insult
* One week of new or worse respiratory symptoms or clinical insult
* Symptoms can not be explain by [[Heart|cardiac]]<nowiki/>disease
* Symptoms can not be explain by [[Heart|cardiac]] <nowiki/>disease
* Bilateral opacities in [[Chest X-ray|chest X-Ray]] or [[Computed tomography|CT]]
* Bilateral opacities in [[Chest X-ray|chest X-Ray]] or [[Computed tomography|CT]]
* Compromised [[oxygenation]]
* Compromised [[oxygenation]]
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* Neurogenic pulmonary edema
* Neurogenic pulmonary edema
|-
|-
|Parasitic infection with VLM (eg, Ascaris Strongyloides, filaria)
|Parasitic infection with VLM (eg, Ascaris, Strongyloides, filaria)
|Acute
|Acute
|✔
|✔
Line 731: Line 731:
* Subpleural nodules, ground-glass opacities observed in chest [[Computed tomography|CT]] <ref name="pmid16714661">{{cite journal |vauthors=Sakai S, Shida Y, Takahashi N, Yabuuchi H, Soeda H, Okafuji T, Hatakenaka M, Honda H |title=Pulmonary lesions associated with visceral larva migrans due to Ascaris suum or Toxocara canis: imaging of six cases |journal=AJR Am J Roentgenol |volume=186 |issue=6 |pages=1697–702 |date=June 2006 |pmid=16714661 |doi=10.2214/AJR.04.1507 |url=}}</ref>  
* Subpleural nodules, ground-glass opacities observed in chest [[Computed tomography|CT]] <ref name="pmid16714661">{{cite journal |vauthors=Sakai S, Shida Y, Takahashi N, Yabuuchi H, Soeda H, Okafuji T, Hatakenaka M, Honda H |title=Pulmonary lesions associated with visceral larva migrans due to Ascaris suum or Toxocara canis: imaging of six cases |journal=AJR Am J Roentgenol |volume=186 |issue=6 |pages=1697–702 |date=June 2006 |pmid=16714661 |doi=10.2214/AJR.04.1507 |url=}}</ref>  
|
|
* Larve in biopsy  
* Larve on biopsy  
|
|
* [[Eosinophilia]] detected in [[bronchoalveolar lavage]]  
* [[Eosinophilia]] detected in [[bronchoalveolar lavage]]  
Line 762: Line 762:
* Computed tomography pulmonary angiogram [[CT pulmonary angiogram|(CTPA)]] or catheter based [[pulmonary angiography]] <ref name="pmid17848685" />
* Computed tomography pulmonary angiogram [[CT pulmonary angiogram|(CTPA)]] or catheter based [[pulmonary angiography]] <ref name="pmid17848685" />
|
|
* Most emboli comes from [[iliac]], [[femoral]] and [[popliteal]] veins
* Most [[Embolic|emboli]] comes from [[iliac]], [[femoral]], and [[popliteal]] veins
|-
|-
|Reactive airways dysfunction syndrome
|Reactive airways dysfunction syndrome
Line 786: Line 786:
* History of exposure
* History of exposure
* Acute onset with sympotoms in 24h  
* Acute onset with sympotoms in 24h  
* Airway obstruction > 3 months <ref name="pmid4028848">{{cite journal |vauthors=Brooks SM, Weiss MA, Bernstein IL |title=Reactive airways dysfunction syndrome (RADS). Persistent asthma syndrome after high level irritant exposures |journal=Chest |volume=88 |issue=3 |pages=376–84 |date=September 1985 |pmid=4028848 |doi= |url=}}</ref>
* Airway obstruction > 3 months<ref name="pmid4028848">{{cite journal |vauthors=Brooks SM, Weiss MA, Bernstein IL |title=Reactive airways dysfunction syndrome (RADS). Persistent asthma syndrome after high level irritant exposures |journal=Chest |volume=88 |issue=3 |pages=376–84 |date=September 1985 |pmid=4028848 |doi= |url=}}</ref>
|
|
* Burning sensation in the throat  
* Burning sensation in the throat  
Line 794: Line 794:
__NOTOC__
__NOTOC__
{{Wheeze}}
{{Wheeze}}
Please help WikiDoc by adding content here.  It's easy!  Click  [[Help:How_to_Edit_a_Page|here]]  to learn about editing.


== References ==
== References ==

Revision as of 00:46, 27 February 2018

Etiology on the basis of anatomy Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam Imaging
Onset Cough Dyspnea Fever Slurred speech Cyanosis Clubbing Auscultation Labs Pulmonary function testing Chest imaging Other Gold standard
Extrathoracic upper airway diseases Laryngeal edema

(Anaphylaxis)

Acute - - -
  • Not specific
  • Not required
  • Not required

Acute onset with one of them:

Two or more after the exposure to a likely allergen

BP reduced after exposure of a known allergen

Cricoarytenoid arthritis Acute - - -
  • Clear chest
Vocal fold edema/hematoma/paralysis[2] Acute - - -
  • Not specific
  • Variable
  • Clear chest
  • Not required
Paradoxical vocal fold motion Acute - - -
  • Clear chest
  • CT and color flow doppler to rule out other diseases[4]
Laryngeal stenosis[6] Acute, Chronic - -
  • Not specific
  • FV loop variable
  • Clear chest
Laryngocele Chronic - - - -
  • Not specific
  • Normal function
  • Clear chest
Epiglottitis (supraglottitis) Acute - - -
  • Normal function
  • Clear chest
  • Tripod posture
  • Drooling
  • Tenderness of the anterior part of the neck
Goiter Chronic - - - -
  • Airflow limitation of the volume loop depending on the size and localization[10]
Postnasal drip syndrome Acute - - - -
  • Increase of IgE
  • Positive intradermic test[13]
  • Clear chest
  • Sinus CT mat be helpful
  • Clinical diagnosis
Relapsing polychondritis Acute - - -
  • Variable flow volume loop
  • Tracheal narrowing
  • Cartilaginous calcification, bronchial wall thickness, and tracheal narrowing is observed on CT 
  • MRI can distinguish fibrosis from inflammation 

Mc Adam criteria:[15]

  • Involvement of cartilage of ears, ribs, nose, and eyes
Retropharyngeal abscess Subacute - - -
  • Normal function
  • Neck CT or presence of pus during the surgical procedure [17]
  • Pain with neck extension
  • Dysphagia
  • Head in sniffing position
Tonsillar hypertrophy Acute, chronic - - ✔ hyponasal speech - -
  • Not specific
  • Flow loop shows inspiratory slowing
  • Clear chest
  • Not required
  • More in children and adolescents
Tumor of pharynx/larynx/upper trachea Chronic - - - -
  • Not specific
  • Flow loop shows inspiratory slowing
  • Not required
  • CT provide information about the grade of invasion
  • MRI can make a difference between tumors in the mucosa or bone marrow[19]
Central airway diseases

(Intrathoracic upper airway obstruction)

Mediastinal mass/lymphadenopathy Chronic - - -
  • Size, location, and density of the mass can be observed
  • In chest CT . location, size, tissue characteristic, and relationship with other structures of the mass is observed
  • Information of posterior mediastinal mass can be provided in chest or spine MRI [21]
Respiratory papillomatosis Chronic - - -
  • Not specific
  • Not specific
Tracheobronchomalacia Chronic - - - -
  • Not specifc
  • Airway compression from other structures
Tracheal stenosis Acute - - - -
  • Not specific
  • FV loop variable
  • Extension of the narrowing observed in CT or MRI
  • Long segment stenosis incompatible with survival[26]
Tracheal and bronchial tumors Chronic - - - -
  • Not specific
  • FV loop variable
Vascular ring or aneurysm Chronic - - - -
  • Not required
  • Usually asymptomatic
  • Chest or abdominal pain appears when other structures are compressed
Lower airway obstruction Bronchiectasis Chronic - - -
  • Tram lines or end-on ring shadows in chest CT [30]
Bronchiolitis Acute - . For bacterial infection in neonates:
  • Hyperinflation
  • Mosaic attenuation
  • Increased bronchial wall[31]
  • Bronchoscopy to rule out other diseases
  • Clinical diagnosis
Carcinoid syndrome Chronic - - - - -
  • Not specific
  • Enlargement of the heart [33]
  • Liver metastases are visualized in MRI
Heart failure Chronic - - - -
  • Not required
  • Clinical diagnosis (test are supportive)
  • High levels of BNP and pro-BNP[36]
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) [37] Chronic - - - -
  • Not specific
  • Mosaic pattern and nodules observed in chest CT
  • Single neuroendocrine cell and/ or linear proliferation of the cells that involves bronchial epithelium
Noncardiogenic pulmonary edema Acute - - -
  • Bilateral alveolar infiltration
  • Bilateral opacities in CT

According to Berlin definition:[38]

  • One week of new or worse respiratory symptoms or clinical insult
  • Symptoms can not be explain by cardiac disease
  • Bilateral opacities in chest X-Ray or CT
  • Compromised oxygenation
  • High altitute pulmonary edema (HAPE)
  • Neurogenic pulmonary edema
Parasitic infection with VLM (eg, Ascaris, Strongyloides, filaria) Acute - - -
  • Not specific
  • Bilateral peribronchial infiltration
  • Parenchymal infiltration
  • Subpleural nodules, ground-glass opacities observed in chest CT [40]
  • Larve on biopsy
Pulmonary thromboembolism  Acute, subacute, Chronic - - - -
  • Not required
Reactive airways dysfunction syndrome Acute - - - -
  • Normal or hyperinflation
  • CT to rule out other diseases
Clinical diagnosis:
  • History of exposure
  • Acute onset with sympotoms in 24h
  • Airway obstruction > 3 months[44]
  • Burning sensation in the throat
  • Chest pain
  • High dose of inhalation of the irritant

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References

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  2. Ishman SL, Halum SL, Patel NJ, Kerschner JE, Merati AL (October 2006). "Management of vocal paralysis: a comparison of adult and pediatric practices". Otolaryngol Head Neck Surg. 135 (4): 590–4. doi:10.1016/j.otohns.2006.04.014. PMID 17011423.
  3. Forrest LA, Husein T, Husein O (April 2012). "Paradoxical vocal cord motion: classification and treatment". Laryngoscope. 122 (4): 844–53. doi:10.1002/lary.23176. PMID 22434681.
  4. Nastasi KJ, Howard DA, Raby RB, Lew DB, Blaiss MS (June 1997). "Airway fluoroscopic diagnosis of vocal cord dysfunction syndrome". Ann. Allergy Asthma Immunol. 78 (6): 586–8. doi:10.1016/S1081-1206(10)63220-6. PMID 9207723.
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  12. Knudsen N, Perrild H, Christiansen E, Rasmussen S, Dige-Petersen H, Jørgensen T (March 2000). "Thyroid structure and size and two-year follow-up of solitary cold thyroid nodules in an unselected population with borderline iodine deficiency". Eur. J. Endocrinol. 142 (3): 224–30. PMID 10700715.
  13. Yu L, Xu X, Lv H, Qiu Z (May 2015). "Advances in upper airway cough syndrome". Kaohsiung J. Med. Sci. 31 (5): 223–8. doi:10.1016/j.kjms.2015.01.005. PMID 25910556.
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  16. Knorr TL, Sinha V. PMID 28722903. Missing or empty |title= (help)
  17. Lazor JB, Cunningham MJ, Eavey RD, Weber AL (December 1994). "Comparison of computed tomography and surgical findings in deep neck infections". Otolaryngol Head Neck Surg. 111 (6): 746–50. doi:10.1177/019459989411100608. PMID 7991254.
  18. Jazi SM, Barati B, Kheradmand A (December 2011). "Treatment of adenotonsillar hypertrophy: A prospective randomized trial comparing azithromycin vs. fluticasone". J Res Med Sci. 16 (12): 1590–7. PMC 3434901. PMID 22973368.
  19. "CDC - Head and Neck Cancers".
  20. Shamberger RC, Holzman RS, Griscom NT, Tarbell NJ, Weinstein HJ, Wohl ME (September 1995). "Prospective evaluation by computed tomography and pulmonary function tests of children with mediastinal masses". Surgery. 118 (3): 468–71. PMID 7652680.
  21. Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L (February 2013). "A diagnostic approach to the mediastinal masses". Insights Imaging. 4 (1): 29–52. doi:10.1007/s13244-012-0201-0. PMC 3579993. PMID 23225215.
  22. "Laryngotracheobronchial papillomatosis: findings on computed tomography scans of the chest".
  23. Aquino SL, Shepard JA, Ginns LC, Moore RH, Halpern E, Grillo HC, McLoud TC (2001). "Acquired tracheomalacia: detection by expiratory CT scan". J Comput Assist Tomogr. 25 (3): 394–9. PMID 11351189.
  24. Majid A, Gaurav K, Sanchez JM, Berger RL, Folch E, Fernandez-Bussy S, Ernst A, Gangadharan SP (July 2014). "Evaluation of tracheobronchomalacia by dynamic flexible bronchoscopy. A pilot study". Ann Am Thorac Soc. 11 (6): 951–5. doi:10.1513/AnnalsATS.201312-435BC. PMID 24960030.
  25. Altman KW, Wetmore RF, Mahboubi S (June 1998). "Comparison of endoscopy and radiographic fluoroscopy in the evaluation of pediatric congenital airway abnormalities". Int. J. Pediatr. Otorhinolaryngol. 44 (1): 43–6. PMID 9720679.
  26. Chiu PP, Rusan M, Williams WG, Caldarone CA, Kim PC (February 2006). "Long-term outcomes of clinically significant vascular rings associated with congenital tracheal stenosis". J. Pediatr. Surg. 41 (2): 335–41. doi:10.1016/j.jpedsurg.2005.11.034. PMID 16481247.
  27. 27.0 27.1 Stevic R, Milenkovic B (November 2016). "Tracheobronchial tumors". J Thorac Dis. 8 (11): 3401–3413. doi:10.21037/jtd.2016.11.24. PMC 5179373. PMID 28066620.
  28. Miller WT (October 2001). "Thoracic aortic aneurysms: plain film findings". Semin Roentgenol. 36 (4): 288–94. PMID 11715324.
  29. Polverino E, Goeminne PC, McDonnell MJ, Aliberti S, Marshall SE, Loebinger MR, Murris M, Cantón R, Torres A, Dimakou K, De Soyza A, Hill AT, Haworth CS, Vendrell M, Ringshausen FC, Subotic D, Wilson R, Vilaró J, Stallberg B, Welte T, Rohde G, Blasi F, Elborn S, Almagro M, Timothy A, Ruddy T, Tonia T, Rigau D, Chalmers JD (September 2017). "European Respiratory Society guidelines for the management of adult bronchiectasis". Eur. Respir. J. 50 (3). doi:10.1183/13993003.00629-2017. PMID 28889110.
  30. Milliron B, Henry TS, Veeraraghavan S, Little BP (2015). "Bronchiectasis: Mechanisms and Imaging Clues of Associated Common and Uncommon Diseases". Radiographics. 35 (4): 1011–30. doi:10.1148/rg.2015140214. PMID 26024063.
  31. 31.0 31.1 Devakonda A, Raoof S, Sung A, Travis WD, Naidich D (April 2010). "Bronchiolar disorders: a clinical-radiological diagnostic algorithm". Chest. 137 (4): 938–51. doi:10.1378/chest.09-0800. PMID 20371529.
  32. 32.0 32.1 Mota JM, Sousa LG, Riechelmann RP (2016). "Complications from carcinoid syndrome: review of the current evidence". Ecancermedicalscience. 10: 662. doi:10.3332/ecancer.2016.662. PMC 4990058. PMID 27594907.
  33. Mota JM, Sousa LG, Riechelmann RP (2016). "Complications from carcinoid syndrome: review of the current evidence". Ecancermedicalscience. 10: 662. doi:10.3332/ecancer.2016.662. PMC 4990058. PMID 27594907.
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  35. Weintraub NL, Collins SP, Pang PS, Levy PD, Anderson AS, Arslanian-Engoren C, Gibler WB, McCord JK, Parshall MB, Francis GS, Gheorghiade M (November 2010). "Acute heart failure syndromes: emergency department presentation, treatment, and disposition: current approaches and future aims: a scientific statement from the American Heart Association". Circulation. 122 (19): 1975–96. doi:10.1161/CIR.0b013e3181f9a223. PMID 20937981.
  36. Doust JA, Glasziou PP, Pietrzak E, Dobson AJ (October 2004). "A systematic review of the diagnostic accuracy of natriuretic peptides for heart failure". Arch. Intern. Med. 164 (18): 1978–84. doi:10.1001/archinte.164.18.1978. PMID 15477431.
  37. Davies SJ, Gosney JR, Hansell DM, Wells AU, du Bois RM, Burke MM, Sheppard MN, Nicholson AG (March 2007). "Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia: an under-recognised spectrum of disease". Thorax. 62 (3): 248–52. doi:10.1136/thx.2006.063065. PMC 2117154. PMID 17099078.
  38. Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, Camporota L, Slutsky AS (June 2012). "Acute respiratory distress syndrome: the Berlin Definition". JAMA. 307 (23): 2526–33. doi:10.1001/jama.2012.5669. PMID 22797452.
  39. Rubinsky-Elefant G, Hirata CE, Yamamoto JH, Ferreira MU (January 2010). "Human toxocariasis: diagnosis, worldwide seroprevalences and clinical expression of the systemic and ocular forms". Ann Trop Med Parasitol. 104 (1): 3–23. doi:10.1179/136485910X12607012373957. PMID 20149289.
  40. Sakai S, Shida Y, Takahashi N, Yabuuchi H, Soeda H, Okafuji T, Hatakenaka M, Honda H (June 2006). "Pulmonary lesions associated with visceral larva migrans due to Ascaris suum or Toxocara canis: imaging of six cases". AJR Am J Roentgenol. 186 (6): 1697–702. doi:10.2214/AJR.04.1507. PMID 16714661.
  41. Stein PD, Goldhaber SZ, Henry JW, Miller AC (January 1996). "Arterial blood gas analysis in the assessment of suspected acute pulmonary embolism". Chest. 109 (1): 78–81. PMID 8549223.
  42. Pipavath SN, Godwin JD (September 2008). "Acute pulmonary thromboembolism: a historical perspective". AJR Am J Roentgenol. 191 (3): 639–41. doi:10.2214/AJR.07.3989. PMID 18716087.
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