Sandbox:farnaz: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 351: Line 351:
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
|}
|}
{{Family tree/start}}
{{Family tree | | | A01 | | | | | | | | | | A01= <div style="float: left; text-align: left; width: 25em; padding:1em;">'''Prevention of pulmonary edema''' </div>}}
{{Family tree | |,|-|^|-|.| | }}
{{Family tree | B01 | | B02 | | B01= '''Non-cardiogenic pulmonary edema'''<br><div style="float: left; text-align: left; width: 25em; padding:1em;"> </div>| B02= '''Cardiogenic pulmonary edema''' <br> <div style="float: left; text-align: left; width: 25em; padding:1em;"></div>}}
{{Family tree | |!| | | |!| | | | | }}
{{Family tree | C01 | | C02 | | | | C01=<div style="float: left; text-align: left; width: 25em; padding:1em;">
❑ Encourage healthy lifestyle and exercise<br>
❑ Precautions for pulmonary edema associated with high altitude<br>
**
❑  (I-A) <br>
❑ Control [[obesity]] (I-C) <br>
❑  (I-C) <br>
❑ Avoid tobacco (I-C) <br>
❑  <br>
❑  <br> </div>
| C02=<div style="float: left; text-align: left; width: 25em; padding:1em;">
❑ Encourage healthy lifestyle and exercise <br>
❑ Treat [[hypertension]] (I-A) <br>
❑ Treat [[dyslipidemia]] (I-A) <br>
❑ Control [[obesity]] (I-C) <br>
❑ Treat [[DM]] (I-C) <br>
❑ Avoid tobacco (I-C) <br>
❑ Avoid cardiotoxic agents (I-C)</div>}}
{{Family tree | | | | | |!| | | | | }}
{{Family tree | | | | | D01 | | | | D01=<div style="float: left; text-align: left; width: 25em; padding:1em;">
'''Consider additional measures in selected patients:'''
❑ Administer [[ACE-I]] if history of [[MI]] or [[ACS]] and reduced [[EF]] to prevent symptoms and reduce mortality (I-A), in all decreased [[EF]] to prevent symptoms (I-A) <br>
❑ Administer [[beta-blocker]]s if history of [[MI]] or [[ACS]] and reduced [[EF]] to reduce mortality (I-B), in all reduced [[EF]] to prevent symptoms (I-C) <br>
❑ Administer [[statin]]s if history of [[MI]] or [[ACS]] to prevent symptoms (I-A) <br>
❑ Consider [[ICD]] placement to prevent sudden death if asymptomatic ischemic [[cardiomyopathy]], > 40 days post-MI, [[LVEF]] ≤30%, on adequate medical therapy, and good 1 year survival</div>}}
{{Family tree/end}}
==References==
==References==
{{reflist|2}}
{{reflist|2}}


<references />
<references />

Revision as of 19:51, 14 March 2018


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

Overview

This is my sandbox.

Image reference

Pulmonary edema
Source: Wikimedia commons


Type 1:

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pulmonary edema
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Cardiogenic
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Non-cardiogenic
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
LV failure
 
Dysrthmia
 
LV hypertrophy and cardiomyopathy
 
 
 
Volume Overload
 
MI
 
LV outflow obstruction
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Direct injury to lung
 
 
 
 
 
 
 
 
 
 
 
Hematogenous injury to lung
 
 
 
 
 
 
 
 
 
 
 
Lung injury plus elevated hydrostatic pressure
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Chest trauma,pulmonary contusion
 
Aspiration
 
Smoke inhalation
 
 
 
Pneumonia
 
Oxygen toxicity
 
Pulmonary embolism,reperfusion
 
 
 
 
 
 
 
 
 
 
 
High altitude pulmonary edema
 
Neurogenic pulmonary edema
 
Reexpansion pulmonary edema
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Sepsis
 
Pancreatitis
 
Nonthoracic trauma
 
Multiple transfusions
 
Intravenous drug use. e.g. heroin
 
 
 
 
 
 
 
 
 
 
 
 
 
 


96 patients (174 eyes, 70% females) were included with a mean age at presentation of 30 years

Cause Symptom Diagnosis Treatment
1
2
3

References

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [4]


Abbreviations: ABG (arterial blood gas); ACE (angiotensin converting enzyme); BMI (body mass index); CBC (complete blood count); CSF (cerebrospinal fluid); CXR (chest X-ray); ECG (electrocardiogram); FEF (forced expiratory flow rate); FEV1 (forced expiratory volume); FVC (forced vital capacity); JVD (jugular vein distention); MCV (mean corpuscular volume); Plt (platelet); RV (residual volume); SIADH (syndrome of inappropriate antidiuretic hormone); TSH (thyroid stimulating hormone); Vt (tidal volume); WBC (white blood cell);

Organ system Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam
Loss of consciousness Agitation Weight loss Fever Chest pain Cough Cyanosis Clubbing JVD Peripheral edema Auscultation CBC ABG Imaging Spirometry Gold standard
Pulmonary edema[1] +/- + - + + + + + + + Basal crackle Normal Respiratory alkalosis Bat wing pattern, air bronchograms Vt, ↑RV Cardiac Catheterization Tachypnea
Acute Dyspnea Respiratory system Chest and Pleura,

Lower airway

Bronchiolitis[2] - - - + +/- + - - - - Wheeze and Crackles WBC Normal Bronchovascular markings Vt Clinical assessment Respiratory syncytial virus (RSV)
COPD exacerbation[3] - + - + + + + +/- +/- +/- Wheeze, Rhonchi, and Crackles WBC, ↑RBC Respiratory alkalosis Hyperexpansion FEV1/FVC Clinical assessment Acute exacerbations of chronic bronchitis (AECB)
Lung carcinoma[4] - - + - - + + + - - Wheeze and Crackles Normal Normal Mass lesion, hilar lymphadenopathy Vt, ↑RV Bronchoscopy  Paraneoplastic syndromes, such as SIADH and lambert-Eaton
Pneumonia[5] - - - + + + - - - - Wheeze, Rhonchi, and Crackles WBC, neutrophilia Normal Lobar consolidation Normal Chest X-ray and CT Scan productive cough
Chronic Dyspnea Respiratory system Chest and Pleura,

Lower airway

Bronchiectasis[6] - - - + + + + + - - Rhonchi, Wheezing, Crackles WBC, neutrophilia O2, ↑CO2 Tram-track opacities FEV1/FVC High resolution computed tomography (HRCT) Chronic productive cough
Interstitial lung disease[7] - - - - + + + + - - Rhonchi, Wheezing, Crackles Normal O2, ↑CO2 Peripheral pulmonary infiltrative opacification FEV1/FVC High resolution computed tomography (HRCT) Pneumoconiosis
Sarcoidosis[8] - - +/- - +/- + + - - - Crackles Normal O2, ↑CO2 Hilar adenopathy FEV1/FVC High resolution computed tomography (HRCT) Hypercalcemia, high ACE
Alveolitis[9] - - - + + + - - - - Basal crackle WBC, neutrophilia Normal  Basal reticulonodular opacification   FEV1/FVC High resolution computed tomography (HRCT) Dry cough
Cystic fibrosis[10] - - + + - +/- + + - - Rhonchi, Wheezing, Crackles Normal Metabolic alkalosis Thick-walled bronchiectasis FEF75%/FVC Sweat test Absent vas deferens
Tuberculosis[11] - - + + + + +/- - - - Rhonchi, Wheezing, Crackles WBC O2, ↑CO2 Patchy consolidation or poorly defined linear and nodular opacities Restrictive, obstructive, or mixed IFN-γ release assay (IGRA)

Acid-fast staining

Night sweat
Autoimmune Wegener's granulomatosis[12] - - +/- - - + - - - - Wheezing, Crackles RBC O2, ↑CO2 Cavitate nodules, ground-glass opacity FEV1/FVC Biopsy demonstrating a granulomatous vasculitis Chronic rhinosinusitis


 
 
Prevention of pulmonary edema
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Non-cardiogenic pulmonary edema
 
Cardiogenic pulmonary edema
 
 
 
 
 
 
 
 
 
 
 
 
 
 

❑ Encourage healthy lifestyle and exercise
❑ Precautions for pulmonary edema associated with high altitude

❑ ❑ (I-A)
❑ Control obesity (I-C)
❑ (I-C)
❑ Avoid tobacco (I-C)


 

❑ Encourage healthy lifestyle and exercise
❑ Treat hypertension (I-A)
❑ Treat dyslipidemia (I-A)
❑ Control obesity (I-C)
❑ Treat DM (I-C)
❑ Avoid tobacco (I-C)

❑ Avoid cardiotoxic agents (I-C)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Consider additional measures in selected patients: ❑ Administer ACE-I if history of MI or ACS and reduced EF to prevent symptoms and reduce mortality (I-A), in all decreased EF to prevent symptoms (I-A)
❑ Administer beta-blockers if history of MI or ACS and reduced EF to reduce mortality (I-B), in all reduced EF to prevent symptoms (I-C)
❑ Administer statins if history of MI or ACS to prevent symptoms (I-A)

❑ Consider ICD placement to prevent sudden death if asymptomatic ischemic cardiomyopathy, > 40 days post-MI, LVEF ≤30%, on adequate medical therapy, and good 1 year survival
 
 
 







References

  1. Martindale, Jennifer L.; Noble, Vicki E.; Liteplo, Andrew (2013). "Diagnosing pulmonary edema". European Journal of Emergency Medicine. 20 (5): 356–360. doi:10.1097/MEJ.0b013e32835c2b88. ISSN 0969-9546.
  2. Holbro A, Lehmann T, Girsberger S, Stern M, Gambazzi F, Lardinois D, Heim D, Passweg JR, Tichelli A, Bubendorf L, Savic S, Hostettler K, Grendelmeier P, Halter JP, Tamm M (2013). "Lung histology predicts outcome of bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation". Biol. Blood Marrow Transplant. 19 (6): 973–80. doi:10.1016/j.bbmt.2013.03.017. PMID 23562737.
  3. Qureshi H, Sharafkhaneh A, Hanania NA (2014). "Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications". Ther Adv Chronic Dis. 5 (5): 212–27. doi:10.1177/2040622314532862. PMC 4131503. PMID 25177479.
  4. Dela Cruz CS, Tanoue LT, Matthay RA (2011). "Lung cancer: epidemiology, etiology, and prevention". Clin Chest Med. 32 (4): 605–44. doi:10.1016/j.ccm.2011.09.001. PMC 3864624. PMID 22054876.
  5. Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà J (2014). "Management of community-acquired pneumonia in older adults". Ther Adv Infect Dis. 2 (1): 3–16. doi:10.1177/2049936113518041. PMC 4072047. PMID 25165554.
  6. Cantin, Luce; Bankier, Alexander A.; Eisenberg, Ronald L. (2009). "Bronchiectasis". American Journal of Roentgenology. 193 (3): W158–W171. doi:10.2214/AJR.09.3053. ISSN 0361-803X.
  7. Baughman RP, Shipley RT, Loudon RG, Lower EE (1991). "Crackles in interstitial lung disease. Comparison of sarcoidosis and fibrosing alveolitis". Chest. 100 (1): 96–101. PMID 2060395.
  8. Moher D, Cole CW, Hill GB (November 1992). "Epidemiology of abdominal aortic aneurysm: the effect of differing definitions". Eur J Vasc Surg. 6 (6): 647–50. PMID 1451823.
  9. Khanna D, Clements PJ, Furst DE, Chon Y, Elashoff R, Roth MD, Sterz MG, Chung J, FitzGerald JD, Seibold JR, Varga J, Theodore A, Wigley FM, Silver RM, Steen VD, Mayes MD, Connolly MK, Fessler BJ, Rothfield NF, Mubarak K, Molitor J, Tashkin DP (February 2005). "Correlation of the degree of dyspnea with health-related quality of life, functional abilities, and diffusing capacity for carbon monoxide in patients with systemic sclerosis and active alveolitis: results from the Scleroderma Lung Study". Arthritis Rheum. 52 (2): 592–600. doi:10.1002/art.20787. PMID 15692967.
  10. Ziegler, Bruna; Rovedder, Paula Maria Eidt; Dalcin, Paulo de Tarso Roth; Menna-Barreto, Sérgio Saldanha (2009). "Padrões ventilatórios na espirometria em pacientes adolescentes e adultos com fibrose cística". Jornal Brasileiro de Pneumologia. 35 (9): 854–859. doi:10.1590/S1806-37132009000900006. ISSN 1806-3713.
  11. Campbell IA, Bah-Sow O (2006). "Pulmonary tuberculosis: diagnosis and treatment". BMJ. 332 (7551): 1194–7. doi:10.1136/bmj.332.7551.1194. PMC 1463969. PMID 16709993.
  12. Cardenas-Garcia J, Farmakiotis D, Baldovino BP, Kim P (2012). "Wegener's granulomatosis in a middle-aged woman presenting with dyspnea, rash, hemoptysis and recurrent eye complaints: a case report". J Med Case Rep. 6: 335. doi:10.1186/1752-1947-6-335. PMC 3492078. PMID 23034218.